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This seminar considered the ethical implications and different legal regulations of new scientific developments and current conduct in contemporary medical practice. The Curriculum Units prepared by the Fellows grew from these explorations.
We considered the arguments for and against recognition of a “right to die” (either by refusing life-prolonging medical treatment or by directly hastening death through physician-assisted suicide) of mentally competent patients, or by surrogates on behalf of mentally incompetent patients, or by parents on behalf of seriously ill infants. In this exploration, we considered the ethical status of adults and children with physical or mental disabilities, including the existence of a social obligation to provide special protections and services to such individuals. Jacqueline Porter’s Unit on the Right to Die deals with this topic.
We discussed new possibilities for genetic manipulations (such as cloning or gene therapy), for the sue of reproductive technologies such as in vitro fertilization (including questions raised by commercial contracts for surrogate mothers) and for organ transplantation (including the scientific developments permitting the use of animals as sources for organs). Jimmy-Lee Moore’s Unit on the Genome, Stephanie Shteirman’s Unit on Science Writing and Grayce Storey’s Unit on Organ and Tissue Donors focus on these issues.
We discussed organizational changes in the delivery of medical care such as the increased prevalence of managed care and increased budgetary pressures for rationing of medical care in ways that are inconsistent with the health needs or wishes of individual patients, and the special risks of such practices for vulnerable individuals such as the elderly and members of minority groups. Carolyn Fiorillo’s Unit addresses many of these questions.
We considered current practices and past abuses in biomedical research, such as the Tuskegee syphilis experiments and, consider the effectiveness of possible remedies (such as requirements for informed consent or regulation by hospital-based Institutional Review Boards) to guard against the repetition of such abuses. Martha Staehili’s Unit focuses on a crucial aspect of this topic-the capacity of individuals to make informed choices to protect their own health-through a specific exploration of tobacco use.
Robert A. Burt