Ethics And Medicine

ETHICS AND MEDICINE Medical ethics traces its roots back as far as ancient Greece, but the field gained particular prominence in the late 20th century. Many of the current issues in medical ethics are the product of advances in scientific knowledge and biomedical technology. These advances have presented humanity not only with great progress in treating and preventing disease but also with new questions and uncertainties about the basic nature of life and death. As people have grappled with issues on the frontier of medical science and research, medical ethics has grown into a separate profession and field of study. Professional medical ethicists bring expertise from fields such as philosophy, social sciences, medicine, research science, law, and theology. Issues in Medical Ethics. The advent of new medical and reproductive technologies in recent years has complicated how ethical decisions are made in medical research and practice. The following highlights some of the most prominent issues in medical ethics: abortion, and cloning. Abortion In 1973, the United States Supreme Court decision in Roe v. Wade made abortion legal. The Court’s decision sparked extensive controversy that has continued into the 21st century. In general, abortion opponents believe that life begins at conception and that a surgical abortion is the equivalent of murder. Pro-choice advocates believe that abortion is a private matter between the mother and her physician. Abortion, termination of pregnancy before birth, resulting in, or accompanied by, the death of the fetus. Some abortions occur naturally because a fetus does not develop normally or because the mother has an injury or disorder that prevents her from carrying the pregnancy to term. This type of spontaneous abortion is commonly known as a miscarriage. Other abortions are induced—that is, intentionally brought on—because a pregnancy is unwanted or presents a risk to a woman’s health. Induced abortion, the focus of this article, has become one of the most intense and polarizing ethical and philosophical issues of the late 20th century. Modern medical techniques have made induced abortions simpler and less dangerous. But in the United States, the debate over abortion has led to legal battles in the courts, in the Congress of the United States, and state legislatures. It has spilled over into confrontations, which are sometimes violent, at clinics where abortions are performed. This article discusses the most common methods used to induce abortions, the social and ethical issues surrounding abortion, and the history of the regulation of abortion in the United States. As noted earlier, abortion has become one of the most widely debated ethical issues of our time. On one side are pro-choice supporters—individuals who favor a woman’s reproductive rights, including the right to choose to have an abortion. On the other side are the pro-life advocates, who oppose abortion except in extreme circumstances, as when the mother’s life would be threatened by carrying a pregnancy to term. At one end of this ethical spectrum are pro-choice defenders who believe the fetus is only a potential human being until it is viable. Until this time the fetus has no legal rights— the rights belong to the woman carrying the fetus, who can decide whether

or not to bring the pregnancy to full term. At the other end of the spectrum are pro-life supporters who believe the fetus is a human being from the time of conception. As such, the fetus has the legal right to life from the moment the egg and sperm unite. Between these positions lies a continuum of ethical and political positions. A variety of ethical arguments have been made on both sides of the abortion issue, but no consensus or compromise has ever been reached because, in the public policy debate, the most vocal pro-choice and pro-life champions have radically different views about the status of a fetus. Embryology, the study of fetal development, offers little insight about the fetus’s status at the moment of conception, further confounding the issue for both sides. In addition, the point when a fetus becomes viable is constantly changing—with every passing year medical advances make it possible to keep a premature baby alive at an earlier stage. The current definition of viability is generally accepted at about 24 weeks gestation; a small percentage of babies born at about 22 weeks gestation have been kept alive with intensive medical care. This combination of medical ambiguities and emotional political confrontations has led to considerable hostility in the abortion debate. For many people, however, the lines between pro-choice and pro-life are blurred and the issue is far less polarized. Many women who consider themselves pro-life supporters are concerned about possible threats to reproductive rights and the danger of allowing the government to decide what medical options are available to them. Similarly, many pro-choice individuals are deeply saddened by the act of abortion and seek to minimize its use through more education about, and use of, birth control. Many people on all sides of the controversy feel the political debate has led to a stalemate because it ignores the nuances of the issue. In response, participants in the abortion debate find common ground in the admission that the issue is surrounded by complicated, difficult questions that require more than simplified pro-life or pro-choice rhetoric. Cloning A sheep named Dolly was successfully cloned from a cell of an adult female sheep, according to a 1997 announcement by Scottish scientist Ian Wilmut and his colleagues. In 1998 scientists in South Korea announced that they had created an embryo from the cells of an adult woman, although they had halted the embryo’s growth before it divided into four cells. These events, and several other successful attempts at cloning mammals, have led many scientists to believe that cloning humans may one day be possible. This possibility has touched off a debate about the ethics of creating human clones, the circumstances under which human cloning might be used, and the possibility of using the technique to manipulate the traits of children. But a number of potential benefits of cloning are often ignored in the debate about its use for human reproduction, according to some scientists. Cloning may one day be used xenotransplantation, the process of transplanting animal organs into humans. Cloning techniques could be used to create animals whose genes produce proteins that prevent the human rejection of organs. These donor animals could provide organs, such as heart, kidney, alleviating the shortage of available organs for medical transplantations. Cloning techniques could create mammals that produce

milk containing a particular drug, revolutionizing drug development into an efficient and cost-effective process. In agriculture, cloning may be used to create livestock that are resistant to infectious diseases. Widespread livestock slaughter caused epidemics such as foot and mouth disease or mad cow disease could be eliminated, according to advocates of cloning. The ethical issues relating to cloning are being taken up right now by the National Bioethics Advisory Commission, which was created by President Bill Clinton in 1995 and first met in October 1996. Most of the concerns center on efforts to create clones of human beings. Some people might want to make a human clone because they want to have a child with certain characteristics. Most scientists seem interested in cloning in order to learn what they can about how genes (the basic units of heredity) affect the development of an organism from the embryo to adulthood. Cloning achieves several purposes. First, it puts a nucleus (the part of a cell that contains most of the cell's genetic information) that is differentiated (specialized for a specific purpose) in charge of controlling the entire development of an organism. This tells us the limits on nuclear change during such development. Second, it puts a nucleus from one source into cytoplasm (the semi-liquid material of a cell outside the cell's nucleus) from another source, telling us things about the interaction of nucleus and cytoplasm in development. This is important because it tells us how much the cytoplasm of the egg contributes to development as compared to the genes in the nucleus. As we learn more about development, it is becoming clear that the cytoplasm plays a major role in the early stages of development. Third, it creates genetically identical individuals. All of these are important research aims in understanding genetics and development and how to manipulate organisms. Reasons not to clone are generally due to the expense, technical difficulties, and, in the case of cloning people, the ethical issues involved.

for Ethics

JESSIE L. LABISTE JR. BSED 4A