A cancer patient wishes to die and refuses further treatment.

With two children and a husband both pleading for her to continue, the physicians have made a choice. 

A choice that wasn’t ultimately up to them. 

A choice that must be honored and respected from the patient’s functional state of mind.  

Bioethics is a complicated umbrella term within the medical field, involving the concerns and morals of multiple studies, ranging from life sciences to public health and everything in between. But what falls into being morally ambiguous? Is the patient always in the right? These are questions left to be answered daily by physicians across the nation. 

Except it isn’t.

Abortion, one of the controversially heaviest bioethical issues, has been banned or restricted in its early stages in 21 states. Placing a constriction on doctors and clinics from withholding services and operations in fear of imprisonment. 

There are four types of abortion restrictions: Targeted Regulation of Abortion Providers (TRAP), parental involvement, consent laws, and the Hyde Amendment. 

According to The Center for Reproductive Rights, TRAP laws single out physicians who provide abortion care and require various legal requirements that are different and more burdensome than those imposed on physicians who provide comparable types of care.

These repercussions often fall under location and where abortion is able to be provided.

“Everybody in the healthcare profession deals with ethical issues,” said Joshua Franklin, a psychiatrist resident at the University of Pennsylvania. 

States have implemented numerous laws to restrict medical services, including gender-affirming care and physician-assisted dying. What is deemed morally right for all these cases isn’t made by the physicians nor the patient but instead by the state.

“The social and political process has harmed the physician’s ability to provide care when it’s believed it’s our ethical responsibility to take care of those who need it,” Franklin said. 

The bioethics that make up all these topics are incredibly difficult. The line is often blurred between what should be deemed morally right and wrong from the public eye. 

“It’s important that the public holds physicians accountable,” Franklin said. 

A moral compass in medicine may often intercept the general public’s perception, either through conflict or agreement, including the right of a patient to wish to die. 

The topic of physician-assisted suicide remains surrounded in debate. When a critical patient is fully capable of decision-making and in a stable mental state, their choice between life and death manifests in the form of consent. 

“I had a lecture on bioethics,” said Isabella Lolos, a senior at King Philip Regional High School. “Having to make decisions for made-up situations was difficult enough, I couldn’t imagine having to make those every day.” 

Euthanasia, according to the National Library of Medicine, is the practice of a physician or nurse intentionally ending one’s life to eliminate the patient’s pain and suffering, which comes in two types: active and passive. Active euthanasia is when the physician deliberately injects the patient with lethal drugs, or the death is caused by actions directly from the physician. 

While active euthanasia is illegal in every state, there is a loophole exception for incurable or terminally ill patients: passive euthanasia.

In 1990, the U.S. The Supreme Court ruled that the refusal or withdrawal of medication from the patient is within their rights, even if this action results in their passing. In Conservatorship of Drabick, the California Court of Appeal authorized the removal of a nasogastric feeding tube from a 44-year-old man who was in a persistent vegetative state as a result of an auto accident. Acknowledging that the right to refuse treatment was cemented in both the common law and a constitutional right of privacy. 

Many acts have been made by the states themselves, such as Oregon’s Death with Dignity Act, which allowed terminally ill individuals to end their lives through the lethal dose of medication through self-administration. 

Nonetheless, this debate goes further in its impact on physicians. 

In 2016, a cross-sectional study was conducted, where 3000 Dutch physicians were given questionnaires regarding whether they refused or accepted a request for assisted suicide, or euthanasia. 

According to Biomed Central (BMC), where the study was conducted, the emotional burden that stemmed from preparing and performing assisted suicide or euthanasia was experienced by 72% of physicians. With 49% of physicians having an experience of pressure to grant the request. 

Medical ethics impact healthcare professionals significantly, with the debate in politics only furthering the pressure and limits placed on physicians. 

“Taking a moral stance interrupts the flow of work,” said Paul Brodwin, a professor of Anthropology at the University of Wisconsin-Milwaukee and Adjunct Professor of Bioethics and Medical Humanities at the Medical College of Wisconsin. “If only for a moment and exposes the background justifications for action.” 

Clinicians are placed in an incredibly tough moral position with their patients over issues that they endure every day. However, they often go overlooked as simply being part of their job description. 

Author of “Everyday Ethics: Voices from the Frontline,” Brodwin explores the mental health of clinicians serving the most marginalized individuals in the US healthcare system. The difficulties that come along with holding the responsibility of incredibly vulnerable individuals’ lives at the cost of the emotional well-being of healthcare workers. 

“From the point of view of psychiatry, I understand that in the early to mid-20th century, there was rampant abuse of psychiatric power where psychiatrists would hospitalize people indefinitely against their will. A set of reforms were admitted afterward where laws were put into place to limit physicians’ powers,” Franklin said. “Now I feel as if I know what’s right for my patient working in the mental health field. However, I acknowledge that physicians years ago believed they were as well.” 

Bioethics shroud decisions with conflicting morals on a trim level, such as minor appointments, to larger scales, abortion conflicts, and those who specialize in making such decisions. 

As the complexity of the medical field grows with new technology and further advancements, the debate on medical ethics will only become broader. Holding many at stake, it’s up to the public to take a stand. 

“There has to be some kind of balance between physicians’ determination and accountability for the public at large,” Franklin said.