Tag: rights

Bioethics Blogs

Neil Gorsuch, Aid in Dying, and Roe v. Wade

In the absence of any “paper trail” that would give clues to Supreme Court nominee Neil Gorsuch’s views on abortion, many commentators have turned to his book, The Future of Assisted Suicide and Euthanasia, based on his doctoral dissertation at Oxford, where he worked with natural law theorist John Finnis.  Ronald M. Green notes with alarm that Gorsuch relies on an inviolability-of-life principle that would likely lead him to vote to overturn Roe v. Wade.  Furthermore, Green writes that Gorsuch’s conservative preference for allowing states to make their own decisions, would lead to a return to the pre-Roe reality in which women would have to travel long distances for abortions in those states that allowed it.  (https://ronaldmgreen.com/2017/02/17/how-will-neil-gorsuch-vote-on-roe-v-wade/)

However, there are more dire possibilities to consider. In a long and fascinating essay in Vox (March 20, 2017), J. Paul Kelleher argues that Gorsuch is not an originalist in the Scalia mold, but actually a natural law adherent like his mentor Finnis.  Natural law theorists believe that there is an over-arching moral law that judges can and must rely on when existing laws are unclear, or manifestly unjust.  The recognition of human life as a “fundamental good” that can never be intentionally harmed, is an example of such a moral law, and one that Gorsuch relies on in his condemnation of assisted suicide.

It’s important to see that Gorsuch is not merely agreeing with the current legal status of assisted suicide in our country.   In Washington v. Glucksberg, in 1997, the Court declined to follow the logic of the “privacy” cases stretching from contraception through abortion and find a constitutional right to assistance in ending one’s life.  Glucksberg leaves the country, with respect to assisted suicide, in the same position in which we would left with respect to abortion, if Roe were overturned: at the mercy of the legislative wisdom of the individual states.   Gorsuch goes further in arguing that the equal protection clause of the 14th amendment forbids treating the lives of terminally ill people differently from those of the healthy, by allowing the “killing” of the first but not the second (a view often argued by philosopher Felicia Nimüe Ackerman).  In other words, Gorsuch would presumably view favorably an appeal to the Court to strike down existing “death with dignity” laws in Oregon and elsewhere.

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

Conscientious Objection Accommodation in Healthcare – Clashing Perspectives

by Brian D. Earp / (@briandavidearp)

On behalf of the Journal of Medical Ethics, I would like to draw your attention to the current issue, now available online, which is almost entirely dedicated to the vexing question of conscientious objection in healthcare. When, if ever, should a healthcare provider’s personal conviction about the wrongness of some intervention (be it abortion, euthanasia, or whatever) be accommodated?

In a paper that has already attracted much attention, Ricardo Smalling and Udo Schuklenk argue that medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

In part, they base their argument on their judgment that “the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive” (emphasis added).

It seems clear that a lot hinges on what is meant by “unreasonable” there–and on who should get to decide what falls under that label. One answer to this question might be, “society should get to decide, through the enactment of laws, which ideally express the view of the majority of people as to what is reasonable or unreasonable in medical and other contexts.”

“Therefore,” this answer continues, “if a doctor thinks that some legally allowed service X is immoral, then she should rally her fellow citizens to lobby their representatives to change the relevant law; but she should not be excused from providing the service, if by law the patient is entitled to receive it.”

“And if she really doesn’t want to do X,” the answer concludes, “she can always leave the profession and take up some other line of work.”

This is a rough summary of what Smalling and Schuklenk do in fact say.

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

Texas Considers Letting Doctors Lie to Patients

by Craig Klugman, Ph.D.

The Texas Senate just passed a new bill (SB 25) that would shield doctors from a lawsuit if a baby is born with a disability even if the doctor knew of the concern and chose not to tell the parents. Opponents of the bill say that it permits doctors to lie to their patients if the doctor believes that knowledge might lead the woman to choose an abortion. The Houston Chronicle reports the bill’s aim is to “chip away at abortion rights.”

The Texas law does not go as far as a 2015 Arizona law that mandated physicians lie to patients by telling them that an abortion can be reversed. The new Texas bill would “allow” doctors to lie to patients and shield them from lawsuit unless the patient could prove gross negligence. The burden is on the patient to prove that the doctor should not have lied.

One of the first rules of professionalism that I teach in undergraduate and medical school bioethics courses is that in general, you never lie to the patient. Telling the truth is a bedrock concept necessary to respect patient autonomy. In order to make decisions, patients need to have knowledge of their condition and their treatment options (risks, benefits, and alternatives).

There are a few circumstances in which lying to patients is ethically acceptable: If the physician has strong reasons to believe that information would push the patient to do harm to him/herself or others, or if the family has requested that a patient not be told information because of cultural practices and the patient has agreed that she/he does not want to know the news.

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

Aid-in-Dying Laws and the Physician’s Duty to Inform

Guest Post: Mara Buchbinder

Paper: Aid-in-dying laws and the physician’s duty to inform

Why do so many people assume that any clinical communication about aid-in-dying (AID, also known as assisted suicide), where it is legal, ought to be patient-initiated? Physician participants in my ongoing study tend to assume that physicians should wait for patients to initiate discussions of AID. The clinical ethics literature on communication about AID has reinforced this expectation by focusing on how to respond to patient requests. Consequently, bioethics has largely remained silent on whether there is a professional duty to inform terminally ill patients about AID laws and their clinical and legal requirements.

As a medical anthropologist, I pay attention to such gaps in professional discourse, as they often indicate ideas that are so taken for granted that they escape formal expression. In this case, bioethics’ silence on professional obligations to inform patients about AID suggests to me that initiating such a discussion is widely viewed as dangerous. But why? My recent article in the Journal of Medical Ethics began with this puzzling question.

In the United States, where my research is based, in addition to many other Western societies, there is a pervasive cultural stigma against talking about death, as described in the Institute of Medicine’s 2014 Report on Dying in America. Yet there is something bigger at stake here for physicians, who may be more accustomed than most people to talking about death and dying: the idea that mentioning the possibility of hastening one’s death can be deeply injurious to the patient and the patient-provider relationship.

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

The Future of Bioethics: Organ Transplantation, Genetic Testing, and Euthanasia

By Ana Lita

When you think of bioethics, some of the first hot-button topics you may consider are organ transplantation, fertility and genetic engineering, and end-of-life-care. The Global Bioethics Initiative serves as a platform to address many bioethical questions and engages in public debates to develop resolutions to present and emerging issues.

Dr. Ana Lita, founder of the Global Bioethics Initiative, discusses the various areas GBI addresses and highlights the organization’s contributors in their prospective fields. She acknowledges the valuable contribution of the current president of GBI, Dr. Bruce Gelb, in the field of organ transplantation. She also addresses the original co-founder of GBI, Dr. Charles Debrovner, and his lifelong passion in the field of fertility and genetic engineering. Lastly, Dr. Lita offers a brief insight into the future of Bioethics in these uncertain times.

ORGAN MARKETS AND THE ETHICS OF TRANSPLANTATION 

Recent developments in immunosuppressive drugs and improved surgical techniques have now made it much easier to successfully transplant organs from one human body to another. Unfortunately, these developments have led to the rise of black-markets in human organs. This underground market is where people who need kidneys to survive or to improve the quality of their lives, for example, purchasing such organs from impoverished persons in the developing world. In January 2017, scientists announced that they successfully created the first human-pig hybrid and a pig embryo with some human characteristics. Given the increasing need for transplant organs, should such markets be regulated and legalized?  Could the success of therapeutic cloning eliminate the need to consider this option?

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

So, What is Not to Like about 3D Bioprinting?

Guest Post: Gill Haddow & Niki Vermeulen

Paper: 3D bioprint me: a socioethical view of bioprinting human organs and tissues

Bioprinter developed by Alan Faulkner-Jones & Wenmiao Shu (Strathclyde University).  Picture made by Beverley Hood (Edinburgh College of Art) during a recent laboratory visit.

Picture this: It is twenty years’ from now and , one of your organs has stopped functioning properly or even at all. You will not need to wait in the long line of the human organ transplant list however. Instead, you can have an organ ready made for you. Bespoke design and ready to use. Who would not want this as a future scenario? While 3D printing is working with inorganic materials, the intention of bioprinting is to work with organic materials (including living cells) to create structures approximating body parts. These new forms of printing, should they be fully realised, will, it is argued, have the same revolutionary and democratising effect as book printing in their applicability to regenerative medicine and industry. Individually designed biological structures or body parts will become as available as text in modern literate societies. Not only would it make organs widely available to those who need them, but 3D printing organs would also resolve entrenched ethical problems ranging from eliminating the market in human organs and avoiding recipient rejection to averting human or non-human animal organs. Therefore, long-term 3D bioprinting has the potential to be a ‘game-changer’, no longer necessitating the need for living or deceased human donation as human organs would be printed on demand.

However, the technology is not yet at the level required to bioprint entire organs.

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

Mortal remains

One of the star exhibits in the Royal College of Surgeons’ Hunterian Museum of anatomy in London is the skeleton of Charles Byrne, an 18th Century Irishman who was about 8 feet tall. However, the museum is to close in May for renovations and there are calls to use the opportunity to remove or bury the remains. Does this make sense?

A celebrity in his day, Byrne died in 1783 of ill health and drink in London. He knew that John Hunter wanted to dissect him after his death, so he directed his friends to sink his body in a lead-lined casket in the English Channel. Alas, Hunter succeeded in stealing the body anyway and it eventually turned up in a display case.

Similar events darken the history of the Australian state of Tasmania. The last full-blood Aboriginal Tasmanian, William Lanne, died in 1869. Although the story is murky, it appears that before his funeral the Surgeon-General of the colony, William Crowther, stole his head for “scientific study” and someone else removed his hands and feet. There is no record of scientific studies. Crowther went on to become premier, and an impressive bronze statue of him was erected in the centre of the city.

The last full-blood Aboriginal woman in Tasmania, Truganini, was terrified that the same thing would happen to her and directed that her body be cremated. Her wishes were ignored and her skeleton ended up in a display in the Hobart Museum. It was finally cremated in 1976.

Nowadays body-snatching would not be tolerated (although the Hunterian Museum still refuses to remove Byrne’s body from display).

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

New Zealand river declared a legal person

In the latest wrinkle in debates over personhood, a Māori iwi (tribe) in New Zealand has succeeded in getting Parliament to recognise the Whanganui River as a legal person.

“It’s not that we’ve changed our worldview, but people are catching up to seeing things the way that we see them,” Adrian Rurawhe, a Māori member of Parliament. The North Island river, New Zealand’s third longest, also known by its Māori name of Te Awa Tupua, will be represented by two legal guardians, one appointed by the iwi and the other by the government.

The settlement, which has been in dispute for at least 140 years, also includes NZ$80 million in financial redress and $30 million toward improving the environmental, social, cultural and economic health and wellbeing of Te Awa Tupua. 

Riverine personhood is an untested concept in a Western legal system. According to the government, Te Awa Tupua will now have its own legal personality with all the corresponding rights, duties and liabilities of a legal person. Lawyers say that the river cannot vote and cannot be charged with homicide if people drown in it. But it will have to pay taxes, if liable. The gender of the river is unspecified at the moment.

“I know the initial inclination of some people will say it’s pretty strange to give a natural resource a legal personality,” said New Zealand’s Treaty Negotiations Minister Chris Finlayson. “But it’s no stranger than family trusts, or companies or incorporated societies.”

As soon as the third reading of the bill passed, members of the gallery broke into a waiata (a song of celebration) which is well worth watching. 

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This article is published by Michael Cook and BioEdge under a Creative Commons licence.

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

Costa Rica’s resistance to legal IVF crumbles

Ronald Reyes/The Tico Times    

A girl named Maria José has become the first IVF baby to be born in the Central American nation of Costa Rica. Her parents, Jenny Garbanzo y José Barana, had been lobbying for the right to access IVF in Costa Rica since 2007. However, under a ruling by the Supreme Court in 2000, IVF was banned because it resulted in the destruction of embryos. It took substantial international pressure to force the government to give in.

The first IVF procedures were carried out in middle of last year at two certified private clinics.

The Inter-American Court of Human Rights (IACHR) has also ordered the government to make IVF available at public hospitals. Construction of a public fertility clinic is scheduled to begin in August next to the National Women’s Hospital, near the Costa Rican capital of San José. The government is also funding overseas training of IVF specialists from Costa Rica for the clinic. The first procedures in public hospitals will begin in 2018. 

This article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

Source: BioEdge.org.

This article was originally published on BioEdge.org under a Creative Commons License. If you enjoyed this article, visit BioEdge.org for more.

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

A New Zealand River Now Has The Legal Rights Of A Human

The legislation marks a monumental victory for the local Māori people, who view the river as “an indivisible and living whole,” Gerrard Albert, lead negotiator for the Whanganui tribe, tells The Telegraph.

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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.