What difference does it make to be a Christian physician? In this essay, we suggest an approach to answering the pressing of question of who we are to be as Christians who are called by God to practice medicine. Drawing from our years of clinical experience we present a reflection and exhortation in which we bring together the work of scholar-mentors who collectively inform how we consider and answer the question; in so doing we hope to offer fresh perspective and encouragement. We introduce the thesis that medicine is fundamentally an eschatological enterprise throughout human history, expectantly following the healing ministry of Christ.
Category Archives: Original Article
The Nurse Practitioner’s Oath: A Christian Hippocratic Framework for Nurse Practitioners
The nursing profession has long cared for and sought to heal the sick. The nurse today functions within healthcare teams inside hospital systems or in outpatient settings. Throughout the nursing profession, ethics has been important. The Nightingale Pledge was the ethical standard for the ideal nurse adapted from the Hippocratic Oath and named after Florence Nightingale. It held the nurse responsible to God, forbid harming the patient, and commissioned nurses to promote the health of patients and assist physicians in this endeavor. The profession advanced in 1965 to create nurse practitioners to address the needs of access to healthcare. Nurse practitioners are nurses with advanced graduate-level training to examine, diagnose, treat, and prescribe in order to help and heal patients. The nurse practitioner role was originally created for nurses to assist physicians to see more patients independently. Unfortunately, nurse practitioners do not have any ethical framework or oath that shapes their practice. Only one proposal of a nurse practitioner code of ethics has been attempted. There are no oaths for nurse practitioners to serve as an ethical framework for nurse practitioners. Like the Nightingale Pledge that was fashioned from the Hippocratic Oath, nurse practitioners ought to practice from the moral framework of Hippocratism. Moreover, medicine and nursing were both influenced greatly by early Christianity, and Christian nurse practitioners ought to practice Christian Hippocratism. In order to base the virtuous nurse practitioner’s practice in an ethical framework, an Oath for Nurse Practitioners is proposed.
Hippocratic Resistance: Conscientious Medicine and Strategic Ethics
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
A Higher Calling: Bioethical and Christian Perspectives on Medical Drone Delivery in Developing Nations
This review discusses the emerging technology of medical drone delivery and the associated logistical, bioethical, and Christian worldview considerations. Utilization of drones for delivering medical supplies, though a groundbreaking advancement enhancing medical accessibility and timeliness, raises significant bioethical concerns rooted in principles like beneficence, non-maleficence, autonomy, justice, and explicability. These concerns entail ensuring equitable distribution of medical resources for public benefit while safeguarding patient privacy and data integrity. It is imperative for companies to adhere to regulatory frameworks and transparently communicate about this emerging technology. Addressing these challenges necessitates stakeholder collaboration, involving manufacturers, healthcare providers, regulatory authorities, and communities. From a Christian worldview, key principles encompass the sanctity of life, justice and equity, responsible stewardship of resources, and community welfare. The bioethical implementation of medical delivery drones depends on finding a balance, leveraging technological progress for societal good, and mitigating risks through conscientious, accountable practices. By embracing this approach, the healthcare sector can effectively leverage drone technology to enhance patient care and public health outcomes while upholding the intrinsic values of healthcare, such as compassion, empathy, and human connection.
Emerging Technology and Public Health Ethics
Emerging technology used in public health surveillance has increased tremendously in the past decade and especially during the COVID-19 pandemic. Technologies such as surveillance video monitoring, facial recognition software, and artificial intelligence are used with increasing frequency in the name of preventing or containing diseases. These same technologies have been used by governments for uses other than public health surveillance in so-called “function creep.” Such uses can infringe upon individual autonomy and personal privacy. Ethical analysis during the COVID pandemic typically followed utilitarian analytical frameworks. This presentation uses a virtue ethics analysis of surveillance technologies emphasizing honesty, responsibility, and compassion. Utilitarian ethical analysis leads governmental actions to seek actions and use technologies that protect the most people, but do not necessarily benefit minority groups. Virtue ethics presents a firmer ground to protect the health of the community while safeguarding minority rights through its focus on the moral development and character formation of the public health professional, the individual, and the community. Lastly, a Christian reflection on such issues is examined. Ethical analysis of public health surveillance technologies must precede use of such technologies. A virtue ethics approach can assist in such analysis, supporting the health of the community while protecting the rights of the vulnerable.
Ethics of Virtual Reality at the End of Life
Clinically, virtual reality (VR) applications can be used to control pain and to treat psychological disorders. Christians should be attentive to issues of embodiment and excarnation when approaching this technology. At the end of life, VR can help mend one’s relationship to one’s body and promote relationships of care and love between persons. Negatively, VR can be depersonalizing if it alienates a patient from the flesh world. However, VR can help a patient towards a good death as a pain relief adjunct when used within a caring community.
Transformations in Care: An (Old) Physician’s Perspective
So, what I would like to talk about is a physician’s perspective on the transformation in care—changes in healthcare, changes in healthcare finance, and changes in healthcare ethics.
The Moral Status of the Embryo in the Ethical Debate over In Vitro Fertilization
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
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
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.