MEDICAL ETHICS

• Related question:
  •   Under medical ethics, discuss the merits and demerits in the abortion case.
  
  
  Introduction
  Usually debates about abortion focus on politics and the law: should abortion be outlawed and treated like the murder of a human person, or remain a legal choice available to all women? Behind these debates are more fundamental ethical questions which are not always given the specific attention they deserve. Some believe that the law should not legislate morality, but all good laws are based upon moral values. A failure to openly discuss those values can obscure important discussions. Can we find any objective answer to the question “…is abortion ethical?” I believe we can, but as one might expect, it will not be a simple answer of yes or no.
  
  
  What is Medical Ethics?
  Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The field of ethics studies principles of right and wrong. There is hardly an area in medicine that does not have an ethical aspect. For example, there are ethical issues relating to the following:
  •   End of life care: Should a patient receive nutrition? What about advance directives and resuscitation orders?
  •   Abortion: When does life begin? Is it ethical to terminate a pregnancy with a birth defect?
  •   Genetic and prenatal testing: What happens if you are a carrier of a defect? What if testing shows that your unborn baby has a defect?
  •   Birth control: Should it be available to minors?
  •   Is it ethical to harvest embryonic stem cells to treat diseases?
  •   Organ donation: Must a relative donate an organ to a sick relative?
  •   Personal health information: who has access to your records?
  •   Patient rights: Do you have the right to refuse treatment?
  •   When you talk with your doctor, is it ethical for her to withhold information from you or your family?
  Furthermore, there are four basic principles of medical ethics. Each addresses a value that arises in interactions between medical service providers and patients. These principles address the issue of fairness, honesty, and respect for fellow human beings:
          i.            Autonomy:
  People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions are not in the best interest of the patient.
        ii.            Beneficence:
  All healthcare providers must strive to improve their patient’s health and to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.
      iii.            Non-maleficence:
  “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. One should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.
      iv.            Justice:
  The fourth principle demands that one should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. One should be able to justify ones actions in every situation.
  
  
  Our Critique: The ethics of Abortion
  Abortion is a difficult issue; no one approaches it lightly or makes a decision about whether to have an abortion lightly. Abortion also touches upon a significant number of important, fundamental ethical questions like the nature of personhood, the nature of rights, human relationships, personal autonomy, the extent of state authority over personal decisions, and more. All of this means that it is very important that we take abortion seriously as an ethical issue; seriously enough to identify the various components and discuss them with as little prejudice as possible.
  For some people, their approach to the ethical questions of abortion will be purely secular; for others, it will be heavily informed by religious values and doctrines. There is nothing inherently wrong or superior to either approach. What would be wrong, however, would be to imagine that religious values should be the determining factor in these debates. However important religious values may be to someone, they cannot become the basis for laws that apply to all citizens.
  If people approach these debates openly and with a willingness to learn from others with different perspectives, then it might be possible for everyone to have a positive impact on others. This may allow the debate to move forward and for progress to be made. It may not be possible for broad agreements to be reached, but it may be possible for reasonable compromises to be achieved. First, though, we need to understand what the issues are:
          i.            Is the Fetus a Person with Rights?
  Much debate about the legality of abortion involves debating the legal status of the fetus. If the fetus is a person, anti-choice activists argue, then abortion is murder and should be illegal. Even if the fetus is a person, though, abortion may be justified as necessary to women’s bodily autonomy but that would not mean that abortion is automatically ethical. Perhaps the state should not force women to carry pregnancies to term, but it could argue that it is the most ethical choice.
        ii.            Does the Woman have Ethical Obligations to the Fetus?
  If a woman consented to sex and/or didn’t properly use contraception, then she knew that pregnancy might result. Being pregnant means having a new life growing inside. Whether the fetus is a person or not, and whether the state takes a position on abortion or not, it is arguable that a woman has some sort of ethical obligation to the fetus. Perhaps this obligation is not strong enough to discard abortion as an option, but it may be enough (in some instances) to limit when abortion can be ethically chosen.
      iii.            Does Abortion Treat the Fetus in an Unethical, Callous Way?
  Most debates on the ethics of abortion focus on whether the fetus is a person. Even if it is not a person, however, this does not mean that it cannot have any moral standing. Many people reject abortions later in pregnancy because they intuitively feel that there is something very human about a fetus, which looks so much like a baby. Anti-choice activists rely heavily upon this and they have a point. Perhaps the ability to kill something which looks like a baby is one which we should avoid.
      iv.            Ethics of Personal, Bodily Autonomy
  It is arguable that a right to abortion is a right to control one’s body and the death of the fetus is an avoidable consequence of choosing to continue a pregnancy. That people have some ethical claim to personal, bodily autonomy must be regarded as fundamental to the conception of any ethical, democratic, and free society. Given that autonomy exists as an ethical necessity, the question becomes how far that autonomy extends.
        v.            Is it Ethical to Force a Woman to Carry a Pregnancy to Term?
  Should the state really force a woman to carry a pregnancy to term? If legalized abortion is eliminated, then the law will be used to force women to carry pregnancies to term, using their bodies to provide a place where a fetus can develop into a baby. This is the ideal of anti-choice activists, but would it be ethical? Not permitting women a choice over being pregnant and reproducing is not compatible with justice in a free, democratic state. Even if the fetus is a person and abortion unethical, it should not be prevented through unethical means.
      vi.            Ethics and the Consequences of Sexual Activity
  Pregnancy almost invariably occurs as a consequence of sexual activity; thus, questions about the ethics of abortion must include questions about the ethics of sex itself. Some argue, or at least seem to assume, that sexual activity must carry consequences, one of which may be pregnancy. It is therefore unethical to try to prevent those consequences whether through abortion or contraception.
    vii.            Does the Woman have Ethical Obligations to the Father?
  Pregnancy can only occur with the participation of a man who is equally as responsible for the existence of the fetus as the woman. Should women give fathers any say in deciding whether the pregnancy is carried to term? If men have an ethical obligation to support a child after birth, do not they have an ethical claim on whether a child is born? Ideally, fathers should be consulted, but not every relationship is ideal and men do not run the same physical risks as a pregnant woman.
  viii.            Is it Ethical to Give Birth to an Unwanted Child?
  While anti-choice activists like to hype supposed examples of women having abortions to keep their careers alive, it is far more common that women have abortions because they feel unable to properly care for the child. Even if it were ethical to force women to carry pregnancies to term, it would not be ethical to force the birth of children who are unwanted and cannot be properly cared for. Thus, women who choose to abort when they cannot be good mothers are making the most ethical choice open to them.
      ix.            Political versus Religious Debates over the Ethics of Abortion
  There are both political and religious dimensions to ethical debates over abortion. Perhaps the most significant error which people make is to confuse the two, acting as though a decision on the religious front should necessitate a particular decision on the political front (or vice-versa).
  
  
  Conclusion
  Finally, it seems that at the beginning of a pregnancy the zygote, having no sentience and no capacity for suffering, cannot be held to be of much importance compared to the mother. Destroying any life is undesirable, but it is impossible to rationally argue that destroying an early-term fetus, in itself, is worse than (for example) destroying a small animal. In fact, the animal, being sentient and capable of suffering, should be held to be more deserving of compassion than the fetus. Of course we must also consider the emotional trauma that may be caused to the mother and father by the abortion. Nevertheless, a late-term abortion is a different matter. A fetus beginning to develop the early stages of sentience, is capable of suffering and we need to consider the greater trauma to the mother and to the clinic or hospital staff (whose welfare seems often forgotten in discussions of the ethics of abortion) where the abortion is carried out. In this scenario, more consideration needs to be given to the balance of good and bad likely to be achieved.
  
  
  
  
  Back to "300 LEVEL- FIRST SEMESTER"
  Back to "ARCHIVES AND RESOURCES"
  Back to "PHILUZOPHY"