Friday, February 12, 2010

Bioethics: A New State Religion?

Years ago, I read parts of a book, "Jewish Bioethics" by Dr. Fred Rosner. The late Chief Rabbi of Great Britain, Immanuel Jakobowits was a pioneer in developing the field of evaluating ethical dilemmas in medicine in accordance with traditional Jewish teachings. There were times in my life when asking and being informed of Jewish law in a particular instance was of great comfort to me and other family members. People in other faith traditions also turn to their clergy in times when troublesome problems occur. I know of a couple of instances where friends stood their ground when Jewish law demanded efforts to cure the patient that were at odds with prevailing medical wisdom.

I instinctively felt ambivalent when I heard that Rahm Emmanuel's brother, Dr. Ezekiel Emmanuel came out as a bioethicist in discussions of public health. This is an individual hired by the government and put into positions of shaping public health policy. He wants "bioethicists" advising families of the seriously and terminally ill on medical decisions. It has become clear that the new age "bioethicist" is of a different stripe from the personal clergyman called by distraught family.

The Hoover Institution Policy Review focused in a recent issue on the shifting role and definition of bioethics from the domain of personal clergy people and spiritual advisors to an arm of the hospital administration and the government.

Dr. Douglas Hanto is one of the new breed of bioethicist. Two years ago, Lisa Cunningham, a 40 year old social worker with a young son found out about Dr. Hanto when she was at the threshhold of geting a kidney transplant. What did Dr. Hanto do ? How did he touch the life of Ms. Cunningham in her hour of tribulation? The Hoover Policy Review reports as follows.

A few years ago, Hanto, a former head of the ethics committee of the American Society of Transplant Surgeons, had his hospital turn away a fragile patient named Lisa Cunningham, a 40-year-old former social worker with a young son, whose prospective donor read about her plight in a local newspaper. Arthur Caplan, a prominent bioethicist at the University of Pennsylvania, condemned donor solicitation online as “an outbreak of impatience combined with a me-first attitude,” he told a reporter.

How was Ms. Cunningham hurting anyone else? She was on a waiting list for kidneys belonging to deceased individuals. She found a living donor. Everyone behind her moved up the list by one slot. But Dr. Hanto doesn't like that. Everyone has to wait their turn. Dr. Hanto is quite a powerful man.

Bioethicists are expanding their reach, much as Hollywood stars are into areas far outside their professional domain. Consider the view of Ruth Macklin. The HooverInstitution Policy Review continues as follows

"Bioethicists like Ruth Macklin of the Albert Einstein College of Medicine would have bioethics adopt an aggressive pursuit of social justice. “As a liberal, humanitarian bioethicist,” she told interviewers, “I acknowledge that my chief concern is in striving for greater social justice within and among societies, and reducing disparities in health, wealth, and other resources among populations in the world.” Howard Brody opines that the future agenda of bioethics “ought to be concerned with power disparities.” These may be noble aspirations, but one must ask what particular authority or skill bioethicists possess that qualifies them to solve global health problems, let alone economic ones. Achieving social justice in health is a complex task that requires the forging of a meaningful universal agreement on what health care should be like and what kind of scheme should dictate the national and transnational allocation of medical resources. "

Indeed, Sally Santel, the author of the Hoover Institution Journal was invited to address the American Society for Bioethics and Humanities (ASBH) concerning whether or not ASBH should take political positions, her opposition to the idea got a decidedly chilly reception.

It seems that there is an aggressive effort underway to usurp the role once occupied by trained clergy in making life and death decisions. As coercive as religious authority might be, I have the right when consulting my clergyman to hang up the phone and call someone else. People like DR. Hanto take that free choice out of the equation.

Who pays the bioethicist? You can call yourself a doctor. You can have credentials as a computer technician or a plumber. But is it not presumptuous to call oneself a bioethicist? It's almost like calling yourself a dignitary. I want someone trained in and a believer of my faith to guide me in life and death decisions. People like Ezekiel Emmanuel and Douglas Hanto want to change that. Who elected them? How do you discharge them from office?

I have great respect for doctors. They have a lot of schooling and a great deal of scientific knowledge. I have always asked questions of doctors and attached heavy weight to their medical opinions and judgement. But it is my right to incorporate the knowledge they present to me into my own ethical framework. The new system being quietly imposed upon us is one step away from discharging privately trained clergy and replacing them with clergy trained by the state.

I am haunted by the story of Lisa Cunningham, barred from a kidney transplant by a self styled moral arbiter. I fear that such instances of overreaching arrogance will become more and more commonplace.

The system of checks and balances is commonly assumed to involve the legislative, the executive and the judicial. The family, the clergy and the press are all completely independent of the three branches of government. Yet strong and vibrant private institutions such as the family, clergy and press are a critical counterbalance to the overreaching authority of the government. It is critical that this authority not be undermined. As government seeks to do more and more. We must ask ourselves what the price will be. Sphere: Related Content

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