Advanced Search

Is there any validity in the following argument? By medical science we keep people with severe chronical diseases alive and these people are free to reproduce. Already there has been an increase in people with chronical diseases, maybe because of our progression in medical science. So, in the future, it is possibly that we will all struggle with many chronical diseases, unless we accelerate in stem-cell research or genetic manipultaion. With this I see only two opportunities: either deny the chronically diseased to reproduce (Which I think is quite unethical) or "play God" and rid our selves with these plagues with either genetic manipulation or stem-cell research (which is also unethical, for some). But not matter what ethical principles one leans on, these two options are the only sensible ones, of course to the exception of not doing anything (which is also unethical). So we have here, three unethical options, depending on one´s ethical affiliation: 1. Everyone will be chronically diseased. 2....

We have been grappling with these ethical issues since the mid-nineteenth century and the beginning of the Eugenics movement. You have obviously done some deep thinking yourself, and perhaps it is time for you to engage with some texts in history and ethics in order to see how to take the questions further. I suggest Diane Paul's "Controlling Human Heredity" and "The Politics of Heredity" (both cheap paperback books) and an essay by Erik Parens "The Goodness of Fragility" widely reprinted in bioethics texts (there are many other bioethics resources, such as bioethics.net and http://bioethics.georgetown.edu/publications/scopenotes/

How justified is a doctor's decision to practise cosmetics when he had sworn upon the Hippocratic Oath?

The Hippocratic Oath says a number of things, not all of which doctors swear to today (for example, the Hippocratic Oath forbids any kind of surgery). Perhaps you are thinking of the most well-known part of the Hippocratic Oath, that forbids harm. This is regularly interpreted as forbidding "unnecessary harm," e.g. vaccinations hurt, but they are a necessary harm to prevent a greater harm. Cosmetic surgery involves harm to the patient--the pain of surgery and the risks of surgery--so the question is, does it prevent a greater harm? The right people to ask about this is the people who undergo cosmetic surgery--both the ones with successful and the ones with unsuccessful results. They should be fully informed so as to balance the potential harms and benefits for themselves.

Definitions of health tend to focus on the absence of non-health, as in "health is the absence of disease," or in terms of what health affords us, as in "health allows one to lead a vital life." These approaches seem to avoid consideration of what health is. Why do we do this? Is it possible that something can only be defined in terms of what it is not, or what it leads to? How would we go about considering a definition of health?

Actually, the WHO defined health in 1946 as "a state of complete physical, mental and social well-being." So health can be defined positively; the question is how useful such a definition is. Some think that this definition sets the bar too high (who among is is healthy according to that definition?) others that it gives us no help with prioritizing health care interventions (is it more important to improve the health of those who are already fairly healthy or those who are not health at all?), still others that it confuses general well-being with health. It may be that we do not need a general definition of health, just particular definitions appropriate to particular contexts.

An 11-year-old child lies on the operating table, dying from an accident. He asks his doctor if he is going to die. The doctor says "no", knowing the child will be dead in minutes. I say the doctor (it is not me) did nothing wrong. What good does it do for a child to be told he will be dead in a few minutes. This beloved family doctor has been conflicted over this 40-year-old problem and teared up when telling someone (me) for the first time.

The salient feature of this question is that the dying person is an 11-year old child, rather than an adult. Our sympathy is aroused and we wish to protect the child from pain, especially the pain of knowing that s/he is about to die. I think it is important to first ask the question: if the dying person was an adult, would it be appropriate to lie about the prognosis? And I think the answer is "No. The adult has a right to be told the truth about their prognosis if they ask." So, if an adult has that right, why not a child? Some would say that a child "can't handle the information." But I think that depends on the child, and many 11-year olds might be able to handle the information as well as adults, and might use it to e.g. make final statements or requests. The work of anthropologist Myra Bluebond-Langner on dying children shows that children often handle the topic of their own death as maturely (or more maturely) as adults do. The beloved family doctor could probably have made a better decision.