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Karma and Kindness Medical Ethics in Thailand. Scott Stonington MD/PhD Student – Medical Anthropology. Thailand and the Mechanical Ventilator. A New Political and Ethical Problem. Dilemmas. Ethical – Two ethical principles dictate opposite actions
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Karma and KindnessMedical Ethics in Thailand Scott Stonington MD/PhD Student – Medical Anthropology
Thailand and theMechanical Ventilator A New Political and Ethical Problem
Dilemmas • Ethical – Two ethical principles dictate opposite actions • Self-Interest – The decision maker’s interest conflicts with ethical action • Practical – Ethical action is clear, but logistics get in the way
Questions 1) What kind of dilemma does withdrawing the ventilator present to the characters? 2) What bioethical principles do they use to make their decisions?
Principles of Western Bioethics • Autonomy – Patients have the right to make informed decisions about their own health • Beneficence – Do what is best for the patient • Non-Maleficence – Do no harm • Truth-Telling – Never lie or conceal information • Justice – Treat patients equally and fairly
Characters • Gaew – Thai Construction Worker • Ends up in ICU with no cortical activity • Kwan – Gaew’s Wife • Tong – Gaew’s Physician
‘Culture’ and Bioethics in the United States We assume that the principles of Western bioethics are universal
What Kind of Dilemma? • Kwan Practical Dilemma • Dr. Tong Relieving Suffering vs. Karmic Consequence
Advisors Vincanne Adams(Anthropology) Steve Pantilat(Medicine, Ethics) Sharon Kaufman(Anthropology) Paul Rabinow(Anthropology, UCB) Mark Mancall(History, Stanford) Thai Institutions Ministry of Public Health Hospitals: Siriraj, Ramathibodi, BCC, Pitsanulok, Ratchaburi Funding MSTP Pacific Rim Research Program Office of International Programming Acknowledgements