Medical ethics

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(The following text or part of it is quoted from the free Wikipedia article Medical ethics:)

Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice.[1] Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal.[2] It is important to note that these four values are not ranked in order of importance or relevance and that they all encompass values pertaining to medical ethics.[3] However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation.[4] Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.

Values

A common framework used when analysing medical ethics is the "four principles" approach postulated by Tom Beauchamp and James Childress in their textbook Principles of Biomedical Ethics. It recognizes four basic moral principles, which are to be judged and weighed against each other, with attention given to the scope of their application. The four principles are:[5]

  • Respect for autonomy – the patient has the right to refuse or choose their treatment.[6]
  • Non-maleficence – to not be the cause of harm. Also, "Utility" – to promote more good than harm.[6]
  • Beneficence – a practitioner should act in the best interest of the patient.[6]
  • Justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment.[6]

Medical ethics and circumcision

Basically, according to the values of medical ethics, the patient has a right of self-determination. In the case of minors, this right is usually exercised by the legal guardians on their behalf, but may only be used for the benefit of the child. An operation that is not medically indicated, such as circumcision, is therefore not within the sphere of influence of parental rights.[7]

The doctors themselves are not allowed to carry out an operation that is not medically indicated if the "patient" — in this case a child who is unable to give consent — cannot give his or her consent. In this case, there would be criminal acts against the child due to unauthorized bodily harm and infliction of damage.

Mininum age for non-therapeutic circumcision

Medical ethics has long recognized that surrogates have only a limited power to consent for others. That consent must be limited to the diagnosis and treatment of disease.[7] The authority of surrogates to grant consent for non-therapeutic circumcision of children has long been questioned.[8]

Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of non-therapeutic circumcision. They have determined that the alleged benefits are not material, so they do not support granting of consent by a surrogate. Moreover, they comment that even the most perfectly executed surgery produces trauma and harm to the patient. Circumcision also produces tissue loss and loss of function, therefore, circumcision should be performed only after the individual reaches the age of consent and grants consent.[9] Consent by a surrogate for a non-therapeutic circumcision is an unethical practice.

Moreover, in addition to being unethical, Adler (2013) argued strongly that child circumcision is unlawful, [10] so non-therapeutic circumcision of boys is likely to be declared unlawful by a court.


See also

References

  1. ↑ REFjournal Beauchamp J. Principles of Biomedical Ethics. Principles of Biomedical Ethics. 2013; 7
  2. ↑ REFjournal Weise M. Medical Ethics Made Easy. Professional Case Management. 2016; 21(2): 88-94. PMID. DOI.
  3. ↑ REFweb Bioethic Tools: Principles of Bioethics, depts.washington.edu. Retrieved 21 March 2017.
  4. ↑ REFjournal Berdine G. The Hippocratic Oath and Principles of Medical Ethics. The Southwest Respiratory and Critical Care Chronicles. 10 January 2015; 3(9): 28–32. DOI.
  5. ↑ REFjournal Gillon R. Medical ethics: four principles plus attention to scope. British Medical Journal. 1994; 309(184): 184-8. PMID. PMC. DOI.
  6. ↑ a b c d REFweb Principles of Bioethics | UW Department of Bioethics & Humanities, depts.washington.edu. Retrieved 18 January 2021.
  7. ↑ a b REFjournal Committee on Bioethics. Informed consent, parental permission, and assent in pediatric practice. Pediatrics. February 1995; 95(2): 314-7. PMID. Retrieved 2 July 2022.
  8. ↑ REFjournal Hill G. Can anyone authorize the nontherapeutic permanent alteration of a child's body?. The American Journal of Bioethics. 2003; 3(2): 16-8. PMID. DOI. Retrieved 24 May 2023.
  9. ↑ REFjournal Myers A, Earp BD. What is the best age to circumcise? A medical and ethical analysis PDF. J Biosoc Sci. September 2020; 34(7): 560-72. PMID. DOI. Retrieved 23 May 2023.
  10. ↑ REFjournal Adler PW. Is circumcision legal? PDF. Richmond Journal of Law and the Public Interest. 2013; 16(3): 439-86. Retrieved 8 May 2020.
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