Medical Ethics in Post-Modernism: Surrogacy, Doctor-Patient Relationships, Abortion, Euthanasia, and Female Infanticide

Learning Outcomes

1. Understand the post-modernist critique of traditional medical ethics.
2. Explore the ethical dimensions of surrogacy and doctor-patient relationships.
3. Evaluate moral dilemmas surrounding abortion, euthanasia, and female infanticide.
4. Analyze how post-modern philosophy informs contemporary medical debates.

Post-modernism brings a critical lens to medical ethics, questioning established norms, moral universals, and objective truths. The ethics surrounding medical practices such as surrogacy, doctor-patient relationships, abortion, euthanasia, and female infanticide have evolved through the lens of applied philosophy, particularly in the context of post-modern thought, which emphasizes plurality, subjectivity, and skepticism of universal truths.

Surrogacy in Medical Ethics

Surrogacy, the practice of a woman carrying and delivering a child for another person or couple, presents significant ethical challenges, particularly in the realms of consent, autonomy, and commodification of the body.

1. Autonomy and consent: Autonomy is central to medical ethics, and surrogacy involves the surrogate’s full understanding and voluntary participation in the process. Post-modernism challenges the classical liberal notion of autonomy by questioning whether surrogates, especially in underprivileged socio-economic conditions, are genuinely free to consent or if they are coerced by economic pressures.

2. Commodification of the body: The commercialization of surrogacy leads to debates on whether women’s bodies are being commodified. Post-modern feminist critique examines how patriarchal structures might influence the ethics of using a woman’s reproductive capabilities as a means of financial exchange, leading to the potential exploitation of women.

3. Parenthood and identity: Post-modern ethics questions traditional notions of parenthood. With multiple parties involved (the genetic parents, the surrogate, and sometimes egg/sperm donors), post-modern thought encourages us to rethink what constitutes parenthood, kinship, and identity in these cases. These relationships are fluid and resist neat categorization.

4. Global inequalities: The international surrogacy market has raised concerns about exploitation, particularly in countries where surrogacy is a growing industry. Post-modern critiques emphasize the asymmetry of power between affluent couples from wealthier nations and women from impoverished backgrounds who become surrogates.

Important Note
“Surrogacy represents a fractured narrative where biological, social, and genetic roles of motherhood intersect and clash, illustrating the post-modern emphasis on decentered identities and fragmented roles in ethics.”

Doctor-Patient Relationships

The doctor-patient relationship is at the heart of medical ethics. In the post-modern world, this relationship is reevaluated to reflect power dynamics, trust, and patient autonomy in a more fluid and decentralized framework.

1. Power asymmetry: Traditionally, the doctor held an authoritative role, but post-modern ethics seeks to equalize the power imbalance by promoting shared decision-making. The post-modern perspective sees the patient as a co-constructor of the medical narrative rather than a passive recipient of care.

2. Trust and vulnerability: Post-modern theorists argue that trust must be continuously negotiated in doctor-patient relationships. Vulnerability, from both parties, becomes a central ethical concern. Foucault’s notion of biopower highlights how the medical system exerts control over individuals’ bodies, which becomes an ethical issue when trust is compromised.

3. Patient autonomy vs. paternalism: The post-modern shift towards valuing subjective experiences emphasizes patient autonomy. The traditional model of medical paternalism, where the doctor knows best, is challenged, promoting an ethics of mutual respect and dialogue rather than unilateral decision-making.

4. Cultural and individual diversity: In a post-modern framework, ethical decisions in healthcare must consider the cultural and individual differences that impact patients’ choices. Medical pluralism, recognizing diverse perspectives on health and treatment, becomes essential.

Abortion

The ethics of abortion involve complex intersections of autonomy, life, and moral personhood. Post-modern perspectives question traditional views on these issues and open space for more pluralistic approaches.

1. Autonomy of the pregnant individual: Post-modern ethics gives significant weight to the autonomy of the pregnant individual, suggesting that they should have control over their body. Autonomy is viewed not as a universal principle but as something contextually constructed—shaped by social, cultural, and personal factors.

2. The status of the fetus: Ethical debates on abortion hinge on the moral status of the fetus. Post-modernism resists binary thinking, where the fetus is either fully a person or not at all. Instead, it considers the ambiguity of personhood, suggesting that moral status can be fluid and relational, rather than absolute.

3. Moral relativism: In post-modernism, moral relativism is often emphasized, meaning that the morality of abortion can vary depending on individual beliefs, cultural backgrounds, and specific circumstances. This challenges the traditional view of abortion as universally right or wrong.

4. Rights and responsibilities: The ethics of abortion also involves weighing the rights of the pregnant individual against the potential rights of the fetus. Post-modernism encourages a more nuanced and pluralistic approach, recognizing that ethical responsibility may not be reducible to a clear-cut dichotomy.

Euthanasia

Euthanasia, the act of intentionally ending a life to relieve suffering, raises fundamental questions about autonomy, dignity, and the value of life in medical ethics.

1. Autonomy and self-determination: Post-modern ethics places a high value on autonomy, particularly in end-of-life decisions. Euthanasia is seen as an exercise of self-determination, where individuals have the right to decide when and how they will die. However, post-modernism also questions whether autonomy is ever truly free from external influences, such as societal norms or family pressures.

2. Concept of a good death: Post-modernism challenges the traditional concept of a good death, which is often tied to religious or cultural narratives. Instead, it promotes the idea that what constitutes a good death is subjective and can vary significantly from person to person. The ethics of euthanasia, then, must consider these plural perspectives.

3. Moral pluralism: The post-modern view acknowledges the plurality of moral viewpoints on euthanasia, where some see it as a compassionate act and others as morally wrong. Post-modern ethics refuses to adopt a universal stance, instead suggesting that the rightness or wrongness of euthanasia is context-dependent.

4. Physician’s role: The post-modern rethinking of the doctor-patient relationship impacts the ethics of euthanasia. Physicians, rather than being mere gatekeepers of life, are seen as facilitators of the patient’s autonomy and dignity, helping to navigate complex ethical terrain in end-of-life decisions.

Female Infanticide

Female infanticide, the killing of newborn girls, is a deeply troubling issue in many cultures. It raises profound ethical concerns related to gender discrimination, human rights, and cultural relativism.

1. Gender discrimination: Post-modernism critiques the patriarchal structures that underlie female infanticide, exposing how deep-seated gender biases contribute to the devaluation of female lives. It questions the traditional cultural narratives that justify these acts, pushing for a reevaluation of the moral worth of individuals based on gender.

2. Cultural relativism: Post-modern ethics often grapples with the tension between universal human rights and cultural relativism. In cases of female infanticide, the question arises whether it is ethical to impose universal human rights standards on cultures where the practice may be rooted in longstanding traditions. Post-modernism tends to favor a dialogic approach, advocating for engagement with cultural differences rather than imposing external norms.

3. Intersectionality: Female infanticide must be understood through an intersectional lens that considers not only gender but also class, ethnicity, and economic status. Post-modernism encourages a more holistic ethical analysis that takes into account the complex interplay of these factors.

Process Flow Note
“Decision-making in Female Infanticide → Societal pressures → Gender bias → Economic constraints → Ethical conflict”

4. Rights of the child: While post-modern ethics emphasizes plurality and context, it also upholds the importance of individual rights. Female infanticide represents a gross violation of the right to life and underscores the need for ethical systems that protect the most vulnerable, even when cultural norms are at play.

MCQ
Which of the following ethical issues does post-modernism most emphasize in the context of euthanasia?

1. The sanctity of life
2. Moral relativism
3. Power asymmetry
4. Medical paternalism
   Correct Answer: 2