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Unresolved Issues
As medical science continues to advance, in areas such as genet-
ics, the neurosciences and organ and tissue transplantation, new ques-
tions arise regarding the ethical acceptability of techniques, proce-
dures and treatments for which there are no ready-made answers.
Moreover, some older issues are still subjects of continuing ethical
controversy.
At a global level, the 10/90 gap in medical research (only 10% of
global research funding is spent on health problems that affect 90% of
the world’s population) is clearly an unresolved ethical issue.
Despite all these potential problems, medical research is a valua-
ble and rewarding activity for physicians, post-graduates and medical
students as well as for the research subjects themselves. Indeed, phy-
sicians, post-graduates and medical students should consider serving
as research subjects so that they can appreciate the other side of the
researcher-research subject relationship.
2. Match the case studies #1 – #4 above to the follow-up com-
ments A – D below.
Each of these case studies invites ethical reflection. They raise
questions about physician behaviour and decision-making – not scien-
tific or technical questions such as how to treat diabetes or how to per-
form a double bypass, but questions about values, rights and responsi-
bilities. Physicians face these kinds of questions just as often as scien-
tific and technical ones.
CASE STUDY #1
Dr. P, an experienced and skilled surgeon, is about to finish night
duty at a medium-sized community hospital. A young woman is
brought to the hospital by her mother, who leaves immediately after
telling the intake nurse that she has to look after her other children.
The patient is bleeding vaginally and is in a great deal of pain. Dr. P
examines her and decides that she has had either a miscarriage or a
self-induced abortion. He does a quick dilatation and curettage and
tells the nurse to ask the patient whether she can afford to stay in the
hospital until it is safe for her to be discharged. Dr. Q comes in to re-
place Dr. P, who goes home without having spoken to the patient.
CASE STUDY #2