Ethics Archives - Page 61 of 87 - Protection of Conscience Project Library

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

Canadian Medical Association Journal, CMAJ — Canadian Medical Association Journal

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.

Beyond autonomy: coercion and morality in clinical relationships

Maxwell Gregg Bloche

Extract
This article considers the problem of line-drawing between autonomy-preserving and autonomy-negating influence in clinical relationships. The author’s purpose is not to propose particular boundaries, either with respect to reproductive decisions by HIV-infected women or for other clinical choices. Rather, he attempts to shed some light on what drives our disputes about whether one or another influence method is compatible with autonomous choice. The author argues that such disagreements reflect underlying conflicts between normative commitments, and that resolving these conflicts is essential to settling controversies over whether particular influences unduly interfere with autonomous choice.

Bloche MG. Beyond autonomy: coercion and morality in clinical relationships. Health Matrix J Law Med 1996;6(2):229-304.

Restricting Donative Choice: Fetal Tissue Transplantation and Respect for Human Life

Joanna H Kinney

Abstract
I propose that a woman who becomes pregnant with the intent to abort will be treated as an initial aggressor, and as such she will be denied the “abortion exception” that will be granted to the woman who aborts an accidental, unwanted pregnancy. Moreover, I shall argue that a woman should not be allowed to designate the donee of the fetal tissue from her abortion, even though her pregnancy was accidental. Without this restriction, a woman who intends to become pregnant and abort may simply claim her pregnancy was accidental, and thereby claim the exception. Central to this study is the question of fetal worth, and the value to be ascribed to beings not like us, that is, not like human beings who have been born. Although I argue for a moral justification of elective abortions, I intend to show that such a justification should be a narrowly drawn exception to the prima facie duties neither to harm nor to instrumentalize others. I shall also argue that prohibiting a woman from becoming pregnant in order to abort is necessary because such a situation does not fall within the narrow exception for elective abortions, and that such a restriction is crucial to preserving our respect for those with no voice. Finally, I shall argue that the prohibition against becoming pregnant with the intent to abort does not vitiate a woman’s right to terminate an unwanted pregnancy. Rather, this restriction is a necessary condition of the prima facie duties of nonmaleficence and non-insturmentalization.

Kinney JH. Restricting Donative Choice: Fetal Tissue Transplantation and Respect for Human Life. J. Law Health. 1996;10(2):259-286.

(Editorial) A de-facto end to abortion in USA?

The Lancet

Extract
these Bills (one in the House of Representatives and a less wild version in the Senate) are unnecessary and deceptive. . . .The Bills would allow residents and programmes to abstain from abortions on any grounds, not just religious or moral. . . .So what is their objective? It is the de facto ending of abortion in the USA. By allowing more residents and more programmes to opt out of abortion training, safe termination of pregnancy in America will become even more difficult to obtain. Already, the number of competently trained graduates has fallen dramatically. Access to doctors and clinics has shrunk, and too many American women wanting an abortion already face a long and sometimes dangerous search for help. This is an attack on women’s choices and an interference in medical education. If it passes Congress, President Clinton should veto it immediately.

The Lancet. (Editorial) A de-facto end to abortion in USA? The Lancet. 1996;347(9008):1055.

Selective conscientious objection in the United States

Joseph E Capizzi

Extract
It is this author’s position that the concerns of the selective conscientious objector ought to be legally recognized, not because an exemption is granted to the pacifist, but because it is the right thing to do in a democratic society that is respectful of its members’ religious commitments. This is not proposed as yet another right to add to the ever-growing list of individual rights in our society. The point of this essay is not to argue implicitly in defense of liberalism by arguing explicitly for a right deriving therefrom. Rather, it is proposed that the recognition of selective conscientious objection is necessary due to the presence of two existent legal concepts: the free exercise of religion, already extended to pacifists, and the right to confessional neutrality. “Compelling state interests” simply do not, in point of fact, override confessional neutrality. The government’s arguments about the feasibility of determining sincere selective objectors, about the drain of manpower that it claims would occur, and that the selective objector is merely a “political” dissenter and as such should not be granted this privilege, are not convincing.

Capizzi JE. Selective conscientious objection in the United States. J Church State. 1996 Spring;38(2):339-363.

Dentistry is a profession of conscience

S Holen

No abstract available

Holen S. Dentistry is a profession of conscience. Periodontal Clin. Investig. 1996;18(1):39

Pharmaceutically assisted death and the pharmacist’s right of conscience

William L Allen, David B Brushwood

Extract
In this article, we describe the pharmacist’s potential involvement in what has been referred to as “physician assisted suicide”. We suggest that when a physician prescribes a medication for the purpose of terminating a patient’s life, and when that prescription is presented to a pharmacist for filling, a moral dilemma may exist. The basis of the dilemma is the choice a pharmacist may be required to make between the duty to fill a legal prescription for a medication that is deemed appropriate by both the prescriber and the patient, and the duty to adhere to one’s own belief that medication should not be used to end life. We contend that in filling a prescription, especially given the recent advances in pharmacy practice, a pharmacist is no mere bystander in drug therapy. Rather, the pharmacist is an active participant whose values, attitudes, and beliefs should be given consideration.

Allen WL, Brushwood DB. Pharmaceutically assisted death and the pharmacist’s right of conscience. J Pharm Law. 1996;5(1):1-18