Whose Rights Come First: Doctors’ or Patients’?

Medscape

Arthur L. Caplan

Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at the NYU School of Medicine. Conscientious objection—everybody seems to be talking about it these days. What are the rights of physicians, pharmacists, nurses, or other healthcare workers to say that something may be legal but they refuse to do it?

This issue has come up particularly as more and more health systems are merging. You see Catholic hospitals merging with secular hospitals. Catholic hospitals have a huge presence in the American world of hospitals and nursing homes, probably accounting for 40% of all facilities. When mergers take place, whose values predominate? . . [Full text]

(Project response: Freedom of conscience in healthcare: “an interesting moral swamp?”)

World Medical Association Reaffirms Opposition to Euthanasia and Physician-Assisted Suicide

News Release

World Medical Association

The World Medical Association has reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide.

After an intensive process of consultation with physicians and non physicians around the world, the WMA at its annual Assembly in Tbilisi, Georgia, adopted a revised Declaration on Euthanasia and Physician-Assisted Suicide.

This states: ‘The WMA reiterates its strong commitment to the principles of medical ethics and that utmost respect has to be maintained for human life. Therefore, the WMA is firmly opposed to euthanasia and physician-assisted suicide.’

It adds: ‘No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end.’

The Declaration says: ‘Separately, the physician who respects the basic right of the patient to decline medical treatment does not act unethically in forgoing or withholding unwanted care, even if respecting such a wish results in the death of the patient.’

The revised Declaration defines euthanasia as ‘a physician deliberately administering a lethal substance or carrying out an intervention to cause the death of a patient with decision-making capacity at the patient’s own voluntary request.’

It says that physician-assisted suicide ‘refers to cases in which, at the voluntary request of a patient with decision-making capacity, a physician deliberately enables a patient to end his or her own life by prescribing or providing medical substances with the intent to bring about death.’

WMA Chair Dr. Frank Ulrich Montgomery said: ‘Having held consultative conferences involving every continent in the world, we believe that this revised wording is in accord with the views of most physicians worldwide.’

Protection of conscience law approved by Mexican state legislature

Sean Murphy*

By a vote of 35-6, the legislature of the Mexican state of Nuevo León, has approved an amendment to the state health law protecting freedom of conscience for “medical and nursing staff that are part of the state health system,” except in cases of emergency. The new provision was brought forwardby Carlos Leal the Social Encounter Party (PES). The amendment is already being attacked by groups claiming that it will allow discrimination against people seeking health care. [El Informador] [Associated Press]

Rodents With Part-Human Brains Pose a New Challenge for Bioethics

Gizmodo

George Dvorsky

Rapid progress in research involving miniature human brains grown in a dish has led to a host of ethical concerns, particularly when these human brain cells are transplanted into nonhuman animals. A new paper evaluates the potential risks of creating “humanized” animals, while providing a pathway for scientists to move forward in this important area.

Neuroscientist Isaac Chen from the Perelman School of Medicine at the University of Pennsylvania, along with his colleagues, has written a timely Perspective paper published today in the science journal Cell Stem Cell. The paper was prompted by recent breakthroughs involving the transplantation of human brain organoids into rodents—a practice that’s led to concerns about the “humanization” of lab animals. . . [Full text]

Facilitating an unethical practice is unethical

Psychiatric Times

Madelyn Hisaio-Rei Hicks*

I am an adult psychiatrist who has worked in public sector psychiatry in the US and the UK. In both countries, physicians struggle with the ethics and professional meaning of legalized or proposed physician-assisted suicide (PAS). I was recently asked by an organization to host a CME course titled “Best Practices in the End-of-Life Options Act.” Passed in 2016, the Act legalized the practice of PAS in California.

My response to the invitation

Thank you very much for your invitation to join in providing a CME about “Best Practices in the End-of-Life Options Act.”the very serious and complex ethical and legal issue of PAS.

At one point in my 14 years of examining and writing about PAS and euthanasia, I thought that, even though I found PAS to be unethical, in situations where it became legal, perhaps the best that psychiatrists and other physicians could do would be to provide thorough assessments and treatment options for individuals requesting PAS. . . [Full text]