Ethics Archives - Page 59 of 81 - Protection of Conscience Project Library

(Editorial) Physician assisted suicide, euthanasia, or withdrawal of treatment: Distinguishing between them clarifies moral, legal, and practical positions

Larry R Churchill, Nancy MP King

British Medical Journal, BMJ — British Medical Journal

Extract
. . . In unanimous rulings last month, [United States] Chief Justice Rehnquist, writing for the court, held that there is no fundamental right to assistance in committing suicide1 and that, legally, distinguishing between refusing life saving medical treatment and requesting assistance in suicide “comports with fundamental legal principles of causation and intent.”

. . . Attempts to decriminalise assisted suicide in Britain have so far fallen well short of legislation.. . . Pressure groups in favour of voluntary euthanasia seem to accept that it will be difficult to achieve euthanasia legislation in one step but consider that assisted suicide represents a more attainable goal. From an opinion survey of Scottish doctors, the medical profession seems less resistant to assisting suicide than to practising euthanasia. . .

. . . it remains to be seen whether societal acceptance of physician assisted suicide will increase and how it will affect both social support for vulnerable and dying citizens and trust between patients and their doctors.

Churchill LR, King NMP. (Editorial) Physician assisted suicide, euthanasia, or withdrawal of treatment: Distinguishing between them clarifies moral, legal, and practical positions. Br Med J. 1997 Jul 19;315(7101):137-138.

Professional Versus Moral Duty: Accepting Appointments in Unjust Civil Cases

Teresa Stanton Collett

Extract
Conclusion
Tennessee Formal Ethics Opinion 96-F-140 attempts to disconnect morality from the lawyer’s work. The Board’s disregard of the lawyer’s moral and religious objections to accepting the appointment suggests either a hostility to the particular religious beliefs asserted by the inquiring lawyer or a willingness to demand lawyers accept being treated as mere means to clients’ and courts’ ends. Hostility to religious beliefs is deeply troubling when exhibited by those who are charged with providing lawyers’ guidance in discerning their professional obligations, but the second possible interpretation of the opinion is equally chilling. To the extent that the Board’s opinion represents the members’ considered judgment that lawyers are obligated to act as amoral facilitators of any action not proscribed by positive law, the power of the state is dramatically enlarged and the power of the individual and other social institutions dangerously diminished. This result cannot be tolerated under the terms of the First Amendment, nor can it be reconciled with the lawyer’s basic human rights.

Collett TS. Professional Versus Moral Duty: Accepting Appointments in Unjust Civil Cases. Wake Forest Law Review. 1997;32: 635-670.

(Correspondence) Some final responses to Dr. Waugh

Timothy J Cuddy

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

Extract
. . . For people with genuine morals, right and wrong do not change with popular public opinion . . . Before we congratulate our society on its social evolution over the last 50 years, we should reflect on the outcome of the society in history that practised throwing people to the lions, or perhaps the society of the 1940s that practised execution of races believed to be inferior.

[Dr. Waugh planned to respond to these letters but was unable to do so before his death on Apr. 18, 1997. In this issue, CMAJ features a tribute to Waugh (page 1524) as well as an article on issues surrounding access to abortion services (page 1545). — Ed.].

Cuddy TJ. (Correspondence) Some final responses to Dr. Waugh. Can Med Assoc. J. 1997 Jun 01;156(11):1529.

Abortion and our changing society

Douglas Waugh

Extract
When I was a medical student in the early ‘40s, and for a considerable time after that, the artificial termination of pregnancy was considered an unspeakable crime. . . . No one knew for certain how widespread the practice was, but enough patients turned up in emergency departments or in the morgue for us to know it was going on, and to arouse the ire and indignation of society’s moralists. . . . The credit for bringing the revolution about certainly belongs to Dr. Henry Morgentaler, but it is clear that Canada’s social climate had been changing slowly for several years before he defied the law by opening his first abortion clinic in Montreal . . . True, the anti-abortion campaign is not yet dead, but its force has become so attenuated the impact is limited.

Waugh D. Abortion and our changing society. Can Med Assoc J. 1997 Feb 01;156(3):408.

Nuremberg lamentation: for the forgotten victims of medical science

William E Seidelman

Abstract
Fifty years after the Nuremberg medical trial there remain many unanswered questions about the role of the German medical profession during the Third Reich. Other than the question of human experimentation, important ethical challenges arising from medicine in Nazi Germany which have continuing relevance were not addressed at Nuremberg. The underlying moral question is that of the exercise of professional power and its impact on vulnerable people seeking medical care. Sensitisation to the obligations of professional power may be achieved by an annual commemoration and lament to the memory of the victims of medical abuse which would serve as a recurring reminder of the physician’s vulnerability and fallibility.

Seidelman WE. Nuremberg lamentation: for the forgotten victims of medical science. Br Med J. 1996 Dec 7;313(7070):1463-1467.

Human guinea pigs and the ethics of experimentation: the BMJ’s correspondent at the Nuremberg medical trial

Paul Weindling

Abstract
Though the Nuremberg medical trial was a United States military tribunal, British forensic pathologists supplied extensive evidence for the trial. The BMJ had a correspondent at the trial, and he endorsed a utilitarian legitimation of clinical experiments, justifying the medical research carried out under Nazism as of long term scientific benefit despite the human costs. The British supported an international medical commission to evaluate the ethics and scientific quality of German research. Medical opinions differed over whether German medical atrocities should be given publicity or treated in confidence. The BMJ’s correspondent warned against medical researchers being taken over by a totalitarian state, and these arguments were used to oppose the NHS and any state control over medical research.

Weindling P. Human guinea pigs and the ethics of experimentation: the BMJ’s correspondent at the Nuremberg medical trial. Br Med J. 1996 Dec 07;313(7070):1467-1470.

Nuremberg and the Issue of Wartime Experiments on US Prisoners

The Green Committee

Jon M. Harkness

Journal of the American Medical Association

Abstract
Defense attorneys at the Nuremberg Medical Trial argued that no ethical difference existed between experiments in Nazi Concentration camps and research in U.S. prisons. Investigations that had taken place in an Illinois prison became an early focus of this argument. Andrew C. Ivy, MD, whom the American Medical Association had selected as a consultant to the Nuremeberg prosecutors, responded to courtroom crticisim of research in his home state by encouraging the Illinois governor to establish a committee to evaluate prison research. The governor names a committee and accepted Ivy’s offer to chair the panel. Late in the trial, Ivy testified – drawing on the authority of this committee – that research on Us prisoners was ethically ideal. However, the governor’s committee had never met. After the trial’s conclusion, the report was published in JAMA, where it became a source of support for experimentation on prisoners.

Harkness J. Nuremberg and the Issue of Wartime Experiments on US Prisoners: The Green Committee. JAMA. 1996;276(20):1672–1675. doi:10.1001/jama.1996.03540200058032

Descriptive and Normative Ethics: Conscientious Objection

Tina PH Baker

Abstract
Conscientious objection preserves the personal integrity and wholeness of a health care professional’s character and personality. Professionals are obligated not only to codes of ethics and standards of care that guide their practices, but also to personal values. When professional and personal values conflict with health care delivery, nurses are compelled to object on moral grounds on behalf of themselves and the public they serve.

Baker TP. Descriptive and Normative Ethics: Conscientious Objection. Nurs Manag. (Harrow). 1996;27(10):32DD-32FF

(News) “Democracy was never intended for degenerates”: Alberta’s flirtation with eugenics comes back to haunt it

Richard Cairney

Abstract
An Alberta woman recently won a lawsuit against the government of Alberta for wrongful sterilization that took place when she was a 14-year-old ward at the Provincial Training School for Mental Defectives. It was the first time the province has been held accountable for actions taken under the Sexual Sterilization Act, a 1927 law that promoted the theory of eugenics and led to the sterilization of more than 2800 people. It has since been repealed. A physician who served on the province’s Eugenics Board said the decisions were based on the best scientific advice and medical techniques available at the time. Today, she added, eugenics is being practised in a different way through prenatal diagnosis and therapeutic abortion..

Cairney R. “Democracy was never intended for degenerates”: Alberta’s flirtation with eugenics comes back to haunt it. Can. Med. Assoc. J.. 1996;155(6):789-792.

Clinical Practice Guidelines and the Law

Eike-Henner Kluge

Journal summary
With physicians in Canada under increasing threat of malpractice litigation, it has been suggested that adopting clinical practice guidelines (CPGs) as standards of care would free doctors from the fear of litigation initiated by dissatisfied patients. However, ethicist Eike-Henner Kluge argues that CPGs can only be considered general indicators of standards of care.

Kluge E-H. Clinical Practice Guidelines and the Law. Can Med Assoc J. 1996;155(5):574-576.