My Reaction to Shannon's Introduction to Bioethics

Here are my summaries, reactions, and discussion questions on Shannon's text from An Introduction to Bioethics excerpted in our class reader. The photo is of author Thomas A. Shannon. Here's an interview article with him.

I. Main Points (100 words or more-focus on what you want!):

Shannon gives a number of main ethical theories and ethical terms that are useful to know when discussing bioethics dilemmas.

Ethical Theories:

1. Consequentialism decides based on comparing the various effects of various decisions, but the problem is that there is no defined standard for choosing actions,
   
2. Deontologicalism decides based on the duties that the individual has based on religion or other moral codes, but the problem is "the potential insensitivity to consequences."
3. Rights ethics decides based on what "rights" the individual should have, but there is no indication of what should happen when individual rights are in conflict,
4. Intuitionalism is a way of deciding by feeling, but it makes it difficult for one to communicate or persuade others.

Ethical Terms

1. Autonomy: The idea that individuals should be allowed to decide their own destiny.
2. Nonmalefience: The idea that we have an obligation to do no harm. If there is a conflict between one action and another, "proportionate reason" should be used to find the balance between burden/harm and benefit. (I didn't completely understand this)
3. Beneficence: We have an obligation to help others as long as it does not hurt us. It sounds good...I guess? Is it human instinct or does it need to be taught?
   
4. Justice: "What is a fair allocation of resources?" writes Shannon, but is that what justice is? That seems like "fairness" whereas justice is usually the process of finding the truth, no?
   
5. Informed Consent: Some issues are the patient's competence, the amount of disclosure that the patient wants or should get, the patient's ability to comprehend, and the voluntariness of the patient to do what he wants feels is best without coercion.
   
6. Paternalism: Should doctors or parents or other actors intervene and interrupt the autonomy of a person for some reason. Should people be forced to accept something against their will in some cases? This is very interesting. A blood transfusion for a Jehovah's witness or taking cigarettes away from a cancer patient. Should parents be restrained when they are prone to child abuse? Should the government makes laws to force people to do or not do something?
7. Rights: Are rights duties or privileges? Shannon's explanation is confusing. He talks about how "positive rights" are the duty to do something and "negative rights" are the duty to not do something (like not stop a woman who wants to have an abortion). I'm confused. Aren't "rights" what people CAN do, not HAVE TO do. Need a better source on this? Try this article from the Stanford Encyclopedia of Philosophy. Also, do animals have rights? Do all humans have equal rights, and how do we determine that?

II. Critical Reactions (2 or more, agree/disagree/strange/need more evidence/examples etc. Think "How could this article be better?"):

1. On p.16-3, line 32, Shannon writes "autonomy is the all-American virtue...it celebrates the hardy individualism for which our country is famous" but he does not mention what autonomy might mean in other cultures. I think autonomy should be a universal virtue, but I am an American, so I may be biased. He needs to write about this issue to help Americans see a more multicultural perspective.
   
   
2. On p.16-5, line 11, Shannon talks about "impure" paternalism, which he says means deciding to interfere with the will of a person not only based on that person's welfare, but also the welfare of others. I think the word "impure" is strange here, as if it is somehow undesirable. In the example, the doctors try to force a father to get a blood transfusion based on not only the health of the father but also the welfare of the children who need a healthy father. Why do they call this "impure"? They need a better word.

Because it is mostly just explanations of basic ethical vocabulary and concepts, this text is difficult to react critically to! Don't worry too much if you can't find anything...The discussion questions below are more important.

III. Discussion Questions (and my answers, 3 or more)

1. If a 1 year old child needs a blood transfusion to survive, but his parents refuse for religious reasons, what should the doctor do?
   I think the doctor should give the blood transfusion. I think the child's right to live is more important than the parent's right to decide the religion of the child. In this conflict of rights, the child wins.
   
2. Should ethics be universal, or is it acceptable for ethics to be local or case-by-case? For example, should we try to find an answer like Kant's categorical imperative of "Act only according to that maxim whereby you can at the same time will that it should become a universal law."? Should we try to decide "All humans should always allow xxx in this specific case."
   I think universal agreement is difficult, so it may be more realistic to accept situational ethics. However, the United Nations has successfully developed some ethical codes about child's rights, for example, which suggests that universal agreement is better.
   
3. Does the life of each person have equal value in all cases? For example, as Shannon writes on p.8 about justice, should a 15 year old person be given priority over an 80 year old person for a limited resource such as an organ transplant? Should it be a random lottery, or should the doctor decide based on whose life is "priority"?
   I think it is reasonable to give priority to significantly younger persons, but I would question the justice of any prioritization by healthiness or intelligence or social worth (p.7).

Whew! This took me about an hour to type. Is this too much homework for ELP students?