In an earlier exploration of these topics, I wrote: “The pace and scope of the current biomedical revolution is not likely to redefine radically the basic relationship of mutual trust and personal autonomy between physicians and their patients any time soon.”1 I was wrong.
For example, promising neurological research into the prevention of Alzheimer's disease now leads scientists to experiment with fetal brain tissue in order to slow the devastating effects of this illness. But this use of fetal brain tissue has led critics of abortion to worry anew. They fear that in the future abortion, and possibly even infanticide, will be tacitly encouraged by the research agendas of the medical establishment. “Does the use of fetal brains stand as a morally indictable exploitation of nascent human life?” they ask. This is a fair question. The fact that the government has approved this practice for a limited and closely monitored range of medical experiments hardly settles the moral concern. It appears to some that human life is increasingly viewed as a commodity. If so, the erosion of patient trust cannot trail far behind.
At the other end of the life span, the ancient option of euthanasia—now glossed as “physician-assisted suicide”—has seldom been more contentiously argued. Here the breakdown of patient trust may occur on at least three levels. First, why would good doctors help people die? Aren't doctors dedicated to saving, nurturing, or at least compassionately caring for human life, no matter how broken? Second, given the high costs of caring for the dying in the last months of their withering lives, would the legalization of physician-assisted suicide lead finally to a felt duty to die on the part of our weakest and sickest? Third, every year over sixty thousand severely ill patients awaiting transplant surgery are lost due to a scarcity of suitable donor organs. Will the physician-patient relationship of the future be strained by this growing need to harvest spare body parts—a need bound to be more easily met if the terminally or chronically ill agree to orchestrate their deaths via physician-assisted suicide or some similar means? Given the persistent potential for moral and legal controversy inspired by these deeds, it is hardly surprising that the twin issues of abortion and euthanasia have refused to recede from our moral landscape. They represent, after all, ineliminable challenges and measures of how we value human lives and how we define human communities.