Tag: covenant

Bioethics Blogs

Excuse Me, Doctor, What Exactly Do You Profess?

The late Edmund Pellegrino, M.D., revered medical educator, ethicist, and physician, often made the point that a professional professes something. Merriam-Webster  confirms that the etymology of the word, profession, includes the Latin for “public declaration.”

The Hippocratic Oath, probably penned by members of the Pythagorean sect, according to Ludwig Edelstein (see Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore: Johns Hopkins University Press, 1987), has for centuries been accepted as the gold standard for the practice of medicine. Nigel M. deS. Cameron (The New Medicine: Life and Death After Hippocrates. Chicago: Bioethics Press, 2001)
 explicates the Hippocratic Oath as containing four parts:

1.   Covenant with Apollo and others

2.   Duties to teacher

                            Regard teacher as equal to parent

                            Treat him as a partner in livelihood

                            Share money with him when needed

                            Consider his children as siblings

                            Teach medicine to own children, children of teacher, and pupils who take the oath

3.  Duties to patients

                            Use treatment to help the sick, never to injure or wrong them

                            Give no poison to anyone though asked to do so, nor suggest such a plan

                            Give no pessary to cause abortion

                            In purity and in holiness to guard the practitioner’s life and art

                            Use no knife on “sufferers from stone,” but allow others trained to do so

                            Enter houses to help the sick, not to participate in wrong doing or harm

                            Keep oneself from fornication with woman or man, slave or free

                            Not to divulge, but guard as holy secrets those things that are heard by the practitioner

4.

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.

Bioethics News

UN calls on Ireland to change abortion law

The United Nations Human Rights Committee says that Ireland’s abortion laws are a violation of human rights.

In a controversial judgement – the outcome of a case involving dual Irish-US citizen who had to travel to the UK to terminate her non-viable pregnancy – the Committee called on the government to allow women free access to abortion, labelling extant laws “cruel” and “inhumane”. The Committee also asked authorities to compensate the woman, 42-year-old Amanda Mellet, for the distress and trauma she experienced.

Ms. Mallet travelled to the UK for an abortion in late 2011. She told the Committee she experienced immense emotional and psychological distress as a result of having to go abroad for the procedure.

The Committee called on the government to reform the abortion law to protect women in the future:

“…the State party should amend its law on voluntary termination of pregnancy, including if necessary its Constitution, to ensure compliance with the Covenant, including effective, timely and accessible procedures for pregnancy termination in Ireland, and take measures to ensure that health-care providers are in a position to supply full information on safe abortion services without fearing being subjected to criminal sanctions”.

Amnesty International welcomed the ruling, and renewed their campaign for legislative reform.

“The Irish government must take its head out of the sand and see that it has to tackle this issue,” said Amnesty’s head of Ireland, Colm O’Gorman.

Yet some see the ruling as deeply political, and an attempt to bully the country into legislative change. Writing for The American Spectator, Daniel J.

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.

Bioethics Blogs

“The Enormity of the Moral Mission of Medicine”

As I write, Paul Kalanithi’s book When Breath Becomes Air sits atop the New York Times Bestseller List. I highly recommend it. It is beautiful.

This book was written by a dying man. All books are, I suppose, but this author knew with more certainty than most that his time was short. Paul Kalanithi was finishing a grueling neurosurgery residency and on the cusp of a brilliant career when he discovered he had advanced lung cancer. In this book, written during the last months of his short life, he tells his story, a story of his search for meaning. He initially looked for meaning in the study of words, as he collected degrees in English and history and philosophy. But he discovered that meaning is not just read about, but lived, lived in relationships with others. As he thought about relationships, words, minds, and the brains through which words and minds are expressed, he writes that he “couldn’t let go of the question: Where did biology, morality, literature, and philosophy intersect?” The answer wasn’t to be found, for him, in the classroom: “. . . I found myself increasingly often arguing that direct experience of life-and-death questions was essential to generating substantial moral opinions about them. Words began to feel as weightless as the breath that carried them. . . It was only in practicing medicine that I could pursue a serious biological philosophy. Moral speculation was puny compared to moral action.”

And this illustrates one of the great strengths of the book: the profound understanding that medicine is at its heart a moral practice.

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.

Bioethics Blogs

Wheaton College

I guess this is the “other stuff,” in Bioethics and Other Stuff.  I am copying below my essay that was published today on the website of the American Academy of Religion, as part of Religious Studies News.

Wheaton College, Larycia Hawkins, and Our Academic Life Together

The case of Larycia Hawkins has brought much gnashing of teeth in many areas of academe. Hawkins, a tenured professor of political science at Wheaton College, a Christian liberal arts college, was placed on administrative leave with a recommendation for the initiation of termination proceedings. On February 9, 2016 Hawkins and Wheaton agreed to part ways, with the settlement terms remaining private. According to the College, Professor Hawkins was in trouble for her public declaration (outside the classroom) that Christians and Muslims worship the same god. Some commentators suspect that Wheaton was using the theological issue as a pretext for firing someone who is female and African-American, on a mostly white campus, or that she was really under attack for her act of wearing the hijab as a statement of solidarity with Muslim women. But I am going to take Wheaton at its word here, the better to explore some of the academic implications.

Wheaton can perhaps be faulted for a lack of clarity in the lines it draws. But in general, Wheaton and similar colleges go out of their way to make clear to students and faculty what the expectations are for belief and behavior, and what the consequences can be for crossing those lines. (It is also possible that Hawkins and Wheaton are engaged in a genuine hermeneutical debate about aspects of evangelical doctrine, a debate in which I am not qualified to engage.)  

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.

Bioethics Blogs

In the Journals December 2015 – Part II by Melanie Boeckmann

Find the first half of December’s post here.

New Genetics and Society

Beyond and within public engagement: a broadened approach to engagement in biobanking

Jose A. Cañada, Aaro Tupasela, Karoliina Snell

Social studies on biobanking have traditionally focused on public engagement, that is, engagement with donors, patients and the general public as an important factor of sustainability. In this article, we claim that, in order to fully understand the way biobanks work, it is necessary to pay attention to a number of other actors, which have an equal, if not greater, impact on their practices and strategies. This means taking a broadened approach to biobank engagement. By using data collected from interviews with different biobank experts based in five different countries (UK, Canada, Finland, Spain and Iceland), we identify seven communities, including the public, that emerge as relevant. Such relationships condition the way biobanks develop, act and plan. The discussion illustrates how the relationships with those seven communities are articulated. We conclude that there is a need for a broadened approach to biobank engagement in order to understand biobank sustainability.

Adoptable packages and the cost of their adoption: the craftwork of making the right cells for regenerative medicine in Japan

Koichi Mikami

The goal of regenerative medicine is to utilize biological properties of cells for therapeutic purposes. Although substantial international investment has been made in this biomedical technology, the issue of which type of cells best serves for these purposes still remains unsettled. Adopting a conceptual framework from Clarke and Fujimura that the rightness of “tools” needs to be socially constructed, this paper examines the interactions of various actors in Japan and demonstrates two kinds of craftwork as examples of attempts to construct the rightness of the cells for the technology.

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.

Bioethics Blogs

Hungry Canadians: Changing the Conversation from Food Charity to the Right to Food

Graham Riches argues that there is a need to reframe the issue of food insecurity in terms of rights, not charity.

__________________________________________

Feeding hungry Canadians with donated, surplus food is a practice that was imported in the early 1980s from the USA and has become the primary task of charitable food banks. Yet, “food charity,” supported by the food industry and corporate social responsibility, does not work.

Framing food insecurity as a matter of charity is ineffective and ethically challengeable. It also disguises the true extent and causes of food insecurity, namely income poverty and underemployment. Furthermore, it stigmatizes low-income individuals and undermines their human right to adequate food and nutrition. Government looks the other way. Public policy is neglected.

Food security for all requires changing the conversation to “the right to food.” The problem is that domestic hunger is now socially constructed as a matter for charity, no longer a priority concern for government. Long forgotten is Canada’s ratification of the International Covenant on Economic, Social and Cultural Rights (1976). Food is recognized as a basic human need and a human and legal right—protected under international law, and an obligation of government to “respect, protect and fulfill.”

Yet minimalist government (federal and provincial), lower taxes, downloading, and privatization have since de-politicized hunger and the right to food, now airbrushed from political consciousness and public policy. No wonder wealthy, food secure Canada, despite a universal right to health care, has 4 million people (12.5% of the population) experiencing food insecurity due to lack of money.

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.

Bioethics Blogs

Rebuilding Trust

The Texas Tribune reported this week that legislators in Austin have proposed a bill that would forbid physicians from asking their patients about guns.  Joe Gibes has commented on this issue in this blog (“It’s Not Primarily About the Guns” on Sept. 12, 2014).  In Texas, this is set against the backdrop of Open Carry legislation, a change in rules for those licensed to carry a handgun that would do away with the requirement they conceal their weapons.

While this legislation is related to debates about guns and recent gun violence, I think this issue is more closely related to the lack of trust in the medical profession.  Take the vaccine debate of a couple months ago (and Senator Rand Paul’s tweet).  This is tied to concerns about autism, but it reveals a larger mistrust in medical science and healthcare policy.  I think this was exacerbated by the Ebola outbreak in Dallas and questionable management at both the hospital level and county/public health department level and even the federal CDC.

So, now more than ever, we need to rediscover the sacred patient-physician relationship.  Some patients may be wary of a doctor trying to make a buck off their care (see Lesley Stahl’s reporting on the revenue which comes from pharmaceutical companies in the course of cancer treatment).  Doctors may be concerned with the platoon of lawyers tagging along with some of their patients.  Or maybe it is that guy with the MBA running the hospital.  And, of course, there is the government. 

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.

Bioethics Blogs

The right to health, health systems development and public health policy challenges in Chad

Background:
There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development.MethodThis paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14.
Results:
The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions.

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.

Bioethics Blogs

On the supposed distinction between culture and religion: A comment on Sir James Munby’s decision in the matter of B and G (children)

On the supposed distinction between culture and religion: A comment on Sir James Munby’s decision in the matter of B and G (children)

By Brian D. Earp (@briandavidearp)

Introduction

What is the difference between ‘culture’ and ‘religion’ … ? From a legal standpoint, this question is important: practices which may be described as being ‘religious’ in nature are typically afforded much greater protection from interference by the state than those that are understood as being ‘merely’ cultural. One key area in which this distinction is commonly drawn is with respect to the non-therapeutic alterations of children’s genitals. When such alteration is done to female children, it is often said to be a ‘cultural’ practice that does not deserve legal protection; whereas, when it is done to male children, it is commonly said to be a ‘religious’ practice – at least for some groups – and must therefore not be restricted (much less forbidden) by law.

Is this a valid distinction?

Background

First, a little background. Last month, a senior British judge — Sir James Munby — handed down a landmark decision concerning ‘female genital mutilation’ or ‘FGM’ (Munby, 2015). In it, he avers that even ‘minor’ forms of ‘FGM’ – such as ritual nicking of the clitoral hood, which does not remove any tissue – constitute ‘significant harms’ in the eyes of the law. As I have argued previously on this blog (Earp, 2014a), as well as elsewhere (Earp, 2013; Earp, 2015; Earp, in press; Earp, under review; Earp & Darby, 2014), such a view has serious implications for the practice of male circumcision.

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.

Bioethics Blogs

Why Ethicists Should Speak Out Against Torture

Sen. Feinstein of the U.S. Senate released a committee report two months ago on the use of torture by CIA interrogators in the 2000s.  While some have expressed outrage, many have been silent on the matter.  I think ethicists are obligated to speak on this issue, and Christian ethicists should be able to articulate the moral high ground regarding the treatment of prisoners or the fighting of wars.

I will mention a few areas that should be of particular concern to ethicists:

A Stance for the Healing Profession of Medicine

With the exponential growth of biotechnology in recent years, the profession of medicine has become too narrowly focused on its technical enterprise at the expense of its broader calling to heal.  At the heart of the Hippocratic tradition is the concept that the work of the physician is done for the sake of healing and is not to be misused in the service of some other agenda.  The ancients were wise in considering the possibility of medicine becoming a powerful tool in the hands of some enterprise unconcerned with its subject (the patient) or healing.

A program of torture developed by psychologists undercuts this endeavor significantly.  Medical practice of rectal rehydration to keep alive those who probably wish they were dead twists healing practice into an instrument of torture.  The overall agenda of a surveillance agency or government department may contradict the healing endeavor.

We might cover Kantian ethics in every university philosophy intro class, but it seems we are apt to use people as a means to an end. 

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.