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Medical
Ethics
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New medical, reproductive, and genetic technology in the second
half of the 20th century led to increased concern about moral issues
in medical treatment and research. By the 1990s, medical ethics,
or bioethics, emerged as a recognized discipline that involved physicians,
nurses, attorneys, theologians, philosophers, and sociologists.
Many
bioethics issues involve the possible misuse of genetic engineering
technology. The Human Genome Project led to identification of genes
that raise an individual's risk of developing cancer, heart disease,
mental illness, alcoholism, violent behavior, and other conditions.
Tests to detect some of these disease-susceptibility genes became
available in the 1990s.
These
discoveries led to debate over whether genetic tests should be performed
and how the results should be used. Should parents use such tests
to screen their unborn infants? If a fetus tested positive, should
it be aborted? If a woman tested positive for a breast cancer susceptibility
gene, should the information be made available to insurance companies?
Do insurers have a right to deny coverage to people with a genetic
high risk for serious diseases? Do employers have a right to demand
genetic screening tests before hiring people?
Genetic
technology also offers the potential of eventually replacing defective
genes with normal copies in human sperm and eggs. Some fear it will
lead to mandatory eugenics programs, attempts to improve the hereditary
traits of individuals or even entire races. Others argue that advances
in genetic technology could eliminate defective genes and hereditary
diseases from future generations.
An
intense discussion about bioethics occurred in 1997 and 1998, after
researchers in Scotland cloned the lamb, Dolly, from udder cells
from an adult ewe. The experiment showed that it was possible to
clone, or produce an exact genetic copy, of an adult mammal. Medical
ethicists debate whether cloning of human beings should be permitted,
as well as the potential effects on society.
Although
abortion became legal in the United States in 1973, it still causes
heated debate over the rights of the fetus and the pregnant woman,
as well as the question of when a fetus becomes a human being. The
availability of RU-486, also known as mifepristone, an inexpensive
drug that induces abortion, led to concern that more people would
use abortion for birth control. Ethical discussions centered on
whether tissue from aborted fetuses should be used in medical research,
treatment of disease, and organ transplants.
The right
of terminally ill people to receive assistance in dying raised other
ethical dilemmas. Physician-assisted suicide came to national attention
largely through the efforts of Jack Kevorkian, a Michigan physician
who helps people with terminal illnesses commit suicide. Opponents
claim it is unethical for physicians to help patients commit suicide.
Supporters counter that terminally ill patients have a right to determine
the time and manner of their death. While the U.S. Supreme Court in
1997 ruled that states can ban physician-assisted suicide, that same
year Oregon voters rejected an effort to repeal their law, the nation's
first to legalize physician-assisted suicide.
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