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The Southern Cross, Page 8
Falttlh AH?e!
Thursday, April 5, 2001
This whole “new world” of bioethics
By Father Kevin W. Wildes, SJ
Catholic News Service
.Ln the past 40 years a new world
has emerged into American conscious
ness: “bioethics.”
Forty years ago, if the term was
used, it usually referred to issues in
what we now call “environmental eth
ics.” But over time “bioethics” has
come to be identified with many of the
great moral controversies of our day
in medicine and health care: abortion,
health care institutions such as hospi
tals. With these ancient reflections on
medicine and ethics, why would the
new field of bioethics emerge?
■ ■ ■
The first reason is obvious, but we
often fail to reflect on the obvious. For
most of its history medicine sought to
give comfort and relief but could really
do little for patients. If patients were
cured it was thought to be by divine
intervention. However, in the modern
age the development of our knowledge
of the body and its functions has given
tients while lowering the risks in try
ing to discover the problems.
Medicine today has an array of
choices in diagnosing and treating pa
tients.
This increase in our knowledge and
ability to treat patients is a major
factor in the development of bioethics.
But how to apply this knowledge in
the patient’s best interest becomes a
question here.
The older, traditional medical eth
ics was a paternalistic ethic relying on
the physician’s judgment. In the
with differing views to cooperate. Bio
ethics has tried to find common
ground on many questions. One ex
ample are the difficult questions^
around treatment at the end of life.
The field has helped to establish proce
dures, such as advance directives, re
garding treatment in such difficult
situations.
The third reason the field of bioeth
ics emerged is related to this need for
cooperation. Within American life
there often are sharp differences of
opinion about what is or is not morally^
appropriate. In most cases we simply™
get along. But medicine and health
care are different.
First, the substance of many medi
cal interventions involves moral judg
ments. What we should do at the end >
of life or how we should think about
reproduction are not just scientific
questions. They are moral ones too.
Birth, sexuality, family, suffering
[ of us are citizens. We need to be
involved in the national and local
discussions about medicine and
health care policy. Issues like
physician-assisted suicide or cloning
will involve national debate. That
debate will need well-informed,
thoughtful voices.” >
CNS photo from Routers
end-of-life decision making, physician-
assisted suicide, cloning and issues in
health care policy and economics, to
mention but a few.
How and why did this field develop?
There is a long history of interplay
between medicine, philosophy, theol
ogy and ethics. Catholic thinkers for
centuries have been concerned about
the ethical practice of medicine. There
are extensive reflections on the obliga
tions of physicians, patients and
F00DF0RTH0UGHT
us a basis on which to intervene and
change the “natural” course of dis
eases and illness.
Over the last 40 years we have seen
a revolution in medical interventions
— from surgical procedures, such as
bypass surgery, to medical interven
tions such as drugs that lower choles
terol. Our ability to diagnose patients
through imaging technologies such as
CT scans and MRIs has increased our
knowledge of what is wrong with pa-
These days it’s important for nonscientists to “keep on trucking” —
always to keep digesting a little more about science.
Still, just when you thought you finally were ready to write 25 words
(or less) on the meaning of “in vitro” fertilization, along comes a daily
newspaper attempting to inform you exactly how cloning works. Then you
hear a detailed report on the human genome project — and all the while
you’re still trying to remember what “DNA” stands for!
Still, science isn’t just for scientists anymore.
The works of modern science enter into the areas of human
reproduction, medical healing and how people die, for example. We’re left
to ask whether what we are able to do is always what we ought to do.
But there’s more. Scientific investigations into the human body’s basic
makeup get people talking about what it means to be human.
No wonder people say that scientists and nonscientists need to
converse with each other. At stake is not only what people do, how they
behave, but who they believe they are and, ultimately, what they believe
their lives are for.
16 David Gibson, Editor, Faith Alive!
Hippocratic Oath the physician
swears to act in the best interest of the
patient according to the physician’s
judgment.
Is this the patient’s best interest
medically speaking or the patient’s
best interest overall?
While physicians may have strong
views on what is in the patient’s best
interest, the physician is concerned
about the medical best interest of the
patient. The patient must judge what
is in his or her overall best interest.
So, while it may be in my “medical”
best interest to undergo chemo
therapy for cancer, I might judge that
it is in my “overall” best interest to
forego the treatment, complete some
projects, make my peace with God and
my family so that I may have a good
death.
■ ■ ■
The differences of opinion about
what is the best thing to do highlights
a second element that has contributed
to the development of bioethics: moral
pluralism.
In recent years we have become
more aware of the diversity of moral
and cultural views that exists within
secular society. These differences are
certainly evident in medicine and
health care.
Bioethics has emerged as a field
that seeks ways for men and women
and death are all part of health care,
and all are seen within moral frame
works and values.
Second, not only does medicine
touch some of the most important mo
ments in our moral self-understand
ing, but it requires an immense infra
structure. Contemporary medicine in
volves not only the physician and pa-£
tient, but all kinds of health care pro
fessionals, insurers, employers and
society.
So, we need to find ways that men
and women with different moral views
can work together.
■ ■ ■
Why should the ordinary person be
interested in these questions?
First, almost all of us will be&
touched directly or indirectly by the^
powers of modern medical technology.
Either as patients or decision makers
for others, we all will encounter some
of these questions and issues.
Second, all of us are citizens. We
need to be involved in the national and
local discussions about medicine and
health care policy. Issues like physi
cian-assisted suicide or cloning will
involve national debate. That debate
will need well-informed, thoughtful^
voices. ™
(Jesuit Father Wildes is a senior
scholar at the Kennedy Institute oj
Ethics at Georgetown University.)
All contents copyrightO2001 by CNS