Q&A
From the October AD 2009
Our Lady of the Rosary
Parish BulletinOn This Page
Biomedical Ethics?
The Great DepressionQuestion: On the TV they presented “an expert in ‘biomedical ethics’” who sounded anything but ethical in his discussion of abortion, euthanasia, organ harvesting, and other right to life issues. What exactly is “bio-medical ethics?
Answer: The phrase “biomedical ethics” generally refers to a school of thought, evaluating medical practices according to the philosophy of the “progressive” movement. It is another example of powerful lobbies creating new disciplines and funding university chairs to give themselves the appearance of legitimacy.[1] We will come back to “biomedical ethics,” but first let us see how medical ethics have been formulated in Christendom and in the wider context of Western Civilization.
● “Endowed with unalienable rights....” ●
Americans are all familiar with the words of our Declaration of Independence, “all men are created equal; that they are endowed by their Creator with certain unalienable Rights; that among these are Life, Liberty, and the Pursuit of Happiness.” Thomas Jefferson’s critics sometimes claim that he got these ideas from the so-called “Enlightenment,” but, in fact, they are rooted in the Natural Moral Law that is written on the hearts of men, has been known by Christians, Jews, and Pagans for millennia.
And Jesus said: “Thou shalt do no murder, Thou shalt not commit adultery, Thou shalt not steal, Thou shalt not bear false witness. Honor thy father and thy mother: and, Thou shalt love thy neighbor as thyself.”[2]
The Commandments precede our Lord’s time on Earth by roughly fourteen centuries, but even they were known beforehand in substance by thoughtful people through natural human reason. The Code of Hammurabii, one among several written codes based on the Natural Law, was written roughly eighteen centuries before Christ.
Traditional ethics are based on this concept of each individual person being created by God and endowed with the rights necessary for being in the world and working out his salvation. “Thou shalt not commit adultery” is a declaration that mothers, fathers, and children all have a God given right to mutual fidelity and stability. “Thou shalt not steal,” declares the individual’s right to the fruit of his labors and the wages and the property which he acquires. “Thou shalt not bear false witness” proclaims his right to the reputation he earns, and to be free from false prosecution or civil suit.
For purposes of medical ethics, “Thou shalt do no murder,” and “Thou shalt love thy neighbor as thyself” are most important. The first asserts the right of an individual to be safe from unjust attack, without regard to his condition, wealth, or social position; the second demands that human beings treat each other as well as they would like to be treated.
Recall, please that these Commandments, the Natural Moral Law that underlies them, and the rights which they delineate. all reference individuals rather than the average treatment or behavior of a group. And there is an objective right, and an objective wrong.
● “I Swear by Apollo the Physician....” ●
The pagan Greek physician, Hippocrates, who lived about four hundred years before Christ is generally credited with establishing medicine as an art based on natural science. The Hippocratic Oath guided the morality of medical practice for well over two thousand years—an ethic based on the rights of individuals under the Natural Moral Law.
I swear by Apollo the physician ... [an oath so serious as to be witnessed by the deity] that I will fulfill according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art, [but only to teach medicine to those] pupils who have signed the covenant and have taken an oath according to the medical law....
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
[I will leave surgery only to those who are qualified.]
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art ... if I transgress it and swear falsely, may the opposite of all this be my lot.[3]
So we have an ancient pagan physician, clearly aware of the God-given rights of individuals to receive the best care he can provide, that there will be times when he cannot help but still he must do no harm, that he must never even suggest taking the life of a patient or the unborn child, that he must not take advantage of those whom he visits, and that he must maintain their confidentiality. He asks his gods to reward or punish his life based on how faithful he is to these paramount responsibilities
● The “Progressive” Era ●
We have discussed the “progressive” movement before.[LINK] [4] Essentially it rejects the concept of God-given individual rights, replacing it with an unclearly defined concept of “the greatest good for the greatest number.” The concept may take various names, being referred to as “the will of the people,” “the common good,” “the glory of the nation,” “the solidarity of all peoples,” or any one of a few dozen such high sounding but purposefully vague slogans. The essential problem is that some elite group of people must make the decisions for society as to who does or doesn't get what in order to secure this “the greatest good for the greatest number.” Although such schemes may start out with good intentions, it will soon be seen that the less productive, the weak, and the vulnerable, have a lesser place in society, and will be asked to sacrifice for “the greater good” of the others. And, rarely will the Elite rule impartially for society, without regard to their own personal well being.
“Progressive” medicine, our “biomedical ethics,” pretends to make decisions about the relative “worth” of individuals, both to themselves and to society, without regard to any sort of “unalienable rights” granted to each individual by “nature’s God.” “Worth” will depend upon the answers to a number of questions:
How much time and resources have society invested in the patient, or has he invested in himself? (Not just in medical care, but in things like education and training.) How likely is he to make future investments in himself?
Will his future worth be limited by age, mental or physical disability, general health issues, lack of loving parents, parents or society unable to provide resources, society having no need of his skills or having no position for him, etcetera?
Does the patient possess self awareness, self control, the ability to communicate, the ability to contemplate the future and to remember the past, the ability to form connections with others, etcetera?
● 1948—The Declaration of Geneva ●
Following World War II, perhaps recognizing that “progressive” medicine had grown entirely too “progressive” with the elimination of physical and mental “defectives,” involuntary abortion and sterilization, and experimentation on unwilling live subjects under the eugenics minded Adolf Hitler (and perhaps the Russians, who as victors in the War could remain more tight lipped), the World Medical Association determined to “update” the Hippocratic Oath with the Declaration of Geneva:
I solemnly pledge myself to consecrate my life to the service of humanity. I will give to my teachers the respect and gratitude which is their due; I will practice my profession with conscience and dignity; the health of my patient will be my first consideration; I will respect the secrets which are confided in me; I will maintain by all means in my power the honor and noble traditions of the medical profession; my colleagues will be my brothers; I will not permit considerations of religion, nationality, race, party politics, or social standing to intervene between my duty and my patient; I will maintain the utmost respect for human life, from the time of conception; even under threat,I will not use my medical knowledge contrary to the laws of humanity. I make these promises solemnly, freely, and upon my honor.[5]
That was certainly better than wartime atrocity-medicine. It was very encouraging to see the acknowledgement that there must be “the utmost respect for human life, from the time of conception.” But note that the oath is no longer taken before the deity, but has become a pledge to humanity. Instead of the Natural Moral Law, medicine would now be governed by “the laws of humanity.”
The oath has been updated a number of times. By 2005 “I will maintain the utmost respect for human life, from the time of conception; even under threat,” became “I will maintain the utmost respect for human life,” with “even under threat,” moved to refer to using “medical knowledge contrary to the laws of humanity.” [6] By 2006 that last phrase became “medical knowledge to violate human rights and civil liberties, even under threat.”[7] That last change might be good, but the twentieth century left a lot of people with no conception of the Natural Moral Law or Divine Positive Law, and, consequently, with no sure way of knowing what those “human rights and civil liberties” might be.
● A “Brave New World” ●
Abortion: January 22, 1973 the US Supreme Court, contrary to the Constitution, arrogated to itself the authority to overthrow all restrictions on abortion in any of the fifty sovereign States. It based its decision on an hallucinated “right to privacy, found in an invisible passage of the Fourteenth Amendment. The child, of course, had no rights, declared to be a non-person, and not worthy of the right to life clause actually found in that Amendment. Neither the President, nor the Pope, nor the State Governors posted any effective opposition. This violation of the rule of law continues to this day.
Euthanasia: Euphemistically, “euthanasia—ευθανασία” means “good death.” In the United States, Oregon and Washington have legalized physician assisted suicide, and in Montana it became law by judicial fiat. But far more common is the so-called “passive euthanasia, in which the patient refuses or is refused life sustaining medication, nutrition, or water.
Medical Care Rationing: Part of the debate currently raging over socialized medicine it the question of who will receive and who will be refused medical care. In some cases modern medicine has to allocate scarce resources, treating some patients and not others. There are only so many hearts, livers, kidneys, etcetera available for transplants; only so many doses of a vaccine; only so many working dialysis machines, and so on. The inefficiencies of Socialism would undoubtedly extend scarcity to other medical resources—physicians, nurses and technicians; hospital and emergency room beds; uncommon medicines, and so forth. The passage below is excerpted from an article authored jointly with Obama advisor and socialized medicine proponent, Ezekiel J Emanuel MD.
“Principles for allocation of scarce medical interventions”
Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritising adolescents and young adults over infants.
Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfilment requires a complete life. As the legal philosopher Ronald Dworkin argues, “It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies and worse still when an adolescent does”; this argument is supported by empirical surveys. Importantly, the prioritisation of adolescents and young adults considers the social and personal investment that people are morally entitled to have received at a particular age, rather than accepting the results of an unjust status quo. Consequently, poor adolescents should be treated the same as wealthy ones, even though they may have received less investment owing to social injustice.
. . .
Strict youngest-first allocation directs scarce resources predominantly to infants. This approach seems incorrect. The death of a 20-year-old young woman is intuitively worse than that of a 2-month-old girl, even though the baby has had less life. The 20-year-old has a much more developed personality than the infant, and has drawn upon the investment of others to begin as-yet-unfulfilled projects. Youngest-first allocation also ignores prognosis, and categorically excludes older people. Thus, youngest-first allocation seems insufficient on its own, but it could be combined with prognosis and lottery principles in a multiprinciple allocation system.[8]
Question: Were there moral aspects to the Great Depression? A lot of people suffered for well over a decade. Shouldn’t someone be held responsible? Can we prevent such a thing from happening again?
Answer: One of the great strengths of the US Constitution as it was written is the “separation of powers” principle. The power to make laws and to make wars is vested in the Congress, a body formed by Representatives from all of the States according to their population, and a Senate with two men from each State as “ambassadors” from the State legislatures. The President is expected to be an executive of the laws passed by Congress—major appointments and treaties he makes must be ratified by the Senate. In theory, this should spread the power of government over the entire population, reducing any concentration of power to a minimum.
However, as George Washington predicted, the political party system has concentrated power in two blocks; and the Seventeenth Amendment (a child of the “progressive” era) deprived the State governments of their say in federal legislation, cabinet appointments, and treaties. Perhaps worst of all, the Congress has progressively given its powers over to the President.
● Alphabet Soup Agencies ●
In wartime the President is Commander in Chief of the armed forces, so it is reasonable for him to be allowed more authority than normal in order to prosecute the war declared by Congress. During World War I various federal agencies came into being to acquire and pay for the necessities of war. But politicians rarely give up power once they have it, and many of the WWI agencies remained in existence well after the war. The Great Depression was the opportunity for Hoover and Roosevelt to expand the agencies under Executive direction—to extend the Depression both in time and severity—and ultimately to establish permanent agencies with the ability to legislate without the action of Congress, and to exert powerful control over every sector of the economy and many aspects of private life. The agency names are often reduced to three or four letter abbreviations. We will list a few of them, and return next month to comment on the more important ones.
Reconstruction Finance Corporation [RFC 1932] ended 1954.
Federal Emergency Relief Administration (FERA) [1929]
Civilian Conservation Corps (CCC), 1933.
National Labor Relations Act (NLRA) / Wagner Act, 1935: set up National Labor Relations Board [NLRB]
Works Progress Administration (WPA), 1935.
Tennessee Valley Authority (TVA), 1933.
Agricultural Adjustment Act (AAA), 1933.
National Recovery Act (NRA), 1933.
Public Works Administration (PWA), 1933.
Federal Deposit Insurance Corporation (FDIC) [1933]
Securities Act of 1933, created the SEC, 1933.
Civil Works Administration (CWA), 1933-34.
Indian Reorganization Act, 1934.
Social Security Act (SSA), 1935.[9]
NOTES:
[2] Matthew xix: 18-19.
[3] Hippocratic Oath, slightly paraphrased and abridged http://www.rosarychurch.net/answers/hippocratic.html.
[8] Govind Persad BS, Alan Wertheimer PhD, Ezekiel J Emanuel MD http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60137-9/fulltext
[10] Cliffird Berryman, Library of Congress
