Bioethics Topics

Medical Ethics or Bioethics, study of moral issues in the fields of medical treatment and research.

The professional fields that deal with ethical issues in medicine include: -medicine -nursing -law -sociology -philosophy and theology though today medical ethics is also recognized as its own discipline.

Medical ethics traces its roots to several early codes of ethics such as the ancient Greek Hippocratic Oath, which required physicians above all to “do no harm”;

Greek Hippocratic Oath The original version is: I SWEAR by Apollo the physician and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation - to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to

produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.

professional codes of ethics such as the one written by English physician Thomas Percival in the 18th century that provided a foundation for the first code of ethics established in 1846 by the founders of the American Medical Association;

and the Nuremberg Code for research ethics on human subjects that was established during the war crime trials at the close of World War (1939-1945) in response to the gross abuses in human experimentation performed in Nazi Germany;

the advent of new medical and reproductive technologies after the 1950s further complicated the moral and societal issues of medical research and practice;

The four bioethical principles have been described as: 1. The principle of respect for Autonomy - respect for the individual and their ability to make decisions with regard to their own health and future. Actions that enhance autonomy are thought of as desirable and actions. This principle is the basis for the practice of “informed consent” in the physician/patient transaction regarding health care.

The four bioethical principles have been described as: 2. The principle of Nonmaleficence- actions intended not to harm or bring harm to the patient and others. Providing a proper standard of care that avoids or minimizes the risk of harm is supported not only by our commonly held moral convictions, but by the laws of society as well.

The principle of nonmaleficence In a professional model of care one may be morally and legally blameworthy if one fails to meet the standarts of due care.

The legal criteria for determining negligence are as follows: The professional must have a duty to the affected party The professional must breach the duty The affected party must experience a harm The harm must be caused by the breach of duty

The principle of nonmaleficence This principle affirms the need for medical competence.

The four bioethical principles have been described as: 3. The principle of Beneficence - actions intended to benefit the patient or others. The ordinary meaning of this principle is the duty of health care providers to be of a benefit to the patient, as well as to take positive steps to prevent and to remove harm from the patient.

The four bioethical principles have been described as: 4. The principle of Justice being fair or just to the wider community in terms of the consequences of an action. Justice in health care is usually defined as a form of fairness, or as Aristotel once said: “giving to each that which is his due”.

The principle of Justice The society uses a variety of factors as a criteria for distributive justice, including the following: To each person an equal share To each person according to need To each person according to effort To each person according to contribution To each person according to merit To each person according to free market exchanges

defining death – medical ethics struggled to define death in a new way, so that the gravely ill would have the right to live maintained by technology, while those who had technically died would not be maintained on life-support machines

“brain death “

a/ In the United States many states have adopted legislation formally recognizing brain death “the loss of brain function, which controls respiration and heartbeat” as certification of death.

b/ most European nations, Canada, Australia, and Central and South American nations define death either as the loss of all independent lung and heart function or the permanent and irreversible loss of all brain function

reproductive medicine Infertility is also an important area of medical ethics. Many couples who are unable to have children turn to fertility-enhancing technologies for help. Artificial insemination (introduction of semen into the cervix through technical means rather than sexual intercourse) raised new ethical issues about how potential parents should choose sperm or egg donors, on what basis and with what assurances of privacy should donors be requited, and whether donors are entitled to parental rights of financial compensation.

Assisted reproductive technology (ART) The first test-tube baby in the world – Louise Brown (1978)

In vitro fertilization (IVF) – (a method in which fertilization of the ovum with sperm was conducted in a laboratory and the resulting embryo was subsequently implanted in the mother’s uterus). It was soon followed by the development of a variety of other IVF Surrogate mother

Single women The possible use of donor sperm by single women Lesbian women The possible use of donor sperm by lesbian women

Ethical questions connected with (ART)

(IVF) procedure may be not successful doctors may fertilize and implant more than one embryo to increase the chances of success. It increases the incidence of multiple births, which can create a health risk for mother and babies

multiple pregnancies – doctors can abort 1 or more of the embryos to improve the chances that the others will survive what to do with fertilized eggs that are not implanted and the fate of human embryos if the couples who created them died, become incapacitated, or no longer want to have children

the debate is further complicated by the use of tissues and organs from aborted fetuses for research or transplantation.

New kinds of reproduction

Scottish veterinary biologist Ian Wilmot announced the successful birth of a cloned sheep. The news excited many in veterinary and agricultural settings, and promised to speed research on human pharmaceutical by providing identical test animals. However, it was immediately apparent that at some point in the future it might be possible to clone a human using the same or similar technology.

policy analysts and ethicists worried of the possibility that cloning technology might be used by tyrants of small military forces to create engineered humans.

ethicists had emerged who were willing to defend human cloning ethicists had emerged who were willing to defend human cloning. It was argued that cloning is less morally problematic than families created by sperm or egg donation, because cloned children are at least products of their families DNA.

Economic Issues Society Versus the Individual Future Directions In Medical Ethics

The art of Medicine The science of Medicine

The Business of Medicine Alternative Medicine