Tuesday, October 09, 2007

Bioethics & The Sanctity of Life

Bioethics is defined as the application of moral principles to the life sciences, to the many problems in relation to human life that has resulted from the rapid advancement in science and technology.

I will very briefly outline the many bioethical issues which we face today. Included in this discussion are:
1) Beginning of life issues:- such as i)assisted reproductive technologies like sperm donation, eggs donation, surrogate mothers, frozen embryos and lately tailor made test tube babies designed to produce tissue for bone marrow transplantation, ii)cloning, iii)embryonic stem cell research and iv)abortion.
2) End of life issues: euthanasia, dysthanasia, orththanasia, life support and adequate nutrition & hydration for comatose patients and persistent vegetative states,
3) Organ transplantation
4) The death penalty

In the field of assisted reproductive techniques very few are acceptable to the moral teachings of the church. Examples of those techniques which may be morally acceptable are GIFT (Gamete Inta-Fallopian Transfer ) and Lower Tubal Ovum Transfer (LTOT). IVF (In-Vitro Fertilization or test tube babies), Cloning and embryonic stem cell research all involve destruction of embryos and are thus not approved. Presently many Catholics still do not know that IVF is not morally acceptable. There are still some Catholics who still have the mistaken belief that abortion is permissible for health reasons or in cases of rape or incest.

Euthanasia is defined as an action or omission which of itself or by intention causes death, in order that all suffering may be eliminated.
Dysthanasia is defined as the undue prolongation of life which ends in an undignified death. It is an abusive use of extraordinary or inappropriate technological means to prolong life – usually costly and usually done for fear of a malpractice lawsuit.
Orthothanasia means correct dying. It is allowing to die. Human Life must be protected and even dutifully prolonged but should not be unduly or uselessly prolonged. It is not a form of passive euthanasia. It is vital to make a difference between allowing death to occur and intending death to occur.

When treating a dying patient, there is the question of appropriate versus inappropriate care. A patient with terminal and advanced prostate cancer is in severe pain and agony during the last few days of his life. His doctor administers morphine which helps relieve suffering but hastens his death. Is this appropriate? Yes, of course. A lot of doctors still fail to prescribe adequate doses of morphine for their dying terminally ill patients. Adequate hydration and nutrition in patients who are in a coma or in a persistent vegetative state are considered ordinary means and should not be withheld. The only exception is when they are imminently dying or when the nutrition cannot be assimilated by the patient’s body.

Organ donation for the purpose of transplantation is in itself good. It should be encouraged as an act of solidarity and charity. However all risks of harm to both donor and recipient must be kept to the minimum and the benefits must outweigh the risks. There should be no discrimination in the procurement and allocation of organ. Buying and selling an organ is wrong. It is against the dignity and worth of a person and could lead to exploitation, coercive profiteering, poor health standards and misinformation.

As for capital punishment and the death penalty, our late Pope John Paul II have often spoken against this and it would be wrong for a doctor or health care worker to assist in lethal injections and other such procedures.

In summary, as Catholic Doctors we should defend human life from the moment of conception till its natural end. We should inculcate virtues that are essential to ethical and good patient care and I feel that the 5 essential virtues are: 1)Truthfulness in carrying out one’s duty 2) Respectfulness for the patient’s dignity and rights 3) Compassionate and Competent care 4) Humility and 5) Prayerfulness.

Posted by Dr K Y Chong