Tag: abortion

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Educating the church about how to think about bioethics

Janie Valentine’s post on Monday about a Christian health sharing ministry considering the surgical treatment of ectopic pregnancy to be the moral equivalent of abortion points out a major concern related to the church and bioethics. This is particularly a concern regarding the evangelical Protestant church and bioethics. With its hierarchical structure the Roman Catholic Church has a way of connecting the well considered thoughts about bioethical issues that are expressed by Roman Catholic ethicists with the ministries of the church. Protestant churches, and evangelical Protestant churches in particular, have a significant disconnect between those who think deeply about and write about bioethical issues and those who are doing ministry.

The issue of whether to cover the costs of surgical treatment of ectopic pregnancy illustrates the need for people within the church to learn how to think about bioethics and other ethical issues. It is not that we need to have some established evangelical set of ethical positions on issues, but rather an understanding by people in the church of how to properly analyze and think about an ethical issue. Over centuries of thought Christian scholars have recognized the principle of double effect as a good way of analyzing moral dilemmas in which doing something that is good, such as saving the life of a woman with an ectopic pregnancy results in the unwanted bad affect of the death of an embryo. It is clear that we should not focus solely on consequences and do things that are wrong even to save a person’s life, but it is reasonable at times to do good things that have unintended but foreseeable bad effects.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Should We Cure Genetic Diseases?

June 07, 2017

by Professor Bonnie Steinbock

Should We Cure Genetic Diseases?

In “Trying to Embrace a ‘Cure’,” (New York Times, June 4, 2017), Sheila Black notes that in the near future there may be a treatment that could amount to a cure for the genetic illness she and two of her children have — X-linked hypophosphatemia or XLH. Although XLH is not life threatening, it has significant disadvantages, including very short stature (short enough to qualify as a type of dwarfism), crooked legs, poor teeth, difficulty in walking, and pain. A cure would seem to be cause for celebration.

But Ms. Black is ambivalent about the prospect. Although she acknowledges the potential benefits both to individuals and to society, the issue is, for her, complex.

Having a serious disability may enable the development of certain virtues. She writes, “… to be human often entails finding ways to make what appears a disadvantage a point of strength or pride.” Or, as Nietzsche put it,  “That which does not kill us, makes us stronger.”

It’s very likely that having polio made Franklin Roosevelt emotionally more mature and strengthened his character, but would that be a reason to oppose the development of the Salk vaccine? Comedians often credit their talent from having been bullied as children; novelists and playwrights find inspiration in their awful childhoods. Admiring their ability to overcome adversity does not mean being ambivalent about ending bullying and child abuse.

Another reason is that disabilities have created communities that are a source of support and identity.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Most pressing bioethics issue

In yesterday’s post Mark McQuain asked the readers of this blog what they consider to be the most pressing bioethics issue in the context of a call for our president to establish a bioethics council. He referred to my recent post on reproductive ethics and the manufacturing of children. I think that is important. I also think that abortion including the aborting of children with developmental abnormalities such as Down syndrome, euthanasia, and the treatment of children with gender dysphoria are very important. However, my most pressing concern related to bioethics in our society is freedom of conscience.

It is important that we express clearly the value of human life and how that impacts how we understand the ethics of things such as reproductive technology, abortion and euthanasia, but we are living in a time in which many do not listen to reasoned arguments about what is right. Much of our society believes that what is right is determined by how they feel and they desire to be free of any limits on what they can do. They also believe, somewhat contradictorily, that they should be affirmed in being able to do what they desire by having society help them do it; even if that means that others need to do things that they believe to be wrong. Our society is losing the concept of any objective moral values. Without objective moral values it does not make sense for someone to refuse another person’s request for help in fulfilling their desires based on conscience, particularly conscience informed by an objective understanding of right and wrong.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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In Defense of a Physician’s Right of Conscientious Objection

Guest post by Cheyn Onarecker, MD

In their recent “Sounding Board” piece in the New England Journal of Medicine (subscription required), Ronit Stahl, PhD, and Ezekiel Emanuel, MD, PhD, denounce the rights of physicians and other health care professionals to opt out of certain procedures because of a moral or religious belief. The interests and rights of the patient, they state, should always trump those of the clinician. The only role for conscientious objection, in their view, is a limited one, when the appropriateness of a treatment or procedure is being debated.

Once a professional society determines that a treatment is acceptable, the physician must comply or get out of medicine altogether. Stahl and Ezekiel lament that the American Medical Association (AMA) and other medical societies support conscience rights, but, I believe the arguments they advance to eliminate such rights are not convincing and would jeopardize the future of medicine.

First, although the well-being of patients is one of the primary goals of medicine, there has always been a balance between the needs of patients and physicians. Otherwise, physicians would work 24 hours a day, with no time off for family, friends, or other pursuits. Physicians would be expected to respond to all patient requests, day or night. The question is not whether physicians should put patients’ needs above their own, but where the line should be drawn between the needs of the patient and the physician. In emergencies, a patient’s needs triumph, but other situations are not always so clear. When it comes to requests for treatments that violate a physician’s deepest moral convictions, no physician should be forced to cross over the line.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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When Ideology Trumps Reason, Do The Life Sciences Resist or Capitulate?

by Craig Klugman, Ph.D.

The world of the life sciences and medicine is being changed radically in 2017. The proposed Trump budget cuts funding for the CDC, NIH, NSF, NEH, NEA, EPA, and PHS will radically change how science is done, how much science is done and by whom. The US is withdrawing from the Paris Climate Treaty. Cuts to social security that traditionally pays for medical residents have also been proposed. The American Health Care Act will take affordable health insurance away from 23 million people. For the rest of us, the AHCA means higher premiums and less coverage. At the same time, we live in an era of “fake news,” “leaks,” incendiary tweets, and loyalty as the sign of someone’s worth. What might be the impact on medicine, the life sciences and bioethics in the Trumpian era? Will the dominant political ideology affect the practice of science and medicine in more ways than economics? Can ethics help steer a course around ideology?

One change that has already occurred under Trump is an anecdotal decrease in the number of immigrants (documented and undocumented) who are seeking medical care under concern that they will be deported if they show up to hospitals and doctor’s offices. In one case, a woman was forcibly removed the hospital where she was to be treated for a brain tumor and brought to a detention center.

Certainly, there is a U.S. history of medicine following the ideology of the government. Forced sterilization, the Tuskegee Syphilis study, the US radiation experiments and the Guatemala Syphilis studies were all government financed research created to prove a particular ideology: In these cases, species-level differences between the races and that a nuclear war was “winnable.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Interview with Arthur Caplan

by Kaitlynd Hiller and Rachel F. Bloom

It is a difficult task to succinctly describe the professional accomplishments of Arthur Caplan, PhD. For the uninitiated, Dr. Caplan is perhaps the most prominent voice in the conversation between bioethicists and the general public, as well as being a prolific writer and academic. He is currently the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at NYU Langone Medical Center and NYU School of Medicine, having founded the Division of Bioethics there in 2012. Additionally, he co-founded the NYU Sports and Society Program, where he currently serves as Dean, and heads the ethics program for NYU’s Global Institute for Public Health. Prior to joining NYU, he created the Center for Bioethics and Department of Medical Ethics at the University of Pennsylvania Perelman School of Medicine, serving as the Sidney D. Caplan Professor of Bioethics. Dr. Caplan is a Hastings Center fellow, also holding fellowships at The New York Academy of Medicine, the College of Physicians of Philadelphia, the American Association for the Advancement of Science, and the American College of Legal Medicine. He received the lifetime achievement award of the American Society of Bioethics and Humanities in 2016.

Dr. Caplan’s experience is not at all limited to the academic realm: he has served on numerous advisory counsels at the national and international level, and is an ethics advisor for organizations tackling issues from synthetic biology to world health to compassionate care. Dr. Caplan has been awarded the McGovern Medal of the American Medical Writers Association, the Franklin Award from the City of Philadelphia, the Patricia Price Browne Prize in Biomedical Ethics, the Public Service Award from the National Science Foundation, and the Rare Impact Award from the National Organization for Rare Disorders; he also holds seven honorary degrees.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Italian gynaecologists refuse to participate in abortions. 7 in 10 doctors are conscientious objectors

Although abortions in Italy have fallen dramatically in recent years, the number of objectors in most hospitals is much higher than the number of doctors willing to terminate pregnancies. According to figures from the Italian Ministry of Health for the period 2013-2014, in Italy, seven in ten doctors are conscientious objectors in relation to abortion. This varies by region: in Lazio, objectors account for 80.7% of staff, in Molise (centre) 93.3%, in Basilicata (south) 90.2%, in Sicily (south) 87.6%, in Campania (centre) 81.8% and in Calabria (south) 72.9% (The Guardian, 11 March 2017).

La entrada Italian gynaecologists refuse to participate in abortions. 7 in 10 doctors are conscientious objectors aparece primero en Bioethics Observatory.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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European Parliament document announced, as one of its priority, defend women right to abortion

The European Parliament recently announced its “priorities” for its next Commission on the Status of Women are “universal access to sexual and reproductive health and rights.” The EU document implies that limiting access to abortion is an infringement of women’s rights. The EU Recommendation invites the EU Council to “counter the impact of the gag rule”, a term used by abortion advocates have used to denigrate Reagan-era policy which ensures US taxpayer only funds groups that promise not to promote or perform abortions. The text was drafted by the Committee on Women’s Rights (FEMM). FEMM’s rapporteurs described the policy as forms of “sexism and Trumpism”, and said somebody “in the Oval Office wants us to… stop repeating the claim ‘Our bodies – our rights‘”.

Critics of the document underline that the EU Council and Commission have repeatedly affirmed ‘that the organization lacks competence on abortion, a subject left to member states’ legislatures. Furthermore, the EU cannot adopt policies and actions on reproductive and sexual health and rights in developing countries that include abortion. “No support is to be given… to encourage sterilization or abortion”. The relevant rules on foreign aid must also provide that the EU cannot promote abortion as a method of family planning and that it most provide post-abortion counseling, which helps “to avoid repeat abortions”  (C-Fam – Washington USA, February 23, 2017).

La entrada European Parliament document announced, as one of its priority, defend women right to abortion aparece primero en Bioethics Observatory.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Christian Schools and Pregnancy

The New York Times published an article over the weekend titled “Pregnant at 18. Hailed by Abortion Foes. Punished by Christian School.” The author of the piece tells the story of Maddi Runkles, an 18-year-old high school senior who was banned from participating in her school’s graduation ceremony and removed from the student council after becoming pregnant earlier this year.  The article juxtaposes the professed pro-life beliefs of evangelicals with the way that Christian schools often respond to student pregnancy.  At the end of the article there is a quote from Maddi, who says, “Honestly, that makes me feel like maybe the abortion would have been better. Then they would have just forgiven me, rather than deal with this visible consequence.”

While many pro-choice activists accuse pro-life Christians of caring about babies only while they are in the womb, the myriad of Christian crisis pregnancy centers, relief organizations, and other faith-based charities give the lie to this caricature. However, Christian schools face the hard task of fairly upholding the standards of behavior that they expect from their students, while also displaying a consistently pro-life ethic and supporting students who choose life for their babies.

Maddi’s situation demonstrates the importance of Christian schools having well-designed and consistently-applied policies regarding out-of-wedlock pregnancies. Dr. Kimberly Thornbury developed such a policy while she was Dean of Students at Union University, a Christian university in Tennessee.  Union’s campus newspaper reports on what such a policy looks like here.   In contrast, policies that appear arbitrary or vindictive are antithetical to a pro-life witness.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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The Very Early Embryo & Its Moral Signifiance

by Andrew J. Prunty

As technology and biological research continue to develop in the twenty-first century, it is necessary to address and further define the ethical considerations of embryonic research and the appropriate rights that may limit the extent of human research on zygotes, blastocysts, and fetal scientific advancement. Because the area of harvesting embryonic stem cells remains significantly undefined, both legally and morally, there are vastly different opinions between researchers and bioethicists, mainly because of ethical limitations, on the rights that should be granted to cells with the potential to develop into human beings and the consequences of neglecting significant scientific research or advancement.

Current laws in the United States differ at the federal and state level, but there is no consistency in recognizing human embryos as humans, or affording them the same legal rights granted to a child; in fact, legal precedent actually detracts certain rights from developing embryos, favoring a human’s ability to destroy a potential human being (i.e. Roe v. Wade[i]) or the categorization of embryos as property (i.e. Davis v. Davis[ii], A.Z. v. B.Z.[iii], Marriage of Dahl[iv], or Reber v. Reiss[v]). These case law samples suggest the courts’ inability to reach a conclusion as to what is the status of an embryo.

The debate is not only circumscribed to matters of research, but to fundamental controversial and intertwined issues of bioethics such as: when life begins, embryonic stem cells, fetal rights, abortion, et cetera. All these topics are contentious and when one topic arises, they begin to comingle.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.