In this course, we have primarily focused on the medical ethics for physician-patient relationship. I wonder if the principles that we discussed in the class can be applied to being other than humans and people. It would be a very interesting thought experiment to see if artificially intelligent/conscious robots can be given the same moral status as humans which would then open a plethora of dilemmas and questions.

The last few decades have seen a phenomenal rise in computer science and technology. We are accelerating at a pace that we could not have predicted just a hundred years ago. I think we are at a point where the ethical implications for a lot of our scientific achievements are not well understood. But, that has not stopped us from progressing ahead. One field of interest is the invention of artificial intelligent machines. While we already have machines that are intelligent such as smartphones and computers, but they are nowhere near close to the human intelligence. However, the machines are getting smarter and smarter with each iteration and there could be appoint where a computer can rival the intelligence of humans. This event is described as technological singularity. It could potentially trigger runaway technological growth resulting in drastic changes to our way of life.

At this point it is very important to distinguish between artificially intelligent machine and an artificially conscious machine. The former suggests a type of machine that can do a task better and faster than what humans can do. The later suggests a type of machine that has a conscious perception of it doing work.

According to Michael Graziano, a highly reputed neuroscientist from Princeton University, consciousness is generated by the interoperation of various parts of the bran, called the neural correlates of consciousness (NCC). Some computer scientists believe that it is possible to create machines that can emulate this NCC interoperation.

Hypothesizing that such artificial conscious (AC) machine is indeed created, should we then give the machine a moral status or not. I try to battle this using Beauchamp and Childress’s theories of moral status.

• A theory based on human properties: This theory wouldn’t give the machine a moral status. But, it is important to note that this theory also excludes the animals. We now know that many species of primates and cetaceans have significant self-awareness and not giving them moral status would be considered inhumane. AC machine would have the same issue as the animals. Therefore, we need to look at other theories to get a better picture.
• A theory based on cognitive properties: Beauchamp and Childress list 6 conditions under this theory that are necessary for a being to be considered worthy of moral status. I invite you to read those conditions and thing about how AC machine would fall under this theory. I think that a true AC would satisfy all the conditions.
• A theory based on moral agency: According to this theory, a being derives moral status from its capacity to act as a moral agent. A machine can be programmed to follow certain laws that are essential to being considered human. The machine can also consciously choose to follow this rules and tell if something is right from wrong.
• A theory based on sentience: Sentience is defined as a consciousness in the form of a feeling, this is the capacity to feel pain or pleasure. Admittedly, capacity to feel is limited to biological life and while an AC machine can emulate these feelings, it is impossible to know if it “feels” rather than it “thinks that it feels”.
• A theory based on relationships: This theory states that relationship between beings should be for moral status, rather than being directly. This would then follow that dynamic relationships between AC machines and people would be given a moral status.

Let me know what you guys think about this!

Buchanan’s attempt to justify the right to a minimum healthcare through libertarian approach is interesting in the sense that it goes the norm. While proponents for right to healthcare usually argue through the utilitarian grounds, libertarian approach is often employed by the opponents to argue against such right.

It is easy to see why Buchanan would attempt to do so as it provides a framework for libertarians who are opposed to it to look at it in an alternative way and potentially change their views. While his arguments make quite a convincing case, there are some issues with it that need to be addressed.

Buchanan takes a two-pronged approach to state his case. He uses arguments of special rights to healthcare, harm-prevention, and prudential arguments to justify a public health measure such as universal right to healthcare. He uses arguments to show how duty of beneficence would justify coercive policies that are needed to fund such a public health measure.

I will now try to critique his two-pronged approach and state my concerns for it.

• Arguments from Special Rights: The government owes certain groups of people special privileges for rectifying past or present institutional injustices, compensation to those who have suffered unjust harm by the act of private individuals or corporations, and for sacrificing their lives for the good of society. This argument on its own doesn’t help the case for universal right to healthcare as it pertains to special groups of people.

• Argument from the Prevention of Harm: The Harm Prevention Principle that is already used to justify traditional health services such as immunizations, sanitation, etc. can be elaborated to include the universal right to healthcare as it would also aim at improving the health of the population. Buchanan also brings in the equal protection clause from the constitution to further bolster his point. He argues that it would be unconstitutional to not have universal right to healthcare as it would mean that certain sections of the society would be unjustly put to harm.

This argument is probably his strongest argument as it makes a clear case and works in the contest. One issue with bringing in the equal protection clause is that it was originally aimed to prevent the government from unjustly infringing upon the right of selected individuals through making laws. It is analogous to the principle of non-maleficence in the sense that it prevents the government from doing something rather than telling it to do something. Using it to argue for universal right to healthcare therefore isn’t prudent use of the equal protection clause.

• Prudential Arguments: It emphasizes the benefits from an universal right to healthcare as it would improve the productivity of labor and fitness of the society. The argument is not enough to justify that individuals have moral right to healthcare.

Buchanan explains that the above-mentioned arguments taken together provide a convincing case for universal right to healthcare. I don’t necessarily see how it justifies universal right to healthcare because it fails to explain why individuals have the moral right to healthcare. It does however provide a very convincing case for why governments ought to provide universal healthcare to its citizens.

• Argument for Enforced Beneficence: Every person has a duty of beneficence to others. This duty expands to providing for others healthcare. But, if this duty is not enforced then it would be impossible for the whole system to work as people are short-sighted and often fail to see the long-term benefits. Enforcement would take place in the form of individual taxes and penalties.

This argument wouldn’t work through libertarian approach as it twists the duty of beneficence to some extent. Duty of beneficence is considered an imperfect duty as it is a matter of choice of the individuals to help others. It is also very important to note that it should be a choice of individuals who to help. This freedom of choice is very important in libertarianism. Any enforcement would be against the libertarian value of personal liberty. While you may argue that it the right thing to do, doing so through libertarian approach is troublesome. Let me know what you guys think.

Background: One of the biggest issues that I see in our society is the unwillingness of the populace to engage with their beliefs that they hold so dear. The issue of physician assisted suicide is one of the most under discussed and consequently least understood issues of our time. The Society’s inability to separate from its dogmatic beliefs leads to a very myopic discussion about the ethics of physician assisted suicide. This problem has very harsh consequences on patients that are suffering from incurable and often very painful diseases. The case of Sue Rodriguez is such and I find it rather troublesome that the court decided against her wishes. Sue suffered from amyotrophic lateral sclerosis (ALS), a decease that leaves its victim unable to speak, walk, and ultimately kills by paralyzing the respiratory system (Thomas).

Moral Issues: The case presents several moral issues regarding the issue of physician assisted suicide. Arguments against it as listed in Well and Good book are:

• Pain can always be managed through strong analgesics.
• It will result in diminished efforts to improve end of life care for other patients.
• It is a form of killing and inconsistent with physician’s duty to never harm.
• Slippery slope to involuntary euthanasia.

Discussion: One of the greatest advocates of physician assisted suicide, Dr. Kevorkian often said that it is absolutely inhumane for an advanced society to not allow its members who are suffering from incurable and painful diseases to not end their lives. The biggest and the foremost argument in favor of it would be respect for patient autonomy. Choosing what happens to one’s life is very fundamental to being autonomous and the government should not have any say in that regard. Another not so straightforward argument would be the principle of non-maleficence. While aiding to someone’s death is clearly contrary to the principle, I would argue that intentionally forcing patients to suffer though extreme pain, especially when they do not have any potential to get better clearly violates the principle of non-beneficence. Of all the arguments against physician assisted suicide mentioned above, I would like to focus more on the last one as it presents quite unusual challenge when it comes to public policy. The issue is that it will blur the line between right to die and the expectation to die. Opponents argue that if society legalized the act of assisted suicide, it will gradually become an expectation for terminal patients to go through with the option of committing suicide. This claim does have some legitimate merits to it and should be carefully studied and discussed. However, a study from Netherlands, where physician assisted suicide is legal, showed that for the past few years there has been a decrease in the number of people opting for physician assisted suicide, partly because of the change in approach by the Dutch doctors in pain management strategy (Van). A system that adequately addresses this issue must be set in place for carrying out the practice of physician assisted suicide. I encourage you guys to have these conversations with people around you and spread awareness regarding this issue so that we address it and do justice to all the helpless patients throughout the country.

Work cited:

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. 214-22. Print.

Van Der Heide, Agnes. “End-of-Life Practices in the Netherlands under the Euthanasia Act.” ProQuest. N.p., 10 May 2007. Web. 18 Feb. 2017.

Respect for autonomy is one of the fundamental principles of medical profession and I would argue that it must be given a special status because of its history in the medical profession. Until the mid-20^th century, Paternalistic behavior on behalf of the physicians towards the patients was encouraged with the mindset that physicians know best and the patients should not be bothered with medical decisions that involves complex science and often weak evidence. However, this attitude changed during the mid-20^th century because of the revelations of Nazi human experimentation after the World War 2, for the most part.

I was very concerned during our class discussion about moral status when few people argued that prisoners could potentially be given a lower moral status as a result of their moral transgressions. The notion of seeing a fellow human as a lesser moral agent has very disastrous consequences and must never be entertained regardless of the person’s transgressions or supposed inferiority. The absolutely chilling nature of Nazi human experimentation and the justifications given for it by the German physicians involved serve as an irrefutable evidence for my argument.

During the World War 2, a number of German physicians conducted extremely painful and deadly experiments on thousands of prisoners in the concentration camps. The experiments range from the ones aimed to improve the survival of soldiers in the battlefields such as high-altitude experiments, freezing experiments and seawater consumption experiments, to the ones aimed at creating pharmaceuticals and treatments of diseases such as malaria, typhus, TB, typhoid, hepatitis (United). Some prisoners were exposed to phosgene and mustard gas in order to test antidotes (United). The experiments also included the ones aimed that sought to advance the racial and ideological views of Nazi Germany. Such experiments included experiments on conjoined twins, sterilization procedures and serological experiments to determine the differential immunity of different “races” (United). Some were also aimed at establishing “Jewish racial inferiority” (United). The accounts of these experiments is testament to the horrid consequences of a very twisted ideology.

During the Nuremberg trials, German physicians gave justifications for their experiments. One of them, Dr. Gerhard Rose said:

“Without these experiments, the vaccines, which were recognized as useless, would not have been produced in large quantities. The victims of this Buchenwald typhus test did not suffer in vain and did not die in vain. There was only one choice, the sacrifice of human lives, of persons determined for the purpose, or to let things run their course, to endanger the lives of innumerable human beings… Aside from the self-experimentation of doctor, which represents a small minority if such experiments, the extent to which subjects are volunteers is often deceptive. In the majority of such cases, if we ethically examine facts, we find an exploitation of the ignorance, the frivolity, the economic distress, or other emergency on the part of the experimental subjects” (Jay).

The extent to which these physicians tried to justify their actions, is beyond our imagination. How can someone stay blind to these extremely repugnant sights in front of them, while looking at its possible utility in the future.

The principles of autonomy and beneficence are at stake here. Nazi physicians justified that inflicting extreme amounts of pain to a single person is proper if the results from it can save thousands of lives. The prisoners had no say whatsoever in participating in these experiments. The data collected by the physicians did give them insights into various diseases and possible treatments. But, is it morally admissible to go to such lengths in order to discover something that may or may not have any use. I strongly argue that there are some lines that must never be crossed no matter what you see on the other side. Respect for autonomy is a very hard earned principle in medical profession and therefore must be defended more than others.

Citations:

Jay Katz, Experimentation with Human Beings (New York: Russell Sage, 1972), p. 300.

United States Holocaust Memorial Museum. “Nazi Medical Experiments.” United States Holocaust Memorial Museum. United States Holocaust Memorial Museum, n.d. Web. 28 Jan. 2017