Humans have a natural rebellious nature because they feel entitled to control their own life. They do not wish for someone else to coerce them into doing something even if they feel that it is in their best interests. Instead, they wish to be given the chance to choose an action that is in their best interests.  When designing public health policy, it also best to limit coercion as much as possible because it will evoke more cooperation from the citizens.

Firstly, it is important to know that there are three forms of coercion: hard paternalism, soft paternalism, and maternalism. S. Holm describes hard paternalism as giving someone no option, soft paternalism as attempting to influence someone’s choice via manipulation of information, and maternalism as influencing someone’s decisions through guilt (Holland 392). Secondly, it is also important to know that no matter the circumstances, there will always be some level of outside influence on which decision a person chooses to make. The key is to make the person feel as if they have autonomously made the decision.

Obviously, hard paternalism can deter people from going through with a decision because they feel forced into their situation. D. Isaacs, H.A. Kilham, and H. Marshall assert that people “who are coerced into an action may be more likely to perceive the action as being risky than if they are persuaded into it (Holland 403). Essentially, when people are obligated to choose a default choice, they assume that there are underlying consequences that are not disclosed because these consequences will dissuade them from choosing that particular option. For instance, Simon Chapman argues that people are so hostile towards public cigarette smoking because they are forced to share the person’s toxic smoke. Nevertheless, people enjoy sitting around a warm campfire, where they, by choice, inhale its toxic smoke (Holland 408).

Meanwhile, the act of persuading, such as in soft paternalism and maternalism, forces one to unveil reasons why people should choose a certain option over other ones. This allows the person to feel that there are other options, but one particular choice is the best choice due to certain specifications. For example, educating people about the risks of obesity allows people to see that their life expectancy can be improved and their risk of disease can be lowered if they choose to diet healthily and exercise. Using soft paternalism, officials could lower insurance rates for those who live a healthy lifestyle. People still can choose to eat unhealthily, but it would not be in their best interest because they will have to spend more money to cater to a lifestyle that has been proven to shorten their lifespan. From a maternalistic approach, officials could inform parents that an unhealthy lifestyle could lead to a plethora of diseases such as asthma, diabetes, and heart disease that will lead to a poor condition of life as they grow up. Good parents should then feel guilty and thus decide to set a positive example for their children as well as ensure that their children follow this example.

Subsequently, compulsion may not be necessary in order to enact public health policy because simply giving the people an option will respect their right to choice, a key component of autonomy. One of the only instances in which compulsion may work is in a case in which a disease is immediately life threatening. This is because people value their lives and will do anything to preserve them, including subjecting themselves to mandated treatment. Still, people will view this mandate as a choice to do whatever it takes to save their life. In the end, people will comply as long as they feel that they are in control.

Sources:

Chapman, Simon. “Banning Smoking Outdoors Is Seldom Ethically Justifiable.” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 407-11. Print.

Holm, S. “Obesity Interventions and Ethics.” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 392-97. Print.

Isaacs, D., H. A. Kilham, and H. Marshall. “Should Routine Childhood Immunizations Be Compulsory?” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 398-406. Print.

Though the field of medicine during the times of ancient Greeks is very outdated, The Hippocratic Oath is one concept that remains important even to this day. Particularly, there is one line that the general public expects medical professionals to observe: “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice” (Tyson). Interestingly, physicians are expected to judge the best interest of the patient in order to do no “harm or injustice,” but how can one person be expected to determine what is best for another person? Of course, any morally sound clinician wants to ensure that the patient receives the best treatment possible, but to accomplish this they must first combine their professional knowledge with the precise knowledge of every patient’s best interests – a feat that is simply impractical.

According to Veatch, in order to implement a treatment while simultaneously respecting the patient’s best interests, a medical professional must adhere to three principles. First, the clinician must ensure that the patient’s medical needs are met; second, the clinician must ensure that the patient’s other non-medical interests are respected; and third, the clinician must be able to uphold various other societal morals and laws even if these may conflict with the patient’s best interests (Holland 320). As Veatch states, all three of these assertions have the possibility of conflicting with each other. For instance, in a case in which a Jehovah’s Witness has a communicable intestinal disease needs to undergo a critical operation, the surgeon explains that the procedure would require an intestinal bacteria transplant (bacteria from the gut of a healthy individual is transplanted in another individual). He offers an alternative treatment regimen that involves cleansing the gut with potent medications, but this has a very high risk of serious irreversible damage. It is in the patient’s best medical interest to undergo the surgery because the risks are lower, yet this would not be in the patient’s best moral interest. The patient may refuse both treatments and may be willing to live with the disease, although she can spread this disease, which is deadly to other individuals. Thus, the clinician is obligated to treat the patient in order to benefit the greater good, yet this violates the patient’s religious interests and/or her medical and autonomic interests. The clinician and the patient could both agree to the alternative treatment, but this encroaches on the patient’s medical interests. The clinician could leave the patient quarantined for the rest of her life, but this would not be in her best medical and autonomic interests. Subsequently, which option is the best for the patient?

In addition to respecting all three of these factors, medical professionals are guessing to determine the patient’s interests. The most efficient way to diminish the amount of guessing which treatment may work best is for the clinician to strengthen their personal relationship with the patient. Unfortunately, even though the doctor can be “generally warm and caring,” patients may still feel as if there is a distance between them and their physician (Chen). Some people have problems that they would not even tell their best friend, let alone a medical professional who might be a stranger to them. To some patients, medical professionals are experts of their body and know what is best for them with regards to treatment. “Some even said they feared retribution by doctors who could ultimately affect their care and how they did” (Chen). An analogous situation is the classroom setting. Some students often feel afraid to question the authority of the teacher, even if it best serves their learning environment, because the teacher has the ultimate say in their grade. In the medical setting, however, the physician has the ultimate say on the patient’s life.

Essentially, it is nearly impossible for a clinician to act fully within the interests of any individual, especially if they do not know the patient on a personal level. In order for the physician to ensure that most of the patient’s needs and desires are met, the doctor-patient relationship must be strengthened. For this to occur, medical professionals should be more personable to patients in order to make them feel comfortable with divulging information. Meanwhile patients should view their physician as just an average human being with whom they can share their opinions and ideas.

Sources:

Chen, PAULINE W., M.D. “Afraid to Speak Up at the Doctor’s Office.” Editorial. Well. The New York Times, 31 May 2012. Web. 23 Feb. 2014. http://well.blogs.nytimes.com/2012/05/31/afraid-to-speak-up-at-the-doctors-office/?_php=true&_type=blogs&_r=0.

Rosenberg, Jennifer. “Typhoid Mary.” About.com. N.p., n.d. Web. 23 Feb. 2014. http://history1900s.about.com/od/1900s/a/typhoidmary.htm.

Tyson, Peter. “The Hippocratic Oath Today.” NOVA. PBS, 27 Mar. 2001. Web. 21 Feb. 2014. http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html.

Veatch, Robert M. “Abandoning Informed Consent.” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 318-28. Print.

Imagine that cloning oneself could produce an exact replica. The clone would be the same age, have the same mind, and even the same scar that he received as a kid. Many people wish cloning worked this way because they could then be in two places at once and double their productivity rate. In addition, as long as both the person and the clone were treated as individuals this useful procedure seems ethical because the person wants to be cloned, and since the clone has an identical reasoning pattern, the clone would also consent to being a clone. Unfortunately, cloning does not work this way, and the clone would in reality be a completely different individual with identical DNA to the original person.

In his essay “Why We Should Ban the Cloning of Humans: The Wisdom of Repugnance” Leon Kass lists many uses of human cloning. Two of these uses include “’replacing’ a beloved spouse or child who is dying or has died” and “replicating individuals of great genius, talent or beauty” (Holland 34). Like the scenario discussed earlier, these two circumstances are completely impossible because cloning does not duplicate a person. Even identical twins, which are actually clones of each other, are completely different individuals altogether. According to Tina Hesman Saey, “by birth, genetic doubles use their DNA differently…by regulating the activity of certain genes, they can profoundly influence how the DNA blueprint is used to create and operate a living organism.” (sciencenews.org). Hence, the clone may not look the same or have the same physical capacities of the original person due to these epigenetic differences. For instance, check out these clones (identical twins), Otto and Ewald:

Moreover, underlying diseases that were completely shut off or mild could become severe in the cloned individual. If the clone is living a miserable existence due to a diseased state, then this raises even more ethical questions concerning the cloning process.

Furthermore, in the case of cloning females, there is a chance that they could express entirely different genes. This was made evident in the case where a calico cat named Rainbow was cloned, but the CC (carbon copy), the clone, had a completely different fur color. This is because fur color is partially determined by genes that reside on the X chromosome. Female mammals have two X chromosomes, but only one is activated in each cell. The activation pattern varies amongst cells. When CC was cloned, her cells did not adopt the activation pattern of Rainbow. “Rainbow and CC are living proof that a clone will not look exactly like the donor of its genetic material” (Genetic Science Learning Center).

                 Even if epigenetics did not play a role in development, the environment would drastically effect the clone’s development. The clone cannot undergo every single nurturing experience of the original person; hence, they cannot develop an identical mindset, personality, talent, or desires of the original person. The clone would develop into an individual that may not want to have the pressures of living up to the potential of someone else.

Subsequently, it is highly implausible to “replace” a lost family member or friend as well as to “replicate” a celebrity (or rather their talent). Doing so requires duplicating a person’s nature and nurturing exactly. In any matter, this subjects one to appreciate and enjoy, instead of taking for granted, the rare gift that is human life. Additionally, it allows the introduction of new skills into society and/or the creation of a legacy of person who has passed away.

Sources:

Genetic Science Learning Center. “Why Clone?.” Learn.Genetics 26 January 2014      http://learn.genetics.utah.edu/content/cloning/whyclone/

Kass, Leon R. “Why We Should Ban the Cloning of Humans: The Wisdom of    Repugnance.” Arguing About Bioethics. Ed. Stephen Holland. New York:   Routledge, 2012. 130-48. Print.

Lloyd, Sam. “Check out Identical Twins Otto and Ewald.” The Sam Effect. Inbound     Marketing, n.d. Web. 27 Jan. 2014. http://thesameffect.com/check-out-identical-twins-otto-and-ewald/.

Saey, Tina Hesman. “Study Shows Where Identical Twins Part Ways.” Science News. Society for Science & the Public, 17 July 2012. Web. 26 Jan. 2014. https://www.sciencenews.org/article/study-shows-where-identical-twins-part-ways