Has the Time Come for Doctor Death: Should Physician-Assisted Suicide Be Legalized

Wendy N Weigand

Journal of Law and Health
Journal of Law and Health

Extract
The implications of legalizing euthanasia for the medical profession and the potential for abuses are very troubling. Before public policy or legislation is formulated, the ethical issues inherent in the practice of euthanasia must be critically examined. . . It is the author’s assertion that the legalization of assisted suicide and/or physician-aid-in-dying is not the proper course of action at this time. There are too many other options available to doctors, nurses, hospitals and other health care institutions which must be exercised to their fullest extent before any form of active euthanasia is legalized.


Weigand WN. Has the Time Come for Doctor Death: Should Physician-Assisted Suicide Be Legalized. J Law Health. 1993;7(2):321-350.

The Hospital Ethics Committee: Health Care’s Moral Conscience or White Elephant?

David C Blake

The Hastings Center Report
The Hastings Center Report

Abstract
In a morally fragmented society there is no good reason for ethics committees to assume any particular point of view, yet failure to do so compromises their ability to function in either a case-review or an educational capacity. A casuist methodology might enable committees to fulfill both roles.


Blake DC. The Hospital Ethics Committee: Health Care’s Moral Conscience or White Elephant?. Hastings Cent Rep. 1992;22(1):6-11.

Abusing human rights in the health care service under a soft dictatorship in Hungary

Gábor Ternák

Journal of Medical Ethics
Journal of Medical Ethics

Extract
Torture probably ended a long time ago in my country, but now we have more sophisticated ways of abusing human rights – in the way we deliver health care. The falsification of morbidity and mortality figures; not paying attention to the so-called ‘Capitalist’ diseases like drug abuse and even AIDS; not talking about the hazards of environmental pollution – all this has prevented us from taking ameliorating and protective measures.


Ternák G. Abusing human rights in the health care service under a soft dictatorship in Hungary. J Med Ethics. 1991;17(Supplement):40.

The position of the Chilean Medical Association with respect to torture as an instrument of political repression

Gunther Seelman

Journal of Medical Ethics
Journal of Medical Ethics

Extract
We reaffirm . . . our most categorical rejection of torture. Likewise, we reiterate our resolute support of the diverse initiatives aimed at investigating the participation of doctors in these unacceptable and condemnable practices, and the sanctioning of these activities within the medical profession and scientific organisations. . . There exists irrefutable proof that, during the 16 years of dictatorship, doctors and other members of the health care professions caused brutal suffering to their peers. Doctors involved in acts of torture are, for the most part, members of the armed forces. The conduct of these professionals is the result of the displacement of their medical vocation by the doctrine of ‘national security’, which conceives of the masses and their social and political organisations as the ‘internal enemy’.


Seelman G. The position of the Chilean Medical Association with respect to torture as an instrument of political repression. J Med Ethics. 1991 Dec; 17(Supplement):33-34.

Torture and the participation of doctors

Ugur Cilasun

Journal of Medical Ethics
Journal of Medical Ethics

(Notes that no doctors in private practice were known to have been involved in torture in Turkey. Those involved were working part-time or full-time for the government, or in the military.)
Extract
. . . Government pressure, on full or part-time employees, emerges in various forms. Doctors who refuse to participate in the act of torture can be accused of not obeying the orders of their immediate superiors and can be either dismissed from government service, or relocated to other posts with highly unfavourable working/living conditions. Material considerations, fear of being removed from family, and the obvious threat of coming under suspicion of ‘secretly collaborating with public enemies’, etc, exerts such emotional pressure that doctors are forced to participate, directly or indirectly, in the act of torture.


Cilasun U. Torture and the participation of doctors. J Med Ethics. 1991 Dec;17(1):S21-S22.

Remarks on medical ethics

Martin Bojar

Journal of Medical Ethics
Journal of Medical Ethics

Extract
Fulfilling the universal code of medical ethics is the ‘conditio sine qua non’ and we should prevent all attempts to change the basic document of European and world medicine, the Hippocratic Oath. Pross’s paper about the total failure of the German Medical Association to acknowledge and deal with war crimes perpetrated by doctors reinforces the need to adhere to the Hippocratic Oath.


Bojar M. Remarks on medical ethics. J Med Ethics. 1991;17(Supplement):39.

Abortion attitudes and practices of family and general practice physicians

JM Westfall, KJ Kallail, AD Walling

Journal of Family Practice
Journal of Family Practice

Abstract
Background: Approximately 1.5 million abortions are performed each year in the United States. Little information has been published on the abortion attitudes and practices of family physicians. The object of this investigation was to assess the abortion attitudes and practices of family and general practice physicians in Kansas.

Methods: A 19-item self-administered survey questionnaire was designed and mailed to 856 family and general practice physicians in Kansas.

Results: A 63% survey response rate was obtained. Seventy-eight percent of the physicians reported that abortion should be legal, but only 56% of the respondents classified themselves as pro-choice. Conversely, only 8% reported that legal abortion should not be available, even though 33% classified themselves as pro-life. The majority of physicians reported that abortion is an appropriate option to save the life of the mother, in cases of rape or incest, and when a fetal anomaly is diagnosed. Only three respondents (0.5%) had performed abortions during the previous year. In general, female physicians and physicians over the age of 40 years (regardless of sex) were more likely to be pro-choice and to view a women’s personal decision as a circumstance in which abortion may be appropriate.

Conclusions: Physician’s views about abortion and their practice patterns are important components of health care for thousands of women each day.


Westfall JM, Kallail KJ, Walling AD. Abortion attitudes and practices of family and general practice physicians. J Fam Pract. 1991 Aug;33(1):47-51.

Coercive Population Control Policies: An Illustration of the Need for a Conscientious Objector Provision for Asylum Seekers

E Tobin Shiers

Virginia Journal of International Law
Virginia Journal of International Law

Extract
Conclusion

When President Bush successfully thwarted passage of the Emergency Chinese Immigration Relief Act of 1989 and implemented his own order insisting upon “careful consideration” of victims who plead for political asylum because of coercive population control measures in their homelands, he unwittingly illustrated the need for a change in the statutory language. The Executive Order unwisely forces the issue of coercive population control policies into statutory language designed to protect victims of discrimination. Such manipulations would not be necessary if the Refugee Act of 1980 were amended to encompass the Handbook’s interpretation of the U.N. Protocol.

The interpretative guidelines to the U.N. Protocol, and derivatively
to the Convention, call for a “conscientious objector” exception to
military service. The grant of refugee status to individuals who prove
“valid reasons of conscience,” even reasons distinct from religious
claims, recognizes that fitting an individual within the protections of
the refugee definition requires a judgment on the means other nations
use to implement their policy ends, not just the ends themselves.
Rather than relying solely on the five narrow grounds for granting
asylum that were developed in response to the atrocities of World
War II, the U.N. Protocol, as interpreted by the Handbook, also
advocates protection for the individual persecuted by virtue of
mandatory participation in a military service with which he morally
disagrees. Because the debate regarding coercive population control
considers the legitimacy of means employed in achieving governmental
policy objectives, the logic of the conscientious objector exception
also applies to claims such as that of Chang.


Shiers ET. Coercive Population Control Policies: An Illustration of the Need for a Conscientious Objector Provision for Asylum Seekers. Va J Int Law. 1990;30(4):1007-1037.

Ecumenism and Abortion: A Case Study of Pluralism, Privatization and Public Conscience

James Kelly

Review of Religious Research
Review of Religious Research

Abstract
This paper uses the Churches’ responses to the controversy over abortion as a measure of the internalization of ecumenism. The data used in the essay include interviews with ecumenical officers and the minutes of the American Bishops Pro-life Committee. The main conclusion is that during the controversy “mainstream” Protestantism and Roman Catholicism reverted to post-Reformation and pre-Vatican II ideological roles, with Catholicism opposing under the banner of objective moral truth the legalization of abortion and liberal Protestantism under the banner of subjective conscience providing a belated religious justification to the legalization promoted first by secularist activists. This reversal to historic ideological roles actually distorted the more nuanced positions of these Churches in the controversy, but the lack of an ecumenical context obscured these shared tensions and prevented the Churches from contributing to a better public structuring of the moral ambiguities most Americans felt and still experience about abortion and the extent of its legalization. The essay concludes that only in an ecumenical context can religious pluralism lead to more inclusive moral commitments rather than to a further privatization of religion.


Kelly J. Ecumenism and Abortion: A Case Study of Pluralism, Privatization and Public Conscience. Rev Relig Res. 1989 Mar;30(3):225-235.

When caesarian section operations imposed by a court are justified

Eike-Henner Kluge

Journal of Medical Ethics
Journal of Medical Ethics

Abstract
Court-ordered caesarian sections against the explicit wishes of the pregnant woman have been criticised as violations of the woman’s fundamental right to autonomy and to the inviolability of the person-particularly, so it is argued, because the fetus in utero is not yet a person. This paper examines the logic of this position and argues that once the fetus has passed a certain stage of neurological development it is a person, and that then the whole issue becomes one of balancing of rights: the right-to-life of the fetal person against the right to autonomy and inviolability of the woman; and that the fetal right usually wins.


Kluge E-H. When caesarian section operations imposed by a court are justified. J Med Ethics. 1988 Dec;14(4) 206-211.