J. Lowell Dixon
- PHYSICIANS are committed to applying their knowledge, skills, and experience in fighting disease and death. Yet, what if a patient refuses a recommended treatment? This will likely occur if the patient is a Jehovah's Witness and the treatment is whole blood, packed red blood cells, plasma, or platelets.
When it comes to the use of blood, a physician may feel that a patient's choice of nonblood treatment will tie the hands of dedicated medical personnel. Still, one must not forget that patients other than Jehovah's Witnesses often choose not to follow their doctor's recommendations. According to Appelbaum and Roth, 19% of patients at teaching hospitals refused at least one treatment or procedure, even though 15% of such refusals "were potentially life endangering."
François J. Hampson
- Introduction: This note concerned with the
age-old battle between conflicting loyalties. It involves the claim to a
higher, rather than a competing, loyalty. If the state recognizes the
doctor's right to obey the prescriptions and injunctions of medical ethics,
even if they conflict with its own laws, then the doctor has no dilemma.
The state, in recognizing the higher loyalty, makes it, as it were, its
own. The state may not positively enforce the obligations of medical
ethics, but it does at least recognize them as a reason for not enforcing
obedience to its own injunctions. Even where that is not the case, a
doctor is always free to follow his professional conscience and pay the
price, just as the conscientious objector is free to go to jail rather
than fight. The claim of those invoking a higher loyalty goes beyond this;
they claim a right, not merely a freedom, which claim can only be
vindicated if the state in fact acknowledges or is under a legal
obligation to acknowledge it. States have, however, traditionally been
reluctant to recognize any higher or even merely competing claim. . .
- This paper uses the Churches' responses to the controversy over abortion
as a measure of the internalization of ecumenism. The data used in the essay
include interviews with ecumenical officers and the minutes of the American
Bishops Pro-life Committee. The main conclusion is that during the contro-
versy "mainstream" Protestantism and Roman Catholicism reverted to post-
Reformation and pre-Vatican II ideological roles, with Catholicism opposing
under the banner of objective moral truth the legalization of abortion and
liberal Protestantism under the banner of subjective conscience providing a
belated religious justification to the legalization promoted first by
secularist activists. This reversal to historic ideological roles actually
distorted the more nuanced positions of these Churches in the controversy,
but the lack of an ecumenical context obscured these shared tensions and
prevented the Churches from contributing to a better public structuring of
the moral ambigu- ities most Americans felt and still experience about
abortion and the extent of its legalization. The essay concludes that only
in an ecumenical context can religious pluralism lead to more inclusive
moral commitments rather than to a further privatization of religion.
Louise E. Liffrig
- Frequently, nurses may find themselves asked to carry out actions
contrary to personal ethics or to belief about what is best for the
patient. If they had no part in making the decision and disagree with
the action to be taken, they face an ethical dilemma: whether to
perform the action or decline from participation in it. Consideration
must be given to the nurse's obligation to the patient's good, to
medical authority and to the right to act according to conscience. . .