Medical Ethics: A Very Short Introduction

by Tony Hope

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Issues in medical ethics are rarely out of the media and it is an area of ethics that has particular interest for the general public as well as the medical practitioner. This short and accessible introduction provides an invaluable tool with which to think about the ethical values that lie at the heart of medicine. Tony Hope deals with the thorny moral questions such as euthanasia and the morality of killing, and also explores political questions such as: how should health care resources be distributed fairly? Each chapter considers a different issue: genetics, modern reproductive technologies, resource allocation, mental health, and medical research.

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Questions for thought and discussion

• Issues in medical ethics often hit the headlines. Have there been any new stories relating to medical ethics that have caught your attention? What are your views on the relevant issues? Why?



• Where do you stand on the issue of mercy killing (active voluntary euthanasia)? What are the strongest arguments against your position?



• Does the slippery slope argument provide strong grounds against the legalisation of active voluntary euthanasia? What types of empirical evidence would help in answering this question? Make up some empirical data that, if true, would lead you to change your answer to the question).



• Look at the diagram in figure 5 (page 23). Do you think that Henry should switch the points? If you answer is no, would you change your mind if the number of people who would die were one thousand, or one million? Or if one of those who would be killed were Henry’s child? If your answer is yes, would you change your mind if the situation were slightly different and Henry could stop a train that will otherwise kill five people only by pushing an innocent bystander under its wheels?



• Do you think that very large amounts of public money should be used to try and rescue individual yachtsmen who will otherwise certainly die?



• How can doctors reconcile a duty to do the best for the individual patient with a duty to use the healthcare resources equitably between all patients?



• What is your view with regard to the rule of rescue (see pages 32 et. seq.) when applied to healthcare resource allocation?



• What are your answers to the questions posed in the case of the trapped miner (see box on page 37)?



• Should post-menopausal women over the age of fifty be allowed to have a baby using assisted reproduction, as long as she pays the costs herself?



• What is the non-identity problem? Is it relevant in understanding the best interests of a child who may or may not come to exist, depending on the reproductive choices made?



• Identify a type of situation that raises, for you, difficult ethical issues. Try and come up with two case comparisons (real or imaginary) that help you in thinking through these difficult ethical issues.



• Do you think that health professionals should be guided more by the principle of respect for patient autonomy or by the principle of promoting patients’ best interests? What are you reasons for your answer?



• Is it right that a person with a mental disorder can be locked up indefinitely, if considered dangerous to others, whereas a criminal without mental disorder must be released once he has served his prison sentence even if he remains dangerous to others?



• A clinic is investigating the cause of a genetic condition in a child in order to advise the parents about the risks of the condition in any future children. The tests show that, unknown to him, the husband is not the biological father of the child. Has he the right to be told, and what are the clinic’s duties?



• Does a person with a genetic condition have a right to keep the genetic nature of the condition confidential, even from close family members who might benefit from this knowledge?



• Might it be ethically justified to allow a clinical trial to take place in a poor country that would not be allowed in a rich country?



• A 14-year old girl is pregnant and wants an abortion. She does not want her parents to know. Are there situations when it would be right for a doctor to respect the girl’s wishes and not inform her parents of the situation? Could it ever be right for doctors to carry out the abortion without the parents’ knowledge?

Other Books by Tony Hope

• Gillian Butler and Tony Hope: Manage Your Mind (Oxford University Press)