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The Rise of Bioethics

Because the trials received relatively little publicity in the United States and because Americans typically viewed Nazi doctors as Nazis rather than as doctors, few drew connections between Nazi practices and American medical practices. As a result, discussion of bioethics remained largely dormant in the years following the Nuremberg Trials. During the 1960s and early 1970s, how- ever, ethical questions regarding medical care and research in the United States became topics of popular discussion.

Bioethics and the New Technologies One reason for rising concern was the rise of new technologies. Of particular importance was the development of kidney dialysis, a technology that could keep alive persons whose kidneys had failed. Demand for dialysis far outstripped supply, forcing selection committees made up of doctors and in some cases laypeople to decide who would receive this life-saving treatment and who would die. Forced to choose from among the many who, on medical grounds, were equally likely to benefit from the treatment, these committees frequently based their choices on social criteria such as gender, age, apparent emotional stability, social class, and marital status. When news of these committees’ work reached the public, the resulting outcry led to new federal regulations designed to allocate kidney dialysis more fairly.

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Whereas the dialysis debate focused on the right to gain access to life-saving technologies, the case of Karen Quinlan focused attention on the right to die, which essentially translates to the right to refuse medical technologies, from feed- ing tubes to heart–lung machines. At age 21, after ingesting a combination of drugs at a party, Quinlan fell into a coma. Initially, her parents encouraged her doctors to do everything possible to keep her alive and restore her health. Once her parents learned that she had suffered extensive brain damage and would never regain any mental or physical functioning, however, they asked that she be removed from life support and be allowed to die. When the doctors refused, the parents took their fight to the courts. After almost a year of legal battles, Quinlan’s parents won the right to remove her from the mechanical respirator that had kept her alive.

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