Thai Dictionary of Medical Ethics:New Clarity in Ethics

There are many words ethicists and the other people use that are part of our current medical ethics communication whose meanings are, well, unclear? disputed? needing of a more strict definition to prevent unnecessary ethical conflicts both in theory and practice. Well, what we have here may be a solution to the problem.

Steven Miles, MD,Professor of Medicine and Geriatrics,Center for Bioethics,University of Minnesota, while wandering around Bangkok..well, I don't have to describe it all myself since you can easily read the details below by Steve. The main point is that he had the academic curiosity and ethical interest to get a book he bought, A Thai Dictionary of Medical Ethics, translated from the Thai language into English. The difficulties in translation are also described below.

Well, Steve, knowing that the many ethicists participating on a bioethics listserv would find this dictionary a treasure, posted it recently on the listserv. I, too, was impressed by the directness, straigtforwardness and clarity of the definitions and thought this would be a great educational tool for the visitors to my blog. Therefore, with Steven Miles permission, I am doing just that. Thanks Steve. ..Maurice.
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A Thai Dictionary
of Medical Ethics

Translated by Steven Miles

Preface

Recently, after a twenty-hour flight to Bangkok, I found myself walking down a street and, seeing an interesting sign of the mortar and pestle, turning into an alley and then into a small durian-smelling herbal apothecary not far from Chonpatmongkuhnrai-kroenkapsukkahpongkongthaikrup University. A ceiling fan listlessly stirred the monsoon damp air. While perusing the curiosities, I spotted a small well-thumbed Thai dictionary of medical ethics terms that I was able to purchase for a few baht. On the way out the door, the grateful owner gave me a gift of a small plastic bag of some dried herbal powder which he assured me would give me even greater vigor.

The title page and original preface are missing. I do not know the publisher, intended audience, or compiler. The book, despite being well worn, appears to be recent. The author seems to have an imperfect command of idiomatic ethics.
At my hotel, I enlisted the help of a perplexed and inexplicably disappointed translator. Our incomplete ability to communicate in Thai-English was imperfectly bridged with pantomime in the style of classic Thai dance. I apologize for any translational errors that may have resulted however I did want to get this unusual medical ethics work to the audience it deserves.
S. Miles
Bangkok
Jan, 2007



A-C
Abortion n.
the most common and morally controversial procedure in the United States and therefore not discussed by medical ethics except when prefixed with sex selection-, reduction-, or late-term-, etc.

Advance directive n.
not an advanced directive.

Autonomy (respect for) n.
When added to dying, makes comfort food.

Best Interest Standard n.
A flag (often red except to color blind).

Comfort food n.
discussions about ethics of dying. Has not advanced since 1981 so it is readily prepared, served, recognized and digestible.

Confidentiality n.
the tiny residue of information that is left after the essential waivers are signed, databases are linked and lies are accepted.

Cross (Blue) n.
tranquility colored crucifix for afflicting the medically indigent. See Indigence (medical).

D-F
Dead adj.
like porn, common, hard to define, easy to recognize.

Decisionmaker (surrogate) n. a worry approved articulator of best interest or substituted judgment.

Difficult patient n.
generally, the voltage generated by the difference between an ill, fearful disabled person whose life and loved ones are at risk of being financially destroyed by a disease and the clinicians or worry that is discussing that person in a lounge or committee room.

Disability activist n.
A suspicious and inexplicably hostile group of outsiders.

DNAR n.
See DNR.

DNR n.
See DNAR.

Ethics committee n.
an officially recognized worry. See Worry.

Ethics n.
See Moral.

Ethics (clinical) n.
a doughy deep dish Chicago concoction distinguished from ‘medical ethics,’ a traditional Ameri-canized continental fare.

Fairness adj.
the disposition and coloration of most medical ethicists.

Forego v.
a gang spelling of forgo (like Yippie spelling of Amerika)

Futility n.
a siphon for removing puddles of water that form far ahead on highways on hot summer days.

G-I
Indigence (medical) adj.
the state of having an enhanced right to forego treatment.

Informed consent n.
1. a clinical ritual in which two parties with different knowledge and biases speak two languages to create the illusion of choice and a shield from legal action. 2. a form of self governance which, like Churchill’s democracy, is better than all the alternatives.

IRB n.
a specialized and officially recognized worry.

J-L
Jehovah’s Witness pn.
a stick figure in a comfort food forego treatment discussion—not to be confused with a person belonging to the Church of the Seventh Day Adventists.

Judgment (substituted) n.
like salt substitute.

Justice n.
too hard.

Kant pn.
German monolith believed to be an astronomic observatory. It is covered with arcane text that is as routinely cited as it is rarely read. The traverse of its shadow is reputed to reliably point in the right direction.

M-O
Malpractice v.
failing to act with the care and skill of an ordinary practitioner in similar circumstances; i.e. a physician, but not a medical ethicist, can commit malpractice.
Medical disparities n. see Justice.

Moral adj.
conforming to general and mutable standards of right. Having the quality of general expediency (Ambrose Bierce).

Nazi analogy n.
a slippery slope argument that is a high card or low card (like an ace in blackjack [and all slippery slope arguments] except that its point value is assigned by the opponent, not the person playing it.)

P-R
Placebo n.
a treatment of proven no value that is ethically distinguishable from widely used treatments of no proven value.

Principle n.
a right that is not attached to a body. See Right.

Privacy (right to) n.
principle to be respected by everyone except medical ethicists discussing Teri, Nancy, Ashley and Karen and their families.

PVS n.
a rare clinical condition which seems to mimic a Cartesian mind-body dualism and which therefore is of immense importance to medical ethicists at the Academy of Legado.

Right n.
a principle that is attached to a body. See Principle.

Research (corporate sponsored) n. an oxymoron that makes money for academic health centers.

S-U
Science n. [from scientia-to know]
1. a body of knowledge obtained by empirical observation, experimentation, and logical reasoning. 2. revealed truth. 3. a political narrative composed to win friends and influence people. 4. a triangulated midpoint between facts, native beliefs and aspirations, media gullibility, and political machinations.

Snowflake n.
a frozen baby, adoptable.

Stem cell n.
a totipotent cell that can really be anything it is perceived to be e.g., cell, baby, vulnerable citizen, or precursor to Brave New World or Fourth Reich.

Ted Williams pn
a frozen baseball player, nonadoptable.

Trans-human n.
contraction of transitional (outgoing) human, e.g., Barry Bonds, Michael Jackson, Pamela Anderson or less.

TRIPPS n.
see Justice.

Twins (Conjoined) n.
Human curiosities discussed by medical ethics for their scientific and ethics educational value.

Twins (Siamese) n.
Human curiosities exhibited by PT Barnum for their scientific and ethics value.

Ulysses Contract n.
a bondage fantasy.

Uninsured n.
a group of United States citizens that is 25 times more common than the group of dying persons and which receives 1/25 the amount of medical ethics attention. See Justice.

Universal health care n.
an ideal in United States usage; an imperfect working reality in other developed nations.

W-Z
Worry n.
a minion of medical ethicists (coined by Ruth Macklin)

Yuk factor n.
no apparent meaning, may be derived from yuck (an expression of disgust) or yuk (a Bronx laugh).