Term Paper on "Contemporary Issues in Bioethics"

Term Paper 5 pages (1630 words) Sources: 1+

[EXCERPT] . . . .

Bioethics and Morality: An Examination

In this short paper, the author will be dealing with the issues of bioethics (in effect medical ethics) such as justice and autonomy in health care, autonomy rights and medical information, end of life decision-making and eugenics and human genetics. Each of these issues will be examined separately or together as they relate to patient rights and ethics in on more expansive concerns that touches upon the philosophy of science and issues of biotechnology. The implications of the new technology and their impact upon the above issues will be explored as well as the fears and concerns of the author about the slippery slope represented by the eugenics movement and the promise and yet peril of human genetics if it is misused.

In this day of consumerism healthcare is regrettably seen as a commodity. However, the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry's Patient Bill of Rights strives to increase and humanize healthcare by promoting patient participation and communication ("Patient's bill of," 2010). While patients have few specifically spelled out legal rights, they have many unwritten ones (Torrey, 2008). The medical professional functions as the primary arbiter and communicator in this system, especially in the ethical arena. It is their obligation to carry out these mandates, despite what they may have learned earlier to humanize a system that must develop with the social mores of the outside society it serves. Bioethics is tied to the medical profession and their action at all levels and increasingly must deal with these new social mores as well as the implications of new technology upon medicine and the treatment of patients. Unfortunately, technology has the edge in the race to the finish line and ethics is in the mode of catching up. In essence, the present system is one of managed health care.

In the principle of autonomy the right of individual to self-determination is paramount. This is rooted in society's respect for an individuals' ability to make informed decisions about personal matters. The principle has become much more important as societal values have shifted to define quality in medical care in terms of what is important to the patient as opposed to the medical professionals. This increasing importance of autonomy can probably be seen as a reaction of society against the dehumanization of the medical tradition forced on it by technology and modern managed health care. The respect for autonomy is the very basis for informed consent as well as for the formation of living wills. In general, autonomy is an indicator of good health. Many diseases are characterized by a loss of autonomy various ways. Therefore autonomy is also an indicator personal well-being and for the well-being in the medical profession. This has practical implications for the consideration of medical ethics and the balance that needs to be achieved between individual needs and benefits and their effects on the collective ("Principles of bioethics," 2008).

This leads on to the topic of autonomy rights and medical information. Medical information needs to be shared with patients if they are to retain autonomy in the medical decision making process. Unfortunately given the nature of medical technology and managed health care, many times the last person to know and understand all of the implications are the patients themselves.

End of life decision (ELD) making power flows directly out of the possession of personal and complete knowledge of the issues facing them, particularly if patient is in the end phase of life and may be close to death. A recent study found that there are differences between doctors in different countries in their experiences with ELDs. They also differed in their willingness to perform ELDs and in their reception of requests for euthanasia or physician-assisted suicide. On the other hand, foregoing treatment and intensifying the alleviation of pain and symptoms are practiced as well as accepted by most physicians in all countries universally. Physicians with some training in palliative care are much more inclined to perform ELDs. This is also the case with doctors who attend to very high numbers of terminal patients. The study concluded that the resort to facilitating the formation or the execution of the wishes of patient in an ELD is not just apparently only a matter of opportunity, but also a matter of attitude ("Physicians' experiences with," 2010). Bottom line, there is an inherent ethical tension between the want and right of the patient for complete autonomy in the execution of the ELD according to their wants and many times between the oath of the doctor and his moral values.

The issue of ELDs leads directly into issues of eugenics and human genetics which directly challenge the Oath of Hippocrates that the doctors swear and practice by. The field of eugenics and by implication human genetics was tarred by the Nazi experience during the Second World War. Before the Hitler genocide of 11 million innocent Europeans in the Nazi camps (6 million of which were Jews), no one blinked at words such as "racial hygiene" and pseudoscientific racial "theories" supposedly based upon Darwin's theory of evolution. The Nazi such Josef Mengele and the experiments they performed on their victims were motivated only by an egocentric improvement of the Aryan race and by delusions of scientific advancement motivated by warped ideas of racially motivated pseudoscience. In the process, these doctors harmed innocent people instead of curing them and disregarding their Hippocratic oaths. These doctors not only murdered their victims (which was bad enough) but even worse they also animalized and deceived their subjects. The Nazi experience caused other inhumane genocide in the docket of history as well, in particular the infamous Tuskegee syphillus experiment where uninformed black men were unknowingly inflicted with the disease and then allowed to develop the full blown disease without the necessary medical treatment. It was this eugenics tree that the Nazi fruit fell from ("Medicine and the,").

An acquaintance of this author once spoke about their experiences working in a regional archival library where they came upon a dissertation by a Nazi doctor about how he felt duty bound to carry out his party duties of racial hygiene and eugenics despite his Hypocratic oath. The date of the dissertation was 1936 before much of the mass killings started so there was a lot of preparation for the genocide which followed. Any arguments about it not being able to happen in America is wishful thinking given the exposure of the Tuskegee experiment and other attempts to throttle human nature.

The personal concern of this author, especially with regard to eugenics and genetic engineering is that unless technology is used to benefit humanity (and this purpose needs to be paramount), the technology will be turned around and used to enslave and subjugate humanity for some perceived higher human goal such as racial theory or evolutionary progress. In such pseudo analysis humanity is forgotten and ideology comes to the fore, although many times camouflaged in pseudoscience and flawed evidence. Scenarios such as the above have come up so often in human history and almost always result in genocide and horror. This is exactly what moral oaths are supposed to make us think twice about before medical and scientific expertise is enslaved in the cause of genocide and slavery. They remind us of our human consciences and keep us humane and above bestiality that has so often before simply ended in tragedy. Unfortunately, assisted suicide and some aspects of managed health care could potentially justify killing people or withholding treatment in the service of the whole of society to the detriment of individual rights. While medical rationing is just a matter of everyday practice in medicine (witness triage in any emergency room), it has to have the leavening and spice of… READ MORE

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