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I want to announce that at the present our Bioethics Discussion Journal Club is INACTIVE. My intention is to try to establish an active club again. Finally, I want to introduce our visitors to my Bioethics Discussion Blog. The link button to go to that site is located at the bottom of this page.
The blog is much different than this website .The goals of both are to encourage the thoughtful discussion of bioethical issues. This website provides a number of issues about which the visitors can express their viewpoints. I just moderate here. On my blog, I am the one who sets out views and offers opportunity for the visitor to comment on them. I have started out with one bioethical issue and will gradually expand it to sub-issues or other issues as they appear in the news or are of general interest. I will also try to include links to various pertinent resources, which can broaden the discussion. I hope you will give my blog a try and let me know what you think. ..Maurice.
I would like to encourage my visitors to go to the American Medical Association's Virtual Mentor (http://www.virtualmentor.org). It is a place where everyone including medical students can go to read presentations and commentary of issues and standards of practice related to monthly bioethical themes.
This flag identifies
a new topic or one updated in the previous 30 days.
"Informed Consent vs. Incomplete Disclosure in Social Science"
"Who is a Real Professional? On-the-Job Altruism"
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Date: Fri, Dec 27, 2002 8:19 AM
From: saragirl666@hotmail.com
To: DoktorMo@aol.com
Dear Doctor, in viewing your web-site I couldn't decide on one topic specifically to write to you about, hence the title of this e-mail. I recently read a book about euthanasia, assisted suicide, Futile Care Theory, and various other aspects of bioethics. I found many aspects of this "Profession" and its theories and teachings to be profoundly disturbing. To begin with, one of the fundamental beliefs is the right to personal autonomy, yet when it comes down to a decision that involves a patient, or the patients family, voting in favor of prolonged life treatment, the right to accept, rather then reject treatment, can be stripped of them if the physician deems the care to be "unethical" or "futile." How exactly can someone argue that a patients right to reject treatment is unquestionable and should never be violated, and at the same time be willing to also deny someone of the right to remain living if that is their desire? In the matter of ethics, one can surely argue that a physician would have difficulties discontinuing treatment of someone they feel may eventually recover, yet they are required to do so if that is the patients desire. Why then are physicians allowed to use their "ethics" to refuse end of life care to someone who has requested it? In either situation it basically comes down to the patients right to autonomy, yet the rules in one instance don't apply to the other in all cases. Why does bioethics firmly uphold someone’s decision to die, yet question someone’s right to live? As far as care being futile, the arguments for individual cases could go on for years. But I believe it is safe to say that in more instances then not, a doctor cannot "guarantee" that someone is going to die in spite of care, so therefore an issue of futility, in a true and complete meaning, can rarely be established Something quite possibly as disturbing is the belief that an infant is a "non-person”, and therefore doesn't have a right to live; leaving them to be disposed of or experimented on with supposedly no moral ramifications. At what point do you think someone becomes a "person," doctor? Is it their ability to feel pain, their cognitive abilities, their age, or their desire to live? To dispose of someone because they don't yet have an ability to want to be alive is ludicrous. If we take that view in an absolute sense then NO one has ever had a right to live, and therefore if every human had been destroyed upon birth then there would be nothing wrong with that, because after all we aren't really people at that early stage. |
Supposedly most infants that are allowed to die have a debilitating disease, yet how can someone label their life useless or burdensome when nearly all of these diseases can be treated, and in time some even cured? Better still, how can one argue that letting an infant starve to death or dehydrate is much more humane then giving them the option of living with a disease or disability? Dying in either of these ways would obviously be painful, so where is the humanity? Whose welfare is being benefited in these situations? Since it is apparent that a bioethicist wouldn't bat an eyelash at starving a "nonperson" and causing them a painful death, why should the public be lead to believe that this field of medicine is aimed at humanitary pursuits? In all reality isn't bioethics really a justified way of labeling people as useless, if it is the consensus of some "educated" people held in high esteem? If it isn't then why is the public so vastly uneducated about this field? No one that I know has ever even heard of this, let alone understands what its teachings entail. Could it be that if the majority of the general public knew in detail what bioethics is, that they would be outraged by its lack of respect for life or human worth, or worse yet even be educated enough to know what kind of medical decisions they want to make for themselves, thereby inhibiting an ethicists ability to taint their judgment on end of life care when it is too late for them to make a truly well-thought out choice.
I am an atheist, and I am not afraid of death. I do not however agree that life has the small amount of sanctity that bioethics affords it. In any case, it should be up to a person on how to execute their decisions as regards end of life care, and other personal medical matters. I doubt seriously that most people realize that those rights can be stripped of them if someone else deems their life "futile," and if you disagree with me then maybe you can explain why assisted suicides of people in horrible pain and other supposedly humane aspects of bioethics are featured in the media, while you'll rarely hear a documentary speaking of the virtues of starving infants or denying people medical treatment they need in order to live.I would appreciate a response to my inquiries. Sincerely, Sara Inteller |
| What happened in the United States on September 11 2001 was so terrible and so grossly unethical and representing such a threat to peoples of our country and of the world that it would seem that the societal significance all of the bioethical discussions on this website just pales by comparison. One can say, "Why worry any more about whether cloning, euthanasia or genetic testing is ethical or whether a patient has received informed consent when such an unbelievable magnitude of maleficence has just occurred?" But is such comparison valid? All of society is made up of individuals and how individuals interact with each other has discrete moral value concerns that cannot be trumped or ignored by the concerns for the events such as what happened on September 11th or the Nazi holocaust, for example. In fact, it is the ignoring of the individual and that person's needs, goals and basic human rights, which has contributed to such events. | MORE ON SEPTMBER ELEVENTH AS VIEWED FROM MARCH 2002 The viewpoint of my editorial reminder 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? If you would like to read more about this and perhaps contribute your ideas click here. For another perspective of September 11th read the following from one of my visitors: |
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Date: Wed, Mar 6, 2002 4:38 PM
From: janet@anzca.edu.au
To: DoktorMo@aol.com
I visited your page recently for the first time in several months, and read with interest your piece on the September 11 tragedy. I'm thankful you concluded that our concern for other issues should not diminish because of this, but I find myself angry that the question should need to be asked in the first place, that people (not picking on you in particular!) continue to labour under the delusion that a large-scale, in-your-face tragedy somehow renders all other ethical issues irrelevant. It may perhaps help us get things in perspective and weed out some of the genuine trivialities that we've been stewing over, but it does not make all issues trivial. In the months after September 11 I had a number of people ask me how I could care about this or that when so many people had died. Those questions disturbed me, and a few weeks ago I read something by one of my least favorite newspaper editors on a different topic which helped me understand why. The editor was discussing the cruel live sheep export trade, and sanctimoniously told readers that their concern for the sheep would soon evaporate if they pictured children in this situation instead. Well no, dammit, it wouldn't. Two wrongs do not make a right. Some people may judge one wrong as being greater than another, but the lesser one does not then evaporate. Similarly, some tragedies are silent, chronic, largely hidden from the public eye, and eminently ignorable by well-off Westerners, but for all that they are no less tragic than September 11. To name just a few ... consider that thousands of third world children die EVERY DAY from malnutrition and easily treatable illnesses. That millions of people live in grinding poverty on the bare edge of existence with no chance to rise above their circumstances. That many more are killed, repressed and displaced by wars which have nothing to do with them. |
That slavery and torture still happen in
many parts of the world. That thousands upon thousands of the so called
"food animals" killed every year in our slaughterhouses are skinned and
butchered alive and fully conscious because of lack of control and
supervision on the production line. That thousands of healthy animals are
"euthanised" annually for no greater crime than being unwanted by the humans
who have supposedly taken on responsibility for their care.
I would consider each one of these things to be a tragedy of "an unbelievable magnitude of maleficence", easily on a par with September 11. Perhaps even more so because of the very fact that, when they are acknowledged at all, it's usually with a shrug and an attitude of "I won't think about that because then I might feel guilty and have to change my comfortable life". These things are happening each and every day, causing a total of death and suffering far greater than September 11, but they don't make the headlines. Enough people who cared and who opened their hearts in the same way they did to the September 11 victims could make an unbelievable difference to many of these situations. I don't mean to make light of September 11 or the victims' suffering, but I freely admit it makes me angry that events like this are considered the epitome of tragedy against which all else is supposed to pale into insignificance. The real tragedy to me is the number of horrors in this world about which people don't care. Janet Devlin |
Regarding what society considers the duties of a physician, there are some who wonder whether physicians are responsible to not only prevent and treat disease but also to make patients look and feel more attractive and powerful.
Do you think it is right for the role of a physician to include writing prescriptions or carrying out procedures in order to improve the patient's appearance and performance in the absence of disease or deformities from birth or injury or illness?
YES- 42%
It appears there is, in this unscientific poll, a support by a number of visitors that physicians should not have a role which includes treating appearance or performance in the absence of illness or injury. However, to read the comments of visitors who wrote on this subject, click here: Is a Role of Physicians to Prescribe or Perform Procedures for Cosmetic Reasons in the Healthy?
Perhaps you will contribute your opinion to the discussion.
What should be the criterion for death?
Whole Brain Death 22
Permanent Absence of Consciousness 15
Some Other Criterion 2
It appears that our visitors selected whole brain death over the classic cessation of heart beat and respiration by 3:1. Interestingly, a fairly close second most popular criterion was the controversial permanent unconsciousness. One might conclude that the visitors who voted find the classic criterion inadequate for todays medical necessities. Any comments?
To comment in more detail on this topic or to read what others think click to go to "Cloning of Humans: Is it Ethical? Should it be Done?
Somewhat Important-1
Important-9
Very Important-27
Obviously virtually all responders to the poll found that advance directives were important or very important. Interestingly, of the 27 who found them "very" important 13 had their own directive. Of the 9 who found them important only 2 had their own directive. I suspect the population who represent visitors to this bioethics site may have a greater appreciation of advance directives than the general population. I would be interested in the comments of others about this poll.
Realtime free online information from a bioethics resource person: University of Pennsylvania Center for Bioethics Bioethics HelpLine. (Hours Sun thru Thursday 7 pm to 11pm EST) http://ajobonline.com/hsbioethics/
Virtual Mentor-Monthly bioethics themes with presentation of issues and discussions http://www.virtualmentor.org
Web links to numerous world-wide bioethics sites and bioethics journals: Eubios Ethics Institute in Japan http://www.biol.tsukuba.ac.jp/~macer/Info.html
This site has been accessed times since 1/4/97.