Last week I attended the 12th Annual Conference of the American Society for Bioethics and Humanities. I found it a fascinating meeting, and was thrilled to see that some of the nation’s leading ethicists were in attendance; they are sort of like idols to me. But as I went to each session, I was struck by how difficult a field bioethics has become. And I was equally struck by how, within chiropractic, we often do not need to confront the issues that are daily challenges in medicine.
For example, one of my sessions addressed this problem: for children with medulloblastomas, there are three possible therapies which can be offered. Each carries a mix of difficult decisions. In one case, there survival rate for Therapy A is highest (90%), but it also carries the highest rate of leaving a child with reduced capacity for intelligence (after treatment, intelligence will be 40% what it was before treatment). In Therapy B, the survival rate falls a bit, but the rate of mental retardation decreases a bit as well. And in Therapy C, the survival rate is lowest, but intelligence is generally preserved. The question was not, which one should a parent choose? The question was, do we even tell the parent about option A, which has best survival rate but almost invariably will impair the future mental capacity of the child. And the program was devoted to discussing when and where medical paternalism might be justified.
A second session was less life-threatening in its question, but was equally interesting. How honest should a medical student be in revealing to a patient that he or she is indeed a student at all? In training, medical students (and chiropractic students, of course) gain skills by treating actual patient under the supervision of attending physicians. Do patients want to know that the person treating them is a student? Do we have an obligation to tell them? How do we respect autonomy?
Can we benefit from past wrongs? Should we use data from Nazi concentration camp experiments? Should Roman Catholics allow their children to be vaccinated using vaccines grown in the tissues of aborted fetuses or accept treatment that came from the use of human stem cell lines? Do we apply consequentialist theories here or deontological ones? Is it right to make a good from an evil? There are no easy answers here.
It turns out that bioethics is a vibrant field that can cast light onto difficult subjects and issues. And we are confronting them- genetic research, stem cell research, gene therapy, the Human Genome Project, organ transplantation, public health ethics (population as opposed to personal level bioethics) and so on. It is why I find this so fascinating.