Advanced Search

Is it ethical for a surgeon to perform an operation on his own mother?

Is it ethical for a surgeon to perform an operation on his own mother? Especially when it may involve the finding of a cancer?

Doctors try to avoid such situations, and, I think, for good reason. They add extra stress to what is already a difficult task -- stress for the surgeon and also stress for the patient. Such extra stress, in turn, is likely to diminish the prospects for success. And a surgeon who performs a major operation on his mother may then be acting unethically by not giving his patient the best chances of a successful outcome. If so, he should step aside, even if his mother would prefer to be operated by him.

But what if some surgeon is, and is known by his mother to be, especially cool and unemotional, thus adding no stress to the proceedings? Or what if he is much better than the other available surgeons so that his greater skill more than makes up for the extra stress? In such cases, I would think, there's nothing unethical about him doing the operation himself -- provided, of course, his mother agrees. So, as I see it, performing a surgical operation on a loved one is not unethical as such, it is unethical -- often -- only because of its likely impact on the chances for success.

To see whether this makes sense, you can consider a more homely example. Imagine your spouse has a life-threatening accident and needs to be driven to the next emergency room at once. It's probably a bad idea for you to do the driving -- you would probably not be at your best. If so, you ought not to endanger your spouse's life, and your own, by insisting on being the driver -- provided there's another good driver available who is much less affected by the emergency. But if the only other available driver is your neighbor's son, one month into his L-sticker, then you may be the better bet and your doing the driving is then beyond ethical reproach.

Society holds the viewpoint that it is wrong to attempt to create better humans

Society holds the viewpoint that it is wrong to attempt to create better humans (through Eugenics). That is, we shouldn't play god. Medicine goes against natural selection, and therefore it is playing god. It theoretically also makes evolution stall, and makes our species as a collective whole, weaker. So, is medicine right?

One of the reasons that eugenics has often been considered disreputable is that the criteria for "better" humans have been considered arbitrary or worse. But if we could implant a component in our genes that would give us immunity to some dread disease (like those for which we now have vaccines), then I doubt that the standard objections to eugenics would apply to it. The objections to eugenics are not that it goes against natural selection -- as if there were something especially morally significant about natural selection. There is not. After all, the preferences that we express in choosing certain people rather than others as our mates exercises a selection pressure but is not morally problematic.

One way to see the potential problems with eugenics arises just with my comment above -- where I referred to a dread "disease." Surely, you might say, we can all agree that genetic manipulation for the elimination of disease would be worthwhile. But what counts as a disease? At one time, a slave who was prone to run away repeatedly was considered as having a disease (drapetomania). At one time, homosexuality was considered a disease. So even if someone appealed to the elimination of disease as a justification for eugenics, this argument might be used for immoral purposes.

Is the sale of human organs ethical?

Is the sale of human organs ethical?

It is difficult to give an answer that would cover all possible cases, and I suppose I can imagine an individual case where purchasing a organ would be permissible. But as a practice or policy, it is not ethically permissible--this because a market for organs would provide incentives for people to sell when they shouldn't--for health reasons and otherwise. The poor and desparate would be exploited in the most horrific ways. If you'd like an example, the film, Dirty Pretty Things, offers a compelling portrait of just the sort of exploitation a market in organs would cultivate.

Why shouldn't we test drugs and cosmetics on mentally challenged or severely

Why shouldn't we test drugs and cosmetics on mentally challenged or severely disabled human beings, rather than animals?

Other things being equal, perhaps we might. But of course they're not equal. Our social morality -- the morality we live by -- is 'speciesist' in the sense that human beings -- whatever their mental or physical capacities -- are considered to be due special protection. If we were to seek to remove that protection, chances are that it would probably degrade our ethical sensitivities to the point that things went overall worse for non-human animals than they do at present. What we should be asking, rather than your question, is: Why should we continue testing drugs and cosmetics on non-humans to the extent we do, when we wouldn't dream of carrying out such testing on human beings with similar capacities?

Isn't it more morally acceptable that we use consenting, informed adults in

Isn't it more morally acceptable that we use consenting, informed adults in scientific tests rather than animals? The adults would at least know what they were being tested for and the possible benefits. Added to which the tests are likely to be safer as scientists would be more likely to value a human life rather than that of an animal. Plus this way would fulfil the moral criterion for both utilitarianism as it decreases suffering for the reasons aforementioned and Kantianism but using no one as a mere means, human or animal (although Kant himself argued that an animal cannot be used as a mere means I will ignore this as it is arguable and that if we can avoid using them as a mere means then we should). Could it also be argued that testing on animals is even worse when no consenting, informed adult volunteered? And that such tests shouldn't be done under any circumstances? Many thanks :)

I think the PETA people will think I have a very blind moral eye, but I am inclined to think that your question makes the issue far more simple than it is. For one thing, I think there are morally significant differences between different species of non-human animals. I wouldn't think of causing gratuitous suffering or death to a wild primate, for example, but gladly crush mosquitoes to death whenever given the chance. For another (and related to the first, in fact) I think the very idea of whether animals do or do not consent and how this notion may apply to them is hardly obvious, and perhaps simply otiose. If animals (or some species) do not and cannot give consent or refuse it, then it seems to me this is not a useful more indicator for them.

Imagine I am a scientist working for a pharmaceutical company and I spend 25

Imagine I am a scientist working for a pharmaceutical company and I spend 25 years working on a drug that will cure a disease. I patent my work, but the patent only lasts for 8 years. In that time, the pharmaceutical company sells the drug at a high price but uses most of its profits to fund more research. After 8 years, anyone can replicate my drug. Why should I allow generic brands, in that 8 years, to make my drug? I know many more people would have access to it if I did, but at least when my company is in control of it there are quality controls and secondly, my work is not only funding more research but is something I invested a great portion of my life in. Is it fair to argue for generic drugs in that case?

Your reasoning appeals to a false dichotomy. You assume that either we give monopoly pricing powers to inventors and thereby effectively deny access to recent drugs to poor patients or we allow generic companies to compete and thereby effective deprive inventors of their rewards and of funds for new research ventures. But there are further options.

One would be to allow generic companies to compete immediately (thereby reducing the price of a new medicine to near the marginal cost of production) and then to reward inventors in another way, for example with a reward (out of public funds) proportioned to the impact of their invention on the global disease burden. All patients would benefit for much cheaper access to recent drugs, and taxpayers would pay a little more. Millions of lives would be saved through this innovation -- not merely because poor patients get access to cutting-edge drugs, but also because biotech and pharma companies would gain an incentive to research remedies for the diseases that predominantly affect the poor.

So, while I agree with you that inventors should be rewarded -- for fairness to them and also for encouraging and enabling new research ventures -- and also agree that the quality of pharmaceuticals (whoever produces them) must be strictly maintained, I don't see how any of this needs to come (as it now does) at the expense of poor patients.

Do patients have an absolute moral right to the confidentiality of their medical

Do patients have an absolute moral right to the confidentiality of their medical records?

An absolute right is presumably one that cannot be outweighed, forfeited, and/or alienated. (Such a right can still be waived -- e.g., by allowing your doctor to show your medical records to someone you nominate.) Let's look at these three issues with regard to the assumed moral right to the confidentiality of one's medical records.

It seems evident that this right can be outweighed. Suppose, for example, that a society faces a serious risk of a pandemic involving a life-threatening and highly virulent pathogen (ebola, avian flu). May such a society require doctors to notify the authorities of any positive diagnosis so as quickly to isolate the patient and prevent contagion? With potentially millions of lives at stake, any right to confidentiality must surely give way.

Less confidently, I would also think that the right in question can be forfeited, at least in part. Here is a possible case. Suppose the right is not outweighed by the danger to a single person. So, even where AIDS is still a deadly disease, an AIDS patient has a right that his doctor not tell his sexual partner of his condition even when she (the doctor) has good reason to believe that her patient is having unprotected intercourse with his partner. This sub-right could, I think, be forfeited, for instance by malicious intent. What if the patient allows his doctor to tell his relatives but not his lover of his condition because "I really don't want my lover to survive me"? Or what if the patient tells his doctor that he plans to begin a sexual relationship with someone he envies so as to ruin this person's life? In such cases, I would think, the doctor should be morally (and legally) free to warn the intended victim if she cannot persuade the patient to desist.

I am uncertain about whether a moral right to the confidentiality of one's medical records might be alienable. By alienating this right, its bearer would not merely waive it on one occasion (by allowing the doctor to share medical information about him with a third party), but would give this right away, in whole or in part, for a period or forever. A film star, for instance, might then sell to a magazine the right to full and indefinite access to all her present and future medical records (or some more limited right to medical records -- concerning her pregancy status for the next 48 months, say). Should such contracts be enforceable? Or should the moral right be conceived so that it cannot be alienated in this way? I am inclined to the latter view, but a confident answer would surely require a lot of thought.

In conclusion. A moral right to confidentiality of one's medical records may well be inalienable, but it cannot plausibly be conceived as one that can never be outweighed or forfeited.

Is a doctor or an optometrist ethically or morally obligated to report a patient

Is a doctor or an optometrist ethically or morally obligated to report a patient with poor eyesight to the state department of motor vehicles?

I assume we're imagining that the doctor knows that the patient hasn't herself reported her optical problems. I suppose the first thing to try would be asking the patient to do so. Now imagine that the patient refuses, or that the doctor has reason to suspect that the patient won't make a report. The first issue is whether the law requires the doctor to inform the authorities. If it does, then it seems to me pretty clear that she should do so. If the law doesn't require this, then the doctor may be subject to legal, or professional, obligations of confidentiality. If those are absent too, then I'm inclined to think she should go ahead and make the report. It might be said that it would damage the relationship of trust between her and her patient, and I guess that is more than likely if the patient's driving licence is revoked! But that seems a price worth paying. Nor do I think it would do much if any harm to the reputation of the doctor, or doctors in general, if it became known that the doctor had reported her patient's condition on the ground that the patient herself had not done so. Indeed it might be thought irresponsible to keep the information confidential. It might, of course, make it less likely that patients in a similar situation in future would consult their doctors. But I can't see that that is especially relevant here, since such patients would anyway be those inclined to drive without reporting their defective eyesight.

Is there anything morally problematic about health inequalities which correlate

Is there anything morally problematic about health inequalities which correlate to inequalities in social-economic status? If so, what, if anything, should be done? How can our "modern ideals" (health care system - NHS) be applied to the teachings of Rawls and Nozick?

If there are moral problems with inequalities in general, then they should apply to health issues also. If there are not such moral problems, then they need not. That is, if we allow inequalities to exist then we should not be surprised or even shocked that they exist in health care also, indeed we should expect this. Poorer people tend to be less capable at acquiring public health resources, and have often adopted unhealthy life styles for reasons connected with their poverty, and so any general attack on social inequality should work towards improvement in general health levels among the deprived sector of society. But this is only if you value equality, it might well be that those thinkers who do not would see it as perfectly acceptable for such inequalities to persist given the general desirability of inequality as a social phenomenon.

Is it morally justifiable to give minors the right to consent to treatment, but

Is it morally justifiable to give minors the right to consent to treatment, but not the right to refuse treatment?

How can there be a right to consent without a right to refuse? The problem here is conceptual, not moral.