The Central Question in Medical Ethics
A patient is lying on a hospital bed hooked up to several machines regulating his bodily functions. The doctor has informed the family that the patient is brain dead. His spouse makes the decision to pull the plug but his mother argues against it. It is the mothers opinion that her son is still alive, and deserves to be treated like a person, even though his brain is no longer functioning. The spouse holds the opinion that any trace of her loved one has left with the death of his brain and only his body remains.
Suddenly, both remember the patients wishes to not be sustained on life support, and they collectively decide to pull the plug. This example illustrates the central debate in the ethics of medicine: What constitutes a person? Does the level of brain activity characterize an individual as a person? Is a persons body simply “on loan from the biomass”? The answers to these questions determine the outcome of every medical decision from Abortion to Euthanasia. An analysis of the main arguments arising in these controversial issues will serve to illustrate this point.
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The idea of personhood is readily apparent in the ethical debate concerning Abortion. The question of whether a fetus is a person surrounds the entire idea. On the one hand it is argued that if a fetus is a person, then that person has a right to life, and to kill it would violate that right. The opposite side of the argument claims that the the fetus is but a cellular growth and has no human properties. The question of personhood is important here because it determines and issue which may occur after it has been answered. If the fetus is a person, then it is a separate entity from that of the pregnant woman.
It may share the same nourishment, but it has its own separate nervous system and brain. It is not simply a growth such as an extra limb or a tumor, which can be removed easily. If this were the case then an abortion would not be such a controversial issue. After all, the removal of a brain tumor isn’t. In this case, the argument of personhood surfaces as the central questions regarding this issue. Abortion is not the only issue illustrating the importance of personhood. Another is that of Cloning. Cloning faces the issue of potentially creating another human being from the DNA of a pre-existing one.
The cloned individual will be an exact genetic copy of an already existing individual. A major argument in this debate of therapeutic cloning faces the psychological damage a cloned individual may face. Opposers feel that a cloned individual is a person, and that one person should never do something to another person which may cause him/her harm. Therefore, cloning should not be considered, because it may have potentially damaging psychological effects on the cloned individual. The opposite view states the opinion that cloning individuals may offer great Therapeutic promise.
If there are a large supply of “harvestable” bodies then there would be more opportunity available to the original population for optimal health care. Here, we again see, that the central argument behind cloning is whether or not the clone can be considered a person. If so, then cloning is unethical as it can cause the person psychological damage. If not, then the clone has no rights and can be created to supply the original with organs, or cells if the need were to arise. This issue also arises in the debate surrounding Reproductive cloning.
If personhood is defined as having a soul, then it must be asked if a cloned individual is capable of having a soul. If so, then it must be treated as equally as any person should. If not, is there any purpose of creating it to live amongst our families? Once again, the question of whether an individual is a person or not, is central in arguments concerning the ethics of cloning. The issue arises once more in the arguments concerning Euthanasia. Euthanasia, otherwise termed as “mercy killing” presents the option of a medical professional assisting a chronically ill, competent patient, in his/her own death.
The argument for this is based around the a person’s quality of life. If the patient has no quality of life and is never going to improve, why let them suffer? In order to determine if an individual should be allowed to end their life, we must first determine if this individual can be considered a person. If so, then a person has a right to a good quality of life, and should be allowed to decide if he/she will continue living in misery. If not, then a doctor must do what is medically best, ie: keep the individual alive as long as possible.
The same central issue arises in those placed on life support. If a person is purely in the mind/brain, then in regards to a patient who is brain dead, withholding essential medical treatment or to even actively stop the body from functioning could never be considered unethical, in fact, it could be considered morally justifiable. If the soul is what makes up the person, then who is to say that the soul leaves the body when the brain stops functioning? The medical professional would then still be morally obligated to keep the heart of the patient beating and provide sustenance.
Once again, the question of personhood must be answered before any advancement can be made. There are many who claim that the central issue in medical ethics is not what constitutes a person at all, but what rights the person should be given. This argument, otherwise known as autonomy, is indeed important, but it is not the central question to be answered when facing ethical issues in medicine. In every medical issue previously discussed, one must determine what characterizes a person first, before the rights of that individual can come into play.
In the issues surrounding abortion, one must determine if the fetus is a person first, before it can presume that the fetus has the human right to live, and is not just a cellular growth. The issues surrounding cloning must first determine if the clone can be considered a person. Once this has been established, the issues of what rights the clone has can be assessed, otherwise the clone would only be a storage unit for the organs or cells the original person may require. In the issue of Euthanasia, one must first determine if the “brain dead” individual is a person, before one can begin to acknowledge the wishes this person my have had.
Otherwise, the mother and wife of the man at the beginning of this paper, would have argued over the major decision to pull the plug forever, instead of recognizing the patients wishes to be released. While autonomy is important, it is not the central issue surrounding medical ethics, although, it may be the next central issue. To conclude, the issue of personhood is relevant to every medically ethical debate, ranging from abortion, to cloning, to euthanasia. The question of what constitutes a person must be answered before any other question, including autonomy, can be assessed.