Biomedical Ethics Addresses Difficult Issues about Health

Article excerpt

Numerous advances in medical research, education and patient care are being made in Oklahoma. This column will introduce you to some of the programs that will make it possible for us to live longer, healthier lives.

But the ability to prolong life through medical technology can raise questions. Many people do not fear death, but fear not being allowed to die. Biomedical ethics is a process that helps physicians, patients and their families make these difficult decisions.

The Supreme Court decision in the Cruzan case determined that an individual has a right to refuse treatment if that desire is made known. But Nancy Cruzan could not articulate the desire to be taken off life support and there was not clear and convincing proof that she wanted to die.

"I think it was, as decisions go, pretty good," said Dr. Richard Wright, director of the University of Oklahoma Biomedical and Health Care Ethics Program. "It fully reaffirmed an individual's right to refuse medical treatment regardless of anything else. And it made it possible for an incompetent person to have that right exercised on their behalf, provided that the desire can be documented.

"The problem with the Cruzan case was that the court decided Nancy Cruzan had not made her wishes well enough known. But it could have been a lot worse. They could have said you can't do that.

"The problem is that it is inappropriate for legislators and the legal system to be making decisions on these kinds of cases. By allowing the courts to intervene, we get people who know nothing about ethics, health care or the specific case making the decision. The state, through the courts and legislature, has no business interfering in that decision-making process," said Wright.

"The decision is a private matter between the patient, the physican and, if the patient is incompetent, the appropriate proxy decision maker for the patient. This is an ethical process, not a legal one."

Teaching biomedical and health care ethics at the University of Oklahoma helps health professionals understand the conflicts involved in ethical dilemmas to make the right decision. It involves teaching the process of decision making, recognizing ethical problems, recognizing different ways to deal with ethical problems and learning to understand different viewpoints.

The goal of the program is to integrate the instruction of ethics into the curriculum of the seven colleges of the University of Oklahoma Health Sciences Center, which covers multiple dimensions of the health care community. …