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INTRODUCTION

The contributions of medicine in securing our health are undeniable.

Due to different health crisis that emerged, the healthcare system has

become especially important today more than ever before. Medical specialists

continuously seek for better solutions that would address numerous health

problems and issues.

The medical practices that existed long before and new medical

procedure that are executed in different health institutions are helpful and

beneficial to the patients. However, despite the good intensions of performing

it, there are practices that divides people’s opinion as to its purpose due to

some ethical issues it constitutes.

On this paper we will try to look at some controversial medical

practices such as Euthanasia, Plastic Surgery, Abortion, Organ Donation,

Circumcision, Electroshock Therapy …. through the lens of different ethical

ideologies. This paper includes real life cases of medical procedures, and this

will also provide us an in-depth perspective and analysis regarding the basis

of determining whether these procedures, which are currently executed by

medical professionals, should be considered ethical or not.

MEANING OF ETHICS
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Ethics is the branch of philosophy that examines right and

wrong moral behavior, moral concepts (such as justice, virtue, duty) and

moral language. Ethics or moral philosophy is a branch of philosophy that

"involves systematizing, defending, and recommending concepts of right and

immoral behavior". The field of ethics, along with aesthetics, concerns matter

of value, and thus comprises the branch of philosophy called axiology.

(“History of ethics - Wikipedia”)

Various ethical theories pose various answers to the question "What is

the greatest good?” and elaborate a complete set of proper behaviors for

individuals and groups. Ethical theories are closely related to forms of life in

various social orders.

1.EUTHANASIA

1.a Definition and Process of Euthanasia

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The term euthanasia is derived from the Greek words EU which means

good and Thanatos which means death. Euthanasia is the practice of ending

a patient's life to alleviate the patient's suffering. The patient in question is

usually terminally ill or in excruciating pain and suffering. Instead of

condemning someone to a slow, painful, or humiliating death, euthanasia

allows the patient to have a relatively "good death." There are different types

of euthanasia and these are: Active euthanasia, killing a patient by active

means, for example, injecting a patient with a lethal dose of a drug, this is

sometimes called “aggressive” euthanasia; Passive euthanasia, Passive

euthanasia, this is a process of allowing a patient to die on purpose by

removing artificial life support such as a ventilator or feeding tube; Voluntary

euthanasia, the one with the consent of the patient; Involuntary euthanasia,

the one without the consent of the patient, for example, if the patient is

unconscious and his or her wishes are

unknown; Self-administered euthanasia,

where the patient administers the means

of death; Other-administered

euthanasia,  a person other than the

patient administers the means of death; Assisted, the patient administers the

means of death but with the assistance of another person, such as a

physician; Mercy-killing, the term “mercy-killing” usually refers to active,

involuntary or nonvoluntary, other-administered euthanasia or in other words,

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someone kills a patient without their explicit consent to end the patient’s

suffering and; Physician-assisted suicide, this refers to active, voluntary,

assisted euthanasia where a physician assists the patient.  A physician

provides the patient with a means, such as sufficient medication, for the

patient to kill him or herself.

1.b Sample Case of Euthanasia

In January, a young Dutch woman drank poison supplied by a doctor

(“The troubled 29-year-old helped to die by Dutch doctors”)

and lay down to die. Euthanasia and doctor-assisted suicide are legal in the

Netherlands, so hers was a death sanctioned by the state. But Aurelia

Brouwers was not terminally ill - she was allowed to end her life on account of

her psychiatric illness. "I'm 29 years old and I've chosen to be voluntarily

euthanized. I have chosen this because I have a lot of mental health issues. I

suffer unbearably and hopelessly. Every breath I take is torture…"

A team from the Dutch TV network, RTL Niue’s spent two weeks

recording Aurelia as she journeyed towards her date with death - 2pm on

Friday, 26 January. On a whiteboard in her home, she crossed off the days

with a heavy black marker pen. During those last weeks, she spent her time

with loved ones, doing craftwork and riding her bike in Deventer, the city she

adored. She also visited the crematorium - the place she had chosen for her

own funeral service.

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1.c Legal Perspectives on Euthanasia

Since the April 12, 2001, law, which went into effect on April 1, 2002,

euthanasia has been legal in the Netherlands for more than 15 years. The

Netherlands was the first European country to legalize euthanasia.

Euthanasia has more than tripled since legalization. Even though the precise

conditions established by law have not changed "stricto sensu," their very

broad interpretation has created increasingly contentious situations.

Euthanasia on people with psychiatric disorders, dementia, the elderly, or

those suffering from multiple pathologies, for example, has nothing to do with

the initially established legal requirements. Other viewpoints are being

expressed, most notably by some doctors who oppose the trivialization of

euthanasia. Other countries such as Belgium, Luxembourg, Canada, New

Zealand, Spain, and Colombia.

Meanwhile, in the Philippines, euthanasia is not legal due to the

religious communities' dominance, which prevents the Euthanasia Bill from

being ratified. Furthermore, the majority of Filipinos regard Christian doctrine

as the foundation of their faith. However, some people, mostly from the

poorer sections of the country, continue to practice it. They have no choice

but to use euthanasia to relieve the patient's suffering and save money on

medical treatments. Furthermore, medical technologies and professionals in

the Philippines are not completely advanced. Common Filipino physicians

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may lack the necessary skills to effectively treat complex diseases. When

medications reach the point of life and death, operations may fail, rendering

all treatments paid for by the patient's relatives in vain. Similarly, medical

technologies to cure various diseases are not fully available; if they ever are,

they will be prohibitively expensive.

1.d Ethical Perspectives on Euthanasia

If certain actions are forbidden, as deontology requires, it may seem

natural to assume that killing is one of them. However, this viewpoint is overly

simplistic. Only the killing of innocent humans is prohibited, according to most

deontological ethicists and the sanctity of life doctrine. The doctrine can

support both the slaughter of animals for food and the death penalty.

However, when it comes to innocent people, the doctrine is extremely strict. It

is applicable to all humans. Only active killing is prohibited by deontology. It is

consistent with this doctrine to allow people in poor countries to starve to

death while we live well. Even some types of active killing can be morally

acceptable (and even required) if they are not intended. For example, if the

intention is to kill the pain rather than the patient, it may be morally

permissible to administer a painkiller that kills her. The patient's death is thus

a foreseen but unintended consequence of the action. It is morally acceptable

to administer a lethal dose if there is a reasonable proportionality between the

good desired and the bad anticipated (Assuming there was no other option to
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keep the patient pain-free). Similarly, withholding nourishment from a patient

in a persistent vegetative state and allowing them to die is permissible. What

this viewpoint forbids is what most doctors and politicians in most Western

countries oppose: a system in which a doctor actively and intentionally kills a

patient at the patient's request.

The basic moral rights viewpoint holds that we can do whatever we

want with ourselves. Prohibiting patients from killing themselves or doctors

from assisting them would be morally illegitimate. Furthermore, forbidding

doctors from actively and intentionally killing their patients at their patients'

request would be morally illegitimate. This is not to say that euthanasia

should be considered a positive right. There are only negative rights,

according to the moral rights approach. A patient cannot demand that his or

her doctor conduct euthanasia. However, if both the patient and the doctor

agree that this is what should be done, no one should interfere with their

voluntary agreement. This would be a violation of their autonomy.

The goal of utilitarianism is to act in the most beneficial way possible.

In some cases, it is reasonable to believe that euthanasia would have been

the best option for the patient. However, utilitarianism requires that we not

focus solely on the patient. Other people may be affected by the patient's

decision to choose euthanasia, and even if euthanasia is in the patient's best

interests, it may be wrong due to the negative impact on the patient's

relatives. However, if the patient's relatives support his or her decision,

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utilitarianism would recommend euthanasia. Even if utilitarianism requires

euthanasia in some cases, this does not answer the question of whether it

should be legalized. If utilitarianism is a proper moral starting point, we should

choose the legal system with the best outcomes. And it is possible that even

the best legal system forbids some morally correct actions (and allows some

morally wrong actions). As a result, we must consider the implications of

legalizing euthanasia

1.e Interpretation

Voluntary active euthanasia is a morally acceptable action because it

has the potential to alleviate suffering for both the patient and their loved

ones. The primary goal from an act-utilitarian standpoint is to perform the

action that will maximize the positive and minimize the negative

consequences of any given situation. Patients who are terminally ill are

frequently in a state of constant pain which may only be alleviated by their

eventual death in cases where euthanasia is authorized. Passive

euthanasia is currently viewed as the only morally permissible option for

ending the patient's life. However, if active euthanasia allows a consenting

patient to die, Act-utilitarianism claims that people should avoid suffering

while waiting to die naturally. Active euthanasia is the morally correct course

of action. Allowing a patient to avoid the risk of spending the rest of their

lives in pain leads to the greatest positive results. The patient and their
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loved ones endure most of the consequences. However, Active euthanasia

should not be the default solution to every difficult situation.

2. PLASTIC SURGERY

2.a Definition and Process of Plastic Surgery

Plastic surgery is a special type of surgery that can change a person's

appearance and ability to function. The first procedures were carried out in

the 16th century to correct disfigurements, and the first cosmetic surgery was

carried out by John Peter Mettauer about 200 years ago, in 1817. Timmie

Jean Lindsey was the first woman in the world to have silicone implants

placed in her breasts in 1962. There are two types of plastic surgery

procedures, and these are Reconstructive Procedure and Cosmetic

Procedure. Below shows the difference of these two procedures.

Reconstructive Cosmetic 

This type of procedure is used to correct Also known as aesthetic. This

flaws on the face or body. These include procedure alters a part of the body that

physical birth defects such as cleft lips the patient dislikes. Making the breasts

and palates and ear deformities, larger (augmentation mammoplasty) or

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traumatic injuries such as dog bites or smaller (reduction mammoplasty),

burns, and the aftermath of disease reshaping the nose (rhinoplasty), and

treatments such as rebuilding a removing fat pockets from specific

woman's breast after breast cancer areas of the body are all common

surgery. cosmetic procedures (liposuction). 

2.b Sample Case of Plastic Surgery

Kylie Jenner an American media

personality, socialite, model, and

businessperson. She went through a cosmetic

surgery called Lip augmentation, it is a procedure that can make your lips

fuller and plumper. Lip augmentation with injectable dermal fillers is now the

most popular method. Dermal fillers of several types can be injected into your

lips and around your mouth. However, Kylie Jenner said she regrets some of

her lip injections. “Well, I definitely made my lips a little too big at one point,”

she told her sister Kim in an Allure interview. “I got excited and felt like I

needed to do a lot. And then you were like, 'Kylie, you need to chill.' And then

I had to go back, and have it fixed, and it was a crazy process. Thank God I

did not end up on Botched.”

2.c Legal Perspectives on Plastic Surgery

Considering the developments and expansions made in the definition

of "Disease," psychiatrists and experts at the time began to declare that a

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person's physical defects were a reflection of an inner mental disorder, thus

physical features that did not meet a certain degree of perfection were seen

as a kind of disease and, as a result, cosmetic surgical operations aimed at

reflecting inner beauty, in this case, mental beauty, were seen as the only

kind of treatment needed. The main doubts about the legality of cosmetic

surgeries were dispelled by considering the purpose of the treatment of these

types of surgeries as well as contemporary theories in the authorization of

surgeries aimed at improving one's appearance, so that cosmetic surgeries

are now considered legal.

2.d Ethical Perspectives on Plastic Surgery

It is up to competent adults to decide whether they want to have surgery. If

the patient has received enough information, it is necessary to respect their

wishes and their right to make an informed decision. The risks of surgery and

other available options must be disclosed. These ideas are even more

relevant to aesthetic surgery, where the patients have no apparent "illness."

There are significant ethical concerns with elective aesthetic procedures that

could have long-term negative effects on bodily function and health. Before

choosing such treatments, careful thought must be given because the

patient's right to autonomy in these circumstances may conflict with the

doctor's duty of care. Additionally, medical professionals must act in the

patients' "best interests" according to beneficence principle. It is acceptable to

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have surgery to boost a patient's confidence and self-worth. Furthermore,

non-maleficence principle makes sure that an aesthetic surgeon never acts in

a way that might be harmful to a patient or against their best interests. If

consultant aesthetic surgeons do not think the surgery is in the patient's best

interests, they may refuse to operate. Aesthetic surgeons should be wary of

operating on patients who have excessive expectations because the risks of

the procedure could outweigh any potential advantages. Meanwhile,

according to justice principle, physicians must make sure that everyone has

access to healthcare. Fair access to healthcare is viewed as a fundamental

human right.

2.e Interpretation

Following the principles of medical ethic which includes principle of

respect for autonomy, principle of non-maleficence, principle of beneficence

and principle of justice, the procedures of conducting a plastic surgery is

ethical for as long as it is voluntary and not forcible.

CONTRCEPTIVE STERILIZATION 
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3.1 Contraceptive Sterilization Defined

Birth control and sterilization are methods for both men and women to

avoid getting pregnant. There are many different birth control options

available, and some of them also offer STD protection.

Sterilization is a long-term method of birth control that works wonders

to stop pregnancies. However, it is challenging to undo if you change your

mind, and it offers no STD protection. Males and females can both be

sterilized. A vasectomy is performed on men, while a tubal ligation is done on

women.

Vasectomy Tubal Litigation

During this procedure, the vas Surgery used by women as a

deferens, the tubes in the male method of birth control. The fallopian

reproductive system that carry tubes are tied, clamped, cut,

sperm, must be cut, sealed, or banded, or sealed shut during this

blocked. A vasectomy stops sperm procedure. This stops sperm from

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from leaving the testicles. The man ascending the tube to meet the egg

can still ejaculate and experience and stops an egg from moving from

orgasm after this surgery. Ejaculate the ovary through the fallopian tube

fluid will still exist, but it will not where it might encounter an egg,

contain any sperm. preventing pregnancy.

3.2 Sample Case of Contraceptive Sterilization

On September 30, 1992, Dr. Mahesh Shah performed a laparoscopic

tubal ligation on Laura Aiello at Muhlenberg Regional Medical Center. During

the procedure, a Verres needle inserted by Shah in Aiello's abdomen

perforated her mesocolon and mesenteric arteries and lacerated her left iliac

vein. In performing a laparoscopic tubal ligation, a Verres needle is inserted in

the patient's lower abdomen into the peritoneal cavity, which contains the

intestines, uterus, ovaries, and stomach. When the needle is properly in

position, the carbon dioxide gas is introduced into the abdominal cavity to

push the intestines away from the area. The Verres needle is then removed,

and a laparoscope is inserted. A second incision is made in the upper pelvic

area to introduce a cutting instrument. The laparoscope allows the doctor to

view the procedure. Sterilization is completed by a procedure that places

plastic bands on the fallopian tubes.

Aiello's expert testified that Dr. Shah deviated from the acceptable

standard of medical care by inserting the Verres needle to a depth that was
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far beyond the operative area. Dr. Shah's expert testified that the Verres

needle could have nicked the iliac vein in the absence of negligence and that

there was no evidence that Dr. Shah had failed to conform to the accepted

standard of care. The expert further noted that the insertion of the Verres

needle was a blind procedure that required an exercise of judgment in

determining the proper angle and depth of insertion.

3.c Legal Perspectives on Contraceptive Sterilization

While many nations legalized voluntary sterilization as a form of

contraception, some only allow it for medical or eugenic ones. Minimum age

requirements and parental or spousal consent are possible additional

restrictions. Among those countries that does not permit the execution of

human sterilization are Malaysia, Myanmar, Saudi Arabia, Rwanda.

Venezuela and Guatemala

3.d Ethical Perspectives on Contraceptive Sterilization

The requested sterilization of nulliparous women and young women

who do not want to have children is ethically acceptable. The main

consideration guiding an ethical sterilization should be respect for a patient’s

individual right to reproductive autonomy. In addition, obstetricians and

gynecologists should offer pre sterilization counseling that puts the patient's

needs first and includes a discussion of the patient's reproductive goals.

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However, patients must be informed as soon as possible and given access to

an alternative method of contraception that they find acceptable, or they must

be referred to another provider if individual doctors or institutions refuse to

perform sterilization due to patient preferences or institutional policies.

Meanwhile, considering the view of religious group, the fact remains

that the Bible does not directly address all of the moral and spiritual

ramifications of many contemporary medical procedures like vasectomy and

tubal ligation, despite the fact that it is possible to find equally devoted

Christians with strong opinions on both sides of the issue. We are aware that

some religious groups, like the Roman Catholic Church, and movements

within the Christian community are adamantly against using any form of birth

control and view voluntary sterilization as presumptuous and sacrilegious.

However, many Christians of good conscience and faith consider tubal

ligation and vasectomy to be legal and respectable birth control options

3.d Interpretation

Sterilization is ethical as long as it considers the four principles of ethics

which includes respect for patient’s decision, patients are provided with full

knowledge about the procedure, and they are also given alternatives.

However, few passages in the teachings of Islam, Christianity, and Judaism

explicitly forbid contraception, but various religious edicts have interpreted

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these passages too broadly by calling for the outlawing of the majority of

contraceptive methods.