Category Archives: Original Article

Hippocratic Resistance: Conscientious Medicine and Strategic Ethics

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Abstract

Conscientious medicine enjoys a long history, with roots reaching back to the Hippocratic Oath. Conscientious objection (CO) as a particular manifestation of such practice carries broader implications for healthcare and society. While patients have the right to decline treatments, they are free to do so for a variety of reasons, even against medical advice (AMA). Healthcare professionals (HCPs), on the other hand, are viewed differently. When it comes to morally questionable interventions, they may be asked to put aside their own convictions out of a sense of obligation or duty. Critics claim that conscientious objection that delays or limits interventions can cause harm. Supporters of conscientious objection argue that there is a growing list of interventions that raise larger questions about the definition of harm and the very nature of humanity. Not only is objection justified in such cases, but it may also be essential to the honest practice of pluralistic medicine. This essay argues that conscientious objection is a defending characteristic of medical ethics as part of the healing identity, with strong historical roots. In addition to safety and policy, conscientious practice acts as an ethical line of defense that has protective qualities for society. Current literature on this topic speaks to the clinical challenges involved with balancing objection and access. This essay uses historical examples going back to Hippocrates to illustrate how respecting individual conscience is strategic for the collective endeavor of medical ethics.

Keywords: Autonomy, Authority, Nonmaleficence, Conscientious, Conscience, Medical Ethics, Integrity, Hippocrates

The Moral Status of the Embryo in the Ethical Debate over In Vitro Fertilization

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Abstract

On February 29, 2024, the Alabama State Legislature raised a national debate over the ethics of In Vitro Fertilization. The Los Angeles Times on March 4 declared the law’s assumption that the embryo is a person (and by extension would have moral status) must be opposed because it stifles the right of women to have abortions and use IVF. In this paper I argue that an embryo has moral status based on what I call its “organic destiny,” which reveals its goodness of existence. I explain this according to the inner directivity of biological life to mature through the stages of being an embryo, newborn, toddler, to adulthood. The biggest ethical problem with the procedure of IVF is what to do with the leftover embryos not used in the process. IVF per se does not necessarily overlook the moral status of the embryo, but to discard the leftovers because they are now superfluous would overlook and disrespect their moral status. Thus, for the procedure of IVF to recognize ethically the moral status of the embryo, it should proceed with only one embryo at a time.

Keywords: In Vitro Fertilization, Moral Status, Embryo, Organic Destiny, Aristotle, Bible

Professional Integrity in Healthcare Professionals: What, Why, and How

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Abstract

In this article, the authors discuss some empirical and conceptual basics of professional integrity of conduct in healthcare professions, such as nursing and medicine. They do so in three sections: the basics of professional conduct, including what they are, why they are, and how they work together, integrating original research as well as practical applications. We suggest professional integrity is integral to ethical caring practice, for the good for the patient is at stake, involving the trust of the patient in the professional, in her professional position, and in her profession as a whole. Professional integrity is the moral quality to keep together three dimensions of one’s person, one’s professional practice, and the patient’s interest. Several factors are identified either supporting or eroding professional integrity and the ability to manage integrity issues in practice. Those factors constitute five rules of thumb as well as reflective tools.

Keywords: professional ethics, professional integrity, moral wholeness, reliability, trustworthiness

The Ethics of Uterine Transplant in Absolute Uterine Factor Infertility: A Review of Uterine Transplant Today from the Lens of the Belmont Report

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Abstract

The miracle of childbirth and childrearing has been apparent since the beginning of time. Most women can birth children, and consequently, it is distressing for those who suffer from infertility. Medicine and research have advanced to provide relief from this type of suffering. Previously, absolute uterine factor infertility, or absence of a uterus, has been untreatable. However, advances in surgical and transplant techniques have made uterus transplantation a possibility for this type of infertility. Many risks are involved for women and children throughout the transplantation, pregnancy, and birthing process. As scientists, medical professionals, and Christians, we must ask, do the ends justify the means? This article will review the promises, perils, science, and current statistics of uterine transplantation from the specific view of research ethics. It will analyze the ethical permissibility or impermissibility of continuing research or approving this type of infertility treatment from the lens of the Belmont Report, with additional attention to the Montreal Criteria, traditional transplant ethics, the epistemology of science, the purpose of medicine, the particular view of Christian bioethics, and biomedical ethics. After reviewing these methods with statistical analysis of current research data, it will be perceptible from all presented views, with special attention to the research lens of the Belmont Report and Christian bioethics, that they do not permit uterine transplantation.

Keywords: AUFI, Biomedical Ethics, Christian Bioethics, Infertility, IVF, Medical Ethics, Transplant Ethics, Reproduction, Uterus, Organ Transplantation.

Variance in Viewpoints: Protestant Perspectives on Birth Control and Assisted Reproduction

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Abstract

One’s view of the link between sex and reproduction typically correlates with one’s stance on birth control and assisted reproductive technologies such as IVF. While the Roman Catholic Church holds a clear conviction regarding these technologies and interventions, Protestant (bio)ethicists and individuals alike vary in their viewpoints. When it comes to contraception, Protestants typically fall into three categories: completely against, completely in support, or allowed with restrictions. Opinions on assisted reproduction typically are affirmative or opposed. Through an examination of historical landmarks and varying Protestant perspectives, this article demonstrates how one’s theology of sexuality, or lack thereof, influences reproductive decisions.

Keywords: contraception, sexuality, assisted reproduction, women’s health, reproductive technologies, religious ethics

Ethics and Empirical Knowledge: A Critical Ethical, Partially Detached Interpretation of Experiences of Relatives of Patients Who Received Euthanasia

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Abstract

The use of empirical data in ethics is on the rise. At the same time, its role in “discovering the good” is much debated. Many scholars—especially those rooted in a modernist, liberal philosophical thinking and influenced by the natural sciences discourse—claim that ethicists should detach from their own considered moral judgments. Others are in favor of disclosing one’s own moral presuppositions in advance. Both positions can be difficult for Christian and other religious ethicists. Detachment could make ethical reflection meaningless and disclosure could alienate the ethicist from their interlocutors. In this article, we propose a four-step framework for the meaningful synthesis of empirical knowledge and ethical reflection. As a case, we use materials from our recently published collection of lived experiences of relatives of patients who received euthanasia.

Keywords: Ethics, Empirical Knowledge, Euthanasia, Theological Ethics, Detachment

Does the Use of Puberty-Suppressing Drugs Satisfy the Requirements of Informed Consent?

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Abstract

Gonadotropin-releasing hormone analogs (“puberty blockers”) have rapidly become the preferred method of treatment for childhood gender nonconformity or for teenagers experiencing various levels of gender dysphoria. Use of these drugs raises questions regarding the ability of prepubescent children to give an informed consent to life-altering interventions with unknown future effects. The article argues the use of puberty blockers fails to meet the standard of informed consent.

Keywords: Gonadotropin-Releasing Hormone Analogs, Puberty Blockers, Informed Consent, Gender Affirmative Model.

Human Flourishing and Contentment in a Biotechnological Context

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Abstract

Flourishing and contentment are connected but distinct. In Christian perspective, the goal of human enhancement is not conducive to human flourishing, whereas a therapeutic approach to the body is. However, the virtue of contentment means willingness to forgo even therapeutic treatment under certain circumstances. This article attempts to argue for these conclusions with reference to the contrast between the natural and the transhuman and by considering the significance of disability and the church as the body of Christ.

Keywords: Contentment, Enhancement, Flourishing, Nature, Therapy, Transhumanism