Your Wisdom vs Conventional Wisdom in Medical Ethics: Speak Up!

I have repeatedly stated on this blog that I felt that those who visit here and even those who don't all have views of medical ethics which when expressed are as valuable to consider as those presented by bioethicists. With that in mind, I am eager to present on my blog an exercise to discover what my visitors think about a number of "settled" issues in medical ethics which represent the "norms" or "conventional wisdom" and which physicians use as the guideposts for the management of their patients. There is also "conventional wisdom" markers for medical researchers and the overseeing Institutional Review Boards (IRB).

Franklin C. Miller and Robert D. Truog, writing in the July 2008 issue of the American Journal of Bioethics "An Apology for Socratic Bioethics" discuss the issue whether bioethicists should always go along with the "conventional wisdom" guideposts, often bearing practical values in medical ethics, but instead challenge the norms with a more philosophic analysis of the issues. The authors do suggest that this sort of challenge might end up degrading those practical benefits to the patients.

Here is the exercise. I have extracted from the article a list of examples of medical ethics "conventional wisdom" statements which are recognized and considered by physicians and researchers. Take one or more of them and let us know whether you approve of this medical ethical norm or whether your wisdom suggests something different. I look forward toward your responses. ..Maurice.

About Death and Dying

A. There is no valid ethical distinction between withholding and withdrawing life-sustaining treatment.

B. Intentionally causing death (killing) is wrong; letting patients die is permissible.

C. It is unethical to deliberately hasten death but permissible to provide palliative treatment that risks hastening death under the doctrine of "double effect".

D. Brain death equals death.

E. The removal of vital organs should never be the proximate cause of death of an organ donor. ("Dead Donor Rule")

Research Ethics

F. No patient should be randomized to a treatment known to be inferior (clinical equipoise)

G. Financial payments to research participants are morally suspect because they may be "coercive" or consitute "undue inducement."

H. Financial payment to research subjects is not a benefit to be counted in risk-benefit assessment by IRBs.