• Objective to revise medical ethics. What did we cover? Medical Ethics Questions of morality that are raised by medical situations. Medical Ethics Religion and medical ethics Attitudes to abortion Different attitudes towards abortion Reasons for different attitudes Attitudes to fertility treatment Responses to issues raised by fertility treatment and cloning Attitudes to euthanasia Different attitudes towards euthanasia and suicide Different attitudes towards suicide Reasons for different attitudes Using animals in medical research Beliefs about the use of animals in medical research Revision note making: use different coloured pens (i.e. Bible teaching, roman catholic, liberal protestant) create sub titles, use little pictures and use bullet points. Ethics 1: MEDICAL ETHICS examples of question you could get. (a) [1 mark] 1. 2. 3. (b) 1. 2. What does Abortion mean? What does euthanasia mean? What does sanctity of life mean? [2 marks] Describe what is meant by ‘cloning’. Give two reasons which might lead a person to commit suicide. (c) [3 marks] 1. Give three statements explaining what you understand by ‘euthanasia’. 2. Describe the attitude of some Christians towards sex before marriage. 3. Describe the attitude of some Christians towards suicide. Ethics 1: MEDICAL ETHICS examples of question you could get. (d) [6 marks] 1. 2. 3. 4. Explain Christian views about abortion. Explain Christian views about fertility treatment. Explain Christian views about suicide. Explain the attitude of some Christians to helping a terminally ill person to die. e) [12 marks] Discuss this statement. You should include different, supported points of views and a personal viewpoint. You must refer to Christianity in your answer. 1. ‘Euthanasia should never be allowed.’ 2. ‘Animals can be used in medical research, because humans are more important than animals.’ 3. ‘Only God has the right to take life.’ 4. ‘God created all life so only god should take it away’ 5. ‘Abortion is always wrong’ Key words Definitions Abortion Deliberate termination of pregnancy by removal and destruction of the foetus. AID Artificial insemination by donor. AIH Artificial insemination by husband. Clone An individual organism or cell produced asexually from one ancestor to which they are genetically identical. Denomination A branch of Christianity; different types of Christians. Embryo A foetus before it is 4 months old. Euthanasia When someone is helped to die without pain before they would have died naturally. Fertility treatment Medical treatment to help a woman become pregnant. Genetic engineering The deliberate modification of the characteristics of an organism by manipulating its genetic material. IVF In vitro fertilisation. The egg and the sperm being Medical ethics Questions of morality that are raised by medical situations. Sacred Holy, having something of God or the divine. Sanctity of life The belief that all life is given by God and is therefore sacred. Suicide Deliberately ending one’s own life. brought together in a test tube. Top Bible Quotations to use in Medical Ethics! Bible bits: ‘Let us make man in our image, in our likeness, and let them rule over the fish of the sea and the birds of the air,..’ (Genesis) ‘God made man in his own image’ (Genesis 1:26-27) ‘God gives Adam the ‘breath of life’’. (Genesis 2:7) ‘Do not murder’. (Exodus 20:13) ‘God is responsible for the giving and taking of life’ (Job 1:21) ‘the body is a temple of the Holy Spirit’’ (1 Corinthians 3:16=17) Medical Ethics 1.Sanctity of life • Christians often say that they believe in the ‘sanctity of life’. They mean that they believe there is something special and holy about human life. • For Christians, human life is different from other kinds of life, because people share something of the nature of God. • The book of Genesis describes how God made Adam, and then ‘breathed into his nostrils the breath of life’. Christians regard this as the giving of the soul. Genesis also says that people are made ‘in the image of God’. • Christians believe that each person has a ‘soul’, which does not die when the body and the mind die, but lives on after death. It is the soul that is judged by God, and which can join God in heaven for ever. • The Bible also teaches that God plans each human life. • Christians believe that they should treat all human life with respect. • Because Christians believe that God has given their lives to them, they think that they have a responsibility to take care of themselves and of others. Key words: Sanctity of life: the belief that there is something special or holy about life. Soul: the non-physical part of a person which may go to heaven when the person dies. Bible bits: God made man in his own image (Genesis 1:26-27) God gives Adam the ‘breath of life’. (Genesis 2:7) ‘Do not murder’. (Exodus 20:13) God is responsible for the giving and taking of life (Job 1:21) ‘the body is a temple of the Holy Spirit’ (1 Corinthians 3:16=17) 2.Attitudes to abortion • An abortion is when a foetus is expelled from its mother’s uterus before the pregnancy reaches ‘full term’ (usually 40 weeks). Sometimes this happens naturally and is called a ‘miscarriage’, or a ‘spontaneous abortion’. However, ‘abortion’ usually means ‘procured abortion’ when the foetus is removed deliberately. • Roman Catholics believe that life begins from the moment of conception, on the very first day of pregnancy. Some other Christians believe that the foetus cannot really be described as a person until later in the pregnancy, when it becomes more recognisably human. Others believe that it becomes a person when it is capable of surviving on its own, at about 22 weeks. • Roman Catholics believe that the killing of an unborn baby is morally wrong in all circumstances. However, if abortion is needed to save the mother’s life, such as in the case of an ectopic pregnancy, they would accept the doctrine of double effect. This says that if something morally good has a morally bad sideeffect, it is right to do it providing the bad sideeffect was not intended even though it was known. • The Church of England also opposes abortion but recognises that there can be certain conditions when abortion would be morally acceptable such as the child would experience a low quality of life due to severe medical disabilities, or in the case of rape. • The Methodist Church says that abortion is always an evil but recognises that there are cases where abortion may be the lesser of two evils: if the child would be born with an incurable disease for example. • Some Christians are more willing to accept early abortions than those which take place later in a pregnancy. Bible bits: ‘Do not murder’ (Exodus 20:13) God creates people in the womb (Psalm 139: 13-16) 3. Christian attitudes to fertility treatment • Fertility treatment is used when people want to have children but are unable to conceive naturally. Usually, this is because of some kind of medical problem. However, there are different Christian attitudes to fertility treatment. • IVF (in vitro fertilisation) involves the egg and the sperm being brought together in a test tube. If conception takes place and an embryo is formed, it is placed inside the woman’s uterus. • Another method of fertility treatment is artificial insemination. Sperm is collected and placed in the woman’s uterus artificially: – Sometimes, this is the husband’s sperm: AIH (artificial insemination by husband). – Sometimes sperm can be used which may come from an anonymous donor: AID (artificial insemination by donor). The law now states that anyone donating sperm or eggs has to provide their details, so that at the age of eighteen a person conceived in this way can seek out their biological parents. • Roman Catholics believe life begins at conception. This causes a major problem with fertility treatment (such as IVF) which can produce spare embryos. Some of these embryos may be thrown away during the process, stored or used in medical research, which they believe goes against the sixth commandment. • The Roman Catholic Church does not believe that having a baby is a God-given right but rather a divine gift. • Also the Roman Catholic Church is opposed to AID because they think that the introduction of a third party is a form of adultery. Key person: Hannah – Old Testament figure who could not have children for many years because God had ‘closed her womb’. Bible Bits: God made humans in his own image (Genesis 1:26-27) God will not allow Hannah to have a baby until he decides it is the right time (1 Samuel 1:5) • The Human Fertilisation and Embryology Act 1990: – Frozen embryos may be stored for a maximum of ten years. However, these can only be implanted and used if both partners agree. – Scientific experiments may only be carried out on embryos up until fourteen days after conception; after this time they may not be kept alive. • Some Christians believe that fertility treatments should be encouraged because they bring so much happiness to people who would otherwise not be able to have children. • Other Christians believe that fertility treatment is wrong. They consider that God chooses whether people have babies or not. This is part of the teaching about sanctity of life. 4.Christian attitudes to cloning • Cloning creates a genetically identical animal or plant from another. • The most famous example of a cloned animal was Dolly the sheep (1997-2003). • Plants are often cloned; when someone takes a cutting and grows another plant from it, they are producing a clone. • Human identical twins are also clones of each other. • Most of the concerns about cloning relate to the possibility that it might be used to clone humans. Most Christians feel that the cloning of a human, were it to be possible, is unacceptable. • Most countries have banned the use of cloning to produce human babies (human reproductive cloning). • In therapeutic cloning (or cell nucleus replacement), tissues are created. Single cells are taken from a person and ‘reprogrammed’ to create stem cells, which have the potential to develop into any type of cell in the body in order to provide replacement organs or limbs. In 2001 the Human Fertilisation and Embryo Act allowed the use of human embryos in stem cell research, using leftover embryos from IVF treatment. • Many Christians feel that research into therapeutic cloning is against the will of God as it is unnatural. They argue that human life should not be tampered with – we should not ‘play God’. • Others would say that people have a God-given responsibility to care for creation and if therapeutic cloning would benefit humans it is a good thing as long as it is strictly controlled. •The Roman Catholic Church teaches that cloning separates the procreation of children from the sexual act and often involves the creation and subsequent destruction of a large number of fertilised eggs. This is against Roman Catholic teaching on the sanctity of life. Key words: Cloning: the making of a replica. Reproductive cloning: cloning which creates offspring. Stem cells: single cells which have the potential to be ‘reprogrammed’ to develop into any type of cell in the body. Therapeutic cloning: a medical procedure where single cells are taken from a person or embryo and ‘reprogrammed’ to create stem cells which can be used in medical treatment. 5.Christian attitudes to suicide • Most Christians believe that it is wrong for a person to commit suicide, although they recognise that these people may have gone beyond the stage where they are able to make rational decisions. • Suicide is when a person ends his or her own life. In the UK less than one in 100 deaths every year is the result of suicide. • In the past, suicide was considered a serious crime, and the Christian Church treated it as a sin. •Christians might argue against suicide by saying: - God chooses when people are born and when they die. -Suffering can bring people close to God. -Suicide is a form or murder, even if the murderer and the victim are the same person: and one of the Ten Commandments is ‘You shall not murder’. -Paul said that the body was a temple of the Holy Spirit and so the body should be treated as a place where God lives, and should be respected. -Suicide is sometimes viewed as a mortal sin against the Holy Spirit which prevents the person entering heaven. In the past this meant that suicides could not be buried in consecrated ground. -Suicide is sometimes regarded as a selfish response which ignores those people left behind. • The Samaritans is an organisation that was started in 1953 by the Reverend Chad Varah who was a Church of England vicar. It provides confidential emotional support to anyone needing it – including those who may be contemplating suicide. The Samaritans is available to anyone, of any religion or none. The volunteers do not give advice or tell the caller what to do, but listen and help people to work out their own answers. Key point: Most Christians believe that the right response to suicide is to be loving and forgiving. People who attempt suicide should be helped to overcome the reasons which made them want to kill themselves. People who do commit suicide should be regarded with respect and understanding not condemned. 6. Christian attitudes to euthanasia • The word ‘euthanasia’ comes from two Greek words: ‘eu’ meaning good, and ‘thanatos’, meaning death. Literally, it means ‘a good death’. •There are different types of euthanasia: •Voluntary euthanasia is when someone asks for the end of his or her own life but is unable to commit suicide without help. This is often called ‘assisted suicide’. •Involuntary euthanasia is when other people decide that it would be for the best if someone’s life ends, because he or she is not able to make that decision independently, such as someone who is in a persistent vegetative state. •Active euthanasia is when action is taken to bring life to an end; e.g. a lethal dose of drugs might be given. This is against the law. •Passive euthanasia is when action is taken to stop giving further treatment such as antibiotics or invasive, painful surgery, even though death will be the result. •The Roman Catholic Church is totally opposed to euthanasia, and teaches that any act which deliberately brings about death is the same as murder. It teaches that ordinary treatments, such as feeding a patient, must always be continued, but that ‘extraordinary’ treatments, such as a complicated operation that is unlikely to succeed, need not be given. They do this by applying the doctrine of double effect. •The Anglican Church has a similar view to the RC Church. It teaches that although the deliberate taking of human life is forbidden, there are strong arguments that people should not be kept alive at all costs when they are suffering intolerable pain. To allow someone to die may be the most living thing to do and applies the Christian principle of agape. •The Quakers do not have a untied view on euthanasia. For Quakers what is important is that they do the most loving thing. •Many Christians support the hospice movement. Hospices care for the dying. They do everything they can to make a patient more comfortable, such as keeping severe pain under control (called palliative care). They try to give the dying patient a peaceful and happy end to life and aim to provide an alternative to euthanasia, believing that a ‘good death’ can be achieved without killing, if the patient is surrounded by care, love and support. •Quality of life versus sanctity of life? Many Christians and non-believers would wish to consider the quality of life of the patient. Christians in particular would want to compare this with teachings about the sanctity of life: should a patient be forced to live even though they are in desperate pain which cannot be relieved? This is the basis for Christian belief that humans are the most important part of creation and that God gave them control over all other living things. Do you think this means humans can do whatever they like to animals? Explain your reasons. • Christians do not think it is acceptable to be cruel to animals but some believe that they can be used for medical research. • Treatments for diseases have resulted from animal research, e.g. dialysis machines to treat kidney failure and the development of drugs to prevent rejection in organ transplants. Animal experimentation was also central in creating vaccines for tuberculosis, a disease which kills 3m people each year.