Friday, January 31, 2014

Bioethical Issues in Life Stages



During one's life, ethical issues are raised from the time of conception to the time of death. We must deal with bioethical issues from the beginning of life, to the quality of life, and finally to death and dying.
     One of the ethical issues our society deals with is abortion. In 1973, "the Supreme Court ruled that women had a constitutional right to abortion, and  that this right was based on an implied right to personal privacy emanating from the Ninth and Fourteenth Amendments." (usccb.org, n.d.) Additionally, "In Roe v. Wade the Court said that a fetus is not a person but "potential life," and thus does not have constitutional rights of its own. The Court also set up a framework in which the woman's right to abortion and the state's right to protect potential life shift: during the first trimester of pregnancy, a woman's privacy right is strongest and the state may not regulate abortion for any reason; during the second trimester, the state may regulate abortion only to protect the health of the woman; during the third trimester, the state may regulate or prohibit abortion to promote its interest in the potential life of the fetus, except where abortion is necessary to preserve the woman's life or health." (usccb.org, n.d)
     The law is clear on abortion rights. However, the ethical issue still remains. "The matter of abortion, the quintessential bioethics topic, raises intensely personal issues for many people. It is a polarizing and divisive issue that raises discussions about morals, science, medicine, sexuality, autonomy, religion, and politics. A central matter is deciding what we can say about unborn children, initially known as embryos and later, fetuses. What is their moral status – how much do they matter, and what are our obligations towards them? The matter of 'personhood' arises, as a philosophical and legal discussion about what rights to grant them. 
     'Personhood' aside, what is our relationship to them, all of us as members of the human family? Should their lives be protected, or should their mothers be allowed to make decisions about killing or protecting them? If killing is allowed, under what circumstances may it take place? If their lives are not protected, what kind of crime is it to perform an abortion on a woman without her consent, or to cause her to suffer a miscarriage? The ethical aspect of abortion is related but distinct from the legal. Whether or not it is moral, should abortion be legal? Generally prohibited but with some exceptions? Should it be regulated? Publicly funded? Should doctors and nurses be able to object according to their conscience? A less prominent but still important debate focuses on the reasons why women might seek abortion. Is it at all times a free choice, or are women responding to coercion in any way?  Is it a free choice to seek abortion in desperation because of poverty, violence, or lack of support? What should be the community and policy response to women who feel unable to give birth to their children? And what is the role of the father in decisions about abortion?" (bioethics.org.au, 2013)
     All in all, there is a lot to consider when we look at the issue of abortion. I personally believe it is a woman's choice, since her life is tied to the fetus'.
     During the next stages of our lives, we can look at many issues relating to sustaining and improving quality of life. One of the issues that has been a hot topic over the last several years is genetic science. "There was a pivotal moment in the that too place in the early 1950s, which has given rise to the burgeoning field of molecular genetics. In 1952, two now famous Nobel Laureates, Francis Crick and James Watson, discovered the molecular structure of DNA (a double helix) and confirmed that DNA was indeed the genetic material. Now the race is on to decode the genetic information, to discover the genetic basis of all our human traits, and to use genetics to reveal our phylogenetic relationships. What is more exciting and controversial is the possibility of manipulating our genes so as to restore damaged health or even enhance many of our biological functions. However, as is the case with any scientific and technological developments, there are whole host of ethical problems that must be considered. The possibility of manipulating our genes in order to enhance our biological, as well as psychological nature, is hugely problematic. It is foreseeable that it may lead to a new eugenics, and a radically undesirable change in our human nature. There are also other ethical issues relating to genetic information and the implications of having such information, for example, genetic discrimination and the ethics of genetic screening."(bioethics.org.au, 2013)
    As stated,  one of the biggest issues relating to genetic science is the ability to create a biological and psychological superior person. The Human Genome Project, which goals were to, "identify all the approximately  20,000-25,000 genes in human DNA, determine the sequences of the 3 billion chemical base pairs that make up human DNA,  store this information in databases,  improve tools for data analysis,  transfer related technologies to the private sector, and  address the ethical, legal, and social issues (ELSI) that may arise from the project." (ornl.gov, n.d.) was completed in 2003. With this knowledge, we could, in theory, allow potential parents to pick out eye color, hair color, height, weight, appearance, intelligence, and lack of disease predispostion. The implications are very scary. If you stop to think about it, the people who could afford to this, are the 1% we hear so much about in the news every day. I think this would put an even bigger gap between the upper class, and the middle and lower classes.
      Looking now at the end of life, one of the ethical issues is the topic of Euthanasia. "Euthanasia is the intentional and painless taking of the life of another person, by act or omission, for compassionate motives. The word euthanasia is derived from the Ancient Greek language and can be literally interpreted as ‘good death.’ Despite its etymology, the question whether or not euthanasia is in fact a ‘good death’ is highly controversial. Correct terminology in debates about euthanasia is crucial. Euthanasia may be performed by act or omission - either by administering a legal drug or by withdrawing basic health care which normally sustains life (such as food, water or antibiotics). The term euthanasia mostly refers to the taking of human life on request of that person – the euthanasia is voluntary. However, euthanasia may also occur without the request of person who subsequently – euthanasia is non-voluntary. Involuntary euthanasia refers to the taking of a person’s life against that person’s expressed wish/direction.
     Central to discussion on euthanasia is the notion of intention. While death may be caused by an action or omission of medical staff during treatment in hospital, euthanasia only occurs if death was intended. For example, if a doctor provides a dying patient extra morphine with the intention of relieving pain but knowing that his actions may hasten death, he has not performed euthanasia unless his intention was to cause death (Principle of Double Effect). Euthanasia may be distinguished from a practice called physician-assisted suicide, which occurs when death is brought about by the persons own hand (by means provided to him or her by another person)." (bioethics.org.au, 2013)
   Euthanasia is one of the more complicated issues that we as a society, particularly those in health care, have to deal with. While I believe, everyone should have the right to deny treatment, it's hard to determine what the right thing to do in any given situation is. What I do know, from personal experience, is that a person might decide that death is preferable to suffering one day, they may not feel the same way the next.
      During my lifetime, I have seen many stories relating to bioethics in the media; from Dr. Kevorkian, a doctor specializing in euthanasia, to  Dolly the sheep who was successfully cloned. One of the cases that stuck with me was the Ayala family.
     The Ayala family had struggled through several treatments when their daughter Anissa was diagnosed with  chronic myelogenous leukemia. Anissa was put on the bone marrow donor list, but a donor was not found through the national database. When Anissa's parents realized their daughter might succumb to the disease, they decided to conceive a child that could possibly be a bone marrow match to their daughter. The family received national attention, as they were the first family to publicly announce this decision. The Ayala's successfully conceived a daughter, Marissa, who was born on April 3, 1990. In late May of 1991, a bone marrow transplant was performed and both girls(women now) are both healthy and thriving.(Chang, 1991)
     This issue is one I have struggled with. I think the Ayala family did what was best for them, and it worked out for the family. I think this happened because the family was emotionally stable, loving, and supportive. However, what if the bone marrow transplant wasn't the end of the journey for baby Marissa? What if her sister had multiple problems, and Marissa was subjected to more procedures? What if she had to give an organ? Should she have a say in the process? What if she felt she was only conceived to be a spare body to save her sister? I agreed with the outcome of the situation, because it was the family's decision. However, I think that a decision such as this needs to be considered very carefully, as it could have a negative outcome on both children, depending on the family situation and how far any procedures go.
   As we have seen, there are many bioethical issues throughout our individual lives, but also those that affect society as a whole. While there are always choices to be made, there will be people to argue both sides of any ethical issues.

SOURCES
usccb.org, (n.d.) Summary of Roe v. Wade and Other Key abortion Cases retrieved July 1,
   2013 from http://old.usccb.org/prolife/issues/abortion/roevwade/CaseSummariesforwebsite4-
   18.pdf

Bioethics.org.au, (2013) Abortion retrieved July 1, 2013 from
     http://www.bioethics.org.au/Resources/Resource%20Topics/Abortion.html

Bioethics.org.au, (2013) Genetics retrieved July 1, 2013 from
     http://www.bioethics.org.au/Resources/Resource%20Topics/Genetics.html

Bioethics.org.au, (2013) Euthanasia retrieved July 1, 2013 from
     http://www.bioethics.org.au/Resources/Resource%20Topics/Euthanasia.html

 Chang, I., (1991) Baby Girl's Bone Marrow Transplanted Into Sister : Health: Parents conceived

     the child in an attempt to provide a donor for leukemia-stricken sibling., Los Angeles Times,

     retrieved July 1, 2013 from http://articles.latimes.com/1991-06-05/news/mn-212_1_bone-

     marrow-transplantation

 Beaty, K. (2013) Bioethical Issues in Various Life Stages

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