1. I agree with Richard McCormick’s argument. In my opinion, life is not an absolute good because there are some patients (I use patients since this is a bioethics-related question) that have suffered much pain and anguish every single day of their lives as they struggle to fight against some debilitating disease or terminal illness. Sometimes they are in a state of semi-consciousness, being fed painkillers that limit their awareness. If such is the life of a person/patient, then death is not an absolute evil. Death may even be seen as a form of release from the suffering that plagues the patient.
It does not follow that just because our level of medical technology is quite advanced and that there are now new methods of treatment, that we should preserve life at all costs. Why so?
I shall discuss some of the principles of bioethics to further illustrate my point. First is the principle of autonomy. “In a prima facie sense, we ought always to respect the autonomy of the patient. Such respect is not simply a matter of attitude, but a way of acting so as to recognize and even promote the autonomous actions of the patient. The autonomous person may freely choose loyalties or systems of religious belief that limit other freedoms of that person.” McCormick, T.R., (1998). As an example, if the religion of the person prohibits him from taking a blood transfusion and even upon the doctor empathetically telling the patient that acceptance or denial of the transfusion is a life or death decision, and the patient refuses to undergo such a procedure and the doctor acquiesces to the decision, then the patient autonomously chose his religious beliefs take precedence over his health, and the doctor chose to respect the autonomy of the patient over his duty to provide “benefit” to the patient under his care.
Secondly, “the principle of non-maleficence requires of us that we not intentionally create a needless harm or injury to the patient, either through acts of commission or omission.” McCormick, T.R., (1998). But, there are times wherein unintended harm may come to a patient even though that harm is a side-effect of the life-saving treatment. However, if the patient is dying or in severe pain, the patient may forgo life-saving treatment if he autonomously deems that prolonged living in such a condition is worse than death.
Thirdly, the principle of justice states that medical treatment or benefit should be given without discrimination and since, admittedly, resources are scarce, with ajust allocation of resources. There are cases (lots of them in the Philippines) in which the family of a patient had to sell their appliances, car, and house, take a loan from the bank and relatives, but in the end, the patient dies. The family is left homeless and heavily in-debt. The allocation of resources was not justly done, as the family members that remain are now (most likely) in a state of poverty and nothing to show for it except the monumental effort they put into saving their kin. Not that it’s not worth it, but the loss they suffered with the medical bill would set them back too far for far too long, they may not even recover.
As such, the obligation to sustain life, although good, is a limited one because it is up to the patient to decide autonomously (if he is still judged as being autonomous) if he still wants to live or not, the patient is in severe pain and refuses treatment if life is worse than death in such a condition, and the allocation of scarce resources (such as money in this time of Global Financial Crisis) is not just anymore.
2. I would adopt parts of Kantian ethics and existentialist ethics and mix it with some of my own conceptions. This can be seen in the values of duty, freedom, accountability, the formula of universality and the formula of humanity, authenticity and existence before essence.
We exist before we are given or give meaning to our lives. At our birth, we are but beings nursed by our parents. It is up to us to shape our own present and future. But this freedom to shape our own self is both limited and unlimited at the same time. Freedom goes hand-in-hand with responsibility and a clarification of freedom also clarifies what one is responsible for. It is limited because when we choose our paths in life, and if we are to have an authentic existence (meaning being true to what you’ve chosen), then we are limited by our path. But freedom is also unlimited in that our path ha a goal or destination to reach, we can choose whatever means to reach that goal.
The primary consideration of the means to reaching that goal is that fellow humans are not means to an end, but ends in themselves. This means that whatever choices we make, we must always take into consideration the other people involved and if they are to be ut to harm in reaching our goal. Further consideration is also given as to the nature of the actions made. The acts one makes when striving towards that goal should also be as if those acts are universal laws of all beings.
Duty also plays a role here in that whatever your paths in life are, you have duties that correspond to those choices. These duties must be fulfilled, but with respect to the formulations of universality, humanity and authenticity, taking into account the limited and unlimited freedom you have. Therefore there are now guideposts (and not absolute laws, mind you) as to how you fulfill your duty.
Accountability is a given because you also have freedom both limited and unlimited, to decide upon your actions. Though you take into consideration the humanity and universality of your actions, ultimately, you cannot leave it up to the universe and humankind to answer for your own choices. It is still you who chooses to shape your life, and thus, you are accountable for your own actions.
A moral individual is someone who shapes his own fate. He has freedom that is limited by his paths and unlimited in his ways to achieve his goal through his paths. In his unlimited freedom, he also takes (heavily) into consideration whether his actions obey or apply to the formulations of universality and humanity. With that freedom, he is also accountable for his own actions and even the guideposts of humanity and universality cannot save him from himself if the consequences bite him in the behind. The duties he chose with respect to his paths must be fulfilled, but only upon applying the guideposts to his actions. He remains an authentic individual as he remains true to his path and to his duties, but with respect to the guideposts.
Sun Mar 29, 2009 11:24 pm