Ethics

The concept of bioethics arose with the evolution of medicine during the 50’s and 60’s. Medicine was now prolonging death and conducting research rather than prolonging life. Modern medical marvels were causing the degradation of various social and moral norms. The problems that modern medicine raised were social, political and even legal in nature and so the medical profession was in need of non medical advice.

The use of organ transplants compounded this issue. Terminally ill patients were the best source of organs such as hearts and many were pronounced dead eventhough they were technically still alive for the sole purpose of obtaining organs.

In order to address these issues a committee of the Harvard Medical School introduced the concept of �brain-dead’. This was supposed to ease the burdens that resuscitative measures caused and to remove the controversy surrounding organ transplant. People with no brain activity were being pronounced as brain dead and hence their organs were able to be removed while the heart was still beating and circulation was maintained; this ensured that the organs did not deteriorate. However there were still problems with this definition since numerous people that had been pronounced brain-dead actually recovered. Even today the definition of death remains undecided.

In the next article Ronald Cranford reveals the confusion that can arise if medical terms such as brain-stem death, and irreversible coma are not used in their proper context. He then goes on to define and explain these terms. For instance in a persistent vegetative state all higher brain functions are lost but the brain stem remains intact and hence vegetative functions such as respiration and primitive reflexes are unaffected. When a patient is brain dead however both higher brain functions and brain stem functions are lost.

In conclusion he states the physicians should stop using such confusing and inaccurate language, and should adhere to the medical realities of the cases at hand. As new cases and problems in the future can only be expected to become more complicated the medical community should undertake a more active role in the definition and medical aspects of these syndromes.

The last article talks about the role of feeding tubes. Before these tubes patients that had no means to ingest food or fluids eventually died in a state of severe malnutrition