Transcript Slide 1

Karma and Kindness
Medical Ethics in Thailand
Scott Stonington
MD/PhD Student – Medical
Anthropology
Thailand and the
Mechanical Ventilator
A New Political and Ethical
Problem
Dilemmas
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Ethical – Two ethical principles dictate opposite
actions
Self-Interest – The decision maker’s interest
conflicts with ethical action
Practical – Ethical action is clear, but logistics get
in the way
Questions
1) What kind of dilemma does withdrawing
the ventilator present to the characters?
2) What bioethical principles do they use to
make their decisions?
Principles of Western Bioethics
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Autonomy – Patients have the right to make
informed decisions about their own health
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Beneficence – Do what is best for the patient
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Non-Maleficence – Do no harm
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Truth-Telling – Never lie or conceal information
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Justice – Treat patients equally and fairly
Characters
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Gaew – Thai Construction Worker
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Ends up in ICU with no cortical activity
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Kwan – Gaew’s Wife
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Tong – Gaew’s Physician
‘Culture’ and Bioethics in the
United States
We assume that the principles of
Western bioethics are universal
Which bioethical principles are at
work in Gaew’s Case?
What Kind of Dilemma?

Kwan
Practical Dilemma

Dr. Tong
Relieving Suffering
vs.
Karmic Consequence
The Quest for a
Thai Bioethics
Acknowledgements
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Advisors
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Vincanne Adams
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(Anthropology)
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Steve Pantilat
Thai Institutions
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(Medicine,
Ethics)
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Sharon Kaufman
(Anthropology)
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Paul Rabinow (Anthropology,
UCB)
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Mark Mancall
Stanford)

Ministry of Public Health
Hospitals: Siriraj,
Ramathibodi, BCC,
Pitsanulok, Ratchaburi
Funding
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
(History,
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MSTP
Pacific Rim Research
Program
Office of International
Programming