Medical Ethics I: the Beginning of Life

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Medical Ethics I the Beginning of Life

• Moral decision making related to medical research
  and practice

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Important Principles

• 1. Life is a gift of inestimable value
• All uses of technology must respect human life
• 2. Science and technology are valuable resources
• Can have positive effects on life
• Must be used to support human dignity and life

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• 3. Humans are a unity of body and spirit
• We are more than the sum total of our parts
• 4. What is technically possible is not for that
  very reason morally admissible
• Not every potential medical breakthrough
  necessarily serves humanity
• Advances must be measured in terms of respect for
  life

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Terms

• DNA
• The intricate interlocking chain of genetic
  material that makes up all living cells
• Artificial insemination
• Mechanically introducing a sperm to a uterus to
  facilitate fertilization
• Embryo
• A fertilized egg possessing a unique genetic
  makeup
• In Vitro
• Literally, in a glass
• An embryo that is placed in a womans uterus

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In Vitro Fertilization and Marriage

• Catholic view of marriage
• Unitive (love, connection) and procreative
  (creating life)
• Problems with IVF
• Separates the unitive and procreative
  characteristics of marriage
• Destruction of unused embryos - ending of human
  life
• Children understood as being gifts from God.

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Genetic Engineering

• Changing inherited characteristics by changing
  the makeup of a plant, animal, or person
  limiting to and prefering specific desirable
  physical or psychological traits.
• Eugenics (from Greek well born a program
  that tries to steer human reproduction in a
  specific direction. Restricting immigration from
  places other than Europe (1907-1937) in fear of
  contaminating the American gene pool. Climax
  Holocaust.

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Cloning

• Cloning - creating a plant, animal, or person
  asexually. They is genetically identical with a
  donor plant, animal, or person.
• There are two major types of cloning
  reproductive and therapeutic

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Reproductive/ therapeutic cloning

• Reproductive
• 1) Genetic material transferred from a donor
  adult cell to an egg whose nucleus has been
  removed
• 2) The reconstructed egg which contains the DNA
  must be treated with chemicals in order to
  stimulate cell division
• 3) Then it is transferred to the uterus of a
  female host where it develops until birth
  (Dolly).
• Therapeutic - is the production of a human
  embryo for the use in stem cell research.

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Abortion

• Abortion
• The spontaneous or induced expulsion of a fetus
  from the womb.
• Dealing with those that are caused / not
  miscarriages
• Roe vs. Wade (1973)
• Supreme Court allows women to choose whether or
  not to have an abortion
• Rights of woman over rights of unborn child

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Church Teaching

• Human life must be respected and protected
  absolutely from conception.
• Key points
• A new and distinct human life begins at the
  moment of conception
• Respect for life at all times in all situations
• Even in cases of rape or presumed disorders
• The right to life outweighs any others rights

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Abortion Arguments

• Pro-life
• Human beings are required to respect their bodies
• Life begins at the moment of conception
• All life is sacred
• Unborn have a right to be born
• It is wrong to kill an innocent human being and
  wrong to legalize an action that is immoral

• Pro-choice
• Human beings are free to do whatever they think
  is right
• It is unclear when life actually begins
• Quality of life is more important than life
• A woman has a right to determine what happens to
  her body
• It is wrong to put ones moral position into law

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Culture of Death

• The basis of human life is not the sacredness of
  life and human dignity, but is the ability to get
  what we want
• People have the right to more than they need,
  even as poverty causes death for others

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Culture of Death (2)

• People who cause a burden to others as less
  worthy of life
• The quality of a life as the only measure of
  whether it is worth living
• Euthanasia ? the intentional killing of someone
  whose life is deemed no longer worth living

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Culture of Life

• We are images of God more than our physical
  bodies
• Being fully alive means reflecting God by loving
  God and one another
• Calls people to share what they have with others

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Culture of Life (2)

• Views all people as gifts of God, even those who
  require extra care
• Sees life as worth living even if it involves
  suffering
• Respects and fosters the dignity of each person
  as being created imago dei.

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• Medical Ethics II
• Moral Issues Near the End of Life

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Pain and Suffering

• One of the great, enduring questions Why do we
  feel pain and suffer? Important question.
• Reality no one is free from either is
  widespread and common

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Jesus and Suffering

• 3 belief statements
• Suffering does not separate us from God. God
  cares about our suffering.
• God does not let us face our suffering alone.
  God is always with us, lightening our burdens and
  giving us sufficient strength.
• Suffering IS NOT THE END. It need not destroy us
  or defeat the possibility of eternal happiness
  in Gods kingdom.

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Euthanasia

• Deliberately taking steps to bring about a
  persons death for the purpose of eliminating
  suffering

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U.S. Bishops Statement on Euthanasia (1980)

• In modern society, in which even the fundamental
  values of human life are often called into
  question, cultural change exercises an influence
  upon the way of looking at suffering and death
  moreover, medicine has increased its capacity to
  cure and to prolong life in particular
  circumstances, which sometime give rise to moral
  problems.

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U.S. Bishops Statement on Euthanasia (1980)

• Thus people living in this situation experience
  no little anxiety about the meaning of advanced
  old age and death. They also begin to wonder
  whether they have the right to obtain for
  themselves or their fellowmen an "easy death,"
  which would shorten suffering and which seems to
  them more in harmony with human dignity.

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Euthanasia (cont)

• Two types
• Direct (Active) / Indirect (Passive)
• Direct Euthanasia
• Involves taking deliberate steps to end the life
  of a suffering and incurably ill person

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• Indirect Euthanasia
• Deliberately not taking steps to prevent a sick
  persons death, precisely with the desire and
  intention that this withholding will lead to or
  cause death
• All forms of Euthanasia are immoral
• Violate Human Dignity and the value of life

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Physician-Assisted Suicide

• Physician-Assisted Suicide
• Closely related to Euthanasia
• A person who is incurably ill killing him/herself
  with the help of a physician

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• Seemingly positive motivation
• Reducing suffering (patients and familys) by
  ending life
• Immoral action
• Violates human dignity
• John Paul II false mercy
• Loss of hope

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Allowing Death to Occur

• Involves withholding or withdrawing useless or
  disproportionately burdensome treatment, thus
  allowing to die from the fatal disease or
  condition
• Key difference from Euthanasia
• The intention of the action must be considered
  it is not that one wills death to occur, but that
  one accepts the fact that death cant be
  prevented

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Right to Die Principles

• 1. Death is imminent
• 2. Illness is irreversible
• 3. All ordinary means are exhausted
• 4. The person is at peace with God
• 5. Excessive burden on the family.

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• Ordinary means of life support
• Medical procedures that offer sufficient or
  reasonable benefits without excessive or undue
  burdens to the patient or family (food, drink,
  medication, medical procedures)
• Extraordinary means of life support
• Medical procedures that offer little hope of
  benefits or which cause undue or excessive
  burdens to the patient or family

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Living Will

• A legal document in which people make known their
  wishes about what medical or health care
  treatment that would or would not want if they
  became seriously ill.
• Usually expresses a persons wish not to receive
  extraordinary means of life support
• Potential problem ? not all situations addressed
  and no one named to make decisions

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Care for the Dying

• How do we, as Christians, care for the terminally
  ill, especially those with intense suffering?
• Respect for human dignity
• Must always reassure the individual of their
  holiness as a child of God

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• Practically face end of life issues
• Living Will
• A declaration that a competent adult makes
  identifying the medical care desired if s/he
  becomes incapacitated
• Durable Power of Attorney (Designated Decision
  Maker)
• Someone appointed to make medical decisions for a
  person who is incapacitated

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Hospice

• Hospice
• An intense, multi-faceted, spiritually based
  approach to assisting people through the dying
  process
• Does not try to either hasten or postpone death
• Attempts to help the patient live last days/weeks
  as comfortably and fully as possible