---

Since Sept. 11th, Setting the Need for Society to Benefit over the Wishes, Desires and Autonomy of Individual Patients

---

The viewpoint of my editorial reminder, on the homepage of this site, written in September 2001 as a response to the terror of September 11th 2001 might need to be modified with another reality as suggested in an article titled "Bioethics after the Terror" by Jonathan D. Moreno in the American Journal of Bioethics, vol. 2 no. 1 (Winter 2002). The question raised is whether the social consensus about individual autonomy of medical research subjects or patients might be changed because of the event of September 11th and subsequent further concern about terrorists attacks on the US homeland and a prolonged "War on Terrorism." Will there be more emphasis on the need for the good of the community and society rather than for the autonomous based good of the individual? In some ways this has already been happening in non-medical situations such as part of the attention to airport security and security in other venues and the rounding up and detention of some innocent people by the Justice Department.

With regard to bioethical issues, consider the area of medical research for example. If the medical research deals with homeland defense matters using human subjects, might there be some overlooking and non-reporting when researchers stray from currently established rules and guidelines for ethical behavior with respect to the autonomy of the subject because the goal of the research is more important to society than "minor" ethical variances with regard to subjects?

Another example: individual genetic information may no longer be confidential in order to provide a means of personal identification or monitoring for possible changes in genetic makeup occuring due to suspected biowarfare techniques.

Clinical issues in the case of the individual patient may be viewed more from the aspect of what is best for society rather than the wishes or desires of the patient. How do you feel about the balance between the individual and society in these troubled times?

Here is the question:

Do you think that people, since September 11th, will set their concerns about need for society to benefit over the wishes,desires and autonomy of individual patients?

---

While my opinion is yes, I don't have too much to say on that. However, I did want to say that I don't believe that Sept. 11th, while gruesome and awful on an immense scale, still pales in comparison to most of the wars we have had. I feel comparing the Nazi empire to 9/11 (in your forward) is a bit extreme, as the Nazi's killed something like 12 million vs. 9/11 with less than 3 thousand. And this isn't limited to WWII. Look at World War I, Vietnam, Kosovo, Chechnya for crying out loud. All have multitudes unheard of killed in a cosmic blink. I'm from the US, I am still outraged about the whole situation, yet I feel somehow that something is taken away from other horrendous event when such statements are made. It was bad enough as it was. We don't have to add onto it by over-emphasis.

Joel Mendel

P.S. No, I'm not an advocate for peace at all times, I'm glad we overran the Taliban, the Nazis, etc. I just feel that the bloodiest days of the US deserve to be recognized and remembered for those who lost their lives for us to live the way we do today. The bloodiest day of the Revolutionary war was over 4000 americans killed, as was the civil war's. We lost over 30 thousand in a day in the Korean war, and about 2500 at Pearl Harbor.

America had grown complacent just before the terrorist attacks of September 11th. Both as individuals and as a society. But what is a society? One could argue that a society is nothing more than the sum of its individuals.

Indeed, I believe that many had forgotten this idea; I certainly did. At first, the victims of September eleventh were just a body count to me. Yet, I began to see the faces of family members searching for the lost, and the injured sitting on street curbs still in the throes of shock and disbelief. That was when the full gravity of the attacks bore down on me. Those acts of terror were not attacks on the American society as a whole, but specifically attacks on each and every one of her people. They were attacks on individuals.

A year ago I would have been worried if America had begun to place a strong emphasis on her own condition as a society. Now, however, I think it has become nearly impossible to use the word, "society" without imagining a veritable flood of faces- each one unique. Special. Individual. For me, at least, society has an altogether new meaning.

A mechanic cannot repair a car. He or she fixes those individual parts which cause the whole of the car to cease its functioning properly. One simply cannot fix a vehicle without taking consideration for its individual parts. So it is with society. Many have allowed themselves (myself included) to try and draw a line between society and the individual. I am not so sure this is even possible anymore. What's more is that America thrives on individuality. Such uniqueness is one of the major seperators between America and the other nations of the world.

I will not venture to say what America will do in the future concerning ideals that attempt to place society before the individual. My hope is that the two terms are not so estranged anymore. My dream is that America will refer to the needs of society as truly the plural form of treating the needs of her people- one by one by their own dues.

Cody A. Carlson

At the point at which we set our concerns for society to benefit over the wishes,desires and autonomy of the individual we will have lost and the terrorists will have won. This approach is no less tyranical than that of the Taliban.