Wednesday, October 26, 2011

Autonomy (again!)

There was a fascinating (read "scandalizing") lecture yesterday in Med Ethics. A geneticist spoke in very distracted fashion about the ethics of her science. I was mostly studying embryology during this (and emailing the minutes of the CMA-SS meeting), so I happily didn't have much of an occasion to get angry. However, the members of my small group all came in frustrated with the disorganization and opinions expressed. I did pay enough attention to catch some highlights for you: may have your own moral beliefs, and that's fine, but you have a duty to refer the patients to get complete care.
Context: the patient wants contraceptives or abortion, and those desires are "complete care." The lecturer then continued, saying that she provides what she calls "non-directive counseling," that is, she "will talk about termination" with patients. Still speaking decisions regarding abortion and contraception, she said:
It is not your decision to make, it is the patient's decision to make.
...[W]e make those decisions [the decision not to counsel abortion or contraception] based on our own experience, our religious beliefs, and a number of other things; but patients make those decisions that same way we do, so their decisions may be different than yours.
Apparently, the patient and I can't arrive at the same answer, because we have two impossibly different collections of rules to follow.

But people don't make decisions by consulting a slab of mental commandments and tabulating the dilemmas they create when they intersect! We make decisions based on what is the good we see and the habits we have. I could go on a long rant about principlism, but now is not the time; in fact, now is the time to study for Friday's test. But principlism as an explanation for human behavior fails. The truth is, we act according to the goods and habits described by virtue ethics (Aristotle was right).

There was more to be said about this lecture, but I'll split up the material into two posts.


  1. Oh the 'women's health' issue! Yes, she has a right to complete care and complete care is not shutting down a properly working system for a patient's convenience. Especially when the risks for shutting it down include breast cancer, hepatic neoplasms, blood clots that can (and do) lead to fatal embolisms, etc etc.

    Complete care is informing the patient of how their body works, fixing what isn't working, and how to adapt to the functionality of their body. Something that Natural Family Planning/ Fertility Awareness does a fantastic job of doing.

    But I may be biased. :)

  2. You're not biased for declaring the truth. (Your blog is great!)

  3. I love that! I'm definitely going to start using it. (Thanks!)