Bioethics, Thai style

PLoS Medicine this month has an interesting series on Social Medicine well worth checking out. Among the offerings is an article entitled 'Is there a Global Bioethics? End-of-Life in Thailand and the Case for Local Difference.' Using the case of a construction worker who is injured and placed on life-support, Stonington and Ratanakul argue that such situations as experienced in Thailand involve ethical conflicts that cannot be understood or dealt with by means of the 'Georgetown mantra', i.e. beneficience, non-maleficience, autonomy and justice. The only way to conceive and handle these bioethical dilemmas is to place them in a specifically Thai-based conceptual framework.

The article is a bit of a teaser, because it does not say how the case was resolved. When Lek, the construction workers brother, is advised by Dr. Nok to become ordained as a monk in order to help his brother achieve mental clarity and 'let go' of his attachment to life, there is no indication of whether or not this actually turned the trick. If it didn't, was Dr. Nok then forced to remove the ventilator, causing himself serious karmic damage in the process? Or is Gaew, the man in question, still languishing in a Thai hospital somewhere?

End-of-life issues involving medical technology take a culture's ethical framework and stretch it to the breaking point. That phenomenon, at least, is universal.