Q.1: Identify the following and explain and discuss the ethical issues that make them significant in Bioethics:

(a) The Baby M. Case:

            It is a case about a surrogate motherhood, where a woman Mary Beth Whitehead agreed to bear a child for another couple, William Stern and Stern’s Wife. In this case, the details are very sad and emotional as things unfolded in that pattern. Mary Beth Whitehead received the payment from William Stern to give birth to a child for them. The total payment paid to her was $10,000. It was agreed that when child birth would happen, the child would be taken over in the custody of William Stern and his wife as legal parents. Whitehead agreed that she would hand over the child to them. Everything went normal during the whole pregnancy period, until the birth of Baby M. The child was handed over to Stern and his wife. But things suddenly changed, when Whitehead asked the couple to give her child back. She refused to sign the agreed parental rights document. This started a new battle between the couple and Whitehead as a court case was filed for the legal parental rights of the Baby M. The case was to decide two matters, first matter was to decide whether surrogacy was valid and legal, and other matter was to decide who would be custodial parents of the child (Fuchs)

            In the first instance, the court decision went in favor of Mr. Stern, as child custody was given to him, and surrogacy contract between Stern and Whitehead was also upheld. This decision was made, because court knew about the conversation between Stern and Whitehead, where a threat was made by Whitehead that she will harm baby physically. Looking at this threat, the court decided that it was not viable to give her the custody of the Baby M, so she was denied any parental rights. But Whitehead was not ready to go down without fighting this case to its ultimate end, so she made an appeal to Supreme Court of New Jersey. After looking at facts of the case, and analyzing each element in detail, the Supreme Court came up with an historic decision, which stated that surrogacy was not valid, and it was considered as an illegal thing to do. The surrogacy contract signed between the two parties was declared illegal, as well as parental rights of Whitehead were also restored. However, court decided that it was in best interest of the Baby M. that she should be handed over to Stern for the custody. So, custody of the child was given to Stern, but Whitehead was given visitation as well as parental rights. It was first time in U.S history that surrogacy was declared illegal under the law because act was considered degrading women in so many ways (Family Source Consultants)

            The case very much shows the ethical issue related to biomedical practices like giving birth to a child. This process involves biomedical practices, so Baby M. case its relevancy with Bioethics. This Baby M. case was of great importance with regards to Bioethics, because it identified so many potential ethical issues. The first issue was surrogacy itself as it raised question on its validity. This practice was dealing child like a commodity, which was ethically wrong. The other ethical issue was snatching motherhood of the mother, who gives birth to a child, but then baby is taken away, whereas baby is certainly attached with her biological mother emotionally and physically. It is ethically wrong to ask women to give birth to a child for other people. It is like degrading women as a whole, because they cannot be considered as machines providing children for other couples. The decision made in Baby M. case was instrumental to put a full stop for the ethical issue of surrogacy. There are few lessons to learn in this case in terms of dealing with ethical issues:

Surrogacy cannot be considered legal and right thing to do as it is ethically wrong

Women cannot be used as an element of producing children as commodities

Justice is to be served for all after looking at relevant facts so that no one is denied of their rights

Surrogacy is not just an ethical issue, but it is also against morality because it degrades women as a gender

(b) Nadya Suleman:

            The story of Nadya Suleman is a crucial one to look at some ethical issues relating to bioethics. Nadya is a divorced mom, who already had six children, but she opted to get more children through in vitro fertilization (IVF). In 2009, she gave birth to 8 octuplets through IVF process. It is important to understand that what actually the process is. IVF is actually a fertilization process, where sperm and egg are combined together, but they are not combined in the body, rather outside the body. Then embryos are transferred from lab to the woman’s uterus. This process helps women to get pregnancy and give birth to child. In normal circumstances, it looks very normal and ethical to do so, but questions were raised on this medical and clinical process, when Nadya gave birth to eight children. In VF process, the number of implanted embryos for Nadya was six in total, which is beyond ethical and moral guidelines. Such high number can be critical for woman’s pregnancy as well as various risks is also associated for children to be born. So, ethical question was raised on this whole case that how doctors and medical staff involved in this process allowed this risky procedure to happen. Why someone did not stop or advice Nadya from doing so, as it was not only risky for her life, but it was also risky for the life of eight children. It was amazing that Nadya along with new eight born babies did not face any critical medical issues in this whole IVF process. But this is not to affirm that it would happen in every other case as well. The issue raised so many questions on ethical standards adopted by the medical persons, who are involved in IVF. In UK, there is legal obligation that more than two embryos cannot be implanted, but Nadya’s case was an example that in United States, there are no such legal restrictions. This ethical issue case asks for new rules and regulations regarding IVF process in United States (UNC Press Blog)

Q. 2

Answer the following question – What exactly is the difference, according to James Rachels, between active and passive euthanasia? What view concerning the morality of active euthanasia did he defend? What arguments did he give in favor of his position?

            It is important to understand the term euthanasia before differentiating active and passive euthanasia as per the views given by James Rachels. Euthanasia is a process to deliberately killing a patient by taking some actions. It means that doctors assist in such process, where it is confirmed that patient cannot recover, so he should be killed rather suffering from pain, so patient’s life is taken to free them from pain and agony. It is important to know that many questions have been raised on the morality of euthanasia as it is not considered ethical to kill someone. In many countries, euthanasia is considered illegal, and no one can assist in this process because it will be considered a murder. But there are few states in United States, which allow euthanasia with certain conditions. When patient is ready to voluntarily allow doctors to kill him/her, then such euthanasia is allowed in various parts of the world such as Switzerland, Netherland, Belgium as well as U.S states of Washington and Oregon. But if patient gives no consent on voluntary basis, then he/she cannot be processed with euthanasia to take his/her life. The euthanasia has two major types, one is called active euthanasia, and the other type is called passive euthanasia (Nordqvist)

            It has been observed that heated debate continues for this bioethics issue whether medical practitioners should be allowed to conduct active and passive euthanasia. The ethical issues have been sorted out in this regard, which means that things can go in two direction; first argument is that passive euthanasia can be morally right in few circumstances, and it can be considered permissible, and the other argument is that active euthanasia cannot be practiced as it is equal to doing a murder etc. But James Rachels have raised questions on this distinction between the two arguments. He said that there is no considerable difference between active and passive euthanasia, rather he made a further argument that it is viable to go with active euthanasia rather passive euthanasia, because active euthanasia helps to minimize the suffering as well as pain of patients, and their life is taken quickly, rather leave them to die with so much suffering and pain. Rachels said that if both kind of euthanasia are opposed by someone, then it seems logical to him, but if someone says that active euthanasia is wrong, but passive euthanasia can be allowed, then he can’t understand this argument. Rachels said that if patient is going through pain, then it is better to use active euthanasia so that patients suffering and pain can be reduced as early as possible (Rachels)

            It is a fact that various arguments have been given against as well as in favor of active euthanasia. Therefore, it is essential to look at both so that it can be concluded that which argument is stronger with given logic. So, here are few arguments in favor of active euthanasia while taking the argument of James Rachels that there is no considerable distinction between the two methods:

In various cases, active euthanasia can be gentler and more considerable because patient’s pain and suffering is quickly minimized.

        There is no moral justification for letting die as compared to killing, because outcome of both methods is same in the end. Rachels gave example of Jones and Smith, where one drowned a child, and other just stood away watching a child to drown in water, but in both cases, child was killed.

If passive euthanasia is considered morally right, then active euthanasia should also be considered right because in both cases, the patient will ultimately lose his/her life because of any cause. In active euthanasia, the cause of death could be a doctor assisting euthanasia, and in passive euthanasia, the cause of death could be medicine, which was withdrawn for patient to let die (Rachels)

On the other hand, few strong arguments against active euthanasia have also been given, and some of these arguments are given below:

The process is considered cruel as well as unnatural

If voluntary euthanasia is performed to go with active euthanasia, then it is morally wrong because it is like assisting a suicide, where person has given consent to die, and if consent of patient was not taken, then it will be considered murder.

In terms of self-interest, active euthanasia has contradiction, because there can be situations, where a person may have been wrongly diagnoses anything, or he/she may recover from a disease naturally.

The process of practicing active euthanasia is like playing as God, where fate of a patient is being decided by the family member or physician.

Sometimes, social pressures as well as financial pressures may force a person to volunteer for euthanasia, because he/she don’t want to see his/her family members in trouble. It is ethically wrong that someone dies for the sake of others, where he/she could have lived more.

It is argued that active euthanasia cannot be legalized on the basis of reducing suffering and pain of patient, as there are many other techniques are there to minimize the pain of patients, so they should be given those treatments to reduce their pain and suffering towards end of their lives (Strinic)

        The above discussion elaborates the fact that Rachels is not in favor of either active or passive euthanasia, because both are morally wrong. He just tried to make a point that there is no distinction between the two, and if passive euthanasia is justified by any means, then no one can deny the right of active euthanasia as well.

Q. 3

What is a “person” in the moral sense? Why do most arguments on both sides of the abortion issue rest on claims about whether fetuses are persons? Why did Judith Jarvis Thomson, in her article “A Defense of Abortion” claim that abortion can be defended even if we grant that the fetus is a person right from the moment of conception? What analogies did Thomson give to support her position? Do you think she was right? Why or why not?

            Morally, it is believed that when conception begins, and soul is acquired by the fetus, then it is considered to be a person, and it is also said that when conception starts, soul is actually and immediately acquired after that, so since from start of conception, fetus will be considered as a “person”. Now, different arguments are given in favor or against abortion, even fetus is considered a person or not considered a person. When someone is killed by abortion, it is wrong because a person is denied from a future value of his/her life. Then there is other argument that fetus is not considered a person, so abortion is ethically right and permissible. And one more argument is that even you consider fetus as a person, it is still permissible to go for abortion. It means that different views are held for the process of abortion. On the other hand, Judith Jarvis Thomson has provided her own defense in favor of abortion. It has been said by her that people give arguments against abortion by saying that fetus should be given his rights, but she said that rights of fetus cannot overlook the rights of a women, who is pregnant. She said that a pregnant woman has all rights to her body, and can-do abortion if needed. It means that if there are circumstances, where woman wants to finish its pregnancy and proceed with abortion, then morally it can be allowed to do so, because it is her body in the end, and she should be given the right to make a decision about her body (Thomson)

References of the ethical issues that make them significant in Bioethics:

Family Source Consultants. The First Contest Surrogacy Case: The Story of Baby M. 2019. 22 March 2019. <https://www.familysourcesurrogacy.com/first-contested-surrogacy-case-story-baby-m/>.

Fuchs, Erin. This Nasty Court Case Helped Make Surrogacy Illegal In New York. 2014. 22 March 2019. <https://www.businessinsider.com/the-case-of-baby-m-2014-2>.

Nordqvist, Christian. What are euthanasia and assisted suicide? 2018. 22 March 2019. <https://www.medicalnewstoday.com/articles/182951.php>.

Rachels, James. "Active and Passive Euthanasia." New England Journal of Medicine 292.2 (1975): 78-80.

Strinic, Visnja. "Arguments in Support and Against Euthanasia." British Journal of Medicine & Medical Research 9.7 (2015): 1-12.

Thomson, Judith Jarvis. "Judith Jarvis Thomson: A Defense of Abortion." Philosophy and Public Affairs 1.1 (1971): 47-66.

UNC Press Blog. Ethics and the California octuplets case. 2009. 22 March 2019. <https://uncpressblog.com/2009/02/06/ethics-octuplets/>.