What is medical ethics — and why does it matter?

Editor’s note: In this weekly column addressing medical and health care issues, doctors from Mercer University’s medical school provide useful and timely information on a variety of topics. Readers with questions for the doctors can email them at groover_ce@mercer.edu.

I am 67 years old, and sometimes I’m asked about my plans to retire. I don’t have any. I like what I do too much, thinking about two of the most important questions in medicine: Just because we can do something in medicine, is it the right thing to do? And, what does it mean to be professional in medicine? I’ll take a short look at the first question now and consider the second another time.

I entered medicine in 1974, and it has been exciting to watch medical discoveries appear. For example, the structure of DNA was discovered in 1953, and within a few years scientists found out how to decipher the genetic code and how to identify errors in the code that lead to genetic conditions such as Down’s syndrome, sickle cell disease and cystic fibrosis, among others. Today, a new technique, CRISPR, offers the possibility that we may be able to repair genetic defects. Imagine a couple at risk for having a baby with the genetic condition Huntington’s disease being able to test an embryo to see if it has the faulty gene, and to correct the error before the baby is born.

But any such technology can have unintended consequences. Can human embryos be modified not just to correct genetic errors leading to diseases, but also to change other characteristics of the baby? Should we manipulate embryos in order to select eye color, to increase height or to enhance intellectual or athletic ability? Do we want a world of designer babies? Do we want a world of genetic sameness that might lower our ability to adapt to future challenges to the species?

The challenge for medical ethicists is to look at developments in medicine and to consider the implications. Because we can keep an individual’s body alive with ventilators, dialysis and artificial feeding, should we? When should we not keep a body alive? Who gets to make that decision, and on what basis? Was it right for the state of Texas to keep Marlise Munoz’s body alive for two months, after she was declared brain dead, over her previously stated objections (and the objections of her husband) because she was 14 weeks pregnant at the time of her death?

How do we decide who should receive scarce resources such as organ transplants, expensive technology or costly drugs? Should Sarah Murnaghan, an attractive, 10-year-old girl with severe cystic fibrosis have received adult lungs despite medical evidence that the outcome was not favorable given her size? Who was denied the opportunity to receive these lungs when they were given to Sarah? Did the parents’ ability to mount a PR campaign influence the decision, and was this fair to other potential recipients?

The job of a medical ethicist is to think of questions that should be considered when making a decision, and to promote a process for making decisions that that takes into account those values we hold most important: personal choice, faith and fairness in making decisions regardless of economic status, race, creed, sex or other such factors. It is the challenge of participating in these difficult decisions, and the support and encouragement of colleagues similarly engaged, that keeps me wanting to stay involved for as long as I am able.

This story was originally published November 14, 2016 at 4:27 PM with the headline "What is medical ethics — and why does it matter?."