Bioethics- An Introduction to Medical Law

Bioethics:
The relationship between medical law and medical ethics:
- Importance of ethics due to its tradition - tradition of self-regulation
o Hippocratic oath [Ancient Greek]
- Questions go to the heart of the meaning and value of human life
o What we do to our bodies and other people’s bodies.
- The practice of medicine affects us in a particularly intimate way
o ie some of the subject matter of this course will be personal in a way that land law or trusts law is not.
- If no shared religion, secular ethical principles or moral theories become more important
From medical ethics to bioethics:
- Shift took place from last 50 years- not interchangeable terms.
o Medical ethics= ethics of good medical practice-what it means to be a good doctor.
 Origins in the Hippocratic oath
 Emphasis of the duties of a doctor towards his patients.
- Susan Sherwin
o Until v recently, conscientious physicians were trained to act paternalistically toward their patients, to treat
patients according to the physician’s own judgement about what would be best for their patients
o Problem:
 Health care may involve such intimate and central aspects of a patient’s life = difficult for anyone other
than the patient to make choices that will be compatible with that patient’s personal value system
- Heather Draper and Tom Sorrell
o There are duties not to use health services casually
 Doing so is morally wrong since they’re taking away time and resources better spent on more urgent
cases
- Bioethics= wider questions for society in the practice of medicine:
o Social consequences medicine has
o ‘–rapid technological progress poses complex dilemmas
 eg what do you do if parents refuse to allow brain dead child to be taken off the ventilator?
 Is it up to the parent? The potential limits of paternal autonomy.
 Is it okay to take an organ from someone who has ‘died’ but is breathing?
o Medical paternalism challenged, the principle of patient autonomy ascendant.
 Rise of patient autonomy.
 Used to be that doctors knew best. People aren’t as deferential - right to make decisions about
their medical treatment.
 Due to the internet-> WebMD etc- finding out what treatment they want etc.
o Might patients have duties too?
 Patients have a duty to follow advice- not to contribute to antibiotic resistant
 Not spreading false information e.g. antivaxxers
 Duty not to overuse healthcare services.
 Public/political accountability of the medical profession
o Helga Kuhse and Peter Singer
 There has been greater public awareness of the value-laden nature of medical decision-making, and a
critical questioning of the basis on which such decisions are made
 Bioethics goes beyond the scope of traditional medical ethics in several ways.
 Goal = not the development of, or adherence to a code or set of precepts, but a better
understanding of the issues
 Prepared to ask deep philosophical questions about the nature of ethics, the value of life, what
it is to be a person and the significance of being human
 Embraces issues of public policy
How do we make difficult ethical decisions?
- Bad ways to make decisions:
o The ‘yuck factor’:
 People just saying: ‘I just think its wrong’
 Need to be able to articulate a reason why it’s wrong
 Mark Sheehan
o The subjectivity of emotions means that they cannot function in arguments because,
unless they are universal, they cannot form the basis of a claim on another person
o Is this the ‘wisdom of repugnance’?
 Bioethicist - he thinks that this represents some deep inner wisdom [when we just think yuck] - says it
in the context of human cloning- we know its wrong because we just feel it
o Or ‘nasal reasoning’?
 Orwell- you sniff a problem and can tell what it is
o Is there a role for emotions?
 How we feel about something is always going to be a starting point- but we shouldn’t just leave it
there.