SPECIAL TERM | BIOETHICS

Module 4: How should Life and its Extension be Ethically Viewed?

Assessment Case Analysis

Name LEYSON, Liv Leanne L. CYS MEB24
Professor Ms. Janet Luistro Date August 20, 2021

1. Identify and explain the ethical duties that are exemplified by the following
characters in the 1978 movie entitled - COMA.

a. Dr. Susan Wheeler

Non-maleficence. Susan Wheeler, being the protagonist in the movie,
begins an investigation to uncover the sinistral truth about the unexplained
comatose happening in healthy patients - motivated by the death of Nancy
Wheeler and Sean Murphy. With this motivation in mind, Susan aims to stop
this cruel agenda by tracing the gas line induced with carbon monoxide to
prevent the same instance that happened to the past twelve patients.

Veracity. Upon learning the truth about Jefferson Institute being a black-
market and about carbon monoxide being used in O.R. 8 at Boston
Memorial– Dr. Wheeler shared the activities of this criminal organization to
her lover, Dr. Mark Bellows, who saved her. She did not show any hesitancy
to keep this truth from anyone.

b. Dr. George Harris

Veracity. The head of Boston Memorial Hospital, who was later discovered
as the mastermind behind the organization at Jefferson Institute
accommodating the illegal organ trafficking, demonstrated failure to
practice veracity as a leader. Dr. Harris geared towards his agenda
completely hiding the truth about organ selling in the black-market.

c. Nancy Greenly
Non-maleficence. Before the day Nancy was put into a comatose, she
talked to Susan about undergoing Dilation and Curettage for menstrual
irregularity. The decision to approve of dilation of her womb to insert the
curette (meant to cut the fetus into pieces) was a challenging decision made
by Nancy was a practice of non-maleficence to herself for the protection of
her reproductive and holistic health.

d. Dr. Mark Bellows

Beneficence and Non-maleficence: Dr. Wheeler found an ally in her lover,
Dr. Mark Bellows, who in the latter part of the movie found himself sinking
into Susan’s claims when he heard Dr. Harris’ insistence to use O.R. 8
despite being directed to O.R. 2. Eventually, he traced the gas line into the
main tunnel to keep Dr. Susan from dying from inhaling carbon monoxide to
hopefully save her life. This act of preventing harm to benefit Susan
Wheeler demonstrated both beneficence and non-maleficence.
 SPECIAL TERM | BIOETHICS
Module 2: Why Study Bioethics and Which Principles Should be Applied?

2. How much should humans intervene in natural selection when it comes to

extending life, particularly organ transplantation? Explain your answer in
the light of ethical principles.

The surgical operation of removing a damaged organ and replacing it with

a new one is the simplest definition of organ transplantation. Over the last 50
years, the medical procedure has grown exponentially and distributed medical
advances with developments in areas such as cadaveric and living organ
donation, anti-rejection drugs to increase success, xenotransplantation, artificial
organs, splitting of organs, and stem cell research.

It has been seen over the years how humans have been constantly taking
over natural selection by artificial-respiration devices, kidney dialysis, machines
to keep people breathing, conquering infertility by technology, so on and so forth.
The humans have intervened very much so, and as long as these
interventions strictly fulfill the guiding principles on ethical duties given by
autonomy, beneficence, non-maleficence, and justice, organ transplantation may
proceed. Primary areas or principles involved are:

Autonomy: For the purpose of transplantation, cells, tissues, and organs

may be removed as long as any consent required by the law is obtained.
Additionally, there is no reason to believe that a deceased person objects to it.
Beneficence: Physicians must not directly involve themselves with
procedure when a potential donor dies, nor should they be responsible. Organs
should not be up for sale and must be freely donated.
Non-maleficence: Minors and illegally competent individuals should
comply with laws on minors and physicians should not engage in transplantation
procedures if the organ is obtained by exploitation and the like.

Distributive Justice. Not everyone needing an organ may easily get one.
Organ shortage exists, and if people were to intervene with natural selection – it
is necessary to fairly divide resources. Unfortunately, not enough organs are
availably for everyone in need. The concept of distributive justice explains that
there is no one “right” method to distribute organs, but rather, there are many
ways a person could justify why an individual deserved the organ over the other.

One possible list of distributive justice criteria was provided by the

University of Washing on School of Medicine, which enumerates: 1) To each
person an equal share, 2) To each person according to need, 3) To each person
according to effort, 4) to each person according to contribution, 5) To each
person according to merit, and 6) To each person according to free-market
changes. Equal access is another criterion for distributive justice. Organs
are distributed to patients based on the length of time (i.e., first come, first
served, and age (youngest). This theory encourages a compact system of
distribution that is free of biases on race, sex, income level, and geographic
distance from the organ. “Everyone should have equal access to organs
because everyone could potentially benefit from the system.”

Increasing organ donation. Humans provided strategies to increase

cadaveric organ donations through education, mandated choice, presumed
consent, and incentives.
 SPECIAL TERM | BIOETHICS
Module 2: Why Study Bioethics and Which Principles Should be Applied?

3. Give your own ethical perspective to this line in the movie "we are dealing
in an area of uncertainty, an area where there are no rules, contradictory
laws and no clear social consensus as to what should be done"?

Uncertainty stems from everything people could not control. These may
be the outcomes of our decisions, phenomena, effects of the decisions of the
authority, or even how people around us would act. In between of right and
wrong, there lies a very wide spectrum of uncertainty, but humanity managed
to find its way around it—laws were created, social norms were formed, and a
justice system was established. We humans have discerned that uncertainty
is inevitable and uncontrollable—but we can control how to respond:

Humans created rules. To say that there are no rules is to say, “to each
his own.” – because there are different rules for different individuals, groups,
communities, or even nations. Humans created laws. Contradictory laws do
exist because the justice system does – wherein attorneys use laws against
each other. We have the liberty to establish a social consensus – but we fail
to become consistent due to the lack of unity in humans. However, despite of the
logical and sensical truth of the line delivered in the movie, we move forward
with our response. We must still rely on the laws we are bound to follow and
continue to exercise the right choices—choices that benefit human rights, and
choices that eliminate further uncertainties. We deem what is right based
on what is written in the law, and what can do no harm.

In ethics, issues and problems exist—and these are due to

uncertainties in decision-making. On the website named WebMD, doctors were
asked ethical questions and it is a clear sight from the results that all doctors do
not agree on what is right. One question said, “Would you ever hide
information from a patient about a terminal or preterminal diagnosis in an effort to
bolster their spirit or attitude?”, and there is 14.6% who answered Yes, and
59.8% No. Stated in the PMA Code of Ethics in Article II Section V, a physician
should exercise good faith and honesty in expressing opinion/s as to the
diagnosis, prognosis, and treatment of a case under his/her care. This goes to
show that while laws exist, they are disregarded by others because they may be
1) unaware, or 2) careless. Decisions as such fail the ethical duty of veracity,
and this must be judged by the law accordingly.

As Dr. George states, “Our society faces momentous decisions. Decisions

about the right to die, about abortion, terminal illness, prolonged coma,
transplantation—decisions about life and death. But society isn’t deciding.
Congress isn’t deciding, courts aren’t deciding. Religion isn’t deciding because
society is leaving it to us—the doctors.” While this is an impactful statement, as
an aspiring medical professional, I choose to abide by my ethical duties and
decide for the sake of non-maleficence, beneficence, fidelity, justice, and
veracity. I will exercise reparation and gratitude. I am aware that everything is
uncertain; that there are no rules, laws contradict, and no social consensus, but I
leave it to individual accountability. I have liberty, and I will use that freedom
for ethical decision-making and pursue quality of life for my patients when I
become what I aspire to be.
 SPECIAL TERM | BIOETHICS
Module 2: Why Study Bioethics and Which Principles Should be Applied?

REFERENCES:
A. CODE OF ETHICS OF THE PHILIPPINE MEDICAL ASSOCIATION. (n.d.).
https://www.philippinemedicalassociation.org/wp-
content/uploads/2017/10/FINAL-PMA-CODEOFETHICS2008.pdf
B. Ethics of DeNoon, D. J. (2010, November 10). Doctors Answer Tough Ethical
Questions. WebMD; WebMD. https://www.webmd.com/a-to-z-
guides/news/20101110/doctors-answer-tough-ethical-questions
C. Organ Transplantation Center for Bioethics. (2004).
https://www.ahc.umn.edu/img/assets/26104/Organ_Transplantation.pdf
D. Evolutionary Ethics | Internet Encyclopedia of Philosophy. (2021). Utm.edu.
https://iep.utm.edu/evol-eth/
E. Jonsen, A. R. (2012). The Ethics of Organ Transplantation: A Brief History. AMA
Journal of Ethics, 14(3), 264–268.
https://doi.org/10.1001/virtualmentor.2012.14.3.mhst1-1203.