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Organ harvesting with or without consent may be defended on utilitarian moral grounds. A related philosophical question is whether a legal regime of opting into organ donations or opting out of organ donation better serves the demands of justice and morality. Post-mortem sperm donation raises important ethical questions about bodily integrity. Harvesting the sperm of a deceased man raises concerns about respect for corpses; using sperm to create embryos and ultimately to parent the children of dead men raises concerns about parental autonomy and beneficence toward children.

Respect for the intimacy of the experiences of suffering, childbirth, recovery and dying is required by sound ethics. People who are in pain or grieving have an interest in including some people and excluding others. People commonly want to reserve sharing the joys of medical experience with friends and family, no less than the agonies. They have what can be thought of as an associational privacy interest in selective intimacy.

Injured, suffering, and dying adults may badly desire intimacy, even sexual intimacy. A patient may wish to exclude strangers or inessential medical personnel at times when the presence of loved ones is welcome. Parents of newborns may regard strangers photographing their babies as violations of family intimacy.


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If associational privacy is important, a bored visitor strolling the halls of a hospital should not maneuver to watch a randomly selected patient give birth; and if he does, he merits criticism as a morally offensive intruder. Hospitals and hospital patients have clashed over who should be allowed visitation and a role in decision-making or hands-on care. Some institutions have kept extended family, paramours, gay or lesbian partners and children away from in-patients.

Philosophers have debated the existence of a property right in the self, both the physical self and the non-physical self e. One philosopher has argued that we own our selves and owe ourselves a self-love that constrains how we ought to treat our selves and allow others to treat us Annas John Locke famously characterized the relationship between a person and her body as self-ownership.

However, other philosophers have held that persons are stewards of their bodies rather than owners Honore In medical contexts, under rubrics of privacy, individuals are sometimes ascribed rights of self-ownership and the ownership of parts and products of their bodies Moore In this vein, a philosophically interesting invasion of privacy argument was advanced in the landmark California case Moore v. Regents of the University of California Without his knowledge or consent, University of Southern California research physicians developed a commercial cell line from tissue removed from leukemia patient John Moore.

In a related case that did not result in tort litigation in her lifetime, cells taken from Baltimore resident Henrietta Lacks were the basis of an important immortal cell line, HeLa. Lacks died in , but the cell line created using her cervical cancer cells without her knowledge or consent lives on.

It has been used in the treatment and eradication of numerous conditions and illnesses, including polio, without any financial reward to her or her heirs.

Faces of Medicine

But proprietary understandings of privacy continue to find expression in health care and health research contexts. Scholars suggest that individuals have privacy interests in their genes, genomes and bio-banked tissue specimens. These are sources of health information that reflect what individuals and their biological families are like, and what will become of them. Infertility medicine is a growing field, one dependent upon gamete donation and cryopreservation of embryos. While many courts have rejected viewing frozen embryos as property, they have struggled over how to allocate rights over embryos in cases of separation, divorce, death, moves and changes of heart.

In recent years identify theft has become a privacy problem in the delivery of health care. Consumers must worry both about the confidentiality of their medical records and physician encounters, and about the possibility that someone will appropriate their personal identifiers and then use them to defraud health care providers and insurers. Birth control and abortion are common practices the world over.

Faces of Medicine: A Philosophical Study | Journal of Medical Ethics

They were once criminalized on moral and medical grounds, but are generally available today. Laws categorically criminalizing contraception and abortion, were struck down in the U. While Catherine MacKinnon argued that ascriptions of rights of privacy are merely palliative distractions from a more basic quest for gender equality, other feminists have argued that privacy rights play a proper role in achieving reproductive autonomy and pave the road to greater education and employment equality Allen ; MacKinnon Official Roman Catholic doctrine opposes all non-natural birth control, birth control devices and all intentional abortions Pope Paul VI, , Humanae Vitae.

Some regard human sexuality as having an essentially reproductive purpose and artificial birth control as unethically unnatural. Thomas Aquinas taught that the fetus lacks a soul until forty to sixty days after conception Finnis Those who oppose abortion on personal moral or religious grounds, sometimes also oppose public law and public policies that permit abortion.

Philosophers differ on the question of the morality of abortion Jonsen ff. Advocates of abortion freedom maintain that government should not take sides in what is irreducibly a moral debate, and that individuals should be free to make up their own minds about the moral status of the unborn Richards Some philosophers have denied that fetuses are moral persons, stressing that they are not self-conscious subjects of experience.

Those who oppose abortion freedom argue that it should not be left to private choice because the unborn are equal members of the moral community, along with newborn infants. Membership in the moral community is conferred by human status or potential personhood, these philosophers argue.

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Religious ethicists sometimes characterize the unborn as having souls. Peter Singer has argued that science proves that unique human lives do not begin at conception. Instead, fertilization begins a process of initially pluripotent cell development that may result in several human lives, due, e.

Philosophers Margaret Little and Rosalind Hursthouse contributed nuance to the ethics of abortion debate by arguing that while autonomy and privacy concerns are important, sui generis considerations of obligation and virtue are ethically relevant to decisions about terminating a pregnancy Little ; Hursthouse The trend in public policy, dating back to the s in the U.

The law tends to permit women to obtain abortions freely in the first trimester and then to limit access to second and third trimester abortions. Philosophical differences in how societies think about abortion ethics are reflected in the four major models of abortion regulation found around the world. The models of abortion regulation are 1 the model of prohibition; 2 the model of permission; 3 the model of prescription; and 4 the model of privacy. In countries characterized by the model of prohibition, most or all abortions are prohibited by criminal laws.

In the West, the Republic of Ireland has been an example of the model of prohibition. In countries characterized by the model of permission, early abortions are readily available to women who meet legislated government eligibility criteria and adhere to official procedures. Germany and Japan are examples. In countries characterized by the model of prescription, abortions were not only permitted, but encouraged or required to avoid government penalties.

While liberalization may be in progress, China has been the signature contemporary example of the troubling model of prescription, apparently prompted by concerns about over-population and limited resources.

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Finally, in countries characterized by the model of privacy, abortions are freely available to women who wish to obtain them, without having to meet eligibility criteria or adhere to detailed government procedures designed to limit access. Canada is an example of the model of privacy. While the U. Wade used to be a nation in which the model of privacy prevailed, it has taken on some of the features of a model of permission regime since when the U.

Supreme Court announced it would begin allowing restrictions. In most countries, the public relies on licensed physicians and hospitals for medical care. The medicines physicians recommend are available only from professionally trained, licensed pharmacists. Some policy-makers have argued that health care practitioners should be free to decline to provide services for which they are professionally trained if doing so genuinely violates personal conscience Dresser They say pharmacists who decline to dispense medication are placing their personal values and autonomy above the values and autonomy of patients.

Furthermore, pharmacists, like physicians and nurses, enjoy the benefits of regulation and have chosen their professions voluntarily. Private reproductive choices can be exercised only if sufficient numbers of health care professionals are willing to perform lawful services.

Should health care workers be required to dispense medications and perform procedures that violate their personal scruples? Most bioethicists agree that in the context of emergency medicine, conscientious refusal has no place. A physician should not refuse to terminate an ectopic tubal pregnancy threatening the life of the mother, for example. There is significant disagreement, however, about whether morally-based refusal is warranted by retail pharmacists. Whether pharmacists can ethically refuse may depend upon the proximity of other pharmacists willing to serve in their places.

Ethicists also disagree about whether physicians may use their scruples as rationales for refusing to answer medical questions or refer patients to abortion providers. Some legal commentators and philosophers have argued that infertile men and women have a right to procreative privacy, and a right to use technology to bear children.

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It may be argued that the ability to freely choose ART, like the ability to freely choose sterilization, abortion and birth control, is called for by the right to privacy. But ART use raises moral concerns. One concern is the false hopes ART creates in a world in which the technology is expensive and the success rate low. The availability of affordable treatments can cause conflict within families. Women report feeling pressured by their families to undergo repeated painful attempts to get pregnant. It may argued that adoption is a more satisfying, affordable and socially commendable option for becoming a parent.

The use of reproductive technology has led to bioethical concerns about the handling of the earliest beginnings of human life.


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  7. Ethical concerns surround exposing otherwise healthy women to the uncertain health risks of repeated rounds of fertility drugs and high-risk multiple pregnancies with twins and triplets. In a few tragic cases children created using ART have been unwanted, raising questions of responsibility and the just role of family law. What should happen if the people who contract with a surrogate mother to carry a child for them using donated egg and sperm change their minds after a child is conceived? Should the mind-changers be deemed the parents?

    Should the gestator be deemed the parent; the gamete donors? Should parentage be assigned by a judge based on the best interest of the child? The realm of reproductive technology is surprisingly laissez faire in the U. Some U. There is a right to reproduce, they argue, and a right to use other people and social resources to help one reproduce.

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