medical ethics

First do no harm: People, as well as politics, are crucial when covering medical conscience fights

First do no harm: People, as well as politics, are crucial when covering medical conscience fights

It's one of the most famous phrases in the world of medical ethics: "primum non nocere." That's Latin, of course. It means, "First do no harm."

Ah, but who gets to make the ultimate decision about whether a particular medical procedure or strategy for care will do harm to a patient? Is that ethical/moral call up to the patient, the doctor, the doctor's boss, an insurance company or even lawyers representing the U.S. government?

Now flip that question around. What if doctors pledged something like this: "First, do good." Who gets to decide what is good? Clearly, there are legal, ethical and, yes, religious questions linked to these decisions and that has been the case for centuries.

So let's pull these ancient questions and values into our litigious age.

A patient requests an abortion, perhaps even in the second or third trimester. The doctor (or perhaps a nurse) is an orthodox Catholic, a Mormon, a traditional Muslim, an Eastern Orthodox Christian, an Orthodox Jew or someone else with a deep and consistent belief that it would be wrong, a mortal sin even, to take part in this procedure. Some questions linked to medical care for trans patients, especially children, would create a similar ethical/theological crisis. Doctors do not agree on what causes "harm." Many disagree on what is "good."

How do reporters cover stories linked to these debates? First, do no journalistic harm?

Hold that thought. Here is the top of a Washington Post feature -- from the national desk, not the religion team -- on this semi-new front in America's culture wars.

The Trump administration will create a new conscience and religious freedom division within the Health and Human Services Department to ease the way for doctors, nurses and other medical professionals to opt out of providing services that violate their moral or religious beliefs.

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The New York Times runs two Charlie Gard editorials, with one in the news pages

The New York Times runs two Charlie Gard editorials, with one in the news pages

At the heart of the tragic Charlie Gard case are two clashing values.

On one side: Doctors and UK officials who argue that they have the power to rule that cutting life support, and ceasing an further experimental treatments, is in the child's best interest.

On the other side are the stricken infant's parents, who believe that they should have the right to care for their child with their own funds and with the help of other doctors who want to treat him.

Pope Francis, of course, issued a statement backing the rights of the parents:

“The Holy Father follows with affection and commotion the situation of Charlie Gard, and expresses his own closeness to his parents. ... He prays for them, wishing that their desire to accompany and care for their own child to the end will be respected.”

It's impossible to understand this story without a clear presentation of the parental rights claim, which clashes with the rights articulated by UK officials and a specific set of medical experts. There are two essential points of view.

Editors at The New York Times know this, of course. They know this because one of their own columnists -- while expressing his convictions -- clearly described the standoff. However, it's interesting to note that the latest Times news story on this case covers the arguments of the state, but contains zero clear references to the parental-rights arguments. The pope is mentioned, for example, but the content of his words was ignored.

In other words, the Times ran two editorials: one an op-ed column and the other, alas, an unbalanced, advocacy news report in the news pages.

Columnist Ross Douthat opened his essay like this:

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Spot the religion ghosts: Who loves Charlie Gard the most, his parents or state officials?

Spot the religion ghosts: Who loves Charlie Gard the most, his parents or state officials?

Like millions of other people in the social-media universe, I have been following the tragic story of the infant Charlie Gard (see http://www.charliesfight.org) and the struggle between his British parents and various government and medical elites over his future.

What is there -- journalistically speaking -- to say about mainstream media coverage of this complex story?

The easiest, and certainly the least surprising, thing to say is that a sad story about a baby's fight for life is way more interesting to gatekeepers in major media when Citizen Donald Trump and Pope Francis enter the drama. #SURPRISE

So now we have some pretty in-depth coverage of the story of infant Charlie, his parents and their supporters around the world. Hold that thought.

If you have followed this story closely you know there are religious issues at the heart of this crisis. There are religion ghosts here. The big question: Who loves Charlie the most, his parents or the state? Who should get to make the final decisions about the long-shot efforts to save his life?

The parents are clearly motivated by religious beliefs and want to fight on, defending his right to life. The odds are long, but they have faith in both God and science.

Government leaders, backed by some (not all) medical experts, say they are defending the infant's quality of life and that the state has the ultimate right to end his pain and suffering.

One of the strongest points in a major New York Times story on this case is that it stresses that money is not the issue. The parents have a vast network of supporters -- now including Trump and the Vatican's pediatric hospital -- to help fund further, desperate treatments.

So what is the issue here? The big question appears to be when government experts can trump parental rights and, yes, religious liberty. Thus, I did find it disconcerting that readers did not learn the names of Charlie's parents -- Connie Yates and Chris Gard -- until 650 words or so into the Times story.

Still, the material that made it into this report is strong.

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