Bioethics Discussion Blog: Ethicists Ethicizing In Public About A Specific Case: Should They?

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Tuesday, March 25, 2008

Ethicists Ethicizing In Public About A Specific Case: Should They?

I received the following e-mail today which I thought raised an important topic about ethics discussion. I have deleted those portions of the e-mail that might in any way identify the writer.

Hi Dr. Bernstein,

I'm a newspaper reporter in [state name deleted]. I ran across your blog and this page while researching a story (specifically, I googled bioethics and withholding medical treatment, and your post of Dec. 10, 2005 popped up.)

We're working on a story about the death of an 11-year-old girl (reportedly of [named disease deleted]) after her parents chose prayer over medical treatment. I'm looking for people well-versed in bioethics who can talk about that decision.

If you would be willing to share your expertise, I would be grateful. I can be reached at [phone number deleted], or on my cell phone at [phone number deleted].

Kindest regards,
[first name deleted]


I wrote back the following which I think covers my view of the subject satisfactorily but are there some aspects of my argument that you find wrong or incomplete? ..Maurice.

[first name deleted], here is the problem I think that all "bioethicists" who speak in the public media should recognize before speaking as requested about a specific case: the full facts are unknown and perhaps unavailable and any comment about the ethics of a specific case is thereby faulty. The facts are essential basis for an ethical decision regarding some action. Each case is different from another and that is why our hospital ethics committee, in consultation, for example, may spend an hour or more with the stakeholders involved in the case-- to get all the facts including the viewpoints of each of them. Now, you may argue that what you are interested in is only my opinion regarding the general issue of the ethics of prayer vs medical treatment for a child. I might be able to do that but your writing of my opinion will still be in the context of the specific [state name deleted] case. And this is the concern amongst bioethicists about the broadcasting opinions to the public by their colleagues or in fact by anyone not closely involved in the case. The Terry Schiavo case would be a relatively recent example of public statements made by ethicists and other "important people" without full knowledge and understanding of all the facts. One other point, telephone conversations with the ethicist may lead to misinterpretations of the comments of either party and misspeaking. Written communication allows time to consider nuances in the questions and responses to be more objectively and effectively handled. Sorry..but good luck. ..Maurice.

p.s.- By the way, the issue of bioethicists speaking to the public about a case might be a good topic for an article. If so, you may use my comments above.

6 Comments:

At Thursday, March 27, 2008 8:12:00 PM, Anonymous 1st year md student said...

I guess I would see this issue in a much broader sense. Most professions have issues dealing with the public. For starters the professional's entire education and experience is being consolidated into a single quote, additionally an extra burden is that the media tends not to cover hypothetical situations but instead focuses on actual cases, while finally the cases themselves are still then factually paraphrased. Ethicists are fortunately part of society and just like judges or scientists communicating with the public in their own forums is treacherous but still very necessary.

I would also have to say that sadly the other side in most of these situations has no reservations about adding in their own opinion while the addition of the ethicist might improve the quality of the discussion. What about if the ethicist only helps guide the discussion? By perhaps contributing questions or a framework by which the public can themselves discuss whatever incident. Such questions in said case of prayer over medical treatment might include. "Wouldn't it depend on how likely successful the medical treatment would be?" "Why should the patient only have to pick one?"Is this decision more the opinion of the patient or of the parent's?" Such additions would certainly help society much more then simple " Bioethicist Doctor Doe MD PHD says that choosing prayer over medicine is wrong" but also I would say they help more then completely staying out of the media coverage on specific cases, incidents that could be used to foster wide spread debate around things we tend not to think about.

 
At Thursday, March 27, 2008 8:50:00 PM, Blogger Maurice Bernstein, M.D. said...

I fully agree. As I suggested, the ethicist should tackle for public consumption ethical issues which have rational arguments on both sides such as "the general issue of the ethics of prayer vs medical treatment." They should educate the public about the various ways an ethical conflict can present itself and then the principles one can use to come to some conclusion. They can also educate the public about the consensus amongst ethicists, if present, concerning the conflict. And in addition educate also about the legal ramifications. My view is that ethicists should stay away from commenting about specific cases which they are not themselves intimately knowledgable.
..Maurice.

 
At Sunday, March 30, 2008 9:01:00 PM, Blogger LisaMarie said...

C'mon...don't be a wimp! You could be just like that "Ask the Ethicist" guy in the New York Times, opining on any and all subjects! You just have to do like he does, and move past that feeling that there might be subjects about which you don't actually possess godlike knowledge. That, and lose your hangups about "ethics" being some kind of body of knowledge that implies a systematic way of thinking about important questions (such pedestrian ideas don't hold him back). He'd be all over this question. I bet the NYT pays better than blogging, too. I look forward to "Ask Dr. Mo"!

 
At Sunday, March 30, 2008 9:27:00 PM, Blogger Maurice Bernstein, M.D. said...

LisaMarie, I have never really believed that an ethicist (whatever that is) can claim to be the knowall of ethics. I have felt that ethics is a "pedestrian" subject itself which unlike the skills required by a brain surgeon to perform brain surgery, the everyday pedestrian can produce a rational explanation or decision in an ethical issue. What I am against is anyone without all the pertinent facts to make conclusions about the ethics involved in any specific case. That to me is a "no no".

Sure, if a news resource wants me to pontificate on a general topic with some reward, I would seriously consider it. But, as I indicated in the text of the posting, if it was in the context of a specific case, I would refuse. ..Maurice.

 
At Saturday, April 05, 2008 1:26:00 PM, Anonymous Anonymous said...

A bigger question to ask is what does it mean for something to be in the "public" realm versus "private". This is a digital age where any information can be digitally recorded (image, voice, text)uploaded to the web and exist indefinately in the internet cloud. These private details can easily be released on a blog or youtube and then be considered public.

This is especially a problem in the legal world with "gag orders"
as anyone can travel to another juristicition and using the international internet get the information from another country who won't have the ban.
Details of this patient's case may have already been circulating on the web before any newspaper got any information whatsoever.

I have seen many physicians post details of someones intimate examination that alhough may be anonymously made, I cannot feel that the patient would of been outraged had they known those details were posted on the web albeit anonymously.


TS

 
At Saturday, April 05, 2008 2:06:00 PM, Blogger Maurice Bernstein, M.D. said...

I would question any decision by an ethicist about a specific case if the ethicist did not know all the facts of the case in any disclosure either public or private. Even, coming to a conclusion intellectually even without any eventual public or private expression would not be the way ethical conclusions about a case should be made. ..Maurice.

 

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