Medical Ethics

MEDICAL ETHICS

Despite Buddhism's long association with the healing arts, little attention has been paid to the ethical issues which arise from the practice of medicine. A small number of monographs provide introductions to the issues and dilemmas which arise in medical practice. These are Ratanakul (1986), Nakasone (1990) and Keown (1995), and these volumes should be consulted in conjunction with the sources listed under the specific subject-headings below. Also relevant is the unpublished Masters thesis by Shoyu Taniguchi (1987a). For general discussions in the periodical literature see Taniguchi (1987b), Mettanando (1991), and Ratanakul (1988; 1990). A useful discussion of Buddhism in terms of the "four principles" approach to medical ethics developed by Beauchamp and Childress (1989) is provided by Robert Florida (1994).The Encyclopedia of Bioethics contains articles on medical ethics in India (Jaqqi, 1987), Asia (Unschuld, 1987), and Japan in the nineteenth century (Kitagawa, 1987). Also on Japan see Umezawa (1988). On medical ethics in imperial China see Unschuld (1979) and on Thailand Violette Lindbeck (1984) and Ratanakul (1988; 1990).
The principal issues to be addressed in contemporary medical ethics may be summarised as moral personhood (the question of who is and who is not entitled to moral respect), abortion, embryo experimentation, genetic engineering, consent to treatment, resource allocation, defining death, organ transplantation, living wills, the persistent vegetative state, and euthanasia. Little systematic attention has yet been directed to these subjects by Buddhist practitioners or scholars, and some subjects have not been discussed at all from a Buddhist perspective. The arrangement of the topics below is neither comprehensive nor final. It is inevitable there will be overlap between the sections, and items which appear under one category may contain discussion of issues or principles which have broader relevance.
At this time, however, it seems useful to identify three groups of issues and related literature. These concern: moral personhood, issues surrounding life at its beginning, and issues surrounding life at its end. There is insufficient literature on resource-allocation, socio-economic issues, or other questions about general medical practice to justify a category on those topics in this review. There are signs, however, that a Buddhist perspective on certain aspects of medical treatment is beginning to appear, for example Epstein (1993) and Kabat-Zinn's (1990, 1994) integration of Buddhist meditation into medical practice, and the growing literature on Buddhism and social justice, such as Jones (1989) and Sizemore and Swearer (1993).