Who has the last word? contemporary medical ethics: a critical challenge to religions
The issue of decision making in medicine and the question of "Who should have the last word?" opens up a whole range of problems. It is impossible to cover the ground in one meeting like this one today. Ethical evolution, like the evolution of many other disciplines particularly the field of law, often starts as a reaction to a new event (a human action or inaction) that an author considers unacceptable. Although the action/inaction involves specific circumstances (such as time, place, and views of the people involved), the reaction attempts to establish that the action/inaction shall thenceforth become unacceptable for others in circumstances potentially very different from the original event.
Many factors, such as economics, affect a society's ethics, in particular, a feedback loop (akin to a yin-yang) with law and other forms of enforceable policy. Ethicists' views that policymakers support eventually lead to policy. Policy eventually leads to a dilemma, then a reaction to the dilemma, and then a new or revisited commentary by ethicists regarding what action or inaction is acceptable. The cycle repeats. This evolution of ethics and law results in a potential source of physician conflict, such as when a physician trained in more current ethical concepts and policy disagrees with a physician who believes in more dated ones
Theoretically, an ethical principle always follows a traceable line of historical events and persons that have prevailed in influence. Looking at the history of an ethical principle (or law) can provide an understanding of why the ethical principle has risen to prominence (or why a law exists) and may enable a practical basis for accepting or rejecting it. Medical ethics principles evolve intertwined with principles in other fields of ethics.
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