scholarly journals The New Challenges for Medical Ethics

2020 ◽  
Author(s):  
Liliana Lorettu ◽  
Jocelyn Aubut ◽  
Rosagemma Ciliberti

The evolution of medicine confronts healthcare professionals with new ethical challenges. Elements such as professional secrecy, patient benefit, justice in the distribution of resources are put in crisis by the evolution of medical procedures. Today, doctors must make life-and-death decisions about many patients. As the resources are not enough for all patients, the ‘first-come, first-served’ criterion crumbles under the weight of the overwhelming demand for treatment. Consequently, they can no longer make treatment decisions based only on proportionality and clinical appropriateness criteria. They must take into account the availability of resources and prioritise patients with ‘the longer life expectancy’. This amounts to saying ‘the weakest will die’ … with the doctors’ consent. While the guidelines issued by scientific societies may well protect doctors from lawsuits, the choice of who to treat and who to let die is left to the conscience of the individual doctor; and it is a choice sharply clashing with the Hippocratic oath and with professional and personal ethics. This and others are a real ethical problem.


2021 ◽  
Author(s):  
Pascal Salin

Liberalism is often criticized because it is said that it is concerned only by economic problems (and not more general human problems) and because it is in favor of selfishness. This is wrong and, in fact, liberalism is, on the contrary, the necessary consequence of a universal and valid conception of ethics. The foundation of liberalism consists in the fact that everyone must be respectful of the legitimate rights of any person (as regards, for instance, his body, his mind, and his legitimate property rights). Therefore, it implies that one ought to be respectful of another person either if this person is generous or if he is selfish (one is not obliged to be selfish, but one has the right to be selfish). Thus, liberalism is founded on the fundamental universal ethics and it is respectful of the individual conceptions of personal ethics. It is not in favor of selfishness, but in favor of individualism. This is why it must be said that liberalism is the only humanistic approach of social problems. However, many people consider that it is ethically justified to impose a redistribution policy to decrease so-called “social inequalities.” But, so doing, a state is not respectful of the legitimate property rights of those who are obliged by legal constraint to pay taxes. A voluntary distribution of resources from individuals who give part of their legitimate resources to other individuals is ethically justified. But it is not the case whenever this transfer of resources is made by using coercion. And it must be added that it has negative consequences. Those who benefit from the redistribution policy are less induced to make productive efforts. And those who have to pay the taxes are also less induced to develop their productive activities. Therefore, the production of resources is diminished by the redistribution policy and all the members of a society (for instance a country) suffer from this non-ethical policy.



2020 ◽  
Vol 3 (3) ◽  
pp. 121-138
Author(s):  
Dr. Bilal Ahmad Khan

Islamic economics based on specific concept of universe and the creation of man is contradictory to the concept adopted and accepted by modern science. Islamic economics postulates although ability and expertise is required for progress and growth but distribution of resources completely dependent on it would be cruel, inhuman and bereft of kindness, and lead to oppression. Islamic economics does not favor making human ability and expertise the fulcrum of resource distribution. It should be kind, considerate and based on justice and fairness. This is because according to Islamic philosophy, ownership is considered to be a trust from Allah which has been bestowed on the rich so that they may utilize it correctly. In Islamic economics the role of the individual, has inclinations and his aims and objectives occupy a central position and are vitally important. He is definitely a rational being but his level of rationality is not confined to the calculations of cost and profit. An individual does not want merely to obtain monetary profit and physical pleasure and leisure but he also wants and aims for something beyond what the material world has to offer. The main aim of the study is to find out the relationship between Islam and economics. In Islamic economics the comprehensive moral training of the individual, his technical and educational ability, his aims and his priorities are of primary importance. According to Islamic economics the means of acquiring wealth has the same importance as wealth itself. Dishonesty, abuse of trust and earning of wealth through fraudulent ways and means may perhaps increase the status of an individual but the society suffers because of it on the whole. This leads to an unjust and oppressive economic system.



Author(s):  
Axel Michaels

This chapter examines the classical Hindu life-cycle rites, the term saṃskāra and its history, and the main sources (Gṛhyasūtras and Dharma texts). It presents a history of the traditional saṃskāras and variants in local contexts, especially in Nepal. It describes prenatal, birth and childhood, initiation, marriage, old-age, death, and ancestor rituals. Finally, it analyzes the transformational process of these life-cycle rituals in the light of general theories on rites of passage. It proposes, in saṃskāras, man equates himself with the unchangeable and thus seems to counteract the uncertainty of the future, of life and death, since persons are confronted with their finite existence. For evidently every change, whether social or biological, represents a danger for the cohesion of the vulnerable community of the individual and society. These rituals then become an attempt of relegating the effects of nature or of mortality: birth, teething, sexual maturity, reproduction, and dying.



Author(s):  
David Wendell Moller

This chapter details the vicissitudes of race and poverty shaped J. W. Green’s upbringing in the Deep South as well as his adjustment to urban living as an adult. His lack of education, employment opportunity, and personal empowerment led to a “life on the streets.” Stoic faith saw him through a life and death in poverty. Mr. Green teaches us that everyone comes to this phase of life with strengths to cull from their cultural and spiritual beliefs. Mr. Green also teaches us that dignified dying does not require the unfettered exercise of personal autonomy, although a deep and abiding respect for the self-worth of the individual is necessary.



2021 ◽  
pp. 104365962110214
Author(s):  
Lei Lei ◽  
Quanxi Gan ◽  
Chunyan Gu ◽  
Jing Tan ◽  
Yu Luo

Introduction With the global aging process intensified, the demand for end-of-life care has surged, especially in China. However, its development is restricted. Understanding the life and death attitude among the elderly and its formation process, and clarifying their needs, are so important to promote social popularization of end-of-life care. Methodology This qualitative study included 20 elderly residents in Nan and Shuangbei Communities, Chongqing City, People’s Republic of China. Data were collected through semistructured in-depth individual interviews and processed by thematic analysis method. Results Three themes and eight subthemes were identified: Characteristics of formation process (passive thinking, closed and single), life-and-death attitude (cherish and enjoy life, quality of life priority, let death take its course) and expectations of end-of-life care (preferences, basic needs, good death). Discussion Life-and-death attitude and end-of-life care expectations of the elderly support the development and delivery of end-of-life care. Furthermore, the individual-family-hospital linkage discussion channel needs to be further explored.



Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 36
Author(s):  
David G Smithard ◽  
Nadir Abdelhameed ◽  
Thwe Han ◽  
Angelo Pieris

Discussion regarding cardiopulmonary resuscitation and admission to an intensive care unit is frequently fraught in the context of older age. It is complicated by the fact that the presence of multiple comorbidities and frailty adversely impact on prognosis. Cardiopulmonary resuscitation and mechanical ventilation are not appropriate for all. Who decides and how? This paper discusses the issues, biases, and potential harms involved in decision-making. The basis of decision making requires fairness in the distribution of resources/healthcare (distributive justice), yet much of the printed guidance has taken a utilitarian approach (getting the most from the resource provided). The challenge is to provide a balance between justice for the individual and population justice.



2019 ◽  
Vol 34 (6) ◽  
pp. 1737-1741
Author(s):  
Rita Loloçi ◽  
Orneda Gega Hoxha

In this study, we will try to explain the correlation that exists between social ethics and personal ethics. Today’s challenges of human society in the field of ethics, morality and consciousness are not the same in different eras and in nations or groups of states. All three of these domains move more slowly than other processes, but are indispensable in everyday life. State authority in constantly way strive to create legal rules, but their non-compliance with ethic, principles of morality and conscience create major problems in contemporary development. Rapid contemporary developments, especially those in the field of technology and science have brought other concepts to social and personal ethics, but the necessity of their presence always adapting to other conditions has been felt. Today’s man seeks to understand it more in the form of ethics and social education. For example: nudity, morality principles to this phenomenon have changed from generation to generation, once considered shame and today as something private. The reality of the moral and conceptual problems that human and society have had over law, the rights and ethics have changed, concepts have been overthrown, and the way how people have been judged for different situations has evolved. Individual’s education in the traditional societies have been very important issue in his/ her life. That was a lifelong learning process instead. Education’s main purpose was to help the individual during his/her life so that he/she was not only responsible and aware of the environment, but to prepare the individual to fit into real life. In the actual society there are different points of views as far as the moral and civilizing education bonds are concerned. A mutual environment asks for mutual values, but on the other hand it is assumed the need to understand, accept and support even the values which may be different from the individual ones. In other words, the civil education has to treat moral as a separate issue, even though there are different opinions like: moral is a personal choice, moral is given by God, moral is a social agreement, etc. What we should emphasize is the fact that dealing with similar points of view is as important as debating against the opposite ones. It would be very positive if this could be achieved for a common understanding. But does everyone understand what moral, social and personal ethic is? Another question adds to this one: How is the problem of moral going to be treated? And is it necessary to set tasks or duties on moral as well? What features must moral education have in a view of the evolution of society as whole in terms of a new worldview? Today humanity is on the rise and is heading towards great organisation, but one must keep in mind that within this uniformity there is also diversity to be respected. The new worldview must be open to new progress and thinking not only from the content but also from the form.



2021 ◽  
pp. bmjspcare-2020-002672
Author(s):  
Sinead Donnelly ◽  
Simon Walker

ObjectiveTo understand the unique ethical and professional challenges confronting first and second year doctors in caring for people who are dying, and to learn what factors help or hinder them in managing these.Method6 first year and 7 second year doctors were interviewed one-to-one by a senior palliative medicine physician (SD), quarterly over 12 months, using a semistructured approach. Thematic analysis was conducted with the findings, following the general inductive approach.Results21 hours of recorded interviews were analysed by SD, and ethical and professional issues were identified. These were discussed with SW, and sorted into seven broad categories. The participants’ accounts of the issues convey a strong ethical sensitivity, developed through their undergraduate training. A recurring challenge for them through their first 12–24 months of work as doctors is being responsible for the decisions, knowing that what they do can have life and death consequences. The participants frequently describe senior doctors as an important source of support, and the lack of such support as leading to moral distress and demoralisation. Another important factor is having opportunity to discuss and reflect on the decisions after they are made. Where such reflection had been facilitated properly, participants displayed considerable growth in their ability to manage ethical challenges.ConclusionSenior support and opportunities for reflection need to be recognised as key factors in enabling first and second year to respond appropriately to ethical challenges in end-of-life care, and in sustaining their well-being through this critical stage of their professional life.



Author(s):  
Sanna Melin Schyllert

In May Sinclair’s fiction, images of sacrifice abound. From the self-abnegating Katherine Haviland in Audrey Craven (1897) to the eponymous antiheroine of The Life and Death of Harriett Frean (1922), Sinclair’s central characters seem to be eternally struggling with the issue of renunciation. The treatment of the theme is heterogeneous in many of Sinclair’s texts, not least in the novel The Tree of Heaven, which both condemns and praises personal sacrifice for a higher or communal purpose. This displays a fundamental insecurity about the nature, function and value of sacrifice. It is this ambivalence, which underlies so much of Sinclair’s fiction, in combination with the individual mixture of philosophies in her work, that will be explored here. This chapter investigates the concept of sacrifice in the war novel The Tree of Heaven and how it is connected to community and feminism. In order to find an understanding of sacrifice as proposed by Sinclair, and its meaning in the lives of both women and men in the context of early 20th century England, the chapter discusses the crossroads in the text between sacrifice, idealism, feminism, and the nation-wide feeling of community that appears to be required in wartime.



<i>Abstract</i>.—Ever since fishing was called recreational fishing, a cruelty charge has hovered around somewhere in the background. In recent times, however, it has made it to the fore substantiated by anthropomorphic reasoning and fuelled by high-visibility papers claiming that fish can feel pain and suffer. Because some segments of the public perceive the infliction of these mental states to fish as abhorrent and not outweighing the costs imposed on the individual fish by appropriate benefits to the human, recreational fishing is coming under attack on moral grounds. Other challenges have also emerged that do not center on the issue of whether fish are sentient or not. In this paper, we describe five of the most prevalent moral challenges to recreational angling, two of which—animal welfare and wilderness-centered perspectives—can offer a constructive outlook by calling upon improved treatment of individual fish (animal welfare) and generally more sustainable management (wilderness perspective). In contrast, if one subscribes to animal liberation or animal rights philosophies, the outlook for recreational fishing is generally negative: it has to stop. A final challenge is associated with the motivations of anglers. The moral argument there is that the activity is carried out largely for angler pleasure rather than as a means of securing survival. The outlook of this ethical challenge sometimes leans towards only accepting one form of recreational fishing: catching, killing, and eating. Voluntary catch-and-release fishing and practices such as tournament fishing with a strict total catch-and-release policy would then not be ethically permissible. In this paper, we highlight the origin and background of each of the five ethical challenges and explain their implications for recreational fishing.



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