Bioethics in the Wake of Hurricane Katrina
Jonathan Moreno has penned an excellent essay on the lessons of the aftermath of hurricane Katrina for bioethics, written in the spirit of regret, horror and concern that, it is safe to say, all those in bioethics now share with the rest of the nation and the world. He writes, for example, that:If the Katrina disaster partly resulted from a failure of institutions, then bioethics must shoulder its share of the blame. Many commentators have observed that the field has wrapped itself in the embrace of the privileged and their problems.[thanks to Sean Philpott and John Kwon]What contribution have we made to the debate about access to health care since the President's Commission in the early 1980s? The failure to create and execute an escape plan for New Orleans' impoverished is part of a continuum of inadequate services that even in ordinary circumstances often proves deadly.
Still more transparent is the sorely limited contact between bioethics and environmental ethics, both in the literature and in institutions. Although we shouldn't exaggerate the influence of bioethicists' voices, the media does provide many of us a soapbox that could be exploited for purposes other than simply to comment on the ethics crisis de jour. The American environmental movement is in its own period of self-examination, following a series of regulatory setbacks and an essay by two influential leaders that roiled the field last year when it proclaimed "the death of environmentalism." (Shellenberger and Nordhaus, 2004) Bioethicists could help reinvigorate the movement by providing new voices and fresh ideas and also enrich our understanding of the reach and significance of our own work.
In the short run, the reconsideration of the scope of bioethics that is proposed could even unite opposing voices in the bioethics culture wars. While conservative and liberal thinkers might continue to disagree about familiar ethical issues like suitable limits on enhancement technologies, they should find common cause in the need to care for a fragile and increasingly ailing planet. Such a discourse would in some ways return us to the insight that gave rise to both fields, that human well-being is dependent upon a complex ecological system in which we are all inextricably linked, one in which we are both actors and patients, doers and sufferers. These brute facts we ignore at our peril.
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My take: I did wonder, how important are my efforts to write a book on end-of-life challenges, in the context of this disaster? Was what I was spending so much effort on... important (enough)?
It took me a while to appreciate this answer:
The principle of social fairness would dictate that bioethics try to change attitudes and policies for more prudent allocation of our finite resources. Err on the side of what is best overall for society. Decisions such as maintaining the functioning of Terri Schiavo's body must be made in the social context. Spending less on patients in PVS and end-stage dementia means more possible funds for the poor who are exquisitely conscious of their own suffering.
- by Stanley A Terman, PhD, MD on Sep 5, 2005 at 1:21 PM | link
The principles of right and wrong do not change.
We are reminded of the importance of those principles in times of disaster. Sometimes in the violation of them and other times because it's so much more likely that we will be faced with the truly hard questions.
But it is in these times that we find out how poorly we are prepared by habit and knowledge to practice what is right.
- by Beverly on Sep 5, 2005 at 1:43 PM | link