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Current essay provides comprehensive analysis of Starson vs. Swayne case from the point of five of judicial reasoning and bioethical issues. Through careful analysis of legal test of capacity which is important in determining person’s ability to be an active player in the judicial process, we analyze if the court’s decision was justified or not.
Bioethics and law
Bioethics is interdisciplinary field lying at the intersection of many sciences including moral philosophy, medicine, law and other important spheres. There is no denying the importance of the fact that its development was greatly connected with the progress of biology, medicine and anatomy which opened the issues of cloning, genetic transformation. As it was noted above many issues of bioethics are interrelated with law and juridical system in whole (Allegretti, 2002, p. 12). Among them the most notable are death lethal injection, using various medications, defining legal capacity and prescribing judicial medical treatment. Some of these mentioned bioethical issues will be touched and analyzed in this essay on the example of Starson vs. Swayne test.
But before proceeding to this analysis it is needed to analyze the interrelation between law and bioethics. As Schneider claims, these two spheres are greatly interconnected as we see that many bioethicists are lawyers and vice versa. It should be noted that bioethics has much to do with politics than with academic institutionalized disciplines and hence it speaks on the language of prescriptions and orders which is so characteristic of law (Capron, 1999, 295; Schneider, 1994)). The issues raised by bioethics are close to those which are rise in law proceeding concerning the multi-faceted and various issues of judicial medicine, regulation of patients’ treatment etc (Washington times, 2004).
Bioethics, generally saying refers to the study of various ethical issues which related to the health care and starting from deciding on how doctor and patients should act to the issues of how national system of health should be organized in general.
Such issues as the analyzed case will shows are extremely difficult and rise controversies between person’s interests and his autonomy to decide on his future life, between free will and medical care of incapable people, the rights and responsibilities of medical workers, the scope of their possibilities etc. As these issues touch the problems of morality and intersect with the development of science they are controversial and results in long legal proceedings and permanent appellation by their actors (O’Neill, 2002). To treat positively these issues means consolidating efforts and griping on modern trends in law, science and ethics. These issues demand the regime of the rules and flexibility, language of duties and responsibilities, strong and effective public policy analytical actions and private preferences. The choice is very wide-spread and controversial lying between deontology, the rigorous character of economics and philosophy (Neuhaus, 2007).
Ethical issues in Starson’s case
As Starson’s case suggest he was a physician who was diagnosed to have mental disorder including manic psychosis and schizophrenia. After that he was put for a certain time in psychiatric facilities. After he was freed from them he committed aggressive insults on the tenants in his house threatening to kill them but during the judicial process was said to be ‘incapable’ and mentally ill and was ordered to pass mental treatment in psychiatric facilities where he had to use mental transforming medications which were prescribed by the doctors. However Starson appealed to Superior Court and it produced the ruling that he is capable of making his own decision on whether take mental medicines or avoid using them.
The contradiction itself became evident when his own mother claimed that she is afraid of his health and said that he really has mental disorder and thinks he is ‘alien’. She also said that she was afraid of his future and that devastates her. Starson considered using mental medications as dangerous for him for he thought that it might transform him into ‘normal’ person which he always thought was like death to him.
From the analysis of the case we see that Starson’s was a renowned physic with many publications in his sphere and the potential for professional growth. Therefore, it should be claimed that’ from the ethical point of view taking these mentally transforming medicines was dangerous and threatening to him as he could loose his brain and thinking capacities. Court who took the decision of Starson legal capacity proceeded from the test and medical results which could not rule out positively whether Starson was mentally ill or not. Therefore, the indeterminacy between his ‘capacity’ and the real state of his health existed. Here, we can observe the wide-spread controversy concerning bioethical issues which lie at the intersection of different ideologies (morality, liberalism), sciences and law rules and prejudices.
The controversy in this case and the set of bioethical issues it raises is bets exemplified by the contradiction between legal capacity and autonomy and his ‘best interests’.
Before analyze this, it is necessary to strictly define what is legal capacity. There is no denying the importance of the fact that the terms legal capacity refers to the person’s ability to make will. If the opposite is true, then it is said that a person lacks legal capacity and is senile, insane etc. This means that he is not responsible for his deeds and should be posited to some psychiatric institutions (Matare, 1999).
In Starson’s case there exists indeterminate situation as can not be declared absolutely incapable and at the same time there exists well-grounded evidence from medical specialists that he is suffering some kind of mental disorder which is also confirmed by Starson’s mother’.
In this situation the judges of Superior Court take liberal point of view claiming that ensuring Starson’s personal autonomy and decision-making is more important that guaranteeing his ‘best interests’. There is no denying the importance of the fact that this ruling and its formulating does have liberal ethical grounds and is no based on real facts being absolutist moral inscription. Another good evidence for this is that Superior Court’s judges denounce medical specialists’ conclusions as being ‘paternalistic’, that is meaning that they lack the respect for personal autonomy and creativity which are guaranteed by liberal ideology (Schaub, 2004).
In this situation it is difficult to say whether Superior Court or medical decision was right on mere ground of their bioethical characteristics. There is no denying the importance of the fact, the Court’s decision is grounded as protecting human autonomy and medical decision – as protecting person’s best interests and health.
Another contradiction lie within the sphere of personal perception of illness which is important in this particular case. There is no denying the importance of the fact that medical specialists who diagnosed Starson said that however he claims that is absolutely normal and healthy, it proves that their diagnosis is true and he should take necessary medications for improving his conditions. Superior Court ruling stated that since Starson declared that he is abnormal and said that he feels good with it and it even helps his scientific career, he is full aware of his illness and hence should take his own autonomous decisions on whether continue medical career and or listen to medical prescriptions or not.
It should be said that this contradiction is tied with the already analyzed one. If the medical specialists can not resolve the issue positively showing total Starson’s incapacity, then Superior Court claims that on the basis of Starson conscious recognition of his partial ‘abnormality’, he is eligible to take necessary steps and actions.
Besides this, Superior Court also used well-grounded argument that medical interference and treatment had not bring positive results and enhancements so far, so there exists no adequate reasons for continuing treatment based on the previous system. Besides this, Court judges claimed that their ruling goes in line with ensuring person’s ‘best interests’ because it allows Starson to continue his scientific studies.
However, this contradiction had proved to be resolved by ruling’s consequences. As the Starson’s case suggests, being in hospital he refused to eat and drink and was at the brink of total mental disorder and even death. In this difficult situation, Superior Court had to recognize that its decision was short-sighted and led to negative consequences and ruled to continue treatment with medications prescribed by medical specialists.
After passing necessary procedures Starson felt the considerable enhancement of his health and mental conditions and even recognized that he has some symptoms which may be attributed to mental illness.
Conclusion
As the Starson’s case analysis shows the issues of bioethics and their implication for judicial practice are very difficult and controversial as they raise multi-faceted spectrum of issues concerning human consciousness, illness, free will, moral and personal autonomy, as well as competency and responsibilities of medical institutions and specialists. There is no denying the importance of the fact that as this case proves sometimes judicial ruling that are focused on some kind of ideological belief may harm real interests of a person and hence the position of medical specialists should be taken into consideration.
As the case showed, however Superior Court had positive and grounded arguments which proceeded from the basic liberal rights of human autonomy, the possibility to decide and act, they neglected important sphere of scientific argumentation provided by medical specialists which claimed that the Court’s position is ruinous for Starson’s health and future scientific activities and that he need urgent medical treatment.
The rightness of medical specialists’ position was proved after the Court’s decision came into action and after Starson suffered deterioration of his mental condition which finally led to his refusing to eat and drink.
References
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Allegretti, J. (2002). The Role of a Lawyer’s Morals and Religion When Counseling Clients in Bioethics. Fordham Urban Law Journal, 30(1), 9-35.
Andre, J. (2002). Bioethics as Practice. Chapel Hill, NC: University of North Carolina Press.
Capron, A. M. (1999). What Contributions Have Social Science and the Law Made to the Development of Policy on Bioethics?. Daedalus, 128(4), 295.
Fantasy Doctors Meet Bioethics; Reflections on Science and Morality. (2004, April 8). The Washington Times, p. A19.
Lauritzen, P. (2007, June 1). Daniel Callahan & Bioethics: Where the Best Arguments Take Him. Commonweal, 134, 8-28.
Levinson, R. & Reiss, M. J. (Eds.). (2003). Key Issues in Bioethics: A Guide for Teachers. New York: Routledge Falmer.
Lin, O. (2004). Rehabilitating Bioethics: Recontextualizing in Vitro Fertilization outside Contractual Autonomy. Duke Law Journal, 54(2), 485-511.
Matare, H. F. (1999). Bioethics: The Ethics of Evolution and Genetic Interference. Westport, CT: Bergin & Garvey.
Neuhaus, R. J. (2007, November). The Politics of Bioethics. First Things: A Monthly Journal of Religion and Public Life, 23-56.
O’Neill, O. (2002). Autonomy and Trust in Bioethics. Cambridge, England: Cambridge University Press.
Schaub, D. (2004, Summer). Bioethics and the Constitution. Public Interest 51-76.
Schneider, C. E. (1994). Bioethics in the Language of the Law. The Hastings Center Report, 24(4), 16-46.
Sunstein, C. R. (1994). Incommensurability and Valuation in Law. Michigan Law Review, 92(4), 779-861.
Sykes, A. O. (2002). New Directions in Law and Economics. American Economist, 46(1), 10-38.
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