“One of the Least of These”: Unrepresented Patients and Christian Bioethics

Abstract Unrepresented patients cannot make their own medical decisions and do not have any surrogate decision-maker. This patient population is highly vulnerable to being harmed, wronged, ignored, and exploited. But the ethical issues related to their care have gotten little attention from Christian bioethicists, which is problematic in light of Christianity’s concern for the poor, the needy, and the vulnerable. This article claims that Christian bioethicists must address these issues, and that Christian morality demands an approach that is different from the status quo. First, it lays out moral principles pertaining to the care of unrepresented patients, focusing on the special obligation to prioritize and protect the vulnerable. Second, it applies these principles to one major ethical problem—the appropriate decision-maker for unrepresented patients—arguing that Christians should favor institutional committees instead of the conventional practices of courts and clinicians.