Medical ethics in an Obama White House

Medical ethicists in the United States are beginning to take stock of what a Barack Obama administration will mean to the medical community -- particularly as it relates to ethical questions.

Without doubt, the White House of George W. Bush has been very conservative when it comes to medical ethics.

But with the election of a more liberal Democrat, as well as the results of several state resolutions that were also on the ballot Nov. 4, American ethicists expect to see a loosening of attitudes.

Writing for MSNBC.com, Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, writes that "the 2008 election will be remembered not only for Obama becoming the first African-American president, but also for its impact on core bioethical topics that have long dominated American domestic politics."

"Divisive issues such as abortion bans failed to gain traction on state ballot initiatives, while newer bioethical concerns that are likely to dominate American politics for years to come, including physician-assisted suicide, emerged. The past eight years of the Bush White House have seen stem cell research and the status of embryos at the centre of the moral values debate. Obama’s election has brought the fight over embryonic stem cell research in the U.S. to an end."

On November 4, Michigan became the tenth state to approve embryonic stem cell research. The Bush White House has refused to fund such work, hampering research in the U.S. Calling the stem cell debate a "stalking horse" of the abortion debate (since objections to the use of embryonic stem cells are based on the same right to life arguments), Caplan points to Nov. 4 vote results in Colorado.

"The voters of Colorado were given the chance to put that view into law with the proposed Amendment 48. The so-called “Personhood Amendment” sought to define fertilized eggs as human beings, extending them constitutional rights. Coloradoans defeated this amendment by a margin of three to one."

Caplan later adds:

"Like it or not -- and I am well aware that many are not ready to let go of these issues -- the nation may be starting to move past the endless battles over stem cells, embryos and abortion."

Also, in Washington state, voters approved a resolution to allow physician-assisted suicide.

Bernard Lo, a professor of medicine and medical ethics director at the University of California San Francisco, for instance, has some advice for the new president, saying he should replace Bush's President's Council on Bioethics when its mandate expires next year.

A National Bioethics Advisory Council can help the American public and the new administration understand the ethical issues and choices that new biomedical advances present and think through the appropriate policy responses. Now is the time to consider this new national Council because the charter for the current President's Council on Bioethics expires next year and the incoming president will have the opportunity to form a new advisory body. The new Council can identify policy options, explain their pros and cons, and make recommendations to policymakers.

That would be a very different body from the current President's Council, which advises only the president and has been used by the White House to find ways to implement pre-determined policy -- such as a recent instruction from Bush to find a way around a California court decision that a doctor cannot refuse in vitro fertilization to a lesbian couple because of his personal religious beliefs.

The President's Council meets this week.

Comments

[Beverly Nuckols, MD, MA (Bioethics)]

The conscience issue is much older than you imply, and was spurred more by the American College of Obstetricians and Gynecologists (see the Christian Medical Association's comments, and more at my blog, LifeEthics) and the various end of life cases over the last 10 years, especially those where the doctor wishes to withdraw technological support while the family wants him to continue.

I do wonder whether any Bioethics advisory committee that Obama names will be as balanced as the President's Bioethics Council. Will there be prolife and profaith members, just as the PBC had Michael Gazzaniga and William May?