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Regulations and organ transplantation in Turkey.

The concrete expression of ethical values in legal arrangements may require a long period. In our experience, this period can sometimes be quite brief when it comes to bioethical issues, as it can be seen in the legal arrangement in Turkey concerning organ transplantations. Turkey can be considered a fortunate country with respect to legal arrangements for organ transplantation in that laws on organ transplantation in Turkey date back to twenty years ago. At the time this law went into effect, the ethical discussion on this issue were yet to begin. The rationale behind the law was to prevent physicians from legal prosecution due to organ transplantation. Yet, the attempt to place organ transplantation into a certain legal framework alleviates our ethical concerns.

Cadaver↗

Raising consciousness.

The national debate over Terri Schiavo exposed a critical gap between emotional fervor about brain-injured patients and the medical science that informs standards of care for them. Some of the questions raised in the public and legal forums point to a need for research and enhanced understanding of the mechanisms of recovery from disorders of consciousness.

Female↗

Ethical issues in artificial nutrition and hydration.

From the time of Hippocrates, approximately 2500 years ago, medical ethics has been seen as an essential complement to medical science in pursuit of the healing art of medicine. This is no less true today, not only for physicians but also for other essential professionals involved in patient care, including clinical nutrition support practitioners. One aspect of medical ethics that the clinical nutritionist must face involves decisions to provide, withhold, or withdraw artificial nutrition and hydration. Such a decision is not only technical but often has a strong moral component as well. Although it is the physician who writes any such order, the clinical nutritionist as fellow professional should be a part not only of the scientific aspects of the order but of the moral discourse leading to such an order and may certainly be involved in counseling physicians, other healthcare providers, patients, and families alike. This paper is intended to give the clinical nutritionist a familiarity with the discipline of medical ethics and its proper relationship to medical science, politics, and law. This review will then offer a more specific analysis of the ethical aspects of decisions to initiate, withhold, or withdraw artificial nutrition and hydration (ANH) and offer particular commentary on the ethically significant pronouncements of Pope John Paul II in March of 2004 related to vegetative patients and artificial or "assisted" nutrition and hydration.

Ethics, Clinical↗

A life not worth living?

The work of Dan Brock and Helga Kuhse is typical of the current stream of thought rejecting the validity of sanctity of life appeals to instill objective inviolable worth in human life regardless of the quality of life of the patient. The context of a person's life is supremely important. In their systems life can have high value, yet the value of life can be outweighed by the force of other disvalues. The notion of quality of life has increasingly come to signify the measurement of the worth of a person's life itself. Having a life equals a personal life. Any objectivity to life resides in 'personal', 'biographical', or 'creative' life, not mere biological life. Personal life represents the minimal threshold for any objective worth. In responding to this challenge, John Finnis has argued extensively that life is an intrinsic good--a basic human good. Following from our grasp of human life as a basic incommensurable good, it cannot be practically reasonable both to affirm that (a) 'human life is a basic human good', and (b) that 'human life qua human life can be intentionally acted against to its destruction'. Yet, if the good of human life can be considered self-evident, the self-evidence of the basic human good qua good does not mean that dialectical reasoning cannot be engaged in to indirectly support the practical reasonableness of respecting the good of human life in the deliberative choices that persons make concerning their actions. It is to the use of such dialectical reasoning, supportive of the status of human life as such a basic human good, that the article is primarily concerned to draw out and articulate.

Attitude to Death↗