Medical, Ethical and Moral Issues

1
Medical, Ethical and Moral Issues in Death and
Dying
2
Legal Systems

• Every society has some type of legal system
  surrounding issues of death and dying
• When social values are established and agreed
  upon the legal system functions more
  efficiently
• Legislation can be a slow complicated process in
  even the best of situations
• Technology and scientific discovery can cause
  gaps between what is possible and what is legal

3
Legal Issues at Death

• Determination of death
• Defining death
• Certification of death

4
Determination of Death
5
Uniform Definition of Death Act - 1994

• An individual who has sustained either 1)
  irreversible cessation of circulatory and
  respiratory functions 2) irreversible cessation
  of all functions of the entire brain, including
  the brain stem
• Some would like to expand the definition to
  include loss of body and social integration
  vegetative states
• Issues Definition of Death - Stanford
  Encyclopedia of Philosophy
• Many protocols now indicate 2 to 5 minutes before
  organ harvest

6
Ethical, Moral and Legal Issues

• Organ Transplants, Euthanasia and Suicide,
  Abortion

7
Organ and Tissue Transplants

• Started in 1950s, but NOTA, National Organ
  Transplant Act passed in 1984
• OPTN - Organ Procurement and Transplantation
  Network was organized for
• Donor and recipient matching, registry of
  transplant recipients, priority lists for
  receiving donation
• In 2004, 6193 people died while on the waiting
  list
• Living donors are increasing 49.4 of all
  donors in 2004

8
Issues in Organ Transplants and Donations

•  Playlist - organ transplants
• Some religious issues
• Immediate burial, Gods ownership of the body
  (though competing values such as a focus on
  life can complicate this), location of the person
  or soul in the organ, determining death and life
  support, desiring organs can mean wishing death
  on another.
• Research question can deal with religious views
  on organ transplants global issues, culture and
  religion in regard to organ transplants or can
  focus on religion views of definitions of death
  (pretty theoretical so be prepared)

9
Assisted Suicide and Euthanasia

• Definition depends on who is acting
• Active vs. passive euthanasia refusal of
  treatment and decision not to treat (DNR, feeding
  tubes, hydration, extraordinary vs. ordinary
  means, etc.)
• What is medically ordinary may or may not be
  morally ordinary (Pope John Paul II artificial
  feeding and hydration is a natural, not medical
  intervention and is always morally required)

10
Moral Arguments for and Against Intentional
Ending of Life

• For prevention of suffering, personal liberty,
  quality of life. Personal liberty is difficult
  because an ill person may not be free of coercion
  or their wishes may coerce others.
• Against preservation of life as the highest
  value, slippery slope argument,
  diagnosis/prognosis could be wrong, help could be
  just around the corner, detracts from the
  physician as the preserver of life, medical costs
  etc. could drive decision (down side of liberty
  argument)

11
Assisted Suicide and Euthanasia

• clip 1
• clip 2
• clip 3
• Religious views can vary within a religion, but
  the view on the purpose of suffering and the
  value of human life will affect the religious
  attitude. Islam, Buddhism and Hinduism most
  clearly against all for different reasons.

12
Abortion in Japan- A Case Study Approach

• Abortion became legalized in Japan in 1948 and
  became the primary legal form of birth control
• Oral contraceptives did not become legal in Japan
  until 1999
• This took a great deal of activism on the part of
  women because the medical system was set up to
  favor abortion and the use of oral contraceptives
  was not viewed positively by medical
  practitioners.
• Abortion was not stigmatized in Japan for social
  and religious reasons
• Since an alternative to abortion has been
  introduced, womens feelings of guilt or distress
  for having an abortion have increased and a
  religious response emerged

13
Religious Understanding of Abortion in Japan

• Phases of becoming socially alive or socially
  dead processes rather than fixed points
  emerging from or returning to the realm of the
  Buddhas and gods.
• A child who has become Mizuko has gone quickly
  from the water of the womb to the unformed
  metaphorical liquid of life and death and from
  there they will return to the world.
• The infant is in a period of waiting and may come
  back to the same family at a later time.
• Social changes caused a need for ritual and new
  representation of a god or bodhisattva to emerge
  into a new type of temple culture and Mizuko-jizo
  began to more strongly represent the protection
  of aborted fetuses.

14
(No Transcript)
15
Issues in Abortion in the U.S.

• http//video.pbs.org/video/1853660685
• Abortion is an extremely divisive
  religious/political issue in the United States.
• Abortion is one example of how legal systems
  surrounding death become more chaotic due to
  diversity in social and religious values rather
  than lags in our social/legal response to the
  development of medical technology

16
Sources

• Corr, Nabe and Corr, 2006. Death Dying, Life
  and Living
• LaFleur, 1992. Liquid Life Abortion and Buddhism
  in Japan