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Development. 2006 Mar; 49(1):18-22.Marsha J. Tyson Darling reflects on the issues she explored in her plenary commentary at the AWID Forum. She brings to the fore the unprecedented challenges posed by the emergence of rapidly developing and largely unregulated new reproductive and genetic biotechnologies. (author's)
[Washington, D.C.], NARAL Pro-Choice America Foundation, 2003 Jan 21. 8 p.Refusal clauses (sometimes called “conscience” clauses) permit a broad range of individuals and institutions — including hospitals, hospital employees, health care providers, employers, and insurers — to refuse to provide, pay, counsel or even refer for medical treatment based on their moral or religious views. (excerpt)
Amherst, New York, Prometheus Books, 1998. 334 p.The author of this book posits that humans are not acting responsibly towards "planet-imperiling" circumstances because of failure to take knowledge seriously enough to act. Seriousness of purpose and informed perception requires an examination of how humans evolved as a species, the social structures of humans, and ethical views that divide humans from nature. The author points out the incongruity of short-term public focus on, for instance, the survival of 3 whales trapped under ice in 1988, while 200 whales were commercially slaughtered without any public outcry. Regardless of the 1988 moratorium on hunting whales, Norway, Iceland, and Japan (for scientific purposes) continued hunting whales. The propensity to ignore harmful practices dates back to the first recorded history of poor farming methods that led to soil degradation and ruined irrigation systems in Mesopotamia. Rachel Carson's early warnings about the danger of pesticides for wildlife were ridiculed. People complain about welfare recipients' immediately spending the proceeds of their welfare checks, while ignoring their own wasteful consumption patterns. Current problems are so severe that nature is not able to correct human error. The author as professional architect believes that city planners and builders can bring about meaningful social change to improve the planet. The aim of this book is to stimulate interest in the limitations of human intelligence, the ethics and beliefs in modern societies, social organizations and government, and solutions. The key is a broad education about what happens when government fails, and the shallowness of materialistic status symbols. Trivia obscures real issues.
[Ending life by medical means. Different attitudes among physicians than in the general population?] Medisinsk avslutning av liv. Er legenes holdninger forskjellige fra befolkningens?
TIDSSKRIFT FOR DEN NORSKE LAEGEFORENING. 1997 Mar 20; 117(8):1135-7.The paper presents the Norwegian population's attitude to euthanasia and to legal abortion in 1982, 1990 and 1995, and compares the responses given in 1995 with the attitudes of a representative sample of 1260 Norwegian physicians. The acceptance of legal abortion by the population seems to have remained constant, while the population's attitude towards euthanasia has become more liberal. Social criteria and a potential handicapped baby were less accepted as causes for abortion in 1995 than in 1990. The physicians are more liberal towards abortion and more skeptical towards euthanasia. The physicians are more reluctant, however, to accept a potential handicapped offspring as a reason for abortion. (author's) (summaries in ENG, NOR)
INTERNATIONAL MIGRATION REVIEW. 1996 Spring; 30(1):171-97.This paper examines the debate as to whether migration is a basic human right or if the claims of outsiders are superseded by the principle of national sovereignty--the moral obligation of states to do the best for their own citizens. In evaluating migration and refugees it focuses on issues of open borders, migration selectivity, the capacity of sovereign states to control entry, the claims of refugees, the relationship between sovereignty and justifiable intervention, and the role of public opinion and morals throughout migration policies. (EXCERPT)
HASTINGS CENTER REPORT. 1990 Jul-Aug; 20(4 Suppl):10-4.In the US religious groups have been active in voicing their bioethical concerns in the public discourse. The Roman Catholic Church and religiously motivated anti-abortion activists have been quite visible in the public discussion of issues ranging from abortion, infertility therapies, withdrawal of artificial nutrition, and direct euthanasia. While some might object to such particularistic groups having a voice in our pluralistic society, their legitimacy comes not from their religious origins, but from their moral convictions. The bioethical literature is full of opinions written from particular religious points of views, but rarely are these opinions grounded in appeals to particular religious beliefs. Rather they are grounded in particular moral convictions that may have originated from religious beliefs. Nonreligious moral convictions have their origins outside of religion, but in the literature it is often impossible to tell them apart. Directly religious appeals are rarely used in the literature since their scope would be limited only to those who shared a common religious belief. Instead, the opinions are grounded in substantive moral principles. It must be understood that theological contributions to bioethics overlap and coincide with philosophical ones more than they conflict. Based on a commitment of openness and dialogue, bioethics provides a forum for people with many different inspirations for their moral convictions to discuss the relevant issues. Theology must play a role in bioethics if only to clarify the issues for the religious community itself. And, since the inspiration and motivation for people's moral convictions can be either religious or not, theology need not be excluded from the public dialogue.
In: Hormones and sexual factors in human cancer aetiology, edited by J.P. Wolff, J.S. Scott. Amsterdam, Netherlands, Elsevier Science Publishers, 1984. 183-90. (International Congress Series 650; ECP Symposium 1)In light of news reports linking the pill to cancer, the author discusses the role of the media in reporting possible dangers associated with oral contraceptive (OC) use. On October 22, the Lancet published 2 studies linking breast cancer and cancer of the cervix with OC use. The newspaper also printed an editorial which said that the drive to end unwanted pregnancies often ignores safety concerns over the pill. Despite these reports, the public reacted calmly, and women did not rush to the doctor to seek a new contraceptive method. But in other occasions, notably in 1969, reports of possible harmful side effects of pill did stir anxiety among millions of women. The information, which had been leaked to the press, had not yet reached physicians, and they found themselves besieged by oral contraceptives users. Although noting that not all stories concerning OCs are sensationalist or irresponsible, the author explains such a story is highly prized by news editors for several reasons: it deals with sex; it reveals a hidden danger in something otherwise thought to be safe; and it attributes guilt to someone (in this case, the pharmaceutical industry). Furthermore, as part of their guiding philosophy, journalists seek to bring an issue to the attention of the public, which is supposed to serve as a jury in rendering an opinion. In doing so, the media treats complex scientific issues too simplistically. Yet despite the evidence attesting to the pill's side effects, its use has continued, which suggests that the public has already assessed its risks objectively.
MEDICINE AND LAW. 1989 Jan; 7(5):483-503.South African law, as many other law systems do, has exercised a strong measure of control over the fertility of its citizens via the sanction of illegitimacy and the prohibition of marriage (and thus legitimate children) between certain individuals (those who are among the prohibited). Until last year, when the Mixed Marriages Act was abolished, marriage across the color line was prohibited in South Africa. The requirement of a valid consent by both prospective spouses in order to enter into the marriage further excludes certain categories of people from procreating legitimate children (the insane, the mentally feeble), while the requirement of consummation will exclude certain categories of paraplegics from solemnizing a valid marriage. Age restrictions on marriages and the requirements of parental consent for minors are further factors limiting the individual's freedom to procreate. These restrictions have a well-established historical basis extending over a long period of time. They can be categorized as attempting to preserve the family unit. The above provisions were formulated at a time when the law never contemplated the amazing advances in human biology which have produced conception artificially; e.g., AID, IVF, and surrogacy. The legislature, both in South Africa and elsewhere, adopted a neutral approach to this fertility revolution at first and watched the legal system struggle to adapt outmoded principles to the new technology. Legislation relating to AID and IVF eventually appeared in many jurisdictions and as a result of its delayed introduction, public opinion has now been educated to accept these new techniques and the legislation looks favorably on these new techniques. This is not the case insofar as surrogacy is concerned. South Africa, England, and Australia have produced essentially negative legislation. Certain American states, however, have adopted progressive legislation which acknowledges and accepts surrogacy. The merits of this are discussed and it is felt that it should be condoned by the South African legislature under certain conditions, as it can now be considered as furthering the interests of the family unit. (author's modified)
[The unclear status of the fetus is an ethical dilemma. Neonatal care can save the fetus when abortion is still legally possible] Fostrets oklara status ett etiskt dilemma. Neonatalvard raddar foster vid abortgransen.
LAKARTIDNINGEN. 1990 May 9; 87(19):1689-90.A striking situation occasionally occurs in Swedish hospitals: a fetus survives late abortion and then all available intensive care resources are employed to keep it alive. The law permits free abortion through the 18th week of pregnancy, but with permission from the social service authorities, the limit for abortion can be stretched to the end of the 22nd week. At the same time it is possible to save the life of a premature birth down to the 23rd or 24th week. The development of a neonatal advanced care is based upon the assumption that it is desirable to save the life of a human fetus no matter how young it may be. At the same time, legislation which legitimizes free abortion up to a certain period of time expresses the view that the life of the fetus up through that time possesses little or no real value. A recent report by a government commission on the individuality of the pregnant woman and the fetus should have dealt with this ambivalence but did not. One possible way out of this dilemma is for society to take an active role in offering the woman economic compensation for bearing the child to term with a view toward giving it up for adoption. The commission's report compromised in not presenting this alternative as an official suggestion because it is too unpopular politically. The result is that tens of thousands of humans in Sweden every year are denied a chance for normal life because the public allows itself to be represented by politicians who lack the courage or the insight to accept the moral consequences of this decision.
In: The patient as partner. A theory of human-experimentation ethics [by] Robert M. Veatch. Bloomington, Indiana, Indiana University Press, 1987. 36-65.The principle of autonomy as the foundation for informed consent is characterized in this chapter dealing with the ethics governing human-subject research. The implications for public policy of 3 theories of informed consent are discussed. The 1st theory of informed consent is the patient-benefit theory, which has its roots in the Hippocratic tradition. This casts doubt on the adequacy of patient-benefit grounds for informed consent, considering that it would eliminate all experiments unrelated to therapeutic intervention. Its implications for public policy, founded as it is on the ethical principles of a private group, should be minimal. The social-benefit theory of informed consent is grounded in the principles of utilitarianism--the greatest good for the greatest number. This theory allows for non-therapeutic intervention, but conflicts with the individual's right to informed consent by its insistence that only in cases where consent facilitates the research is consent necessary. This can lead to large-scale abuses, as evidenced by the Nazi experiments in the 1940s. The 3rd theory of informed consent is the self-determination theory, based partly on the social-benefits idea, but with a limiting principle of informed consent that upholds the rights of the individual over the society. Discussed next is the standard of reasonably informed consent, with suggested additions to the DHHS guidelines. Section III examines the implications of the self-determination theory of consent for subjects in various research settings. Group II subjects (those subjects whose capacity to consent is problematic), present special considerations. This group includes children, formerly competent adults, prisoners, clinic patients, and subjects in experiments where consent would destroy the research. Special review procedures are suggested for this group. A principle beyond autonomy, that of the obligation to promote justice, holds promise for further refining the basis for the ethical principle of informed consent.
Lancet. 1987 Sep 5; 2(8558):575.Dr. Seaman (Aug. 8, p. 339) expresses his concern at Edinburgh and Glasgow Universities' advice to medical students not to undertake electives in certain African countries for fear of HIV infection. To this sad list must now be added the University of Aberdeen, which has included staff visiting these countries in respect of academic interests in their "very strong advice", and has produced a waiver for staff to sign. As Dr. Greenwood points out (June 13, p. 1374) the risk of acquiring AIDS during a trip to Africa as a result of emergency treatment with infected instruments or blood is remote; much more so than the health and travel risks to which students and staff are exposed in other elective activities. 2 issues seem clear to us--1 medical and the other academic. It is a contradiction of professional ethics that doctors (either those in the making or the finished article) should shrink from the sick. The academic judgment is more open to question. Many of us believe that by being members of a university we belong to a wider community of learning than is encompassed by our local campus, a community to which we owe an obligation as teachers. We feel a commonality of purpose and a duty to our colleagues in the universities of Africa. It is a remarkable coincidence that such controversial adviceshould have been issued simultaneously by 3 of the 4 Scottish medical schools. It is a pity that the Aberdeen advice was distributed during vacation time when few were available to benefit from the instruction and when an adequate response to it could not be organized. Perhaps the deans of the medical shools concerned should write to The Lancet to explain their stand and state how they expect members of their universities to respond to academic invitations from, for example, Uganda, Zambia, Kenya, Nigeria, and The Gambia, all countries with which we in this department have academic connections. To ask us to ostracize our colleagues in Africa is a serious matter. It marks a profound departure in university attitudes and policy. (full text)
Hastings Center Report. 1986 Feb; 16(1):33-42.The prochoice movement in its most political manifestation is particularly vulnerable to recent medical and scientific developments. It has never made sufficient room in its public stance for a serious consideration of the fetus. Simultaneously, by deliberately cultivating a supposedly neutral, therapeutic language toward the medical act of abortion, calling it a "procedure," a "termination of pregnancy," and so on, it mistakenly seems to think it can pacify and comfort the conscience, minimizing and denaturing some unmistakeable realities. Medical and scientific developments which threaten the prochoice movement include the lowering age of viability, the emergence of neonatal medicine, the use of the sonogram, embryological knowledge, and late abortions. In attempting to understand the possible impact of the medical developments on the abortion debate, their interaction with other crucial ingredients in the debate will be important. Of special significance are public opinion, the question of the personhood of the fetus, pertinent court decisions and trends, and feminist arguments and political tactics. There is still time for prochoice adherents to show themselves as willing in practice as in theory to concede the moral uncertainty of abortion decisions. If that is not done, the combination of the new medical developments and too many people for too long holding their doubts at bay may well begin shifting opinions. In that event, the prochoice movement will have done itself far more damage than those who try to stop it by bombing abortion clinics.