All posts by Sabrina Tess Zarco

Medicine as a Moral Community: Not So Moral

In The Medical Profession as a Moral Community, Edmund Pellegrino defines a moral community as “one whose members are bound to each other by a set of commonly held ethical commitments and whose purpose is something other than mere self-interest” (Pellegrino 225). It was extremely interesting to me how he referenced Nazi Germany a couple of times throughout his article in order to establish an understanding of how medicine is a moral community. He mentions how, in Nazi Germany, the vast amount of murders would not have been possible without the cooperation of the physicians (228). The Nazis performed thousands of medical experiments on their concentration camp prisoners that were extremely painful and often deadly. Again, without the cooperation of the physicians, these experiments would not have been “successful” (killing them) and many more people would have survived.


In his article, Pellegrino argues that medicine is basically a moral community because of the numerous aspects of medicine that give it a moral status. According to Pellegrino, there are four aspects of medicine that give it a moral status: the inequality of a medical relationship, the nature of medical decisions, the nature of medical knowledge, and the moral complicity that the physician has over his or her patient. The inequality of a medical relationship refers to when the physician takes care of the patient and does everything in the patient’s best interest. The physician does not think of himself or, for example, the patient’s family members. All of the decisions made are made with the patient’s best interest in mind.  The nature of the medical decisions involves proper diagnosis and recommendations that are also done for the patient’s well-being. Moreover, the nature of medical knowledge involves practical knowledge and knowledge that people get through medical education. Pellegrino gave the example of how students in medical school encounter many moral decisions and break moral barriers. Medical school requires students to practice and impose on the privacy of people’s bodies through medical procedures like autopsies. Finally, the moral complicity of the physician refers to the overall responsibility that the physician has for his or her patient. The physician is (or, at least, should be) the one who makes the recommendations for the patient with the patient’s best interest in mind.

Though medicine does have many moral aspects, I would not define it as a moral community like Pellegrino does. He argues that a moral community is independent of what its leaders or members might be at a particular time (225). I think that the Nazi Germany example specifically contradicts this statement because the physicians running the Nazi medical experiments were following orders at a specific point in time. A “moral community” would not perform these kinds of experiments on people if it was truly a moral community. Unless he argues with this example because the Nazis sincerely believed that they were doing something morally correct and had a greater purpose beyond self-interest. So then I pose the question: though a community may be tied together by a set of ethical commitments and does things that have a greater purpose than self-interest, are they really considered a “moral community” if their community involves immoral behaviors like murder?

Works Cited

Pellegrino, Edmund D. “The Medical Profession as a Moral Community” Bulletin of the New York Academy of Medicine 66 (3): 221-232.


Personal Health is Public Health

In Arguing About Bioethics, L.O. Gostin argues that, in terms of public health, government laws take precedence over people’s individual liberties in the event of a “public health emergency” (Gostin 377). He defines a public health emergency as an “occurrence of imminent threat of an illness or health condition caused by bioterrorism or a novel or previously controlled or eradicated infectious agent or biological toxin” (377). The health threat also causes many people to have major disabilities or even die. However, why should we let an emergency happen? Aren’t there steps that we can take in order to avoid the possibility of emergency as best as we can? While preventative medicine is definitely an admirable option, we can take even smaller steps and put public health into our own hands by altering our health habits and behaviors.

The concept of public health emergencies made me think of the movie, Contagion (here is the movie trailer: In this movie, a lethal virus spreads extremely quickly and, soon enough, becomes a pandemic. The virus spreads so rapidly because people do not wash their hands, people touch their faces so many times per day, people don’t cover their mouths when they sneeze, and don’t participate in other sanitary behaviors. Everywhere we go we touch something that someone else has touched and we do not know if that person is sick or not. So, from this movie, we realize that people need to take responsibility for their health behaviors to protect themselves and the public.

While there are laws that override people’s individual liberties in a public health emergency, there are no laws that demand people to wash their hands or not touch their face. Obviously, there never will be. However, in order to avoid a public health emergency, we should focus not only on preventative medicine like vaccines, but alterations of our personal health habits and behaviors. Though we may believe that our personal health behaviors simply benefit us, we are actually benefitting the rest of the public. When a person gets sick, it is very likely that his or her family member or friend will get sick too. People touch the same things and live in close quarters so it is very likely that a virus can be transmitted. Therefore, people need to be responsible and take care of themselves because it is healthy for them and the rest of the public.

Though we may view health in terms of “public health,” it is very important that we do not undermine the power of the individual’s own choices. Again, there will never be laws that demand washing your hands every time we go to the bathroom. But, we should take into account that the doorknob of the bathroom will not have as many germs on it because we washed our hands, so then other people will not get our germs. Small decisions can prevent large outcomes that we would want to avoid. Therefore, rather than focusing on the preparation for a public health emergency, or even focusing on preventative medicine, we should focus on our behaviors that will increase the likelihood that we will stay healthy.

Works Cited

Gostin, L.O. “Public Health Law in an Age of Terrorism: Rethinking Individual Rights
and Common Goods.” Arguing about bioethics. London: Routledge, 2012. 374-
384. Print.

Knowledge is Power

It’s rare to come across someone who refuses to hear information that is offered. In general, people want to know everything—whether it is ordinary gossip or their medical conditions. Therefore, there are many patients who desire informed consent because they want to know the details and reasons behind the medication they are assigned to take.

Informed consent is when a physician is “obligated to obtain the patient’s consent” and to “disclose relevant information about the treatment before obtaining consent and beginning treatment” (Lidz et al, 299).  However, nowadays, the doctor-patient relationship gap has widened and, as a result, there’s a lack of communication between the two. So, “physicians do not often fully inform” and “patients do not fully understand” because the doctors don’t have the time and/or desire to make those connections with their patients (Lidz et al, 299). So, while the patients should have an input on their medical decisions, it’s really the physicians who make them (Lidz et al, 299).

Time is of the essence. The time the physician has with his patient is limited, so the medical situations are treated as an event as opposed to a process. Lidz and his colleagues said: “medical decisions are processes that emerge and evolve over a period of time, not discrete events that occur only once” (Lidz et al, 300). However, usually, informed consent is given to a patient at a time where the medical decision is already made. For instance, when I was a freshman in high school, I needed knee surgery. I did not know what the surgery entailed until that day. I had an idea of what anesthesia was but I didn’t know exactly how it worked until I was about to go into the surgery room and my anesthesiologist started explaining to me what was going to happen. I remember thinking how fast-pace the process was. While she put the IV in me, she quickly asked me questions about any allergies to anesthesia and quickly explained to me how the medicine worked and how my body was supposed to react. At this point, I was already going into the operating room and even if I did not want to, I had to go through with it.

Though this example may be miniscule, I think it’s extremely important for one to be informed about their medical situation if they want to be. Though time is the main issue, I think it’s important for the physician himself to, at least, summarize a patient’s situation and give him or her a broad idea of the medication the physician is giving them. Additionally, it may be necessary to even discuss the side effects or why alternative medicine is or isn’t possible. However, unfortunately, physicians don’t think that informed consent is an “integral part of good patient care” (Lidz et al, 303) so they don’t make it a point in their limited time to discuss medical details that, perhaps, they should share with their patients.

Patients should be informed. Though the physician should share information, I think it’s up to the patient to ask questions so that they are knowledgeable and, therefore, make decisions for themselves. In The Place of Autonomy in Bioethics, Childress says that the principle of respect for personal autonomy includes being competent, informed, and acting voluntarily (Childress, 309). We should want to have respect for our personal independence by being knowledgeable.


Works Cited

Lidz, Charles W., Meisel, Alan, Osterweis, Marian, Holden, Janice L., Marx,
John H., Munetz, Mark R. “Barriers to Informed Consent.” Arguing
about bioethics
. London: Routledge, 2012. 299-307. Print.

Childress, James F. “The Place of Autonomy in Bioethics.” Arguing about
. London: Routledge, 2012. 308-316. Print.