Seeking Medicine’s Moral Centre
Overview
For the first time in two millennia, the Hippocratic ethic of medical care has been supplanted by a new bioethics. The bottom-up set of injunctions to care, of the patient and for society, ha been replaced by a top-down, commercial ethic focused on patient autonomy in a limited system of medical care. To understand this transformation, and its the effect, Seeking Medicine’s Moral Centre focuses on the issue of “medical aid in dying,” (MAiD) in Canada. Uniquely, it introduces ethnography as a tool to parse a set of academic and public articles reflecting the changing face of medical ethics from 1996 to the present. In doing so it joins the professional and the popular as a single dataset. It is the first book to seriously critique bioethics as a medical ethic through its focus on medical aid in dying as a still contested program in care of the chronically ill and fragile. Key audiences include journalists, medical anthropologists and sociologists; ethicists and bioethicists; medical and scientific researchers and policy makers."For 30 years Tom Koch has covered the introduction, acceptance and out of control expansion of MAiD in Canada through a series of journal, newspaper, and magazine articles. Here he combines that work to show how a bottom-up, traditional medical ethic arising within medicine and stable for two Millenia, has been exchanged for a top-down, thinly principled, bureaucratic ethic of care and, he would argue, too often non-care. This ethic focuses only on relief of an individual’s suffering, a goal we all accept, through absolute prioritisation of a right to individual autonomy, including to have medical assistance to end one’s life. It also displays ‘presentism’, looking only to the immediate present and not the past or future to seek wisdom and assess wider and more profound risks and harms of this stance, especially those to vulnerable people, Medicine and society. This book helps us to understand what has happened with MAiD in Canada, which is essential if the damage it is causing there is to be limited. It is also a vital warning to other countries, such as Australia that have expressly adopted the MAiD model, or are considering doing so."
