biomedical ethics: September 2004 Archives

If you are sick as I am


by the creeping and insidious culture of death, Life Matters!
is someplace you might want to read.
The most recent item is about the tragic decision of the Florida courts reversing "Terri's Law".

relisting a resource


Carrying to Term Pages
Help for families and care providers when a baby is diagnosed prenatally with a lethal condition.

more on this moral issue

| | Comments (3)

Some 'Catholic' hospitals offer preterm induction of labor at very early gestational ages for babies known to have lethal birth defects.
The Case against Premature Induction
Prenatal Ethics from OSV

conscience clause


please read article and vote on survey.

OCPs and freedom of conscience


a different kind of 'pro-choice' issue

| | Comments (3)

Sorry not to have had more substance lately, it's been overwhelming. But I thought that some of you might be interested in what follows here. It is a letter I wrote in another forum about the increased demand from some women for cesarean on demand - that is primary cesarean section without a medical indication. As a Catholic, there are pretty clear teachings that I think should prevent this from happening, but the forum in which I was writing is mostly secular. It is also rather international. My letter follows.
On some level, what we are discussing here is the philosophy (and maybe theology) of moral decision making - on both an individual and a societal level
What is interesting about this whole debate is that it strikes at the heart of most ethical dilemmas - a different paradigm among the different parties. We live in a culture of moral relativism, that endorses the concept that there are not any absolute truths. There is my truth and your truth and his truth and her truth. The general culture in the USA values autonomy above all. Other cultures may value beneficence (doing good) and will value doing 'what is right' even against the will of the beneficiary. Some value non-maleficence (doing no harm) and will co-operate with any thing as long as no one gets hurt (I think this is a basic tenet of Wiccan philosophy - but I could be wrong here). Beneficence and non-maleficence are easily confused but there is a difference there. And then there are those whose primary value is justice - if one person can choose a course of action, then that course of action must be equally open to others.

My personal moral philosophy is based on natural law and a belief that there are some absolutes in life. Based upon those beliefs, I choose to refuse to provide certain 'services' that some patients may request. They still have the option to request (or more likely, demand) those services - but they will need to go elsewhere for them.
I think that all midwives do at least some of the same decisionmaking. For example, in my homebirth days, I refused to take as a client an insulin using type one diabetic. I happen to have a lot more knowledge of this particular complication than the average CNM and maybe even the average OB - I could probably manage some one well with this issue and have reasonably good outcomes etc. But my personal moral and ethical decision is that a person with that degree of disease needs a specialist in disease and I am not that.
Similarly, I won't induce labor just because some one is sick and tired of being pregnant. I see this as not only a medical decision but also a moral and ethical one. Cesarean on demand likewise.
I personally think that one of the worst things that has happened to health care in the USA is the attitude of consumerism and entitlement. It has cheapened what should be a trust and covenantal relationship into a financial and contractual deal, and I think it has hurt both patients and those of us who care for and about them

"Proportionate reasons?"


Some 'Catholic' hospitals offer preterm induction of labor at very early gestational ages for babies known to have lethal birth defects.
My understanding of 'proportionate reasons' for preterm induction is that they should be the same, regardless of the presence or absence of fetal anomalies. For example, a mom with worsening pre-eclampsia may need to have her baby delivered earlier than full-term, or risk losing both baby and mother. A mom with real (not gestational!) diabetes ditto. Babies with anencephaly rarely initiate spontaneous labor 'on-time' and inducing them after 37 weeks is not unreasonable.
Some one needs to talk to these hospital ethics committees about the true meaning and intent of the standards for Catholic hospitals.

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About this Archive

This page is a archive of entries in the biomedical ethics category from September 2004.

biomedical ethics: August 2004 is the previous archive.

biomedical ethics: October 2004 is the next archive.

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