Medical Ethicists

Medical ethics as a distinct field arose in the 1960s, although, of course, the realization that an ethical code is an essential aspect of the practice of medicine goes back to ancient times. Physicians throughout the Western world traditionally took the Hippocratic oath (named for the Greek father of medicine) in which they pledged to put the patient's well-being ahead of all other considerations and to observe confidentiality in all doctor-patient transactions. They promised to respect human life and refused to perform abortions or assist in suicides.

By the middle of the 20th century, however, the explosion in medical technology had made ethical decision making far more complex. At the same time, patients were demanding the right to be actively involved in making decisions about their medical treatment; they were no longer willing to passively accept the paternalism of the traditional "doctor always knows best" model of health care.

Recognition of the urgent need for a new emphasis on medical ethics had already been triggered by the revelations of the post-World War II Nuremberg trials in which the world learned of the appallingly inhumane medical experiments carried out by Nazi physicians on human beings. During the next few decades, accounts of unethical medical research projects in the United States also emerged. One notorious case was the Tuskegee Syphilis Study in which medical treatment for syphilis was deliberately withheld from a group of black men so that the progress of their disease could be studied.

Medical ethics addresses the complex questions involved in modern medical treatment and research. Medical breakthroughs in recent decades have saved lives but have also created new dilemmas. In the past, people were considered dead when they stopped breathing and the heart stopped beating. Now, however, brain-injured persons unable to breathe on their own can be kept alive indefinitely in a persistent vegetative state by means of artificial ventilators that breathe for them and artificial alimentation (feeding). Is this life? Who has the right to decide? What would the patient want? What about the people waiting for transplants who would benefit from the organs of the person being kept alive on the ventilator?

The questions are endless: How is competency to make life-or-death decisions for oneself defined? What if parents want to withhold lifesaving treatment from their severely handicapped newborn baby? How do we decide who gets organ transplants? What about the use of fetal-tissue transplants to treat Parkinson's disease and other conditions? When people are suffering intense pain from incurable illness, should physician-assisted suicide be allowed? What are the implications of high-tech reproductive developments, such as in vitro fertilization, artificial insemination, and surrogate motherhood? What about gene splicing and cloning?

The identification of more than 20,000 genes in human DNA as part of the Human Genome Project has created a new world of possibilities—and dilemmas—that medical ethicists will help doctors and patients confront. As great advances in medical research and treatment continue to occur, there will continue to be steady demand for medical ethicists.