The Murky Ethics of Medicine with Dr. Jacob Appel

Who should get custody of an embryo created through IVF when a couple divorces? Should an alcoholic in poor health be forced to go to rehab? Can a pediatrician refuse to see non-vaccinated clients? Or, when you or a loved one is on life support, who says you’re dead?
Bioethicist Dr. Jacob Appel joins Dr. Wendy to consider these and other bioethical questions found in his new book -- WHO SAYS YOU’RE DEAD? Medical & Ethical Dilemmas for the Curious & Concerned. Dr. Appel asks readers to play doctor and decide what they would do if confronted with the dilemma. He then reveals what decisions were actually made in the real-life cases on which his scenarios are based.
Drawing upon the author’s two decades teaching medical ethics, as well as his work as an emergency room psychiatrist, Dr. Appel presents bioethical questions that defy easy answers. Readers will be surprised by their own assumptions:
  • A famous model refuses a C-section necessary to save her fetus because she fears a career-ending scar. Can she be forced to undergo involuntary surgery?
  • A recent immigrant in her nineties is found to have terminal cancer, but her children insist that she not be told the diagnosis. Her family explains that in her culture, doctors shield elderly patients from such news. Should the doctors trust the family and honor the request? Or should they inform the patient?
  • Shortly before his wedding, a man is killed in an accident. His fiancée asks doctors to harvest his sperm so that she can use it to have his child—as she believes these would have been his wishes. His only close biological relative, an uncle, objects. Should a court order the sperm retrieval?
  • A daughter gets tested to see if she is a match to donate a kidney to her father. The test reveals that she is not the man’s biological daughter. Should the doctor tell the father? Or the daughter?
  • A fertility clinic run by evangelical Christians refuses to provide in vitro fertilization to a lesbian couple on religious grounds. Should they be required to do so? Does it matter that they are the only fertility clinic in the community? 
Dr. Jacob M. Appel, MD, is an attending psychiatrist in the Mount Sinai Healthcare System, teaches bioethics at the Icahn School of Medicine at Mount Sinai where he is the Director of Ethics Education in Psychiatry and is a member of the Institutional Review Board. He holds a medical degree from Columbia University’s College of Physicians and Surgeons, a law degree from Harvard Law School, and a master’s in bioethics from the Alden March Bioethics Institute of Albany Medical College.
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