The Wykehamist
is unfairly disadvantaged when it comes to healthcare.
The issue for many medical professionals is that clinical problems are multifaceted and challenging in ways that could require concepts like that of non-maleficence to be put to one side. Medical ethics must also be able to reconcile the nuances of the cultural, religious and societal mindsets of patients. To answer some of these questions, I sat down with Syed Hussain( Coll:, 22-) for a discussion:
What is something you believe Western medical ethics gets wrong? I believe that Western medical ethics too often over-prioritises individual autonomy and negative liberty— the latter being the socalled‘ freedom’ from external stimuli such as the government or family members— leading to the assumption that a competent patient’ s choice should normally trump competing considerations. This sits uneasily with tradition, especially when involving religious and non-Western factors; some cultures see individuals as embedded in families and communities, where moral agency is relative, and duty to kin, the vulnerable and the common good are central. In such settings, insisting solely on individual consent can feel like an erosion of communal responsibility, sidelining family-based deliberation at precisely the moments when collective deliberation and spiritual preparation matter the most.
Do you think the four-pillar framework captures the complexity of modern ethical dilemmas? Beauchamp and Childress’ four principles of autonomy, beneficence, nonmaleficence and justice offer a helpful common language and‘ prima facie’ framework, remaining a powerful starting point for structuring contemporary dilemmas. However, cases like that of Charlie Gard expose their limits, when values clash not just in intensity but also in form; clinicians may emphasise non-maleficence and a‘ best interests’ interpretation of beneficence, while parents appeal more-so to justice( fair access to experimental options), and the responsibility to continue treatment until all hope is exhausted. Cultural interpretations of what constitutes‘ suffering’ should also be taken into account. The four principles may describe these tensions to some extent, but they do not, on their own, tell us how to choose between radically different conceptions of what constitutes as‘ harm’,‘ benefit’, or a just distribution of burden in the pluralistic, technologically advanced societies we live in— take the debates surrounding genetic engineering or abortion.
How should conflicts between parental autonomy and medical judgment be resolved? In conflicts between parental autonomy and medical judgement for young children, I think the ethical anchor should be a robust, comprehensive‘ best interests of the child’ standard, interpreted through a dialogue-centred process that takes parents’ religious, cultural and spiritual commitments seriously, but does not grant them absolute veto powers. Ideally, clinicians and parents should pursue shared decision-making: exploring prognosis and burden together, recognising parents’ special authority, and only turning to the courts when parental choices risk significant or lasting harm, or amount to objectively futile or inhumane treatment. High-profile cases such as that of Charlie Gard suggest that the law is a blunt last resort; a better model would have embedded ethical support and culturally literate chaplaincy early on, so that disagreements are framed less as parental rights versus professional power, and more as a joint attempt to honour the child as a moral patient whose life, and death, have meaning within both family and wider society.
Members of Dr Savory’ s fourth year biology set will understand how understanding the application of ethics can influence a medley of decisions that relate to the medical and broader scientific field, from research into untested Ebola drugs to how the NHS can handle vast arrays of sensitive patient data. With the tidal wave of AI rapidly approaching, and the possibility that human-based decision making may be altered in the healthcare space, being literate with regards to ethics and how we choose to apply them is more important than ever.
With thanks to Xander Sharrocks( Coll:, 22-) and Syed Hussain( Coll:, 22-). Med Soc meets every Friday 16:00-17:00 in Science School B1.
13