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What Roe vs. Wade Teaches Us About The Importance Of Medical Ethics
I’ve had the privilege to be mentored by some of the most talented physicians in the United States. I’ve long sought to understand what common traits allowed them to become miracle workers, and in my assessment, an upstanding commitment to ethical conduct in their medical practice and personal life was foundational to their success. Unfortunately, minimal effort is devoted to teaching ethics within the medical curriculum and the ethical framework young doctors are left with leaves much to be desired.
For my entire life, I believed that Roe vs. Wade would never be overturned as too many things were predicated upon it remaining in place. At the same time, we live in an unusual era that is characterized by rapid change and things people never thought possible suddenly emerging, so the impossible often becomes possible.
There are a variety of explanations for why this is happening (my best guess is it is part of a cosmological cycle) and within many spiritual systems, these types of times are viewed as inherently dangerous because most human beings cannot thrive within rapid change. Those esoteric systems in turn believe a key aspect of the human experience is the process of having a stable center or core which is continually influenced by your external circumstances, and that each individual’s life is a product of the internal stability they can maintain.
This principle is also embodied within ethics and morality. In times of great uncertainty like the ones we live in, it is critically important to have a strong ethical core. In America, this was recognized from the dawn of our Republic:
Unfortunately, as crude memes like the image below demonstrates, that core is often not present:
An odd situation that has arisen in American politics is that the party that supports the right to abortion also supports mandatory vaccinations. Regardless of how you dice it, it is very difficult to use the same logical standards regarding bodily autonomy to support both positions. This recent video is one such example, and I am sure we will see many more in the coming days:
Similarly, many politicians have changed their perspectives on this issue. For example, this was from a 1974 interview:
It is always helpful when contradictions within a system are exposed because they allow one to understand the deeper workings of the system. I likewise argue that the contradictions surrounding bodily autonomy also require an examination of the nature of ethics inside and outside of medicine.
What is Morality?
Typically, the subject of ethics and morality is approached from two different directions. The first arises from those who wish to codify a system of rules which ensures evil and harm are minimized within society. The second arises from truth-seekers who wish to do the right thing but are often not completely sure what it is.
Within Chinese philosophy, one commonly held belief is that when a society loses its virtue, it creates laws. Therefore, regardless of the specific law that is chosen, shortcomings will always emerge. At the same time, were laws not to exist, many evil actions would be perpetrated throughout society. Hence, the law will always be a flawed human institution that ebbs and flows with the general corruption and morality of each era.
When morality and ethics are approached from a legalistic standpoint, dilemmas similar to those found with law arise, except unlike the law there are no real legal penalties for failing to abide by ethical principles. Put differently, in this form of ethics the focus is typically on “How can I bend the rules to get what I want?“ rather than “What is the right thing to do?”
The inherent instability of our era has exposed how prevalent this form of ethics is as the political spectrum continually pressures members of society to take absurd positions that are difficult to defend and inconsistent with each other. In many cases, a debate on the ethics of a politicized issue is impossible because individuals are so emotionally invested in their position the morality or truth of their position is not a primary concern.
One of the best ways I have found to summarize this is that unless someone is willing to suffer to abide by their ethical principles, their specific ethics are relatively meaningless, and are simply arbitrary ideals being chosen for convenience. Similarly, some activists are willing to take a very hard road to do what they feel is right, while others primarily adopt a cause because it is convenient for them and they receive the support of the majority for doing so.
As a result, there are only two paths that can be taken to move forward on the subject of ethics and morality within society:
•A socially agreed-upon process filled with wisdom to develop a generally accurate ethical platform that can create a positive blueprint for society.
•A recognition that ethics and morality are the responsibility of the individual and a shift in discussion towards empowering individuals to independently discern morality.
By and large, religious institutions have served the role of providing the ethical framework for society. Similarly, it is my opinion that the reason why the western world was able to become the dominant superpower was because the Judeo-Christian ethic allowed each nation to focus on developing society rather than its members tearing each other apart.
However, most of the major religious systems were developed during the agricultural era, and as a result, many of the situations we face now were not subjects of consideration at the time when these religions were developed. Because of this, many situations we now face have no clear solution to be found within the ancient spiritual texts.
This general destabilization of morality has been further worsened by the fact societal investment in religion has gradually declined without a replacement institution that also provided a moral framework for the culture to take its place. Like many, I believe this has been extremely damaging and has allowed very wicked and harmful things to take root in our culture.
Throughout the 20th century, many astute authors attempted to predict where the world was going and if we were ultimately heading towards a dystopian future. The central issue they all identified was that as technology increases in sophistication, the need to micromanage society also increases in tandem. These authors thus expected that as time moved forward, greater and greater control over our lives would be exerted by the technological grid that we lived within.
Living in this type of world requires displacing the traditional form of morality which values individual freedom and rights and replaces them with a value system that extols subservience to the technological state. I believe the underlying reason why many traditional institutions including religion have been under a sustained attack is that they create a way of life that is incompatible with the technologist's vision.
One of these authors, Ivan Illich, believed that a society structured around providing its members with the tools and opportunities they needed to succeed and trusting each participant rather than trying to control their eventual outcomes was a viable alternative to the technologists future and dramatically more compatible with the human spirit (more can be read here). Similarly, I believe the only way to avoid becoming part of the technologist’s future is to hold one’s own strong core of morality.
What are the Foundations of Morality?
One of the major challenges with both logical systems and morality is their inherent subjectivity. I hold the belief that universal moral principles also exist that nearly everyone will agree upon, they are often much more difficult to identify. For example, I have always appreciated the deep meaning behind this verse: "Even in the darkest of suffering, a man can sleep. But for the man who inflicts the suffering, his mind cannot rest. Ever."
On many levels, the Golden Rule ("Do to others as you would have them do to you"-Luke 6:31) found throughout the Bible represents one of the best universal moralistic frameworks our culture has created.
Following the Golden Rule, one of the key points I have argued throughout this substack is that it is critically important to defend the rights of individuals you hold apathetic or negative views towards because once it becomes permitted to violate their rights, eventually that same standard will be applied to you. This is somewhat encapsulated by the conservative maxim: “I disagree with you but I will fight to the death to defend your right to say it.“
I have regrettably come to accept a significant part of modern-day activism is selfish (many activists only petition for positions that benefit them). Similarly, I also feel it is very shortsighted when groups campaign for rights to be taken away from one party to enrich themselves because doing so often makes it acceptable for the same violation to later happen to members of that group.
A contemporary example of that gradual encroachment of individual rights is the recent phenomenon of women in women-only prisons being forced to share the space with men who identify as women. This is problematic because these individuals sexually assault and impregnate the women incarcerated with them. When the issue is raised, progressives who have traditionally been staunch allies for women’s rights and protecting women from sexual predators are reluctant to defend these prisoners for fear of being “transphobic.”
As the decades have passed, there has been a gradually increasing disconnect within society from our bodies and our spirits. When one looks at history, those societal disconnections often preceded truly horrific atrocities occurring, and many (myself included) have long believed this is the actual reason why communist governments are so focused on purging religion from their countries.
Over the years, I have listened to the Christian right lament that the loss of God in the society has resulted in a society that no longer values the sanctity of life and is setting the stage for terrible atrocities to happen. I do not believe that the “loss of God” is the only reason we no longer value the sanctity of life, rather I believe this loss is a reflection of the general disconnection we have from everything including our faith. As time has progressed, I have become gradually more and more unnerved by how much less life is valued now than it was even a decade ago.
I often observe things be sequentially carried out through timelines that can be years or decades-long, and in many cases have watched the unthinkable become an accepted aspect of everyday life. For example, in this article, I showed how the Covid vaccine mandates were the product of a decade-long campaign designed to produce the situation we are facing now.
One of the major concerns I have had with this general lack of reverence for life has been what it could lead to. Individuals I know who have witnessed communist genocides provide the clearest reference point I have come across to how evil things can become once the society no longer values life.
Introductory Medical Ethics
In medical school, ethics is typically taught through learning four ethical principles and applying them within a variety of test questions. The principles are:
• Autonomy: The principle that individuals should be free to make their own healthcare decisions, should not be coerced into doing something the doctor but not the patient wants, and that the patient is fully informed about a potential treatment so they can make an informed decision on if they want to receive it.
• Justice: The principle that because there will always be a shortage of medical resources, an effort should be made to fairly and equitably distribute medical services to those who require them. Amongst other things, this means in times of crisis that healthcare is expected to be prioritized for those who have the best chance of survival.
• Beneficence: The principle that medical care should benefit the patient, and that the doctor is responsible for doing whatever they can to improve their abilities as a doctor so they can best benefit their patients.
• Non-maleficence: The principle that a medical intervention should not harm the patient or those around them. Ideally, attention should also be paid to the emotional impacts of a medical intervention.
As many of you might notice, these principles have not been followed whatsoever during the pandemic (and arguably were not sufficiently adhered to before this time). Take a moment to reflect upon the fact that almost all medical education devoted to teaching medical ethics focuses on these four principles, and these items are regularly tested on board examinations to ensure they have been learned.
Similarly, consider this recent statement by a fairly influential medical society, the American Academy of Family Physicians on the abortion issue (there are many other similar statements from other organizations emerging moment by moment). It is quite astonishing given the harsh penalties doctors have faced for treating COVID outside of the hospital and working with vaccine injuries. That said, you could argue the loophole AAFP is using to sustain their position is that the evidence for those treatment protocols is not recognized by the NIH, although requiring that standard does somewhat undermine the rest of their argument.
Likewise, consider this recent statement by Canada’s Prime Minister:
Each of these (and countless other examples you may have already seen) suggest that many of the ethical principles medicine espouses and claims a moral high ground for are nothing more than lip service that will be dropped the moment financial or ideological interests are challenged. This then begs the question…what are the actual ethics of modern medicine?
In the second part of this series, I will attempt to address that question. I'm trying out a shorter format for this one since this was a natural place to split the article, please let me know what you think of it.
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