Late in July 2015, my mother asked a surgeon friend of hers his opinion on gun control. He shook his head sadly and said, “I’ve operated on good guys shot by burglars, I’ve operated on parents accidentally shot by their children and children accidentally shot by their parents. But never have I once operated on a bad guy shot by a good guy.” He does not buy the popular notion that “good guys” with guns can defend themselves from “bad guys” with guns. Of course, this an anecdote from the life of one surgeon. However, most peoples’ opinions on gun control are based on intuition and personal experience rather than data. Good data about gun violence is hard to find, because Congress has refused to provide funding for gun violence research since 1996.
In certain situations, the moral or ethical decision is obvious, but more often than not, there are a number of complicating factors. Almost all decisions we make will affect more than just ourselves, forcing us to weigh our own morality against another’s autonomy. This is particularly true in the case of medical interventions for the sake of another’s health.
Anyone who has been a part of a long-distance friendship knows that there are very few things more exciting than the prospect of getting to see your friend in person for the first time since parting. That excitement is somewhat marred, however, when your friend has so drastically changed that you literally do not recognize them. The summer between my sophomore and junior years of high school, my family moved cross-country from Texas to Indiana, forcing me to leave my best friend behind. We of course kept in touch via text and phone calls, but between the time change and our equally busy schedules, we rarely if ever had the chance to video chat. Combine that with the fact that she is largely an abstainer from social media, and the result was that I hadn’t seen a picture of my friend in a year, at which point I was flying back to Texas to visit her and our other friends. When my plane landed, I grabbed my things and rushed down the escalator to baggage claim, not realizing that I had looked my friend in the face and kept on walking because I did not recognize her. She was about two-thirds the weight she had been when I left. We had discussed how she had started working out and had gone on a diet, but nonetheless, the extent of her weight loss scared me. Over the course of the trip, however, she seemed healthy and in better shape than she had ever been before, alleviating some of my fears.
Cut to two years later, when she was getting off the plane to visit me. Now she was down to probably about half her original weight and, looking at her, I could no longer deny that something was definitely wrong. Her eyes were sunken, her hair was thinning, all of her clothing was too big, and when I hugged her, it felt like I could feel every bone in her body.
This was about a year ago now and I still have not brought up the term “eating disorder” to her. Every time we speak I vacillate about whether or not to broach the topic with her. On the one hand, she is my close friend and if her health was at risk, I would want to intervene on her behalf. On the other hand, I know that I am not in a unique position to say something. She lives with a group of roommates who see her on a day-to-day basis, not to mention she has her parents and siblings who see her more than I do. I justify my silence with the assumption that if anything was seriously wrong someone else would have intervened. We have a mutual friend who previously suffered from an eating disorder and her parents were the ones to get through to her before either of us, or any of her other friends, could.
Perhaps my action, or lack-thereof, reflects some form of the bystander effect, which raises another question about morality. One of the common tenets of ethical decision-making is whether or not you are in a unique position to prevent something from happening. By this standard, any time someone in a more authoritative position can take action, some of the burden of responsibility is taken off of oneself. For instance, in the infamous case of Kitty Genovese, a group of bystanders either heard or saw various portions of both an attack on and the murder of Genovese and all but one neglected to call the police because they assumed someone else in the vicinity would. This kind of moral code can lead to a good deal of damage because this assumption is not always true. That being said, there are no grounds on which to enforce an all-encompassing moral code dictating that everyone should act when they observe something potentially harmful or dangerous.
When wrestling with my decision of whether or not to intervene in my friend’s health, I also consider the possible negative ramifications of speaking up. I worry that if I were to say something, she would find it offensive and that our friendship would suffer because of it or that she would alienate herself. When a seemingly moral choice also has negative ramifications, it is harder to come to a decision. If I knew for sure that she was suffering from some form of eating disorder and that my saying something would ultimately result in her getting better, then the ethical decision would be very clear and I would bring the topic up to her. However, issues of moral or ethical standing are hardly ever this clear cut.
Another issue to consider is the question of morality versus autonomy. My friend remains an autonomous individual in control of her life, so even if it were to prevent some harm, I don’t know that I would have the right to intervene in her life. The line between one’s own sense of ethics and morality and the autonomy of others must be drawn somewhere. Just because I deem an action that I would take to be moral does not mean that I have the right to then carry that action out, taking away someone else’s autonomy, deciding what’s best for another person who has a right to make that determination for him or herself .
The conversation about eating disorders in relation to morality and ethics also calls to the forefront the role of media in the prevalence of eating disorders in American society. There is no denying that eating disorders motivated by body image issues are at least somewhat caused by representations of women in media. Unrealistic body standards are largely derived from the proliferation of Photoshop in magazine images and advertisements. It seems that media personnel who create this content should have some degree of moral responsibility to represent realistic images to their consumers whose lives they are negatively affecting. Questions about morality and ethics in regard to the issue of eating disorders range from the smaller, personal scale to this large scale.
I am still struggling with whether or not I should speak up in my friend’s situation. I have not come to any conclusions as to what the proper moral action to take is. However, I have come to believe that there are no simple guidelines for making decisions. Moral and ethical decisions are more often than not very complicated as well as multi-layered.
On Tuesday it was reported that the first live birth resulting from mitochondrial donation was born in New York to a Jordanian couple. According to The New York Times, the fertility procedure – also referred to as “3-parent IVF” – was performed at a Mexican clinic and the baby is a healthy boy.
The purpose of a donor for this couple was to “overcome flaws in a parent’s mitochondria that can cause grave illnesses in babies.” Thus, the DNA from the egg of the healthy mother who has the mutation, is placed in the egg of a healthy donor after her nuclear DNA is removed. It is important to understand that the mitochondria of a cell are completely separate entities from DNA that determines inheritance.
The Jordanian couple took their chances with the procedure as they had lost two other children to the disease, one at age 6 and the other at 8 months. Dr. John Zhang performed the procedure at the New Hope Fertility Center’s clinic in Mexico as it is “effectively banned” in the United States, though it has been legal in the United Kingdom since last year.
The child is now 5 months old and healthy with normal mitochondria, as was first reported by New Scientistmagazine.
Kelly Collins graduated in 2011 with a BS in Philosophy and Political Science from Florida State University. After moving to New York City shortly after graduation, she began working as a legal assistant in a well-known international law firm. While pursuing her MA in Ethics and Society, Kelly hopes to utilize real-world skills to analyze and reflect upon today’s moral dilemmas.
Tim Colvin is currently a senior at Fordham University from Kings Park, New York. He is a dual major in Political Science and Classical Civilization with a minor in Philosophy. Tim is interested in attending law school and hopes to apply a background in ethics in practice after completing the MA in Ethics and Society.
Millions of people use websites like WebMD every day to gain insight on a range of medical issues from cancer to mental health. This practice, or “cyberchondria,” is a new digital phenomenon that has resulted from online databases of free, medical information.
With about 74 million users each month, the information on WebMD provides some with clarity for our most intimate and confusing health concerns, but for others, it could be a source of anxiety. In a recent article published in GOOD Magazine, Fordham University Center for Ethics Education Bioethicist Dr. Elizabeth Yuko addressed the “ethical gray area” of web diagnosis and online symptom checkers.
“Websites and algorithms are not held to the Hippocratic Oath. Because WebMD is a media organization, rather than an individual medical professional, it is not held to the same legal and ethical accountability as individual practitioners,” notes Dr. Yuko. Unlike WebMD, other online communities and health professionals must operate under ethics codes and guidelines designed by organizations such as American Medical Association and American Psychological Association.
As far as legal liability is concerned, Dr. Yuko explained that because WebMD’s Terms and Conditions state “This Site Does Not Provide Medical Advice,” the website is not “legally obligated to provide a worst-case scenario” while most health professionals, at least in the United States, are held accountable if they do not provide patients with complete information regarding their health conditions.
Dr. Yuko, however, is most concerned with the use of health care sites as a substitute for obtaining diagnoses because people “can’t afford in-person care.” She stated, “This in itself is an ethics issue, but one from a societal, distributive justice perspective, highlighting the fact that not everyone has access to effective, affordable health care.”
The recently published article on doctor’s lack of expertise in treating transgender patients in The Guardian is an important step forward in highlighting current disparities in healthcare services for this population. The study, based on interviews with sample of 23 physicians and psychologists who chose to work with transgender patients, focused on current challenges in providing gender affirming care for individuals who are seeking medically supported transitioning treatments, such as hormonal replacement therapies (HRT).
The minority stress theory suggests that health disparities experienced by gay and bisexual men (GBM) and other sexual minorities can be explained in terms of stigma-related stressors such as discrimination at work, school, religious institutions, communities and families. The unique stressors of an HIV-positive status experienced by GBM, however, has been overlooked within research on minority stress.
Dr. Rendina has been conducting HIV research with GBM for more than ten years. He explained the need to thoroughly test “the role of internalized stigma about sexual orientation, or internalized homophobia, and internalized HIV stigma within a unified model to see whether one or both have an impact on HIV-positive gay or bisexual men.” Although it is already established that GBM are negatively impacted by internalized sexual minority stigma, the purpose of this study was to further explore the impact of HIV-related stressors on the health of GBM.