WHAT DO YOU THINK ABOUT ETHICS, BIOETHICS, MEDICAL ETHICS, ETHICISTS AND HOSPITAL ETHICS COMMITTEES?
As of this date, this blog has been up for 5 1/2 years and contains over 750 threads on ethical issues. And you, the visitor, may have been to this blog previously or this may be the first time that you came. Why did you come in the first place? Was it to learn about bioethics in general or specifically to follow up on some topic which interested or challenged you? And what do you know and understand and think about ethics, bioethics, medical ethics, ethicists and hospital ethics committees?
Do we need ethics when most countries have laws which may trump any consensus of the society as to what is ethical and what is not? Anyway, if we do have ethics and some moral consensus in certain areas, who really are the ones to set those moral boundaries? Is the people or should it be the philosophers or other professionals or even those who call themselves ethicists? And who are ethicists and what do they do or what are they supposed to be doing? What makes it our responsibility to make sure that we stay within those boundaries? Have you heard about ethical issues in medicine? what do you think about them? Do you think that those working in the medical profession are ethical? And has anyone ever talked to you about hospital ethics committees and what they do and what they do not do. Do you believe that hospital ethics committees are the "death panels" that are frequently talked about these days? Do you think that ethics is too much about death and dying and not about living a good life? Can you have a good life and still be ethical?
Many questions and there are many more, but I would most appreciate knowing what you think and asking me what you would like to know. I'll try to explain what I know. ..Maurice.
posted by Maurice Bernstein, M.D. @ 12:23:00 PM
6 comments
6 Comments:
I've just stumbled upon, literally instead of the web widgetry, your blog after an auto tweet of the news feed. Great topic!
Ethics are critical. There are ways to achieve agreement through facilitated discussion and consensus. It is the process to determine them that is challenged by prejudice and omission.
Challenging choices are tough. Where common sense is bereft, making sense common is the solution and can be achieved through spirited dialog crafted by a skilled facilitator that engages participation.
In these times it seems that life-friendly decisions are what makes sense. What are those? How far down the rabbit hole do we need to go to truly be considerate and nurturing? There have been disastrous results from poor choices to date. Of that, I believe we can agree. But, that isn't NOW and NOW is a very powerful place to BE.
What do you think are the best practices of ethical consensus building foundations? Every question has an answer. How do we learn how to ask the best, or least better ones?
What would you recommend as a process to engage and keep things in a 'what is' perspective to prevent having our relationships crashing in a tidal wave from the ocean of emotion?
Can we garner answers, or even questions, by being still for a moment with proper intent? Or do you see a more assertive process?
Would love your input.
Namaste,
Zen
I do believe we need ethics, and ethics committees, because we have moved a long way from what families and communities once experienced in the arena of life and death choices. The advent of life-extending abilities of the medical profession and the machinery that helps them to extend life, along with people's unwillingness to explore their own feelings and beliefs--often leaves it up to professionals to make such decisions. I don't think this is ideal, to say the least. To this end I wrote Facing the Final Mystery: A Guide to Discussing End-of-Life issues, to encourage the conversations between family members and their doctors and clergy, hopefully before a crisis occurs. It is a hard sell--people don't want to talk about death and dying, and yet doing so, in my opinion brings a deeper level of richness to our daily lives and how we related to one another. Laura Larsen RN
Hello Maurice: I am troubled, especially lately, about the word consensus. I do not view moral boundaries as properly being set by consensus views - which is what the Obama administration seem to be supportive. Medical ethical philosophy, it seems to me,varies widely with medical ethics in a clinical setting, at the bedside, and interpreted and applied in a matter of moments - not in essays. The present administration has named Amy Gutmann as chair of the Presidents Committee on Bioethics. She is not a bioethicist. She is a cheerleader for "deliberative democracy." Selected as bioethicists at NIH is Ezequiel Emanuel, not a bioethicists really but an economic philosopher seeking to establish an economic agenda to choosing who will receive basic medical care.
So, Bioethics, now more than ever, is the foundation for protection both of the physician and the patient to ensure that medical ethics is the basis for medical decision making. ( and it is the task of the application of the principles of American Jurisprudence which must inform the protections afforded to individuals.
That's my take on some of the questions you have raised. All the best Bernard
Bluesky,yet certain groups are talking about "death panels" and many patients and families are demanding treatments from their doctors which are futile under the circumstances or even prolong suffering while "looking for a miracle" and yet causing a limitation of financial and other resources for others who could benefit. This means that the population is not ready to accept that there is something called "end of life" which must be rationally managed as one should do in their lives even before the end. Or maybe the problem is that most people, except their doctors [and their doctors won't and don't tell them!], don't know where the "end begins". ..Maurice.
Bernard, good points. This is a big change under Obama from the Bush administration where more broader ethical thinking was rather restricted and limited to certain highly conservative views set by some professional ethicists. It's most interesting how politics can weave its way into ethical thinking from both sides of the political spectrum.
But is there any such thing as societal ethics without politics? ..Maurice.
Zen, sorry for the delay in publishing and responding but like so many errors in the web widgetry what you wrote and what Blogger.com sent to me for my moderation unintentionally ended up in my Spam folder and it almost got thrown out.
This might tell something profound about how the computer system itself is handling and analyzing communication about ethical issues.
I think that the way the public should be presented ethical issues is the way my hospital ethics committee works when we do our consultations regarding a clinical ethical dilemma. We don't provide the stakeholders with our decision of what is the best ethics but we try to educate them regarding the ethical possibilities and the law and proceed to mediate their own discussion leading to a conclusion.
Maybe that is how ethics should be presented to the general public..educate and mediate but the public as stakeholders should make their own decisions.
I am not sure that ethicists are really doing that these days. They may go on TV or other media and make pronouncements about an ethical issue but there is more for the public to make ethical decisions than hearing the personal pronouncement of an ethicist, isn't there? I think it is all about education and mediation. But that is my pronouncement. ..Maurice.
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