Bioethics Essay

There are so many things in this world that people see an ethically unacceptable. A few topics are adoption, cloning, and consent. These are big topics because they are common and most of the public is aware of these controversies. To start, consent is a huge issue in America today. You will not find one thing in that does not require some kind of consent. Patient consent, consumer consent, or parental consent. In the medical field patients have to give full consent to all of their treatments, and or procedures. If a patient does not give consent then the doctors cannot legally proceed with any type of medical treatment. Consent to any treatment is a vital part to both the doctor and the patient. The doctor can only tell the patient the information needed, and tell them what is best for their health, it is up to the patient to decide if they want to continue with treatment or not. For the patient to consent the treatment has to have a high percentage of success, of not they may look for other options. Sometimes doctors will add or embellish information to get a certain response from their patient. It is important for the patient to fully understand their condition, and to know all of their options. A doctor cannot legally make a decision about a patient without that persons consent, and if they are physically/mentally unable to provide the consent the doctor needs, a family member or parent is put in place to make those decisions for the patient. The respect for the human body is determined by the patient. If the doctor feels the patient does not care about how they become healthy, and only wants a positive outcome it leaves many doors open for the doctor to do what they feel necessary to benefit the patient. Ethics in the public sector, such as in hospitals and other health care organizations, cannot transcend politics completely, because the public sector is the political arena. For ethical guidelines to survive, however, they must be based not on political expediency but on sound ethical principles and reasoning. As the knowledge of medicine, technology, and science continues to grow, the challenges of regulation, policy, and ethical issues in the hospital setting and elsewhere in the health care system will occupy physicians for some time to come. Medical informed consent is essential to the physician’s ability to diagnose and treat patients as well as the patient’s right to accept or reject clinical evaluation, treatment, or both. Medical informed consent should be an exchange of ideas that buttresses the patient-physician relationship. The consent process should be the foundation of the fiduciary relationship between a patient and a physician. Physicians must recognize that informed medical choice is an educational process and has the potential to affect the patient-physician alliance to their mutual benefit. Physicians must give patients equality in the covenant by educating them to make informed choices. When physicians and patients take medical informed consent seriously, the patient-physician relationship becomes a true partnership with shared decision-making authority and responsibility for outcomes. Physicians need to understand informed medical consent from an ethical foundation, as codified by statutory law in many states, and from a generalized common-law perspective requiring medical practice consistent with the standard of care. It is fundamental to the patient-physician relationship that each partner understands and accepts the degree of autonomy the patient desires in the decision-making process. As a matter of both ethics and the law, adult patients who have no cognitive impairments should be centrally involved as decision-makers during their medical care. In ethics, the well-established principle of â€Å"respect for persons† that supports this perspective Because no one is usually better suited than adults themselves to appreciate what a diagnosis and treatment means for their lives, patients should ordinarily be respected as â€Å"experts† about the medical treatment that is desirable to them. Respecting patients as the central decision-maker also protects against paternalism, the view that health care practitioners should make decisions they believe to be in patients’ best interests. The law converges with ethics in making it inadvisable for physicians to impose tests and treatments on patients without their knowledge or consent. In the United States, the law will treat medical treatment imposed without consent as a wrongful action. In response to a charge of unwanted treatment, Justice Benjamin Cardozo offered a classic legal opinion in the 1914 case Schloendorff v. Society of N. Y. Hospital: â€Å"every human being of adult years has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits an assault for which he is liable in damages.† Subsequent cases have underscored this right to accept or refuse treatment and underlined rights to self-determination and the right to be left alone – even if choices seem poorly made to others. Informed consent is therefore both a theory and a practice of patient involvement in health care. Its theory rests on well-established ethical and legal views in the United States. In practice, informed consent means providing information that enables someone to make a meaningful decision about the desirability of a medical test or treatment, as measured in terms of its risks and benefits. Some states require that very specific information be provided when certain medical interventions are offered. For example, the U. S. Supreme Court upheld the right of states to require that physicians provide specific information to women seeking abortions. In Pennsylvania, physicians must advise a woman seeking an abortion about the state of fetal gestation, the availability of state-sponsored child support, legal and financial obligations of fathers, and so on. Proponents of this law argue that it is the state’s responsibility to ensure that women know this information before they make final decisions about abortions. If physicians working in states that require specific information to be disclosed fail to do so, they open themselves up to various legal charges. For most medical tests and treatments, however, the state does not direct the specific information that must be disclosed. In most situations, it is physicians, their professional organizations, and institutions that set the standards for disclosure. Of course, the law still has a role to play, it requires that physicians provide all the information that a person could reasonably expect to receive and that the disclosure is consistent with a professional standard of care. This information should be offered in a manner accessible to the patients and in languages they easily understand. Verbal consent is ordinarily sufficient for many if not all routine medical procedures such as blood draws, standard drug regimens, or standard tests. Written permission to test or treat can sometimes be useful documentation in medical records. Major interventions such as surgery or involvement in experimental protocols such as a drug study usually require written documentation of the consent process. The standards of informed consent also forbid physicians from exceeding the scope of any test or treatment agreement, except in emergencies. There is continued debate about the extent of information that should be provided to a particular patient regarding a proposed test or procedure. For example, patients may not always be able to appreciate technical information and for that reason it is sometimes tempting to oversimplify explanations of medical tests and treatments. Research also shows that many people fail to recall central points of the information offered to them when they are told about medical tests and treatments. Nonetheless, as a matter of ethics and the law, it is better to err on the side of more explanation rather than less when it comes to the explanation of medical treatments, and this advice increases in importance as the degree of risk associated with a treatment increases. In practice, health professionals will encounter patients who signal that they do not wish to make decisions themselves. In some instances, patients may not wish to participate at all in discussions about their care, or their family members will make clear that they wish their relative to be protected from medical information (especially if bad news or risk is involved). Situations of this kind are a challenge to implementing practices of informed consent, but to the extent possible physicians should engage patients in discussions about the nature and consequences of their treatment. Parental consent is another issue in adoption. The birth mother does not have to consent to have their child removed for their custody. Adoption is an ethical issue because there are many factor in the adoption process, and the outcome of the child during and afterwards. When the birth parents come into play, things get even more complicated. Many people adopt because they get financial aid from the government to help support the child, and the adoptive parents don’t always use the money for that child. It is important to provide all parties of the adoption with proper options and make sure no rights are violated. No child should be pulled out of their home unless there is a proper cause, and the child is in danger. Another Problem that is often seen with adoption is that the birth parents decided they want the child, or want to be a part of the child’s life. The court and the adoptive parents have to decide if this is a good idea or not. In many cases it is not up to the kids, and they just get tossed where ever someone else feels necessary. Adoption is governed by State law in the United States. Laws and practice in each State vary. No matter where the adoption takes place, overarching ethical considerations should be applied consistently. Consent refers to the agreement by a parent, or a person or agency acting in place of a parent, to relinquish a child for adoption and release all rights and duties with respect to that child. Consent to adoption is regulated by State statutes, not by Federal laws, and States differ in the way they regulate consent. In most States, the consent must be in writing and either witnessed and notarized or executed before a judge or other designated official. In all States, the court may determine that consent of the parent is not needed under specific circumstances, including when parental rights have been terminated, the child has been abandoned, the parent has been convicted of specified crimes against the other parent or the child, the parent has failed to support or establish a significant relationship with the child, or the parent is mentally incompetent or unfit due to abuse or neglect. The court may terminate the rights of one or both parents for reasons including abandonment, failure to support the child, mental incompetence, or a finding of parental unfitness due to child abuse or neglect. An unwed father’s consent may not be needed if he has failed to establish legal paternity, is found to have abandoned or neglected the child or to be an unfit parent, or fails to respond to notice of an adoption proceeding. Nearly all States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U. S. Virgin Islands require that older children give consent to their adoption. Approximately 25 States, the District of Columbia, and the Virgin Islands set the age of consent at 14. Eighteen States, American Samoa, and Guam require a child’s consent at age 12, while six States, the Northern Mariana Islands, and Puerto Rico require consent of children age 10. In 11 States, the requirement can be dispensed with if the child lacks the mental capacity to consent. In 16 States and the Northern Mariana Islands, the court, in its discretion, may dispense with consent if it is in the best interests of the child. Colorado requires that the child be provided with counseling prior to giving consent. In Maryland, a court may grant an adoption only if the child to be adopted is represented by an attorney. The manner in which consent can be executed varies considerably. In many States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands, consent may be executed by a written statement witnessed and/or notarized by a notary public. Other States may require an appearance before a judge or the filing of a petition of relinquishment. Some States require the parent to be provided with counseling, have his or her rights and the legal effect of relinquishment explained to him or her, or be provided with legal counsel prior to consent. In cases in which custody has previously been placed with an agency, the head of the agency may sign an affidavit of consent. In most States, a birth parent who is a minor is treated no differently than other birth parents. However, in some States, the minor parent must be provided with separate counsel prior to the execution of consent, or a guardian ad litem must be appointed to either review or execute the consent. In five States, Guam, and Puerto Rico, the consent of the minor’s parents must be obtained. Adoption is meant to create a permanent and stable home for a child; therefore, a validly executed relinquishment and consent to adopt is intended to be final and irrevocable. As a result, the right of a birth parent to revoke consent is strictly limited. The territory of the U. S. Virgin Islands makes no provisions in statute for revocation of consent; Massachusetts and Utah specifically require that all consents are irrevocable. In most States, the law provides that consent may be revoked prior to the entry of the final adoption decree under specific circumstances or within specified time limits. Idaho requires a parent who revokes consent to reimburse the adoptive parents for any expenses they may have paid on his or her behalf. In Michigan, consent may not be revoked if the child has been placed with an adoptive family unless an appeal of a termination of parental rights proceeding is pending. Virginia permits one or both parents in a direct placement to waive the 7-day revocation period at the time of consent if the child is at least 10 days old and the waiving parent has received independent legal counsel. Waiver by one parent does not affect the right of the other parent to the revocation period. In all jurisdictions, consent becomes final and irrevocable once the court issues a final decree of adoption. Something else that has become a public issue is the consumption of cloned animal products. People want to know they are not eating something fake and man-made. A lot of cloning issues revolve around animals and humans. Some people do not like this due to their religious beliefs because they don’t think you should artificially create someone, and that its God’s will who is created. They also have a problem with the fact that once an embryo is conceived it is a human life, and researchers use them for research and do not preserve the life. The researches do not see the embryo as a human life, and conduct many test on them. Scientists do not view these experiments as people with strong religious beliefs. People often view this as a type of abortion because they are taking a life. People have decided that cloning today is unwise, and unnecessary, and in some cases criminal for humans, although in 2006 the government approved the distribution and consumption of cloned meats. This raised significant objections because the public wasn’t sure if they really wanted to be consuming cloned animals. Most of the ethical issues of cloning be it in animals or humans have been raised by the Catholic Church, as well as other religious organizations. They all strongly oppose cloning as according to the religious belief life begins at conception and that life cannot be created artificially but from the unity of a man and a woman. At the same time, the church together with the other religious organizations argue against therapeutic cloning as well because, as mentioned above, they are guided by the idea that life starts at the conception and once the embryo exists it must be treated as a person, and thus destroying embryos and using them only for the purpose of research is not consistent with the religious view on the issue. Concerns about cloning animals for food go beyond questions of food safety. In addition to concern for animal welfare, many people have ethical and moral qualms about animal cloning. According to recent surveys, for example, 64 percent of Americans think cloning is â€Å"morally wrong,† and another 63 percent would not buy cloned food even it were labeled as â€Å"safe. † A fundamental argument of those who have ethical concerns about animal cloning is that just because scientists can clone animals for food, doesn’t mean they should. The 2008 report by the Pew Commission on Industrial Farm Animal Production concluded that significant changes are needed in how farmed animals are raised in the U. S. , but cloning would move us in the opposite direction. Cloning promotes the objectification and commoditization of animals, treating these living sentient beings as mere machines for human manufacture. In addition, as the public becomes increasingly aware of the treatment of farmed animals, many are concerned that cloning highly productive animals exacerbates animal welfare problems, because these animals tend to suffer from painful infections of the udder, lameness, and other ‘production-related’ diseases. In addition to concerns about animal welfare, many worry that the technology used to clone animals is the same that can be used to clone humans or produce transgenic animals, but the implications of such applications have  yet to be fully examined. Researchers in England and Australia have already backed proposals to create human-animal hybrids, for example by fusing a human cell to an animal egg to create embryos that are 99. 9 percent human and 0. 1 percent rabbit. People are concerned that cloning represents a dangerous ‘transgression’ of science. Many also feel that cloning is â€Å"not natural† because, overall, cloning requires a significantly greater level of involvement and interference with animals’ reproductive performance than conventional production methods. Several religious groups, including from Protestant, Catholic, Jewish, Muslim, Hindu, and Buddhist faiths, have rejected animal cloning on ethical grounds. Cloning and genetic engineering are viewed by these groups as tantamount to â€Å"playing God. † Nearly 90 percent of Americans want the government to factor in ethical considerations when making a decision on animal cloning. Such discussions are taking place around the world, with countries such as Canada, Taiwan, Japan, and the European Union saying they will consider the public’s concerns about animal cloning before deciding if they will accept the technology. The European Commission, for example, asked the European Group on Ethics to issue an expert opinion on the ethical implications of cloning animals for food. The group concluded in early 2008 that, particularly due to the animal suffering involved, it could find no ethical justification for cloning animals. The European Food Safety Authority also concluded that, â€Å"The health and welfare of a significant proportion of clones has been found to be adversely affected.† It was irresponsible for the FDA to allow cloned animals into the food supply without allowing similar discussions to take place in the U. S. Given the severity of the animal health problems associated with cloning, and the magnitude of ethical qualms Americans have with using the technology, there is both a pressing need and an overwhelming demand for the government to establish a proper regulatory framework to oversee animal cloning, one that takes into consideration both ethics and science. In October 2006, AAVS joined with the Center for Food Safety and several other animal welfare, consumer, and environmental organizations to petition the FDA to establish an ethics Advisory Committee, similar to ones set up to discuss human genetic technologies, to provide an opportunity for public participation and transparency in the animal cloning debate. An advisory committee, mirroring the Health and Human Services Secretary’s Advisory Committee on Genetics, Health, and Society, which serves as a public forum for deliberations on the broad societal issues raised by the development and use of genetic technologies in humans, would serve to deliberate both publicly and officially the ethical challenges presented by animal cloning. Though the FDA chose to deny the petition, AAVS continues to work with federal agencies and Congress to ensure that the animal welfare and ethical implications of cloning are fully considered before the moratorium on animal clones is lifted. As surveys have shown, the public’s concerns for animal welfare and ethics have the potential to greatly impact the agricultural market and foreign trade, and consumers should have a voice in how their food is produced. However, the FDA has stated that it will not require food from cloned animals to be labeled. That means that consumers who oppose animal cloning on animal welfare, religious, or moral grounds would be forced to unwittingly make purchases that violate their ethical principles. That is why AAVS is also supporting legislation that would require food from cloned animals and their offspring, if they are approved for sale, to be labeled. Consumers have a right to know how their food was produced so they can make informed decisions about what they buy and what they feed their families.