Issues in medical ethics with a focus on beginning and end of life debates

What you'll learn

• How religious and secular thinkers assess the moral status of embryos, fetuses, patients and persons.
• How beginning-of-life issues such as IVF, PGD, stem cells and abortion are debated.
• How end-of-life debates involve assisted dying, euthanasia, palliative care, law, rights and responsibilities.
• How to compare Peter Singer and Jonathan Glover in extended ethics essays.

Medical ethics is not just “what does the law allow?” It asks what should be done when life, suffering, autonomy and responsibility come into conflict.

The basic ethical toolkit

A strong answer separates four questions:

1. Status — what kind of being is involved?
2. Rights — what claims does that being have?
3. Consequences — what good or harm may follow?
4. Responsibilities — what duties do doctors, families and society have?

Religious approaches often stress life as a gift from God, the command not to kill, and ideas such as imago Dei — the Christian belief that humans are made “in the image of God”. Secular approaches often stress autonomy — self-rule or the ability to make decisions — and quality of life, meaning the extent to which life contains wellbeing, relationships, consciousness or future possibilities.

Beginning of life debates

The status of the embryo

Some religious views give the embryo strong moral status from conception, because a new human life has begun. Roman Catholic teaching, for example, usually opposes deliberate embryo destruction because innocent human life should be protected from its earliest stage.

Other religious and secular views see moral status as gradual. On this view, an early embryo matters, but not in exactly the same way as a conscious pregnant person, a newborn baby, or an adult patient.

Peter Singer rejects a simple “human life is always sacred” argument. He is a preference utilitarian, meaning he judges actions by how far they satisfy or frustrate the preferences of those affected. For Singer, being biologically human is not enough for full personhood. A person, in his technical sense, is self-aware, rational and able to have future-directed preferences.

Jonathan Glover also questions absolute sanctity-of-life reasoning, but he is more cautious and practical. In Causing Death and Saving Lives, he argues that the wrongness of killing is connected to loss of a worthwhile future, violation of autonomy, and effects on others — not simply the bare fact that biological life ends.

IVF, embryo research, PGD, stem cells and cord blood

In the UK, embryo research and fertility treatment are regulated by the Human Fertilisation and Embryology Authority. Research on embryos is permitted only under licence and normally only up to the 14-day rule, before the primitive streak develops. PGD may be licensed for serious genetic conditions.

Supporters argue that IVF helps infertile couples, PGD can prevent serious inherited disease, and stem-cell research may lead to treatments for conditions such as Parkinson’s disease or spinal injury. Cord blood, taken from the umbilical cord after birth, is usually less controversial because it does not require embryo destruction.

Critics worry about the destruction of embryos, “designer babies”, disability discrimination, and the commodification of human life — treating human beings as products to be selected.

Abortion

In Great Britain, abortion is regulated mainly by the Abortion Act 1967, as amended. It is legally available when conditions are met, including approval by doctors, with a general 24-week limit for many cases. There are exceptions, such as serious risk to the pregnant person’s life or serious fetal abnormality.

Religious opposition often rests on sanctity of life, the innocence of the unborn, and the belief that humans should not choose to end life. However, religious traditions are not all identical: some give greater weight to the pregnant person’s life, health, circumstances or stage of pregnancy.

Secular defences of abortion often appeal to autonomy, bodily integrity, compassion, and the fact that early fetuses lack developed consciousness. Singer supports abortion more readily than sanctity-of-life thinkers because he does not think a fetus is a person in the full moral sense. Glover tends to ask what is lost, who is harmed, and whether later abortions raise stronger moral concerns because fetal development has progressed.

End of life debates

Assisted dying, euthanasia and palliative care

In England and Wales, euthanasia is illegal and assisting suicide is a criminal offence under the Suicide Act 1961. Prosecution policy may consider compassion and circumstances, but it does not make assisted dying legal. Other jurisdictions, such as the Netherlands, Belgium, Canada and some US states, allow forms of assisted dying under safeguards.

Religious objections often appeal to God’s sovereignty over life and death, the duty to care for the vulnerable, and fears that legalisation would pressure elderly, disabled or seriously ill people. Religious support for palliative care is often strong because it expresses compassion without intending death.

Secular arguments for assisted dying stress autonomy, relief of unbearable suffering, dignity, and consistency: if patients may refuse life-sustaining treatment, why may they not choose a quicker death? Opponents reply that choice may be distorted by depression, poor care, family pressure or lack of support.

Singer is generally sympathetic to voluntary euthanasia where it satisfies a competent person’s preferences and reduces suffering. Glover also gives serious weight to autonomy and suffering, but he pays attention to safeguards and wider social effects.

Rights, responsibilities, personhood and human nature

End-of-life debates involve competing rights: a right to life, a possible right to die, and a right not to be pressured into death. They also involve responsibilities: doctors must preserve trust, relieve suffering and protect vulnerable patients; families must not treat someone as a burden; society must provide real options, including good palliative care.

Ideas of human nature matter here. A religious view may see humans as dependent creatures whose lives belong ultimately to God. A secular liberal view may see humans as autonomous agents whose choices should be respected. A relational view stresses that people are shaped by families, communities and care networks, so “choice” is never completely isolated.

Evaluating disagreement and social change

Social attitudes in the UK have generally become more permissive about IVF, embryo research, abortion and assisted dying, though all remain contested. Legal change often follows public debate, medical developments and high-profile cases such as Diane Pretty, Tony Nicklinson and Noel Conway, who challenged restrictions on assisted dying.

Religious perspectives remain valuable because they ask society to protect the vulnerable, resist reducing worth to usefulness, and remember duties as well as rights. However, critics argue that law in a plural society should not simply enforce one religious doctrine, especially when citizens reasonably disagree.

Singer’s strength is clarity: he exposes weak arguments based only on species membership and forces a serious discussion of suffering and preferences. His weakness is that his personhood criteria can seem too narrow, especially for infants, people with severe cognitive disabilities, or patients with dementia.

Glover’s strength is balance: he rejects simplistic absolutes but takes consequences, social trust and safeguards seriously. His weakness is that a flexible approach may lack firm boundaries when pressure, cost or social prejudice affect medical choices.