IS MEDICAL ETHICS LOST?
14. 1. IF one talked just with ordinary competent, hard-working, and caring doctors, who are in the great majority, one would think that medical ethics is in good shape. They have a fairly secure feel for what they should and should not do to, or for, their patients. They get this feel from colleagues and from their training. On the whole it leads them to look after their patients as they should, and no trouble ensues.
On the other hand, if one looks at the media, in Britain and even more in the United States, one gets a different impression. It looks as if nobody knows what the duties of doctors are. A great many people have strong opinions about this, differing wildly from one another; and it would be a bold doctor who thought he could be certain about the rightness of any of them. The position is worse with the more controversial questions: about abortion and euthanasia; about the preservation of life and the definition of death; and about various kinds of experimental procedures. But the trouble can easily spread from these controversial questions and infect the general practice of medicine. The huge rise in malpractice insurance premiums in the United States is evidence of this.
How does this contrast come about? Is it just because a lot of interfering non-medical people--clergymen, lawyers, philosophers and politicians--have found business for themselves by raising problems which would not have troubled the doctors if left to themselves? There is some truth in this suggestion, but it is not the whole truth. The truth is that doctors ought to think more seriously about these questions before they are confronted with awkward particular cases, not merely in self-protection against interfering outsiders and busybodies, but because there is a real need for it. Otherwise they may find themselves in the predicament of poor Dr Cox.
It is possible to speculate about Dr Cox's state of mind when he killed his patient at her request, to end her suffering, by injecting potassium chloride ( The Times 2 Sept. 1992; Kuhse 1997: 2 f., 185).____________________