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Medicine and health care in South Africa. A religious/ethical perspective.

Religion and morality are inter-related but nevertheless quite distinct from each other. All the great living religions of the world teach broadly comparable moralities, e.g. the "Golden Rule". In all of them there is general acceptance of the fundamental worth of the human personality. This is true also of the teaching of many moral philosophers, e.g. Kant, who taught that people must be treated as ends and not means. In the Biblical religions such respect derives from the doctrine of the Imago Dei. From this premise stems a number of ethical norms, which, however, are often in conflict and not easily reconciled. Hence, the dilemma of trying to decide on a just and equitable allocation of scarce medical resources and adequate health care in a country where there are not nearly enough medical resources for all who need them. Who lives? Who dies? Who decides? Some ethicists advocate a purely random procedure, recognizing the equal worth of every individual. Others believe there are relevant differences that justify choices being made on valuational or utilitarian grounds. They argue that the distribution of medical care in less than optimal circumstances requires a certain discrimination. Paul Ramsey believes that this problem is so complex as to be almost impervious to human reason. He therefore argues for far greater emphasis on preventive medicine. This raises the question as to whether we should be spending millions on procedures designed mostly for the benefit of the chosen few (who can afford them) when thousands of children are dying annually from diseases for which cures are known but not available to the masses.(ABSTRACT TRUNCATED AT 250 WORDS)

Delivery of Health Care

We must rescue them.

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Abortion, Legal

Bioethics: secular philosophy, Jewish law and modern medicine.

The recent unprecedented expansion of scientific knowledge and the greater awareness and involvement of the public in medical matters, as well as additional causes described here, have impelled the development of a new form of bioethics over the past three decades. Jewish law and philosophy have always dealt with medical issues. In recent years, however, a voluminous body of literature devoted to Jewish medical ethics has developed. It covers all relevant issues and offers Jewish solutions to many complex problems arising from the recent scientific breakthroughs. This article analyzes the differences between Jewish and secular philosophies regarding fundamental moral theories relevant to modern medical ethics.

Beneficence

Whole or parts--a theological perspective on 'person'.

The influence of a theological perspective on nursing may be seen in the ethical debates concerning the beginning and end of life, the presence of theologians on ethics committees demonstrating the scope of opinion being sought. The meeting of theology and nursing to be addressed in this paper centres on the interaction of one human being with another, characterized by the terms community, relationship, response. Theology is concerned with persons reaching their potential not in isolation from, but in community with others. Fragmented care ensues from dividing a person into 'manageable' parts. Christian theology knows no such separation and offers a focus for an understanding of 'person' which has relevance for holistic nursing. The same holds true for groups as well as individuals; to focus primarily on self-interest is to ignore the possibilities for mutual exchange. Living 'in relationship' is both the point of departure and the ultimate goal of all created existence. Autonomy and mutuality are two sides of the same coin and the pursuit of one at the expense of the other is, according to Christian theology, not only illusory but a denial of the purpose of creation.

Ethics, Nursing

The inner workings of an ethics committee: latest battle over Jehovah's Witnesses.

Jehovah's Witnesses who refuse blood transfusions on religious grounds have long created ethical dilemmas for those in the medical profession trying to serve them. A bioethicist working in a clinical setting explores how one hospital ethics committee grappled with the additional problem of pregnant Jehovah's Witnesses, including the complex interdependence of maternal and fetal rights.

Blood Transfusion