Bioethics
Bioethics
Bioethics
uestions
Is it OK to sell our body parts, such as one of our kidneys,
like we buy and sell our material possessions, our cars, or
our mobile phones?
Should the state force people to adopt healthy lifestyles?
Objectives
Medical Hospital
Nursing Staff Judges
Doctors Administrators
Public Health
Bioethicists Citizens
Policy Makers
History
In some respects, bioethics has a very long history. Concerns about how doctor
s treat their patients go back to ancient times, with ethical codes like the Hippo
cratic Oath setting ethical norms; and in the nineteenth and early twentieth ce
nturies, the rapid expansion of the biological sciences began to raise new questi
ons about the possibilities for human progress and the potential conflicts betwe
en science and religion.
Moral Wisdom
Bioethical issues can be approached by Moral Wisdom and to h
ave a good grasp of it, a person should be aware of various ethic
al theories, principles, religion, culture, and laws. In practical bi
oethics, a person’s moral choice sometimes becomes a decision
only by consultation: listening to doctor, nurses, guardians, bioe
thicists, etc. And sometimes the cases remain undecided and end
up in courts before judges.
Moral Theories
Deontological
Consequentialism Utilitarianism
Theory
Autonomy
Non-
maleficence
Beneficence
Justice
Religion
Culture and
Religion
Culture
Bioethics in Thailand
The doctrine of kamma holds that joys and sorrows are the result of one's own pas
t actions. Kamma must run its course or will be manifest in a future life.
Mercy-killing also violates the Buddhist psychology. A physician who kills subco
nsciously transfers his aversion to suffering to the one who embodies the suffering.
Buddhist justice is understood in terms of impartiality and equal treatment.
Compassion goes beyond justice to self-giving and self-denial. It is central to the
path to the attainment of highest human fulfillment.
Ethical Dilemmas
A CHOICE MUST BE MADE SIGNIFICANT CONSEQUENCES EACH OF THE TWO COURSES OF ETHICAL PRINCIPLES
BETWEEN TWO COURSES OF ARE ASSOCIATED WITH TAKING ACTION CAN BE SUPPORTED BY SUPPORTING THE UNCHOSEN
ACTION EITHER COURSE OF ACTION ONE OR MORE ETHICAL COURSE OF ACTION WILL BE
PRINCIPLES COMPROMISED
Ethical Dilemma Decision Making Process
Termination of
Assisted Organ
Pregnancy
Reproduction Transplantation
(Abortion)
Right To Life
Direct Abortion
Indirect Abortion
Case Study: Prenatal Diagnosis and Abortion
A 39-year-old Japanese woman, Naoko, who is in her 12th week pregnancy found her baby w
ith Down’s syndrome through the prenatal diagnosis. She was told by her doctor to decide if s
he still will give a birth or take an abortion. She has to make a decision by the 22nd week of h
er pregnancy when is the time limit, she can take an abortion. The doctor also explained that e
ven though she gives a birth, the baby would have a high risk of heart disease and may not liv
e long. Her husband is against to have the baby to hear that because he is afraid of raising a di
sabled-child and the discrimination by others to his other two children who are 7 and 4 years
old that they have a disabled sibling, while Naomi does not think about abortion at all speciall
y because she has experienced stillbirth 3 years before. Abortion with a reason of the baby’s d
isability or disease is illegal in Japan, however it is allowed to reasons as financial status and
physical condition of the mother. Overcoming the hard time of decision, they decided to have
a baby eventually. Unfortunately, the baby passed away 12 days after she was born for the hea
vy heart disease. However, Naoko felt more appreciation to her baby who was born by herself
even though she had heavy disease.
Assisted Reproduction
A baby could have five parents: the couple who ‘commission’ the child, but
do not provide either the eggs or the sperm (known collectively as gametes)
, the man and the woman who donate the gametes (and who may remain an
onymous) and the surrogate mother, in whom the embryo is placed and who
subsequently gives birth to the baby. Moreover, these techniques allow othe
r possibilities, such as a single woman becoming pregnant without having s
exual intercourse with the genetic father, a postmenopausal woman becomi
ng pregnant, using a donated embryo (and possibly being the surrogate mot
her for her own daughter), a female homosexual couple arranging the pregn
ancy of one partner, using donated sperm, and a male homosexual couple us
ing a surrogate mother to produce a child genetically related to one of them.
Questions: What Is the Family? How to make sure the welfare of the child?
Organ Transplantation
Ethical Issue: The extraction of stem cells from a three to five-day-old embr
yo, or the creation of a cloned embryo through SCNT, inevitably entails the u
se of embryos solely as a means to advance research or therapy, and also enta
ils the destruction of the embryo once the cells have been extracted.
To Treat or Not To Treat?
Medical Futility
Case:
At the other end of life, an elderly person who has lost mental capacity m
ay be admitted to hospital with a severe stroke and a number of other seri
ous medical conditions which will make their ability ever to recover and l
eave hospital extremely unlikely. If they suffer a heart attack, should the s
taff attempt to resuscitate the patient?
Active Euthanasia
Physician-Assisted
Suicide (PAS)
Case Study
A woman was diagnosed with motor neurone disease (the same disease tha
t Stephen Hawking had). This is a condition that destroys motor nerves, m
aking control of movement impossible, while the mind is virtually unaffec
ted. People with motor neurone disease normally die within 4 years of dia
gnosis from suffocation due to the inability of the inspiratory muscles to c
ontract. The woman's condition has steadily declined. She is not expected t
o live through the month and is worried about the pain that she will face in
her final hours. She asks her doctor to give her diamorphine for pain if she
begins to suffocate or choke. This will lessen her pain, but it will also hast
en her death. About a week later, she falls very ill, and is having trouble br
eathing.
Assignment