Volume 13, Number 1, 2003

Editors' Forum

Paul Byrne, MB, ChB, FRCPC
Interim Director, John Dossetor Health Ethics Centre
University of Alberta

This issue of Health Ethics Today marks a departure from the previous editorial policy of devoting an entire issue to one topic. Recognition that ill health is a broader matter than the standard medical disease focussed view is becoming accepted more widely by health care professionals. Similarly ethics as it relates to health should encompass a broad range of issues beyond the areas of clinical ethics, research ethics, medicolegal issues, and resource allocation.

The two contributors to this issue of Health Ethics Today are a step in this direction; they both assist us in seeing the relevance of health ethics from different vantage points. Richard Fraser tackles a very broad issue presenting his view of the Romanow Report’s attempt to tackle the macro-allocation of resources within Canada’s National Health System. Fraser’s paper is critical of Romanow for using the ‘language of values’ to engage in political persuasion and to justify spending for the future direction for Canada’s health system. He contrasts Romanow to other recent reports on health care, which rejected spending as the solution to our problems of supply and demand for health care services. Fraser decries the lack of accountability and transparency at all levels of leadership and advises as to be ‘on our guard when the prescription is packaged in the cloth of values’ – sound advice whether or not you agree with his view of Romanow.

Gregor Wolbring’s paper addresses the issue of labelling individuals based on our concepts of normal. He focuses on disability, a commonly discussed issue in clinical ethics, but from a distinctly different point of view. He argues that the common usage of terms such as disease, disability, defects, impairment and suffering fails to recognize the views of those so called ‘afflicted’. By using norms established by ‘non afflicted’ people the afflicted are then labelled as disabled and suffering and their subsequent care is governed by non afflicted values and judgements. Wolbring makes a strong case to be wary of judgements about difference and questions the basis of what constitutes normal and abnormal in health ethics discussion. Recently the topic of enhancement has emerged in bioethics literature which also serves to make us question the basis for judgements about the normal. If ‘superman/woman’ becomes a ‘new norm’ is ordinary man/woman in some way afflicted, defective or sub-normal? Wolbring’s view helps us realise that such questions are not future science fiction, they have arrived and need our attention today.

Health Ethics Today Credits

Editorial Committee: Vangie Bergum, Paul Byrne, Eileen Crookes, Glenn Griener, Al-Noor Nenshi Nathoo

Distribution: Edna Cunningham Liley

Layout: Creative Services, University of Alberta

The opinions expressed in this newsletter are those of the authors only and not necessarily those of the John Dossetor Health Ethics Centre or the Provincial Health Ethics Network.