Eugenics
Francis Galton
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Eugenics is supporting the marriage and childbearing of people with desired traits to gradually breed out undesirable features from the human population (Positive Eugenics). Although such a concept goes back to the time of ancient Greece, the word "Eugenic", which means good creation, was first used by Francis Galton in late 19th century. Francis Galton was Charles Darwin's cousin. Although he was British, his ideas took hold more in America especially in early 20th century and appeared in legislations and medical practices by outlawing marriage and even sterilization of those who were considered unfit (Negative Eugenics). Published records of that time shows misconduct against minorities, patients with chronic diseases, and those who were considered feeble minded. They forced sterilized these group which is really hideous and horrifying. Later, Adolf Hitler used the same Idea of Eugenicists and led the way toward mass sterilization and extermination of many groups in Nazi Germany including minorities, those with disabilities, LGBTs, and many others.
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Euthanasia
Euthanasia is not a happy topic to talk about and also one of the most controversial issues in medical ethics. Euthanasia is the practice of intentionally ending life to relieve pain and suffering. Is it legal? Is it ethical? And if yes, in what conditions is it permitted and how? These are all difficult questions to answer. There are two kinds of it. one is active euthanasia which is the termination of life by a doctor at the request of a patient. Active euthanasia is only legal in a few countries such as Switzerland. Some with end stage diseases in other countries take a tour to Switzerland to go through active euthanasia. It is called Suicide Euthanasia. On the other hand, passive euthanasia is legal under some circumstances in many countries. In this type the care and managements necessary for continuing life is stopped and the patient loses his/her life (pulling the plug).
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Chimeras
Chimera is a legendary creature in Greek mythology. It is composed of the parts of more than one animal, for example a creature with the head of a human and the body of a lion. With this definition you can say that Great Sphinx of Giza in Egypt is also a chimera. In biology, there is a new field of study and research in which scientists mix parts of human cells with parts of animal cells. The embryos produced in this way are called human-animal chimeras. These hybrid embryos are used in medical research to produce stem cells and study the cure for genetic diseases. There is much debate around the legality and ethical stances of such acts. Some agree and support the idea and some don't. For now these chimeras can only be kept alive for 14 days and not more. These hybrid embryos are never let to mature in complete livable creatures. What do you think will happen if they are grown?
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Ethical Misconduct
The great advances in human health wouldn't have been possible without extensive researches especially during the past two centuries. Ethics is the cornerstone of medical research. All medical researches have to follow strict guidelines and rules to fit in ethical protocols. But not long ago, these rules and guidelines were not as strict as today. I mentioned the Tuskegee Syphilis study in the History of Medicine page as an example of misconduct in research. But ethical violation in medicine was not limited to that case. There are many more examples to bring up. In the 40s and 50s doctors conducted a horrible experiment in Guatemala. They infected soldiers, prostitutes, prisoners, and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects to find a more suitable STD prophylaxis. This study resulted in many deaths and losses. In 2010, the president formally apologized for the misconduct, but do you think apologies compensate for the losses?
Hippocrates' Oath
Hippocrates was a Greek physician. He is undoubtedly one of the most outstanding figures in the history of medicine. Hippocrates' oath is an oath of ethics in medical practice, attributed to this great physician. For centuries, in many communities around the globe, physicians swore to comply with a number of ethical guidelines underlined in this oath and not to violate them. Later many medical societies modified and updated the Hippocrates oath to better suit modern concepts of medicine and human rights. Many countries now have a specific version of the oath to conform to the cultural essentials of their community.
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Can Doctors Receive Gifts?
If you have watched a vintage movie about a country doctor, you may have seen patients bringing dairies and poultry as gifts for the doctor. In today's ethics, accepting a gift is a sensitive issue and the doctor should consider many things before accepting a gift from a patient. If the gift is only a sign of gratitude and the gift's value is not disproportionately high, the doctor can accept the gift but if the gift is going to influence the medical care or secure a preferential treatment it will not be ethical and is prohibited. Sometimes there may be an emotional need behind a gift that accepting them may damage a proper patient-doctor relationship.
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Can Doctors Choose a Treatment for the Patient?
Can doctors influence the patient in receiving a certain treatment? The short answer is no. At the end of the day, is you that has to decide about your medical care and the treatment you may receive. If under 18, you need your parents' consent, if not emancipated. Your physician has to provide all the information, you (or your parents) may need and educate you thoroughly to let you make a proper decision, but they cannot decide on your behalf or influence you in this matter. This is called patient autonomy. People decide about their lives, and they are the ones responsible for the decisions they make. This is a step forward toward maturity, in today's world. Not long ago and maybe still in some parts of the globe, doctors have made decisions for their patients all the way from diagnostic plans to treatments. Anyhow, the world is changing fast and people are taking a lot more control of the way they want to live and what they want to do.
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Informed Consent
Medical research has done a lot to broaden our understanding in every scope of human wellbeing. Researchers try their best to stay inside the limits and borders of morality and comply with ethical principles. Great research societies urge researchers to observe some main codes: An important one is informed consent. It means that you have to explain and give sufficient information to participants about the study and what is exactly going to be done. And then it is the participant who decides to take part in the study or not. Something that didn't happen in Tuskegee and Guatemala Syphilis Study.
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Deceptions in Research
In a medical research, sometimes researchers need to temporarily stress or deceive people, otherwise the research won't work. This is a very sensitive part of the research and researchers have to be cautious. They have to do it only if there is no other choice. They should protect participants from greater than usual harm or discomfort. Since it may be difficult to make a clear and safe decision in this regard, institutes supporting research programs, usually sponsor ethical committees to evaluate the research proposal thoroughly and oversee it during its execution. If it does occur, researchers have to debrief the study afterwards and explain any deceptions that happened during the study and its purpose.
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