VIII. Medical Ethics -- Today's Options by Dr. Felix Fernando

Prior to World War II, medical ethics was a relatively static discipline with a very restricted field of inquiry. Being concerned, as it was, largely with the niceties of professional conduct by doctors towards their patients (doctor-patient relationships) and the maintenance of cordial relations between doctors themselves (medical etiquette), there was hardly anything in this area to commend its study to anyone outside the profession. The ethical code for doctors had been laid down ages ago by Hippocrates, and despite modernized versions such as the Declaration of Geneva adopted by the World Health Organization in 1948, there was really nothing much which could be usefully added to the principles already spelled out by the sage of Cos. Controversial issues were few, and although debates erupted from time to time on topics like vivisection and vaccination, viewed retrospectively, it is clear that what sustained such controversies was the debating skill of the participants (who included celebrities like George Bernard Shaw and Oliver Wendell Holmes) rather than any abiding interest in the public mind or among doctors themselves about the merits or demerits of the moral choices involved. Religious convictions of one sort or another wielded some influence of the issues debated. But, by in large, always do the right thing by their patients, and indeed apart from occasional lapses, this appeared to be the case.

Against this peaceful backdrop, the changes which took place in the scenario of medical ethics during and after World War II can only be described as revolutionary in character. A veritable avalanche of new discoveries and highly refined techniques in biology and medicine has made both medical care and research enormously sophisticated areas of activity where ethical choices of a very novel kind are moving more and more to the forefront and presenting levels of complexity which are becoming increasingly difficult to unravel. These problems are posing a challenge not only to medical doctors and research scientists, but even to the ordinary layman who when everything is said and done will be at the receiving end of the new technologies. Religion too must necessarily take note of the ethical issues raised by these innovations if it is to remain meaningful in any real sense to people caught up in the vortex of such changes.

We are living today in an age where it is possible -- this is just a simple example -- for a child to be conceived outside the womb of its mother with the help of artificial insemination from a father who may have died many years ago. Eventualities such as this may at first sight appear to be a matter of relative indifference to society at large. But on closer scrutiny there are many issues which are seen to surface. Would such a child, for instance, be legally entitled to inherit the wealth of his putative father, and what would be the status of such inheritance in the event of subsequent claims on the estate being made by siblings having the same paternity? If no such claims are admissible, will we have to abandon our present notions of "responsible parenthood?" I am not suggesting, of course, that legal conundrums like this should weigh for a moment against the needs of a childless couple who genuinely desire to have a child. But what if the procedure be adopted as a strategy for national eugenics to produce a nation of supermen which after all is a very natural human aspiration. One cannot forget here the Ordensburg experiment of Adolf Hitler where S.S. men of supposedly Aryan appearance were encouraged to mate with equally Aryan looking maidens for this purpose. Today it does not require a dictator to think up such a plan; the use of genetic engineering for precisely this purpose is being openly advocated as part of the humanist credo to our times.