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Definition
Human Rights
Religious and Cultural Influences in Medical Ethics
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Often times, in the US at least, we tend to have a narrow view of what is accepted in terms of medical customs. Bioethical issues are complicated enough within one cultural setting, so holding a globally-consistent view on bioethics is almost impossible. Along with the globalization of economies, we have seen a globalization of medical care. In 1995, a worldwide conference on genetics and ethics was held over the internet! While such advances have countless benefits, they also reveal the bioethical differences we have embedded within our cultures.
A number of topics have developed around this issue:
China, Pakistan, the former Yugoslavia, Singapore, the United States - all countries that have been accused of abusing or disregarding the "human rights" of their citizens. What are human rights and why are they important to discussion of bioethics? Human rights have been delineated in various official documents, from the US Constitution’s Bill of Rights to the Universal Declaration of Human Rights (UDHR). The UDHR was established by the United Nations in 1948, and it served to protect certain inalienable or natural rights. It establishes that all people are born free and equal. Based upon this belief, the charter goes on to outline various other rights.
What does this have to do with bioethics? The UDHR mentions health and well-being in various articles. In general, it claims that all people have the right to complete care and adequate protection from sickness and suffering. Article 5 states that no one shall be subjected to any form of cruel and unusual punishment. Article 25 gives special consideration to motherhood and childbearing – it states that mothers and their children have the right to special protection. What about China’s birth control policies? Are these standards of medical care unethical in the eye of the global community? Let’s not forget the US Congress’s recent move to reform the American system of welfare. Many women are going to be forced to work even though they cannot afford adequate child care. Is this a violation of Article 25 of the UDHR?
Of course, many laws placed under a certain light might be considered violations, but the basic ideals behind the UDHR are inviolable: 5-year-old children should not be spending endless days sewing soccer balls; women should not live in fear of being shipped off as sex slaves; slavery and indentured servitude should be relics of the past.
International organizations are working to eliminate these problems. The UN, UNICEF, WHO, Amnesty International, The Red Cross/Crescent, Doctors Without Borders, and others are lending their support to the suffering in hopes of alleviating their pain.
What role does religion and culture play in global ethics?
Religion and culture happen to be two of the stronger influences in the lives of patients and their families. Both help to shape bioethical policy around the world. This being the case, these bioethical policies or traditions might develop a certain inconsistency with those of other cultures. In Southeast Asia, for example, doctors often keep their patients in the dark when it comes to terminal diagnosis. They inform the family, but they keep the information from the patient. The physicians believe such news could only cause the patient to suffer more than necessary during his or her remaining days. Such actions would probably be considered unethical in the U.S.
Under Jewish law, a physician is only allowed to treat a patient when the treatment can be reasonably expected to succeed. Hence, Jewish physicians might be disallowed from participating in experimental proceedures. On the other hand, a physician is commanded by Jewish law to practice if he has been licensed to do so. This being the case, some have argued that certain restrictive managed care practices might be contrary to Jewish Law.
One of the most vitriolic of bioethical issues, euthanasia draws strong responses from religious groups. Similar to Judaic doctrine, the Islamic Oath of the Doctor swears to the doctor to "protect human life in all stages and under all circumstances, doing my utmost to rescue it from death, malady, pain and anxiety." While euthanasia is disallowed in Islam, palliative care for the dying is encouraged. The Muslim physician also swears to "keep peoples' dignity, cover their privacies and lock up their secrets." This strong emphasis on privacy has seen recent obstacles in the form of easy access to medical records and discussion of mandatory release of HIV infections.
Unlike the Islamic-Judeo-Christian ethic, the Buddhist tradition places much importance in self-determinism. As a result, euthanasia and physician-assisted suiced are not necessarily looked upon negatively. Buddhists value the ability to decide how and when they will die. Yet, surveys have shown a growing body of Buddhists (especially Thai's) believe that euthanasia is wrong. Interestingly, some Buddhists also believe that palliative care through use of narcotics might not be acceptable because such drugs cloud the mind during the dying process.
The role of culture and religion in bioethics is a prominent one. We cannot hope to create one, all-encompassing "rule book" of medical ethics because of cultural differences. Instead, should we focus on the significance of cultural relativism, the belief that actions within cultures cannot be considered wrong or right, but acceptable or inacceptable within a certain cultural sphere? Can anyone be wrong?