There are many modern bioethical issues. They are typically polarized by ideologically charged perspectives, emotional stories from many angles, and academic debate. Here are four of the most controversial.

 

Eugenics

Infamous for its association with the Nazi regime, the politically skewed eugenic campaign was used to justify the death camps for the Jews in particular, other political and religious fugitives, homosexuals, and the physically and mentally handicapped. Modern eugenic considerations are very adamant that they do not advocate for any more purging, targeting pre-birth options instead. But is it just the same thing?
The reason this issue persists in ethical debate, is because of our increasing understanding of scientific implications. First, with the advent of pedigrees, families were able to see probabilities of genetic disorders being passed on. Mothers with cystic fibrosis or fatal familial insomnia could decide to forgo biological motherhood. Finally, modern increases in birth options and techniques (such as cesarean, artificial insemination, and gamete selection), it has become a pressing issue. To what extent families have a right to choose the characteristics of their children. Could parents choose their children to have more athletic genes, or to have genes that are associated with musical genius? Would the children even be considered theirs anymore? Would such options be accessible only to the rich? Or in socialist states, should the government have the final say?
Beyond the science fiction consideration, the pro-eugenicists emphasize the genetic disorders which plague family lines; and in that sense eugenics can be a difficult campaign to ethically circumvent. Once we have the technology to prevent the suffering of disorders, isn’t it the moral option?

Contraception

The Catholic Church is not alone in officially rejecting both abortion and contraception. In response, many scientists, liberals, and humanitarians have been pushing for increased women’s rights, and wider acceptance of both practices. Specifically, much attention in America is given to African countries, whose birth rates are enormous and life expectancy is short (and brutal).

Most of these nations are studded with independent tribal groups, but even the cities have a rampant HIV and AIDS pandemic. Culturally, very few people in Africa believe that HIV is a real disease. This prejudice is an enormous obstacle to foreign aid, even more than the government corruption which siphons off the money from non-profits. Women have no rights in most of their cultures, often times raped as spoils of war, a prize for gangs, a source of income for families, or because its the only way they can make money to sustain themselves.

The myriad of religions and politics involved make it difficult to create solutions, and make us wonder if we are being too ethnocentric to begin with. Are we being condescending in our plight to help? Even if they swapped their culture for ours, in reality they would be merely trading their social problems for ours.

At home, the issues of contraception and abortion are also taboo, and we have nearly as much ignorance and opposition to introducing sexual education to our schools. The liberal message is supported by many case studies: that the education and empowerment of young women is one of the most significant factors in social change. If they can achieve that much in America or in Africa, I think it would be a self-fulfilling prophecy.

 

Homosex Surrogacy

Should homosexual couples be able to adopt? Homosex surrogacy is a hazy moral dilemma even without any preconceived religious or political opinion. The question does not merely become a question on the legal rights of homosexual couples, but it becomes a concern as to what mental health effects it may have on children.

Missing one model gender in the home is claimed by those opposed to homosex surrogacy to be detrimental to the children’s formation of opinions on the subject of homosexuality itself; to lead to identity issues; and to lead to feelings of isolation from children with platonic families. While I can see the logic behind this argument, I have yet to see substantiated case studies.

These claims also lack proper reference to the kinds of problems the children would face without the surrogacy. Would they grow up in impoverished, uneducated, abusive, or drug-filled homes? It is not fair to just compare this scenario with the platonic model, which would not have been the case in the first place.

There is also the fact that demand for adoption is significantly lower than the supply of orphans, refugees, and children from broken homes. Because the homosex structure is fairly taboo, the parents often have had to fight legally and socially just to be together, and their resulting dedication and enthusiasm in raising children is comparatively greater than many households in America.

 

Euthanasia

Euthanasia is one of the most troubling issues for families. When a relative drops into a coma, it is impossible to tell how long they will be in that state, or if they will ever wake up. The decision to keep or reject life support is emotionally taxing, extremely expensive, and morally uncertain.

A recent New York Times article shows how convoluted the issue is. A video was released September 27, 2012 on youtube, which shows a Korean woman giving consent for her medical treatment to be determined by her family. She has a tumor on her brain stem. The video was cut short from an excerpt which is apparently missing, and the video was taken by a cousin. Ms. Lee has before and after the video consistently conveyed that she wishes to undergo physician assisted suicide (PAS), and has been ruled by psychologists as mentally competent. Her father has been attempting to attain legal guardianship of her, and move her into a nursing home. He claims that doctors are manipulating her decisions, drugging her, and pushing her toward suicide.

It becomes extremely difficult to judge whether the family is unjustly pressuring Ms. Lee to forsake her right to die with dignity, or if someone who is medically involved is pushing for PAS. These concerns existed before PAS was even legalized. Families obviously have a vested empathic interest in keeping their loved ones alive, but they may lack the sympathetic interest in preserving their right to choose. Doctors face a dilemma in trying to stop families from pressuring or changing a patient’s mind, but also face the difficulty of not influencing their decision themselves.

Stereotypically, minority families have much closer ties because of culture as well as language. The family was also religiously opposed to suicide, and they also stated a desire to keep Ms. Lee alive because she was the only daughter in a very long blood line.

Anemona Hartocollis, Daughter’s Right to Die Is Weighed Against Family’s Wish to Keep Her Alive, New York Times. http://www.nytimes.com/2012/10/05/nyregion/in-sungeun-grace -lee-case-right-to-die-is-weighed-against-a-familys-wishes.html?_r=1&ref=euthansia

Some other interesting news in the recent medical world:

 

Male Microchimerism in the Human Female Brain, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0045592

 

Donald G. McNeil Jr., International Donors Get Bayer to Cut Price 0f Implantable Birth Control for the Poor, New York Times http://www.nytimes.com/2012/10/02/science/bayer-cuts- price-of-contraception-implants-for-poor.html

 

Chan et. al., Growing Rates in Academic Fraud, http://www.huffingtonpost.com/huff-wires/20121001/us-sci-science-fraud/

 

Berdasco et. al., Adult stem cells change their epigenome to generate new organs, http://medicalxpress.com/news/2012-10-adult-stem-cells-epigenome.html

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