COMMENTARY: Bioethics becoming a dominant human rights issue

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c. 1998 Religion News Service

(Rabbi Rudin is the national interreligious director of the American Jewish Committee.)

UNDATED _ A recent conference on medicine and religion at Saint Leo College in Florida offered convincing evidence that bioethics is one of the dominant civil and human rights issues of our time.

The two-day meeting, co-sponsored by Saint Leo and the American Jewish Committee, provided an often painful but always honest examination of such questions as patients’ rights, managed care and doctor-patient communication _ or the lack of it _ as well as death and dying, hospice care, the education of physicians, and government’s role in bioethics.

Not so many years ago, such issues were left in the hands of the medical community. It was an era when Marcus Welby, M.D., the beloved TV doctor, epitomized a profession that always knew best.

But the mythical Welby would have been out of place, perhaps even uncomfortable, at the Saint Leo conference because there was sharp criticism of physicians and an emphasis on the equal partnership that is emerging between patient and caregiver.

And, until recently, the religious and medical communities, frequently working in isolation from one other, perceived themselves as adversaries locked in opposition within the arena of bioethics. Happily, that false and dangerous sense of confrontation is ending. Instead, representatives of both communities clearly recognize they must work together to achieve answers to bioethical questions that are morally, medically, and spiritually sound.

At the conference, Cardinal Francis George, archbishop of Chicago, portrayed Catholicism as a medically”interventionist”religion, a position shared by Judaism, too.

However, the cardinal warned:”We live in a world profoundly marked by technology. To become exactly like God becomes more and more a possibility.” George said he worried this problem is based on a selfish attitude that says:”If I want to do it and I can do it, I’ll find a way to do it and you can’t stop me.” The range of voices at the conference was remarkable.

Dr. Richard Frankel of the University of Rochester, for example, described his unique program that videotapes the encounters between patients and doctors. The tapes are critically reviewed to help physicians improve their sometimes limited communication skills.

Frankel cited national surveys indicating 75 percent of all patient-doctor encounters last less than 15 minutes and frequently it is the doctor, not the patient, who does most of the talking.

Frankel also noted a remarkable change regarding whether doctors tell”the truth”to their ill patients. Thirty years ago, he said, 95 percent of America’s physicians hid the truth, but today the percentage is completely reversed with just 5 percent failing to fully disclose a patient’s condition.

James Towey, an attorney from Tallahassee, Fla., is currently president of the Commission on Aging with Dignity and was Mother Teresa’s legal counsel for 18 years. He told conference participants of his first meeting with the late nun in India, when he expected to discuss complicated legal issues with her.

Instead Mother Teresa told Towey”to clean up the patient in bed 46.”Her lesson was clear: Helping one sick person is the place to start if we truly seek to make a difference.

Edmund Pellegrino of Georgetown University was critical of managed care programs in the United States, deploring the estimate that 40 million Americans are currently without medical insurance.”Quality human care is the obligation, not a luxury in a good society. … We are faced with the clash between ethics and economics,”he said.

Dr. Alan Fleischman of the New York Academy of Medicine said there is an”eroding trust in physicians,”and he placed much of the blame on doctors who focus”too often on the disease and not on the patient.”Many doctors, he said, see themselves as”scientists and not healers.” One of the most moving moments of the conference was provided by Anne Thal, the founder of LifePath Hospice in Tampa, Fla.

Hospices provide care to the 400,000 Americans who have”life limiting illnesses”and Thal profoundly touched participants when she declared her hospice work _ caring for the terminally ill _ is”the most Jewish thing I’ve ever done.” The conference didn’t resolve the thorny bioethical questions faced by both practitioners and patients but in bringing together both ethicists and scientists it moved the public discussion of such issues a step further.

DEA END RUDIN

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