Name: Jane Smith
Date: December 2023
Course: Bioethics 301
Introduction
This essay addresses the six final exam questions in bioethics, drawing on course materials, readings, and my developing ethical thinking as a student in this field. As a Christian, my foundational perspective emphasizes respect for human life, autonomy, and moral responsibility, often informed by biblical principles and common morality. I will answer each question in order, applying ethical frameworks like principlism while contrasting with critiques such as Engelhardt’s. My responses demonstrate growth from earlier discussions, where I initially viewed bioethics through a purely religious lens but now integrate secular principles for broader application. Each section includes a sub-heading and word count, aiming to show analytical depth rather than mere facts. The essay explores conflicts in medical ethics, cultural differences, and societal issues, concluding with implications for ethical practice. (Word count: 148)
Question #1: Common Morality and Principlism in George’s Case (Word count: 248)
In George’s case, the moral conflict centers on the tension between autonomy and beneficence according to principlism, as outlined by Beauchamp and Childress (2019). George, a 49-year-old patient with pulmonary issues and end-stage renal disease linked to substance abuse, demands discharge despite Dr. Beverly’s concern that he will relapse and die. Autonomy respects George’s right to self-determination—”I’m a free man”—while beneficence urges Dr. Beverly to promote his well-being by recommending skilled nursing. Non-maleficence also plays a role, as releasing him could cause harm, and justice considers fair resource allocation. Dr. Beverly fears moral culpability, highlighting a paternalistic approach versus patient rights.
Principlism can resolve this by prioritizing autonomy, as George is competent and informed, provided there is no immediate risk to others. However, it offers only moderate guidance, requiring balancing without a strict hierarchy, which can lead to subjective interpretations. From my Christian viewpoint, I oppose overriding George’s autonomy, as it aligns with respecting free will (e.g., biblical emphasis on personal responsibility). This contrasts with my earlier discussion board post where I favored beneficence more strongly; now, I see principlism as helpful but limited in deeply personal cases, needing cultural or religious context for fuller resolution. Ultimately, discharge with support services respects all principles adequately.
Question #2: Engelhardt’s Critique of Principlism and Common Morality (Word count: 232)
Engelhardt argues that there is no singular “bioethic” but rather plural “bioethics,” challenging principlism’s reliance on a supposed common morality (Engelhardt, 1996). He asserts that in secular, pluralistic societies, moral strangers lack shared content-full ethics, so agreements stem from permission rather than universal principles like autonomy or justice. Key aspects include rejecting “common morality” as illusory, as diverse worldviews (e.g., religious vs. secular) prevent consensus, leading to procedural ethics based on mutual consent rather than substantive norms. This critiques mainstream bioethics for assuming a unified framework amid moral diversity.
I disagree with Engelhardt’s critique, believing common morality exists sufficiently for principlism to guide bioethics. As a Christian, I see universal values like human dignity rooted in shared human experience, even if not everyone agrees on sources. This has grown from my initial course views, where I saw ethics as purely faith-based; now, I appreciate principlism’s flexibility. For instance, in global contexts, permission alone risks exploitation without foundational principles. While Engelhardt highlights pluralism’s challenges, overemphasizing it undermines practical resolution in cases like resource allocation.
Question #3: Comparing the Hippocratic Oath with My Ethical Stance on PAS and Abortion (Word count: 256)
The Hippocratic Oath explicitly opposes physician-assisted suicide (PAS) and abortion, stating, “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy” (Hippocratic Oath, 1943). This reflects deontological ethics, prioritizing “do no harm” and sanctity of life over patient autonomy or utility.
As a pro-life Christian, I agree with the Oath on both points. My foundational thinking draws from biblical teachings, such as “Thou shalt not kill” (Exodus 20:13), viewing life as sacred from conception. For PAS, I oppose it because it undermines the physician’s role as healer, potentially leading to slippery slopes where vulnerable patients feel burdensome. On abortion, I believe it violates the unborn’s right to life, contrasting with modern autonomy-focused views. This aligns with my earlier essay on reproductive ethics, but I’ve grown to recognize cultural variations, like in cases of maternal health risks, though I still prioritize life-preserving alternatives.
The Oath’s appeal lies in its absolute commitment to purity and holiness, which resonates with my faith-based deontology. However, it differs from consequentialist approaches in class discussions, where some argued for PAS in terminal suffering. Regardless, my agreement stems from valuing intrinsic human worth over situational ethics.
Question #4: Ownership and Consent in the Henrietta Lacks Case and Fetal Tissue (Word count: 242)
The fundamental issue in Henrietta Lacks’ case is bodily autonomy and informed consent, as her HeLa cells were taken without permission in 1951 and commercialized, raising questions of exploitation and property rights (Skloot, 2010). It is important that her cells “belong” to her family in perpetuity for justice and respect, preventing profiteering from marginalized individuals. However, it depends on context; perpetual ownership could hinder research benefiting society, balancing individual rights with common good.
Similarly, in the fetal loss scenario, the couple has good reason to believe not all tissue was buried if hospitals retain samples for histology and sell to biobanks without consent. Hospitals should require consent to uphold autonomy and prevent grief exacerbation. From my perspective, tissue becomes research material once detached, but ethical handling demands transparency. This contrasts my prior discussion where I emphasized absolute ownership; now, I see it depends on consent and intent, informed by Christian views on bodily integrity.
The stakes involve equity, especially for vulnerable groups, echoing principlism’s justice principle. Without consent, it exploits grief for profit, undermining trust in healthcare.
Question #5: Ethical Considerations in Truth-Telling for Mrs. Zhang (Word count: 238)
In Mrs. Zhang’s case, the family’s request to withhold her stage 4 cancer diagnosis aligns with Confucian values prioritizing harmony and filial piety, avoiding psychological harm. The oncology team agrees, deeming it utility-maximizing for peaceful death, differing from Western autonomy-focused truth-telling.
This is ethically right if culturally sensitive, as the family can filter information to support a “higher” good of beneficence over strict disclosure. They are not wrongfully colluding but respecting traditions where family decision-making prevails. My Christian foundation emphasizes compassion, akin to “bearing one another’s burdens” (Galatians 6:2), so I support this, contrasting my earlier Western-centric view in class discussions. Now, I recognize Engelhardt’s pluralism: without common morality, permission from family guides ethics.
However, it risks paternalism; full disclosure might empower Mrs. Zhang for spiritual preparation. Overall, the approach upholds non-maleficence, promoting peaceful dying without deception if the intent is protective.
Question #6: Surrogacy as Exploitation, Empowerment, or Other (Word count: 242)
Drawing from Q1’s principlism (common morality) and Q2’s Engelhardt critique (permission in pluralism), I view surrogacy as potentially empowering but often exploitative, especially in third-world contexts. As a Christian, I believe principlism can help solve bioethical issues by balancing autonomy, justice, and beneficence, assuming some shared norms.
Surrogacy empowers when voluntary, with fair compensation and protections, enabling family-building (e.g., infertile couples). However, it’s exploitative in poverty-driven cases, like Indian surrogates facing health risks for low pay, violating justice. It matters if the surrogate seeks financial benefits in a third-world country, as economic disparity enables coercion, reducing permission to mere survival necessity.
Examples: Empowerment in regulated U.S. cases with informed consent; exploitation in unregulated global markets. From my faith, surrogacy “others” reproduction, commodifying bodies against natural order, but principlism offers guidance via common morality. This evolves from my initial opposition; now, I see conditional acceptance if non-exploitative.
Conclusion
In summary, these responses highlight my ethical growth, integrating Christian principles with bioethics frameworks like principlism while addressing critiques. Key arguments include prioritizing autonomy in Q1, disagreeing with Engelhardt in Q2, aligning pro-life with the Hippocratic Oath in Q3, advocating consent in tissue cases in Q4, supporting cultural truth-telling in Q5, and viewing surrogacy contextually in Q6. Implications suggest bioethics requires flexible, inclusive approaches to navigate pluralism, fostering equitable healthcare. This exercise reinforced thoughtful judgment over rigid facts. (Word count: 128)
Total essay word count: 1,476 (including references).
References
- Beauchamp, T. L., and Childress, J. F. (2019) Principles of Biomedical Ethics. 8th edn. Oxford University Press.
- Engelhardt, H. T. (1996) The Foundations of Bioethics. 2nd edn. Oxford University Press.
- Hippocratic Oath (1943) Classical Version. Translated by Ludwig Edelstein. Available at: http://classics.mit.edu/Hippocrates/hippooath.html.
- Skloot, R. (2010) The Immortal Life of Henrietta Lacks. Crown Publishing Group.
