Medical ethics refers to the standards of conduct and associated values which govern the relationship between practitioner and patient in biomedical contexts. Adding to this concept is bioethics that covers the values and standards that should apply to research (scientific), doctors, nurses and other biomedical practitioner’s activities. Bioethics attempts to influence how practitioners of biomedicine act within the realms of biomedicine. Yet, it is apparent that both of these concepts (medical and bioethics) tend only to govern western biomedicine.
The alternative, medical ethno-ethics, Richard Lieban suggests is the “moral tenets and problems of health care as they are conceived and reacted to by members of a society” (as cited in Joralemon, 2010, p. 106). Is medical ethno-ethics an alternative to medical and bioethics, applicable to both traditional systems of healing and biomedicine?
For the purposes of this assignment (in particular part a), I will discuss ethics and whether or not a universal concept can be applicable to all systems of healing that acknowledges the many cultural norms and values that guide healing behaviours, and discuss the anthropologist intervening in a medical context. For Part b, I will discuss psychoactive substances (party pills) and animal testing as a current medical ethical issue in New Zealand.
So, is it possible to have a code of ethics that is universally applicable to all systems of healing, biomedicine, traditional and all those in between?
To understand what therapeutic methods has to do with each culture’s definitions of medicine, treatment, health and the boundaries that may (or may not) separate healing practices from religions, or political, or familial. We will see healing merging w...
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...human consumption is due to the testing of toxic substances on animals for results that may produce both false positives and false negatives. That drugs produce different effects in animals as they do in humans, for example, caffeine which is highly toxic to dogs (and is found in party pills) is virtually harmless to humans. To the point that animal testing conducted outside of New Zealand is of greater risk to the animal as many countries, such as China and India who conduct animal testing have little to no animal welfare protection for the animals used. We must consider whether psychoactive substances (that have no medical benefits) that fall under the ‘legal high’ umbrella have a place within our society, and whether we can accept the harmful and potentially fatal testing of animals to provide possibly inaccurate data for optional recreational drug use.
This book addresses one of the common characteristics, and challenges, of health care today: the need to achieve a working knowledge of as many cultures as possible in health care. The Hmong population of Merced, California addresses the collision between Western medicine and holistic healing traditions of the Hmong immigrants, which plays out a common dilemma in western medical centers: the need to integrate modern western medicinal remedies with aspects of cultural that are good for the well-being of the patient, and the belief of the patient’s ability to recuperate. What we see is a clash, or lack of integration in the example of the story thereof. Lia, a Hmong child with a rare form of epilepsy, must enter the western hospital instead of the Laotian forest. In the forest she would seek out herbs to remedy the problems that beset her, but in the west she is forced to enter the western medical hospital without access to those remedies, which provided not only physical but spiritual comfort to those members of the Hmong culture. The herbs that are supposed to fix her spirit in the forest are not available in the western hospital. The Merced County hospital system clashes with Hmong animist traditions.
For those of us who work in an acute care setting nursing is more about vital signs, electrolyte imbalances, arrhythmias, respiratory status and mental status changes just to mention a few of the things that demand our attention on a day to day basis. However, at times we are faced with issues that call into play ethical decision and hence it is important to understand ethical concepts that can influence such decisions. Concepts such as scientism, relativism, post modernism have been recognized as playing a key role in the conflict between science and religion. A conflict that has hindered an important healthcare goal of holistic patient care (Grand Canyon University, 2015).
Kleinman, Arthur M. “What Kind of Model for the Anthropology of Medical Systems?” American Anthropologist, New Series, Vol. 80, No. 3 (Sep, 1978), pp. 661-665.
Albert Jonsen, the author of “A Short History of Medical Ethics”, covers more than two thousand years of renowned medical history in a mere hundred and twenty pages. He covers many cultural customs and backgrounds involving medical discourse, beliefs, and discoveries which have led to the very formation of the distinguished society we live in today. However, throughout this brief tour, Jonsen exploits the fact that even though there have been many cultural differences, there are a few common themes which have assimilated over the years and formed the ethics of medicine. The most prevalent themes of ethics presented in Jonsens text, are decorum, deontology and politic ethics. Decorum is referred to as both the professional etiquette and personal virtues of medicine. Deontology refers to rules and principles, and politic ethics expresses the duties physicians have to the community.
In the US., the therapeutic group seldom has approaches to correspond with individuals of societies so drastically unique in relation to standard American society; even a great interpreter will think that it troublesome deciphering ideas between the two separate societies' reality ideas. American specialists, not at all like Hmong shamans, regularly physically touch and cut into the collections of their patients and utilize an assortment of capable medications and meds.
Ross defines and differentiates between the terms healing and curing. She recognizes the fact that healing and curing are very intertwined and it can be hard to distinguish between the two terms. There are differences between the definitions in scholarly and general settings. She references an ethnographic study of healing versus curing conducted by anthropologists Andrew Strathern and Pamela Stewart in 1999 with native groups in New Guinea. The results of the study looked at how energy used by the different types of tribal healers to either cure or heal a patient. Eastern medicine focuses on how energy interacts with the healing process in connection within the mind. Whereas Western medicine is focused on the mind and the body separately. The practice is considered a holistic approach to finding cures. According to Ross (2013), healing is more a therapeutic process targeting the whole body and specific illness including emotional, mental, and social aspects in the treatment. The act of curing is a pragmatic approach that focuses on removing the problem all together. The life experiences of a person playing into how well certain treatments will heal or cure what is ailing them. These aspects can not be defined with textbook definitions. The interaction that the healing process has with energy is a variable in the success rate. Uncontrolled emotions can have a greater impact on the inside the body than a person can realize. The exploration of energy interaction within the body can be used for greater analysis of health care systems. (21-22). Are Western healthcare facilities purposely “curing” patients just so that they return are few years later? Is Western Medicine built upon a negative feedback loop? The terminolo...
In the book The Spirit Catches you and you Fall Down, ethnocentrism can also be seen. Throughout the book the family and the doctors have different ideas of medicine/healing techniques are often disagreed on. It’s important for the doctor to see that biomedicine has its own intentions of saving patient through standard procedures and beliefs. Understanding those terms will shed some light on the culture of the patient, which has their own intentions, beliefs, and rules as well. Breaking down ethnocentrism to find an agreement is a good goal to accomplish in order have successful prognosis and healing. In addition, shedding the ethnocentrism will allow the doctors to see the different cultural beliefs and not judge right away. Although, some cultural remedies may not always work, it’s wrong for people to have the mindset of ethnocentrism without even considering their beliefs first.
In this diverse society we are confronted everyday with so many ethical choices in provision of healthcare for individuals. It becomes very difficult to find a guideline that would include a border perspective which might include individual’s beliefs and preference across the world. Due to these controversies, the four principles in biomedical ethic which includes autonomy, beneficence, non-maleficence and justice help us understand and explain which medical practices are ethical and acceptable. These principles are not only used to protect the rights of a patient but also the physician from being violated.
Gedge, E., & Waluchow, W. (2012). Readings in health care ethics (2nd ed.). Toronto, Ontario: Broadview Press.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "The Principles Approach." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 36-37. Print.
There are weaknesses in professional guidelines and rules because they are unable to provide the directives for moral reasoning and action is health care situations. Many people state that biomedical ethics provides a framework and emphasis on the person rather than the professional code and legal policy (Beauchamp and Childress, 2001). On the other hand they serve a purpose to provide some direction for professionals however codes of practise do not dismiss.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
Patients have the right to autonomy as a principle of ethics. The physician should not have discussed cultural differences within ear shot of patients. One never knows what cultural beliefs a patient practices. Most western physicians do not have a full understanding of traditional healing to Native American patients unless they live in an area with a large population. “Healthcare professionals must consider the patients decision to implement the treatment plan and the appropriate authorization.”
McGee, Glenn and Arthur L. Caplan. "Medical Ethics." Microsoft® Encarta® 98 Encyclopedia. © 1993-1997: Microsoft Corporation. CD-ROM.
Certain religious groups reject westernized medicine, like the Amish. Yet, for the most part most religions allow their medicinal practices to work in tandem with westernized medicine. For example, First Nations people tend to have a very holistic view when it comes to their surroundings and medicine. Aboriginal traditional approaches to health and wellness include the use of sacred herbs like sage or tobacco and traditional healers/medicine (pg. 5, Singh, 2009). However, they will not reject help from professionally trained doctors and medical staff. Much like other religions, First Nations put a strong emphasis on family/community. Consensus or decision-making is fairly common for them. A practitioner or medical staff member must remember to respect ceremonial objects such as tobacco or traditional blankets, include immediate family members when making a treatment decision, and to accommodate spiritual practices. Normally, organ donation is accepted UNLESS the organ is being removed from someone who is not deceased. First Nations’ believe that their bo...