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At least 289 records · Page 16Linked to original sources
PubMed1998

The cost of refusing treatment and equality of outcome.

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care.

Australia↗
PubMed1998

Transfusion-free treatment of Jehovah's Witnesses: respecting the autonomous patient's rights.

Do six million Jehovah's Witnesses mean what they say? Muramoto's not-so-subtle proposition is that they don't, because of a system of control akin to the Orwellian "thought police". My response is that the fast developing cooperative relationship between our worldwide community and the medical profession as a whole, and the proven record of that community's steadfast integrity in relation to their Christian principles is the evidence that we do! I seek to highlight the inaccuracy of information, which Muramoto admits came largely from dis-enchanted ex-members, by quoting "established" medical ethical opinion that refusal of blood transfusions must be respected as evidence of patient autonomy. Personal experience of my work on hospital liaison committees for Jehovah's Witnesses is reviewed and I endeavour to prove that our view of blood, and its association with life, goes to the very core of the human psyche. Lastly I suggest that faith transcends rationality. Human beings are more than just minds! Our deep moral sense and consciousness that our dignity is diminished by living our lives solely on the "self interest" principle, lies at the heart of true personal autonomy. Maybe it's a case of "two men looking through the same bars: one seeing mud, the other stars".

Advance Directives↗
PubMed1998

Transfusion-free treatment of Jehovah's Witnesses: respecting the autonomous patient's motives.

What makes Jehovah's Witnesses tick? What motivates practitioners of medicine? How is benevolent human behaviour to be interpreted? The explanation that fear of censure, mind-control techniques or enlightened self-interest are the real motivators of human conduct is questioned. Those who believe that man was created in "God's image", hold that humanity has the potential to rise above selfishly driven attitudes and actions, and reflect the qualities of love, kindness and justice that separate us from the beasts. A comparison of general medical ethics and disciplines, and those of the Jehovah's Witness community, is made in this context. The easy charge that frequent deaths result from refusal of blood transfusions is examined. The central source of antipathy towards Jehovah's Witnesses, namely the alleged imposition of extreme and even harmful refusal of blood therapy on our children is addressed. Of course, "...few dilemmas are likely to be resolved wisely or satisfactorily by a blinkered adherence to abstract principles alone. Solutions to most cases will be dictated by a combination of factors. The support of medical ethics by Jehovah's Witnesses, and their willingness to share in reasoned and ethical debate, while at the same time holding firm to their religious and conscientious principles are emphasised.

Adult↗
PubMed1998

Two worlds apart: religion and ethics.

In a recent article entitled, Requests "for inappropriate" treatment based on religious beliefs, Orr and Genesen claim that futile treatment should be provided to patients who request it if their request is based on a religious belief. I claim that this implies that we should also accede to requests for harmful or cost-ineffective treatments based on religious beliefs. This special treatment of religious requests is an example of special pleading on the part of theists and morally objectionable discrimination against atheists. It also provides an excellent illustration of how different the practices of religion and ethics are.

Cultural Diversity↗
PubMed1998

Medicine, ethics and religion: rational or irrational?

Savulescu maintains that our paper, which encourages clinicians to honour requests for "inappropriate treatment" is prejudicial to his atheistic beliefs, and therefore wrong. In this paper we clarify and expand on our ideas, and respond to his assertion that medicine, ethics and atheism are objective, rational and true, while religion is irrational and false.

Cultural Diversity↗
PubMed1999

To clone or not to clone--a Jewish perspective.

Many new reproductive methods such as artificial insemination, in vitro fertilisation, freezing of human embryos, and surrogate motherhood were at first widely condemned but are now seen in Western society as not just ethically and morally acceptable, but beneficial in that they allow otherwise infertile couples to have children. The idea of human cloning was also quickly condemned but debate is now emerging. This article examines cloning from a Jewish perspective and finds evidence to support the view that there is nothing inherently wrong with the idea of human cloning. A hypothesis is also advanced suggesting that even if a body was cloned, the brain, which is the essence of humanity, would remain unique. This author suggests that the debate should be changed from "Is cloning wrong?" to "When is cloning wrong?".

Cloning, Organism↗
PubMed1994

Assisted reproduction in contemporary Jewish law and ethics.

This article recapitulates and extends a discussion of the position of halakhic Judaism (traditional Jewish law and ethics) on various issues that relate to assisted reproduction, including genetic and legal relationships, disposal of untransplanted embryos, embryo tissue research, multifetal pregnancy reduction, preimplantation genetic screening and sex selection and donor gametes.

Aborted Fetus↗
PubMed1984

Nuclear death: an unprecedented challenge to psychiatry and religion.

The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed "pride" by theologians and "narcissism" by psychiatrists. For the first time, humans have power to exterminate themselves and death threatens all ages equally. Pride of power causes leaders to exaggerate their ability to control nuclear weapons; moral pride leads to demonizing enemies. The author considers implications for psychiatrists and clergy, with special reference to preventing a nuclear holocaust.

Attitude of Health Personnel↗
PubMed1996

What went wrong: multiple perspectives on an adolescent's decision to refuse blood transfusions.

Persons with religious beliefs that conflict with mainstream medical practice create a tension for clinicians between honoring the different religious perspectives of the individual or carrying out what they believe to be their professional obligation. This is a patient presentation of an adolescent Jehovah's Witness who refuses blood transfusions. The major issue in this patient is the conflict among three values (1) respect for religious beliefs, (2) respect for a competent person's right to refuse treatment, and (3) the ability of an adolescent to make good decisions for himself. Other dilemmas presented by this patient are the lack of a coordinated plan of care, the lack of communication with the patient and family, and the lack of attention to social factors that influence the patient's situation and his resulting care.

Adolescent↗
PubMed1986

Suicide: ethical and moral issues from a theological perspective.

A historical review of the Jewish, Christian, Islamic, Hindu and Buddist attitudes of suicide. The evolution to the contemporary Christian perspective is discussed citing contributions of Aristotle, Augustine, Aquinas and Donne. Issues raised by life-extension technology are discussed.

Ethics↗