Topic: Religion
April 28, 2016 | Posted By Wayne Shelton, PhD

Much of American history can be described as the struggle to expand the moral community in which an increasing number of human beings are seen as having basic rights under the constitution. We forget sometimes that though the inclusion of all people was perhaps implied in our early documents, as in “We hold these truths to be self-evident, that all men are created equal…” from the Declaration of Independence, it has taken historical time and struggle to come closer to realizing that ideal. This struggle has been the quest for recognition of more and more individuals not assumed initially to have the right to vote and exercise control over their lives, which included African Americans, women, minorities, and more recently the LGBT community. The growing recognition of more and more individuals as being full fledged citizens has been a slow, often painful, birthing process of freedom, in the sense of unleashing human potential and possibilities, within the democratic process.

 

The recent uproar over the Anti-LGBT law passed in North Carolina is a reminder of how difficult it is for many states and communities to accept and accommodate historically marginalized people into the mainstream of society. This law was a quick reaction by the right wing North Carolina legislature and governor to an ordinance passed in Charlotte, similar to what other cities around the country are doing, allowing transgender people to use restrooms according to their gender identity. Perhaps this law also should be seen as a reaction to the Supreme Court ruling in 2015 legalizing same-sex marriage, which has been propelling society toward greater openness and acceptance of LGBT life styles, integrating them into the mainstream. Many who favor the Anti-LGBT law claim that individuals born as male, but are now identifying as female, could pose a risk to women and girls in public bathrooms, though there seems to be no substantial evidence whatsoever of such a risk. My sense is that the individuals who support this law in fact are using risk as a smokescreen in attempting to preserve what they perceive as waning values and norms in society: In the name of conservatism they hang on to an exclusionary vision of society that no longer fits the conditions of expanding freedom and opportunity.

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

October 6, 2015 | Posted By Claire Horner, JD, MA

A Catholic hospital came under fire recently for stating that it would not permit doctors to perform a tubal ligation during a c-section scheduled for October.  According to news reports (including anarticle written by the patient herself), the pregnant patient has a brain tumor, and her doctor have advised her that another pregnancy could be life-threatening.  Her doctor has recommended that she have a tubal ligation at the time of her c-section.  While my knowledge about this hospital, this case, and the participants is limited to what has been reported in the media, it raises an interesting question: in our pluralistic society, where conscientious objection is respected while maintaining a patient’s right to a certain standard of care, is it ethical to allow a religiously-affiliated health care institution to refuse to provide certain treatments it finds morally objectionable?

As background, the Catholic Church has historically been outspoken on bioethical issues and has a strong and robust bioethical teaching.  Catholic hospitals are governed by the Ethical and Religious Directives for Catholic Health Care Services (ERDs), a document promulgated by the United States Conference of Catholic Bishops (USCCB) that clearly articulates the bioethical policies that must be followed in a health care institution based on the Church’s moral teachings.  It explains the Church’s teaching against direct sterilization as a method of birth control based on the principle of double effect.  “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.  Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.” (Directive 53).  In other words, if the sterilization procedure directly treats a pathology, it is licit; if it is used as a form of birth control to prevent a pregnancy, even if that pregnancy would be life-threatening, it is not licit.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

April 10, 2015 | Posted By Wayne Shelton, PhD

The history of America from the beginning was a struggle of opposing ideological perspectives over the role of the state’s power vis-à-vis the consciences of individual citizens. The 17th century Puritans in the Massachusetts Bay Colony basically transported to America the same kind of religious, state intrusion into the lives of individuals they were trying to escape in England by requiring citizens to subscribe to the official state religion. Fortunately, there were courageous individuals there at the time, like Roger Williams (1603-1683), who strongly resisted such requirements. Williams, prior to coming to America, had been educated at Cambridge and worked for Lord Chief Justice Edward Coke. (1552-1634)  Coke was the famous English jurist whose work provided much of the foundations of the Anglo-American legal system, and who famously “declared the king to be subject to the law, and the laws of Parliament to be void if in violation of "common right and reason”.  No doubt Williams’ prior education and influences from Coke, and from others like Francis Bacon (1561-1626) who taught him the way of learning through experiment and observation, helped temper his strong theological commitments in relation to his views about the proper relationship between the authority of the state and religion, and the extent to which the state could have control over the consciences of free individuals, what Williams called “soul liberty”. Williams himself did not have theological quarrels with the Puritans; however, he did not believe religious conviction could be coerced. It was on this moral and political basis, that Williams founded Rhode Island, the first state ever to have a constitution guaranteeing expansive freedom of conscience to individual citizens. Fortunately, the thinking of Williams became the mindset of the key founders, particularly Jefferson (1743-1826) and Madison (1751-1836), of the American constitutional system. (For a full account of Roger Williams’ life and influence, see the wonderful book, Roger Williams and the Creation of the American Soul: Church, State, and the Birth of Liberty by John M. Barry)

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website. 

October 13, 2014 | Posted By Wayne Shelton, PhD

As I have been saying in recent blogs, most of what we do in clinical ethics, but also in most areas of bioethics, is procedural ethics. That is when we are faced with an ethical dilemma, our approach, whether consciously or unconsciously is usually to try to reach a reasonable compromise or consensus among the key participants that are in conflict consistent with well-established values and principles. This tendency reflects an obvious reality about the nature of contemporary ethics that we often ignore: in the current Western moral setting, our only viable methodology for resolving value laden disputes, whether at the micro level in clinical ethics or macro level in healthcare policy, is to attempt to craft an agreement or consensus among those with a say. Whether we are dealing with patients and families at odds with their physician on how to define the goals of care in the hospital setting or trying to build a consensus of opinion among voters in the political arena, we assume there are no final, authoritative moral answers that avail themselves to us. Whether we like it or not, we humans must figure out ethical dilemmas for ourselves and learn to get along.

Yet the idea of procedural ethics remains very worrisome for many people, including such bioethicists and Tristram Engelhardt, Jr. He believes that procedural ethics, such much of what we do in clinical ethics, is not really ethics in because it is based on convention and legalistic type standards. For him ethics worthy of the name must flow from a content-rich, canonical moral tradition that provides moral authority to our everyday ethical and moral judgments. The prototype ethical tradition was the medieval Christian Natural Law perspective grounded in Aristotelian philosophy. Aristotle assumed the inherent order and intelligibility of the cosmos, which also permeated his understanding of ethics. Humans, like all natural things, had a natural function, which was to be rational. But rational did not mean to that ethics was about finding intellectual or theoretical basis for right action according to rational rules in order to know and perform one’s duty—this was Kant’s (1724-1804) ethics during the 18th century following the rise of modern science. For Aristotle, the question was, how can one live and embody the good life; so rationality in this sense meant internal harmony between emotions and decision-making that resulted in well-established habits or states of character. This means finding in all of one’s activities the balance between excess and deficiency, or what he called the “mean”. Over time, forming the right habits according to the mean in all areas of life lead to excellence and happiness or what he called the good life. This was the natural fulfillment of the human function in practical terms consistent with the ancient Aristotelian.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website

September 9, 2013 | Posted By Marleen Eijkholt, PhD

Sarah is 10 years old and has cancer. She has lymphoblastic lymphoma, an aggressive form of non-Hodgkin lymphoma. News reports suggest that her parents and Sarah herself, decided to stop chemo treatment. “Sarah’s father said she begged her parents to stop the chemotherapy and they agreed after a great deal of prayer”. Sarah and her family are Amish. Reports note that they refused chemobecause the side effects made Sarah horribly sick, and that she was worried about losing her fertility. They decided to use a doctor who would attempt to treat the cancer with natural medicines, like herbs and vitamins. 

Over the last couple of days, their court battle has been outlined in the media. The hospital, where Sarah had been treated with chemotherapy, had applied for limited guardianship.  Guardianship would allow them to ‘force’ chemo therapy on her, particularly as they estimated her chance of long-term survival around 85% after treatment. Initially, this guardianship request was refused on grounds that it was the parents’ right to end treatment, while on appeal the judge ruled her best-interest had to be reconsidered. However, the most recent judgment reasoned that the parents were concerned and informed, that they have a right to decide about treatment for their child, that there was no guarantee for success of the chemo, and that guardianship & treatment would go against the girl’s wishes as it could cause her infertility. Guardianship was refused; Sarah’s health is governed by her parents.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

August 26, 2013 | Posted By Marleen Eijkholt, PhD

Circumcision has been on my radar in different ways during my training as a health lawyer/bioethicist. Mostly, the issues presented in the form of ethical controversy about female circumcision; is it a form of mutilation or suppression of women on cultural/religious grounds?; as a tensions between religion, culture and resources, and sometimes in the form of questions around legality. However, these encounters were theoretical, and mostly based on extreme examples, interesting but abstract. When I saw a neonatal male circumcision (infant male circumcision: IMC) in my rounds through the hospital as a clinical ethicist, thoughts about the topic of circumcision revived even though this was male circumcision.

Witnessing this IMC, I observed the medical procedure, I saw that there were no parents at the bedside and that the child hardly cried on the sugar drip. This clinical picture was not what I expected. I never expected circumcision as such a routine procedure, seemingly performed without ritual or cultural significance at the bedside. My cultural bias took over, wondering why such an invasive procedure would be performed on a young child without capacity to consent, even though I also witnessed that the child hardly noticed it. Asking the physician about the reasons for it, he referred to the AAP statements, suggestions about health benefits, and to the fact that it is very common in America and mostly done: ‘because this is what Dads looks like’, without much thought.  Looking into the issue, I found acontemporary discussion regarding controversies about male circumcision, cultural biases and evidence based practices. I imagined and asked myself: how would I advise if I received a consult request about IMC? How should I conceive of right and wrong, also in the face of controversial evidence based studies? Especially since even the AAP encourages readers to “draw their own conclusions” (about the technical report and the primary resources). How can I assess this practice?

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

 

October 10, 2012 | Posted By Wayne Shelton, PhD

The modern era in the West marks the beginning of a new way of understanding the purpose of a social system and how people fit in to it. The transition to the modern world was from a medieval world that was perceived to have inherent ends and truths, based on Aristotelian metaphysics and Catholic moral theology, that provided authoritative answers to fundamental questions about the nature of ultimate reality, knowledge, human nature and morality. In Europe during the 15th and 16th centuries, the radical political turmoil, stemming from the Protestant Reformation, and a growing sense of the rights of humans were leading philosophers like Hobbes (1588-1679), Locke (1632-1704) and Rousseau (1712-1778) to articulate a fundamentally new type of social and political system. Instead of the divine rights of kings to assert complete rule over subjects, which created an obligation for subjects to obey those divine rights, there emerged the concept that the social and political order should be structured so as to protect and preserve the natural rights of human beings qua citizens. This new understanding of how to understand society and individuals—later called social contract theory—provided the conceptual underpinnings of the eventual emergence of democratic systems: The idea that the social system should be structured in a manner so as to allow individual citizens to be free to live according to their life goals and values within the limits of respecting those same rights of others. This meant that individual citizens should agree to give up some of their rights, e.g. to steal and kill, for the larger benefit of living safely and in a manner of one’s own choice. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit ourwebsite.

July 12, 2012 | Posted By Wayne Shelton, PhD

Those of us who work in clinical ethics focus most of our intellectual energy on addressing ethical dilemmas in individual cases. Clinical ethics allows little time for armchair reflection. The urgent cases presented to us require fairly quick decisions. That is, if we are to be helpful, we have to find thoughtful ways to analyze ethical questions and reach prudent recommendations. But even for clinical ethicists, it is worthwhile from time to time to take a step back and consider the historical philosophical context in which we work and the challenges it poses for ethical reflection and judgments.

Clinical ethics has been criticized by some not having an adequate basis on which to give substantive answers to pressing ethical questions in medicine. I want to show how this concern is not only, not a problem, but is a sign of progress. First a little background about the state of contemporary western ethics as expressed in one of the most important critiques of philosophical ethics and morality in the past 100 years.

In his 1981 work entitled After Virtue, Alasdair McIntyre claims the actual moral world in which we live is in “a state of grave disorder”. The concepts and terms we use in contemporary ethical discourse, he believes, are nothing more than fragments of prior conceptual schemes that have largely lost their moral import. Even worse, we use ethical discourse in talking about obligation, rights and duties without fully realizing the lost moral orders in which these words once had their original meaning. This is a concerning charge for clinical ethicists since much of our daily work involves using just these kinds of terms. Do we have a clear grasp of what our moral terms mean and how they are being used?

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

February 20, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

Contraception, women's rights, and religious freedom have dominated the headlines in recent weeks. New guidelines require new health insurance plans to fully cover women's preventive health services, including the provision of birth control pills without co-payments. The administration estimates that by 2013, 34 million American women aged 18 to 64 will receive the benefits specified in the new ruling. Naturally (also, sadly), considering that this is the United States, a firestorm of ill-will began gathering in response. Lately the anti-contraception forces have been in full cry.

The rights of women to a full range of preventive health services are the main concern of the new guidelines. Women's health requirements are not the same as those of men. Also, if we take a breath and step back from this latest manifestation of America's highly destructive "culture war", we might notice that this entire argument could be avoided by instituting a single-payer health care system.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

September 23, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Dr. Michael Minor is the director of the H.O.P.E. Health Initiative for the Congress of Christian Education of the National Baptist Convention and undershepherd of the Oak Hill Baptist Church in Hernando, MS. Dr. Minor is a local, regional, and national champion of faith-based health and wellness mobilization. He is chairing the upcoming state-wide conference, Healthy Congregations Mississippi, planned for October 7-8, 2011.

In our wide-ranging interview, Dr. Minor discusses

  • How faith-based organizations are able to impact community health and wellness
  • Developing a community calendar of health observances and activities
  • Community action focusing on childhood obesity, nutrition, and diabetes
  • Creating health-and-wellness vacation Bible schools
  • New programs for sickle cell sabbaths
  • The need to focus on senior health and wellness

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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