The Maguire Center for Ethics and Public Responsibility hosted a lecture yesterday evening to address the role that anthropologists play in solving ethical dilemmas in clinical practice.
The lecture was lead by SMU anthropology professors Carolyn Sargent and Carolyn Smith-Morris.
The professors questioned the universality of biomedical ethical principles such as respect for autonomy, beneficence, justice and nonmalfeasance, proposing an alternative viewpoint on women’s healthcare worldwide.
Sargent and Smith-Morris focused on the controversial question of whether or not there is a universal common morality.
This concept of a common morality was born out of the so-called “ethical crisis” of the 20th century. During this time, as countries around the world became increasingly interdependent on one another, morals and beliefs began to spread and eventually clash.
This led everyone from medical doctors to anthropologists to raise the question: is there a universal common morality? In other words, do all countries have the same morals?
The obvious answer to this question is no. Every culture has its own set of morals and ideologies. However, the United Nations is trying to develop a code of basic human rights, similar to the moral code.
Four main principles of the moral code include justice, the balance of risks and the possible positive outcome, avoiding harm and the respect in the individual’s (or patient’s) decision-making process.
The professors argue that this concept is impossible to implement for many reasons. Simply because a culture has different morals, this does not make it inferior to the morals of other cultures. Anthropologists look at rituals around the world and try to decide if tradition outweighs rights.
Another aspect of the moral code is the concept of telling the truth. This is often a delicate subject in the medical field, in which doctors struggle with telling the patient how serious their condition really is.
On one hand, the patient has the right to know, but on the other hand, it could affect their recovery.
“Words can be dangerous,” said Sargent. She explained that words have tremendous power over an individual’s mindset. “Words have the power to cure or kill a patient.”
She said that in some cases, telling a patient the truth of their illness could discourage them, leading them to abort hope and eventually die. This is considered inappropriate in a lot of cultures. It can be seen as disrespectful, interfering with the patient’s destiny.
In Uganda, women are denied the right to make individual decisions, therefore excluding them from clinical trials. A woman must go home and ask her husband what she should do, then report back to the doctor. In this case, the right to individual consent is replaced by the notion of collective consent.
Sargent explains that social class, education, cultural beliefs, religion and past experiences with illness and health care, influence each patient’s standards and expectations. Therefore, it is nearly impossible to have a moral code that would successfully apply to every individual.
Doctors hope to negotiate treatment and expected outcomes with their patients, but find it increasingly difficult due to the diversity of morals and ethics of their patients.
Given the complexity of the issue, Anthropologists like Sargent and Smith-Morris help to identify cultural traditions and morals to help doctors and patients eventually see eye to eye.
