Ethics Archives - Page 60 of 87 - Protection of Conscience Project Library

Insider Trading: Conscience and Critique in Bioethics

Laurie Zoloth-Dorfman, Susan B Rubin

Extract
The problem of conscience in ethics consultation is a central part of the creation and selection of the particular standards to which we hold ourselves accountable and the very process by which we come to know,choose, and act on what is right. Finding such standards and agreeing on how to maintain personal and professional integrity forces each of us to regard in the most serious terms the core issues of our work and its meaning. And though external sources such as our profession, religion, or community may all at times influence our sense of appropriate and inappropriate behavior, on some level, each of us must also face these questions personally. At a certain point, we face a confrontation with what we are culturally shaped by modernity to “see” as our own privatized internal guide – our conscience. Turning towards conscience is turning towards a particular kind of confrontation with ourselves.

Zoloth-Dorfman L, Rubin SB. Insider Trading: Conscience and Critique in Bioethics. HEC Forum. 1998 March;10(1):24-33.

There Is No Moral Authority in Medicine: Response to Cowdin and Tuohey

John F Crosby

Abstract
Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.

Crosby JF. There Is No Moral Authority in Medicine: Response to Cowdin and Tuohey. Christ Bioet. 1998 Jan 01;4(1):63-82.

Institutional identity, integrity, and conscience

Keven Wm Wildes

Abstract
Bioethics has focused on the areas of individual ethical choices — patient care — or public policy and law. There are however, important arenas for ethical choices that have been overlooked. Health care is populated with intermediate arenas such as hospitals, nursing homes, hospices, and health care systems. This essay argues that bioethics needs to develop a language and concepts for institutional ethics. A first step in this direction is to think about institutional conscience.

Wildes KW. Institutional identity, integrity, and conscience. Kennedy Inst Ethics J. 1997 Dec;7(4):413-419.

Conscience and Conscientious Actions in the Context of MCOs

James F Childress

Abstract
Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.

Childress JF. Conscience and Conscientious Actions in the Context of MCOs. Kennedy Inst Ethics J. 1997 Dec;7(4):403-411.

(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.