In a letter in the February issue of JOGC, Rebecca J. Cook and Bernard M. Dickens state, “Physicians who feel entitled to subordinate their patient’s desire for well-being to the service of their own personal morality or conscience should not practise clinical medicine” (emphasis added). The statement is unsupported by their own legal references, and it has little to recommend it as an ordering principle in the practice of medicine.
Extract Women in some parts of England have to wait up to two months from first seeking advice about an abortion to having the procedure, says a survey. The delays in referral mean that many women are presenting to services later than nine weeks pregnant and cannot be considered for early medical termination using the abortion pill, mifepristone, despite this being a popular option among women. . .The survey, which was conducted by Voice for Choice—an alliance of national pro-choice organisations including British Pregnancy Advisory Service, Marie Stopes International, and the Family Planning Association—reviewed the abortion services of 243 primary care trusts.
Extract Anti-abortion groups should welcome proposed new regulation allowing patients to access emergency contraception without a prescription, says the Society of Obstetricians and Gynaecologists of Canada. . . . Emergency contraception, or the “morning after pill,” is sold in Canada as levonorgestrel (Plan B). If taken within 72 hours of unprotected intercourse, it can prevent ovulation, or interfere with fertilization, or implantation. . .The Catholic Organization for Life and Family and other anti-abortion groups believe pregnancy begins with conception, not implantation. In a letter to Health Canada, the organization called levonorgestrel an “abortifacient.”.
Abstract What are moral values and where do they come from? David Hume argued that moral values were the product of a range of passions,inherent to human nature, that aim at the common good of society. Recent developments in game theory, evolutionary biology, animal behaviour, psychology and neuroscience suggest that Hume was right to suppose that humans have such passions. This dissertation reviews these developments, and considers their implications for moral philosophy. I first explain what Darwinian adaptations are, and how they generate behaviour. I then explain that, contrary to the Hobbesian caricature of life in the state of nature, evolutionary theory leads us to expect that organisms will be social, cooperative and even altruistic under certain circumstances. I introduce four main types of cooperation – kin altruism,coordination to mutual advantage, reciprocity and conflict resolution –and provide examples of ‘adaptations for cooperation’ from nonhuman species. I then review the evidence for equivalent adaptations for cooperation in humans. Next, I show how this Humean-Darwinian account of the moral sentiments can be used to make sense of traditional positions in meta-ethics; how it provides a rich deductive framework in which to locate and make sense of a wide variety of apparently contradictory positions in traditional normative ethics; and how it clearly demarcates the problems of applied ethics. I defend this version of ethical naturalism against the charge that it commits ‘the naturalistic fallacy’. I conclude that evolutionary theory provides the best account yet of the origins and status of moral values, and that moral philosophy should be thought of as a branch of natural history.
Abstract Over and above fairness, the concept of justice presupposes that in any community no one member’s wellbeing or life plan is inexorably dependent on the consumption or exploitation of other members. Renunciation of such use of others constitutes moral sociability, without which moral considerability is useless and possibly meaningless. To know if a creature is morally sociable, we must know it in its community; we must know its ecological profile, its species. Justice can be blind to species no more than to circumstance. Speciesism, the recognition of rights on the basis of group membership rather than solely on the basis of moral considerations at the level of the individual creature, embodies this assertion but is often described as a variant of Nazi racism. I consider this description and find it unwarranted, most obviously because Nazi racism extolled the stronger and the abuser and condemned the weaker and the abused, be they species or individuals, humans or animals. To the contrary, I present an argument for speciesism as a precondition to justice.
Extract The CMA Code of Ethics begins with the principle that an ethical physician will consider first the well-being of the patient. Physicians who feel entitled to subordinate their patients’ desire for well-being to the service of their own personal morality or conscience should not practise clinical medicine.
Extract There is a considerable amount of academic and popular literature on Nazi medical experimentation within concentration camps, however, the existing research largely focuses on the doctors and the details of their experiments and has neglected two interesting themes. The first neglected theme is the potential legal liabilities and defense strategies of those among the SS leadership, such as SS General Karl Wolff. Wolff facilitated these experiments in a purely administrative capacity, but without his contribution this type of war crime would not have been possible. Secondly, the research has neglected the extent to which Wolff was able to avoid legal accountability for these and other war crimes, as a result of his wartime cooperation with a U.S. intelligence agency and his post-war assistance to interrogators within the Allied Military Intelligence as well as the Nuremberg prosecutors. [2] The present article, which is the first in a series of related studies, focuses largely on the first theme. This article gives particular attention to Wolff’s attempts to avoid prosecution by insisting that the experiments were of a voluntary nature, based on the consent of the research subject, and were, therefore, not criminal acts. Additionally, the article focuses on Wolff’s claim that he did not possess the requisite mens rea or intent necessary to secure a criminal conviction.
Extract This physician may feel ethically torn, but it is the physician’s duty to help enable this patient to make the best decision. By informing the patient about abortion, the physician is not endorsing the procedure, or swaying this mother in either direction, but simply providing information. This use of information will strengthen the relationship between patient and physician because it fosters autonomy and offers a sense of support during a time when it is needed most. Although it may not be a physician’s duty to perform an abortion when the physician feels ethically opposed, it is the duty of the physician to inform a woman about the procedure without allowing personal beliefs to influence her decision.
Abstract The merits of non-prescription distribution of levonorgestrel as emergency contraception (EC), which is effective within 72 hours of unprotected intercourse, are contentious. The advantage of promptness and convenience of access may be offset by the absence of medical counselling. Opposition to EC based on the possibility of the drug acting after fertilization but before implantation departs from standard medical criteria of pregnancy. Physicians who propose to apply non-medical criteria, and use religious objections to abortion to deny prescription of EC, must publicize their opposition in advance, so that women may seek assistance elsewhere. When objecting practitioners, or facilities, become responsible for women for whom EC is indicated, such as rape victims, they are bound ethically and legally to refer them to reasonably accessible non-objecting sources of care.
Extract The premise of this lecture is that there are two different sets of ethical rules, the purely private and a special set arising in the workplace which will differ from occupation to occupation. . . .
• First, I hope it is axiomatic that ethics and morals must accompany individuals at all times no matter what they are doing.
• Secondly, that the moral or ethical position of the individual may in certain circumstances have to take on board other considerations which also have a moral and ethical dimension and that the ultimate decision, though different from one that would be reached in private life by the individual, is nevertheless justifiable and ethical.
• Thirdly, that to violate these precepts, even if it is done in order to give primacy to one’s own ethical code, is not ethical: the individual should resign or seek an alternative occupation. In other words, there are times when to listen to one’s private conscience while remaining deaf to the moral demands of one’s occupation can itself be seriously unethical.
• Fourthly, that weighing these considerations in the balance is no easy task and succumbs to no formula. It calls for the exercise of keen judgment informed by a developed moral framework.
