The English philosopher Herbert Spencer (1820–1903) once observed that “Morality knows nothing of geographical boundaries or distinctions of race.” In an ideal world, human beings would follow a consistent pattern of behavior aligned to values that remain the same, no matter where they live.
In reality, morality and ethics are affected by culture, education, religion, and geographic location. What is considered 'ethical' in one part of the world may be unethical somewhere else. Furthermore, what may be considered ethical at one point in time (e.g., slavery, segregation) becomes unacceptable at a later time period.
Ethics is the basis of decision making in all areas of life, including law, politics, business, and the environment. Problems arising from advances in medicine, science, and technology, however, pose different and more complex dilemmas. To cope with those difficulties, bioethics was developed.
Applied Ethics vs. Bioethics
Applied ethics involves the general question of how people should behave. In the field of philosophy, applied ethics implies a willingness to make difficult life choices in real circumstances. Bioethics, however, is a branch of applied ethics that is less interested in how people should live but more with how people should act under certain circumstances.
At its simplest, bioethics means “life ethics.” More specifically, bioethics is the study of ethical difficulties that arise as a result of medical advances and changes in health care technology. Bioethics affects all scientific disciplines and issues as diverse as patient privacy or animal research.
Bioethics is not the same thing as medical ethics. Bioethics deals with complex issues from a general perspective, while medical ethics focuses on specific case-by-case decisions. For example, consider an issue such as cloning. A bioethicist would engage in reflection on whether cloning is beneficial or not to society, or to problems of population growth. A medical ethicist would debate the right of a physician to create an artificial duplicate life form. Medical ethics is considered a subset of bioethics.
History of Modern Bioethics
Bioethics is a modern phenomenon. Ethical concerns about human experimentation were discussed after World War II, when National Socialist (Nazi) medical abuses first came to light. Although the Nuremberg Code (1947) wrestled with principles such as informed consent, it took another two decades before the discipline of bioethics was developed.
During the 1950s, science, medicine, and technology all advanced rapidly. Within the span of a few years, the mysteries of DNA were decoded, the first organ transplants were performed, and the polio vaccine was developed. Suddenly, new complexities in ethics had to be considered. Medical questions posed by the use of respirators in end-of-live cases often fell to religious scholars to debate, instead of specialists in ethics.
Throughout the 1960s and 1970s, clinical research abuses proliferated. Some were publicized by Henry K. Beecher, or brought to public attention by the media (e,g., the Tuskegee Study of Untreated Syphilis). By the time the National Research Act of 1974 was enacted into law, public policy was focusing on more complex subjects such as abortion and human subject research.
To meet the needs of public policymakers, more and more scholars began writing articles on ethical problems associated with technological advances. From these articles, the discipline of bioethics was born.
Bioethics Provides a Framework for Decision Making
Bioethics involves compromise. One common misconception about bioethics is that it provides correct answers to every problem. The truth is that bioethics provides a framework to make decisions, but it does not make the decision itself.
Sometimes the 'right' decision is one that respects core principles such as autonomy, beneficence, and justice, but does not lead to a happy result — including the patient's death. This makes the principles behind bioethics difficult for many people to accept.
Edmund D. Pellegrino served as Chairman of the President's Council on Bioethics from 2005 to 2009. According to Pellegrino, “biotechnology must be used within ethical constraints” in order to serve society, and it is “the task of bioethics to help society develop those constraints.”
Bioethics Education
There are several degree programs offered in bioethics, either at the undergraduate or graduate degree levels. For further information about national and international programs in bioethics, please contact any of the following institutions:
- Baylor College of Medicine, Center for Medical Ethics and Health Policy. http://www.bcm.edu/ethics/
- Cleveland State University, College of Liberal Arts and Social Sciences, Bioethics Certificate. http://www.csuohio.edu/class/bioethics/BioCertificate.html
- Emory Center for Ethics. http://ethics.emory.edu/
- Indiana University Center for Bioethics. http://www.bioethics.iu.edu/
- Katholieke Universiteit Leuven, Erasmus Mundus Master of Bioethics. http://med.kuleuven.be/education/Bioethics/index.html
- Medical College of Wisconsin, Department of Population Health, Center for the Study of Bioethics. http://www.mcw.edu/bioethics.htm
- National Institutes of Health (NIH), The Department of Bioethics. http://www.bioethics.nih.gov/home/index.shtml
- University of British Columbia, W. Maurice Young Centre for Applied Ethics. http://www.ethics.ubc.ca/
- University of Chicago Division of Biological Sciences, Department of Medicine, MacLean Center for Clinical Medical Ethics. http://medicine.uchicago.edu/centers/ccme/about.htm
- University of Washington, Department of Bioethics & Humanities. https://depts.washington.edu/bhdept/index.html
Bioethics Resources
For more information about bioethics, or to explore issues and current literature in bioethics, the resources listed below are a good place to begin:
- American College of Physicians/American Society of Internal Medicine web site, Ethics Manual (4th ed. 1998). http://www.annals.org/cgi/content/full/128/7/576
- Georgetown University, Kennedy Institute of Ethics. http://bioethics.georgetown.edu/
- Medical College of Georgia, Language of Bioethics. http://www.mcg.edu/gpi/Ethics/ph1sylbus/bioethic.htm
- National Institutes of Health (NIH). http://bioethics.od.nih.gov/
- New England Journal of Medicine Medical Ethics Collection. http://content.nejm.org/cgi/collection/medical_ethics
- President's Council on Bioethics. http://www.bioethics.gov/
- Rock Ethics Institute, Pennsylvania State University. http://rockethics.psu.edu/resources.shtml
- University of Buffalo Center for Clinical Ethics and Humanities in Health Care. http://wings.buffalo.edu/faculty/research/bioethics/
- Wellcome Library, BioethicsWeb. http://www.intute.ac.uk/bioethicsweb/
- W. Maurice Young Centre for Applied Ethics. http://www.ethicsweb.ca/resources/
References
Campos NG, Farmer P. 2004. New malaise: bioethics and human rights in the global era. Journal of Law, Medicine & Ethics, 32:243–251.
Kuczewski MG. 2002. Lecture 1: Bioethics: History & Resources. Neiswanger Institute for Bioethics & Health Policy.
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