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In this BiRT, I explored the political side of bioethics as I researched a bit on the debate around end-of-life medical treatments.

I looked at the particular case of Terri Schiavo. In 1990, Schiavo suffered cardiac arrest and was put in an unresponsive state for the rest of her life. After 8 years, Schiavo's husband petitioned to have her feeding tube removed. After back and forth debate between her parents and her husband, it was finally removed in 2005, where she died shortly thereafter.

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- "Modern bioethical discourse in the West has shown a clear proclivity to follow the Cartesian framework and to define human personhood in terms of higher-brain functions or some similar psychological criteria."

- "[Filial piety] alone is a common reason for children to reject a physician's judgement that any further medical intervention is futile, and to insist that every heroic measure be done for their dying parent."

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- "Discussions of bioethical themes that are widely held in the public sphere, on the other hand, are characterised by the fact that in this sphere there are no collectively shared moral convictions; there is at best partial consensus."

- "At its core, bioethics is about the question of the morally right way to deal with possibilities offered by biology and science."

- "Bioethics came into existence in the context of public debates about issues in (bio)medical science."

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Bioethics is composed of public debates around current developments or theories in medicine/biology in the lenses of both morality and politics, as well as the moral examination of the history of the medical sector.

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1. What is bioethics? An introduction

Let's establish what bioethics is

Define bioethics

2. The Troubled Self of Bioethics

Now that we've established what bioethics is, we can explore my definition. Let's take a look at the debates part of the definition

The troubled self is an example of moral debates in the medical sector

3. Biopower, Styles of Reasoning, and What's Still Missing from the Stem Cell Debates

Example of debates around bioethics over developments such as stem cell technology

Both moral and political

4. Engaging Bioethics

Explores history of debate around assisted suicide, life support

Mostly political

5. Personhood and Bioethics

Explores history of bioethics

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1. BiRT W7 "HeLa Cells"

2. BiRT W3 "Autonomy over Death"

3. BiRT W5 "The 14 Day Rule"

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1. Henrietta Lack's cells taken without her consent

1. Was told she was just undergoing a surgery for a condition she had at the time

2. Cells were then taken and put under research

2. Her cells, called HeLa Cells, were unique.

1. They can grow and replicate without dying

2. Thanks to these cells, scientists developed polio vaccine, vitro fertilization, first cloned human cells, discovery of 46 human chromosomes

3. However, neither her or anyone from the Lack family agreed to the mass propagation of her cells.

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Extensive media coverage throughout the entire ordeal caused the Terri Schiavo euthanasia case to spark massive public attention and subsequent activism. Multiple court reviews, U.S Congress intervention, and even President George Bush were involved. The question of what grounds need to be achieved in order to remove one from life support still remains unclear, and is ever present in modern politics, with groups like the Right-to-Die movement and Not Dead Yet clashing over the issue of voluntary euthanasia.

The case study of Terry Schiavo also resonates with the stories of Nancy Cruzan and Karen Quinlan, all of whom are examples who belong in the history of ethical and political debates of bioethics. The cases around these 3 women concern end-of-life procedures for patients in vegetative/comatose states, bioethical matters which have become heavily political over the years.

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- "The conceptions of the self that animate these central moral theories (Utilitarianism and Kantianism), has contributed to the intractable nature of many bioethical debates."

- "In bioethics, our delineation of what is at issue, and what plausible positions might be taken in any debate, often naturally fall into Kantian and Utilitarian oppositions."

- "These theories are like conjoined twins: it’s hard to think about, or apply one, without simultaneously thinking about the other as foil, as critic, and as competitor."

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- "The question of whether the U.S federal government should fund human embryonic stem cell research became a pivotal issue of debate in the weeks and months leading up to the 2008 presidential election."

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In Engaging Bioethics by Gary Seay and Susana Nuccetelli, we explore the political side of the debates in bioethics. More specifically, in chapter 5 the topic of surrogate decision making.

Surrogate decision making revolves around a few key concepts such as competence and informed consent. Competence is defined in the text as the "threshold of mental maturity and acuity that patients must meet to be able to make autonomous decisions about substantial matters concerning their health."  Informed consent focuses around the doctor-patient relationship. During times prior to significant operations, the medical provider has an obligation to fully inform the patient on what exactly is going to occur. Failure to do so can result in a malpractice lawsuit or other punishment. Court case Natanson vs. Kline is brought up in the text as an example of a landmark event in the history of informed consent.

Combining these two concepts is valid refusal, which can be exercised by a patient once they are fully briefed on the procedures of an operation and are able to make the choice for themselves.

But what if the patient isn't able to make choices for themselves?

The concept of surrogate decision making sparks ethical debates because it is employed when the patient themselves are not able to make their own decisions. Instead, they have their wishes communicated through advance directives or a relative. This causes controversy because no matter how close a relative is to the patient, or how clear an advance directive is, the perspective of the patient in the present moment will never be clear. If they were to have a change of heart, the medical providers would never know of it.

Over the years, surrogate decision making has become political. Since decisions are so difficult to make for someone who can't speak for themselves, many cases have been taken to courts and garnered public attention. Nonresponsive patients on life support have been denied termination by medical courts, even after requests by their family and friends. In other cases, families have fought from within about what to do with their loved one. Either way, over time the matter of surrogate decision making has exceeded just moral parameters and has entered the political sphere due to the attention that it has gained, as well as public involvement. I examined a few specific cases in a BiRT that I used as a source to answer the definition of bioethics, which I will go further into detail about the politics of bioethics.

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When examining bioethics, it is also important to not only focus on the present and future, but the past as well.

Personhood and Bioethics by Edwin C. Hui discusses the history of bioethics, diving into the Western conceptions of personhood as well as the early Confucian school of thought and how it impacts modern healthcare in the East. He shows that bioethics is not all just in the present and the future, but in the past as well.

The section of the text discussing personhood in Western bioethics was especially interesting. As Hui dives into the debate around the subject, he draws ideas from a plethora of 20th century thinkers. Some insist that just brain function and self-awareness are needed for personhood, while others believe complexity to be essential to personhood, such as second order volitions. Yet it seemed all the bioethical thinkers had one thing in common, and that was the belief that personhood was not for all humans. Rational thinking, self-awareness, consciousness, and ability to interact are all common requirements deemed by bioethical thinkers for personhood that not everyone has.

Hui goes on to discuss matters of the East. He does so by examining the effects of Confucianism on medical practices in Asia. Traditional philosophical belief is that the human life is composed of two aspects, the body and the spirit. As a result, medical procedures are approached differently in Asia. For example, organ transplants are looked down upon because people believe that a fracture in the body will cause the spirit to leak out. In regards to Confucianism, many Confucian ideals are in practice today in Chinese medicine. Filial piety is a cornerstone of Confucian thinking. When it comes to end-of-life medicine, Chinese children "insist that every heroic measure be done for their dying parent." This may entail maintaining life support for an unresponsive patient, or extending medical procedures that cause the patient much suffering at the cost of more life. This directly ties to the political debate of end-of-life procedures, as well as the moral question surrounding how much children owe their parents, and if insisting medical care on someone else is ethical.

In essence, Personhood and Bioethics provides a refreshing view on bioethics from an international perspective. Even then, we can see some similarities between the Eastern and Western spheres. Hui gives us good insight on the history of bioethics and how when examining its past, we can still find many subjects for moral and political debate.

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Center Director of Bioethics Margaret R. McLean at Santa Clara University defines bioethics as: "a reflective careful examination of those issues arise in biology and in medicine." McLean's definition addresses that issues exist in biology and medicine, and that those issues require "reflective" and "careful" examinations. Her definition is similar to mine in some ways, especially the first half of mine.

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In his writing, Marcus Düwell introduces his reader to the concept of bioethics, making this piece a perfect reading to use for defining the parameters of bioethics.

Düwell makes sure to establish that bioethics is an ever-changing and contested field of study. Due to publicity being a large part of its nature, bioethics contains many different viewpoints, both political and moral, proving to be anything but consistent. "Discussions of bioethical themes that are widely held in the public sphere... there are no collectively shared moral convictions."

Although it is difficult to pinpoint an exact definition, Düwell still does a good job in attempting to do so. He says, "at its core, bioethics is about the question of the morally right way to deal with possibilities offered by biology and science." This goes hand-in-hand with the first part of my definition of bioethics, where I also agree that a significant portion of bioethics pertains around the public discussion of the morality of medical inventions/methods.

On discussing its origin, Düwell states, "bioethics came into existence in the context of public debates about issues in (bio)medical science."

Both quotes emphasize the idea that bioethics is, a) exisitng on public grounds, and b) the topic of discussion is mostly surrounding the morality of developments in the medical sector.

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Throughout her reading, Rachel Haliburton addresses the clash between Kantian ideals and Utilitarianism in the medical sector, which is framed as the Troubled Self. Debates in bioethics "often naturally fall into Kantian and Utilitarian oppositions." From examining issues ranging from euthanasia to abortion, one can conclude that both schools of thought have valid contentions, which leads to the turbulent nature of bioethics, causing the aforementioned Troubled Self. "It’s hard to think about, or apply one, without simultaneously thinking about the other as foil, as critic, and as competitor."

Haliburton's writing serves as a good source in giving exposition to the moral side of the debates surrounding developments and theories in the field of medicine as well as biotech.

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In Shelley Tremain's Biopower, Styles of Reasoning, and What's Still Missing from the Stem Cell Debates, we can explore a specific example of a debate in the bioethics community around the morality and politics of a scientific advancement: stem cells.

Stem cells have the potential to advance medical research greatly. They create countless opportunities in medicine and healthcare. With stem cells, humanity may be able to harness the power of regenerative medicine, as well as combat diseases more effectively. However, it all comes at the cost of taking said cells from embryos.

Ethical issues then arise when discussing the harvesting part of stem cell research. Are the embryos alive? Do we have the right to harvest them? Furthermore, when we consider the donation process of these embryos, more ethical problems arise. Women from disadvantaged backgrounds may be taken advantage of during the donation process.

An issue as big as stem cells is bound to make the public stage, and in 2008, it did.

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The case of Henrietta Lack's cells being taken without consent is obviously morally flawed. However, the developments from the information obtained from her cells proved to be an invaluable asset to the scientific community, acting as a critical step stone in numerous developments within the medical sector.

Lack's case serves as a prime example of a breeding ground for bioethical debate. We can connect this case back to the concept of the Troubled Self, whereupon we can ask ourselves two questions: can we violate an individual's privacy in the name of public good? Or, do we respect a person as a means to themselves instead as a means to others' ends, even if it comes at the cost of benefit to society?

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This BiRT discusses embryonic stem cell research and more specifically, the 14 day rule and the morality of extending it. Currently, after 14 days embryonic stem cell research is prohibited. This 14 day mark is a short window for researchers to access stem cells, and the time period between 14-28 days is huge in the development of the fetus and could hand scientists valuable insight in human development and stem cells. However, this time frame is inaccessible due to the 14 day rule.

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The motion to wave this 14 day rule, first established in the 70s, is a prime bioethical debate. As research has gotten more advanced, however, the needs of scientists have exceeded the old window of 14 days and some are now calling to expand it. Expanding the window means opening up countless possibilities in research, developments, and medical breakthroughs. On the other hand, pushing it back also raises moral questions like, when do we draw the line on experimentation? Debates like these are the cornerstone of bioethics, where tempting benefits come at a frightening and sometimes unclear costs.

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The right to die movement calls to legalize and normalize physician assisted suicide and euthanasia at hospitals. Hundreds of organizations have been founded, and rallies across the country and the world take place every year outside hospitals, government buildings, and other public spaces. On one hand, people should have the choice to decide when their lives end. Opposers to the movement often cite religion or legitimate state interest to keep its subjects alive.

Parallels have been drawn to the abortion movement, another bioethical subject, which has a similar slogan: "my body, my choice."

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https://gpb.pbslearningmedia.org/resource/biotpd.pd.sci.bioethics/bioethics-classroom-debate/

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Bioethics Classroom Debate | PBS LearningMedia

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High school teacher Cherilee Lewis leads a classroom discussion on bioethics. Students present and discuss a range of issues, including a medical practitioner's obligation to keep a terminally ill and suicidal patient alive. Also discussed: stem cell therapies, in-vitro fertilization, and genetically modified foods.

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Bioethical debates are not limited to professionals with doctorates. Part of my definition was that it is in the public sphere, and that includes people of all ages and education levels.

In this video with PBS, we can peer into a high school classroom debate over bioethical issues. Students were divided into groups and each assigned a scenario.

After discussing their scenario, the groups presented their case and defended their viewpoint on it.

This video is a useful piece of media for my definition because it serves as a video example of the debate aspect of bioethics. Individuals are presenting their own viewpoints on issues in medicine and debating with each other over which courses of action are best, discussing the moralities and politics of said issues.

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You do a really nice job of analyzing the texts from the syllabus but without a claim these wonderful analyses lack an overall aim/structure.

Just titling this content box as "Claim" would have worked.  As it is currently it looks like it is just the answer to one of guiding questions.

That said, your strong and insightful analysis of the texts meant that I was able to infer your answer to the second guiding question of how bioethics is lived.  But I was looking for a clearer, explicit engagement with that question.

Nice work.