The Four Horsemen – War, Famine, Pestilence and Death* – tend to work as a team. War brings famine (and famine, or at least land shortage, brings war). Hunger makes people vulnerable to infectious diseases – and pestilence, famine and war all bring death.
Albrecht Durer , The Four Horsemen of the Apocalypse (1497-8)
But sometimes a new disease turns up unexpectedly, like Ebola in West Africa right now, or smallpox in the Aztec Empire in the 16th century, or the Plague of Justinian in 541AD, the first recorded pandemic caused by the bacterium Yersinia pestis, better known from its second appearance in 1347 as the Black Death.
Historians are good are looking back and finding explanations, and epidemic diseases are most deadly when certain preconditions exist: poverty, poor hygiene, poor nutrition and over-population all make things worse. But sometimes, there are no preconditions, and it doesn’t do to blame the victims: the Aztecs were doing just fine until the Spanish arrived, bringing smallpox to a population that had no immunity to the disease. Continue reading
During the last month Australia and Thailand have had to confront the implications of a terrible medical dilemma, when news broke of ‘Baby Gammy’, the Downs syndrome twin left behind by an Australian couple who paid a Thai woman to carry their child. When the mother found she was having twins, she allegedly refused to abort the pregnancy because of her Buddhist beliefs. The genetic parents subsequently took the ‘good twin’, a girl, back to Australia with them, leaving the boy behind with a mother too poor to pay for his medical treatment. A lot of this is still ‘alleged’ – but just when it seemed the story couldn’t get any worse, it turned out that the new father had formerly been convicted of child abuse. Both Thailand and Australia have been hastily rushing through new regulations on child surrogacy.
Many medical issues have an ethical dimension. Some, like surrogacy, are self-evidently vexed. Others are subtler.
In the current Ebola epidemic, for instance, why does an American patient get flown home for treatment that is not available for Africans? What are the ethics of administering treatment that is still experimental? And why is the language in which the disease is discussed so charged? There has been a lot of talk about how uneducated Africans don’t obey the scientists when they are told to abandon their traditional burial rites and not touch Ebola victims, or wash the bodies of their dead relatives. Yet the said American patient subsequently credited Jesus, not the scientists, for his recovery.
It is against this background that I’ve recently been reading Sarah Ferber’s Bioethics in Historical Perspective (Palgrave, 2013). Continue reading
Posted in Australian Womens Writers Challenge 2014, historiography, medical history
Tagged bioethics, ebola, eugenics, human experimentation, medical ethics, reproductive politics, Sarah Ferber, surrogacy, thalidomide