Bioethics is the study of the ethical issues
emerging from advances in biology and medicine.
It is also moral discernment as it relates
to medical policy and practice.
Bioethics are concerned with the ethical questions
that arise in the relationships among life
sciences, biotechnology, medicine, politics,
law, and philosophy.
It includes the study of values ("the ethics
of the ordinary") relating to primary care
and other branches of medicine.Ethics relates
to many other sciences and bio sciences.
== Etymology ==
The term Bioethics (Greek bios, life; ethos,
behavior) was coined in 1926 by Fritz Jahr
in an article about a "bioethical imperative"
regarding the use of animals and plants in
scientific research.
In 1970, the American biochemist Van Rensselaer
Potter used the term to describe the relationship
between the biosphere and a growing human
population.
Potter's work laid the foundation for global
ethics, a discipline centered around the link
between biology, ecology, medicine, and human
values.
== Purpose and scope ==
The field of bioethics has addressed a broad
swathe of human inquiry, ranging from debates
over the boundaries of life (e.g. abortion,
euthanasia), surrogacy, the allocation of
scarce health care resources (e.g. organ donation,
health care rationing) to the right to refuse
medical care for religious or cultural reasons.
Bioethicists often disagree among themselves
over the precise limits of their discipline,
debating whether the field should concern
itself with the ethical evaluation of all
questions involving biology and medicine,
or only a subset of these questions.
Some bioethicists would narrow ethical evaluation
only to the morality of medical treatments
or technological innovations, and the timing
of medical treatment of humans.
Others would broaden the scope of ethical
evaluation to include the morality of all
actions that might help or harm organisms
capable of feeling fear.
The scope of bioethics can expand with biotechnology,
including cloning, gene therapy, life extension,
human genetic engineering, astroethics and
life in space, and manipulation of basic biology
through altered DNA, XNA and proteins.
These developments will affect future evolution,
and may require new principles that address
life at its core, such as biotic ethics that
values life itself at its basic biological
processes and structures, and seeks their
propagation.
== Principles ==
One of the first areas addressed by modern
bioethicists was that of human experimentation.
The National Commission for the Protection
of Human Subjects of Biomedical and Behavioral
Research was initially established in 1974
to identify the basic ethical principles that
should underlie the conduct of biomedical
and behavioral research involving human subjects.
However, the fundamental principles announced
in the Belmont Report (1979)—namely, respect
for persons, beneficence and justice—have
influenced the thinking of bioethicists across
a wide range of issues.
Others have added non-maleficence, human dignity
and the sanctity of life to this list of cardinal
values.
Overall, the Belmont Report (1979) has guided
research in a direction focused on protecting
vulnerable subjects as well as pushing for
transparency between the researcher and the
subject.
Research has flourished within the past 40
years and due to the advance in technology,
it is thought that human subjects have outgrown
the Belmont Report (1979) and the need for
revision is desired.Another important principle
of bioethics is its placement of value on
discussion and presentation.
Numerous discussion based bioethics groups
exist in universities across the United States
to champion exactly such goals.
Examples include the Ohio State Bioethics
Society and the Bioethics Society of Cornell.
Professional level versions of these organizations
also exist.
Many bioethicists, especially medical scholars,
accord the highest priority to autonomy.
They believe that each patient should determine
which course of action they consider most
in line with their beliefs.
In other words, the patient should always
have the freedom to choose their own treatment
.
== Medical ethics ==
Medical ethics is the study of moral values
and judgments as they apply to medicine.
The four main moral commitments are respect
for autonomy, beneficence, nonmaleficence,
and justice.
Using these four principles and thinking about
what the physicians’ specific concern is
for their scope of practice can help physicians
make moral decisions.
As a scholarly discipline, medical ethics
encompasses its practical application in clinical
settings as well as work on its history, philosophy,
theology, and sociology.
Medical ethics tends to be understood narrowly
as an applied professional ethics, whereas
bioethics has a more expansive application,
touching upon the philosophy of science and
issues of biotechnology.
The two fields often overlap, and the distinction
is more a matter of style than professional
consensus.
Medical ethics shares many principles with
other branches of healthcare ethics, such
as nursing ethics.
A bioethicist assists the health care and
research community in examining moral issues
involved in our understanding of life and
death, resolving ethical dilemmas in medicine
and science.
Examples of this would be the topic of equality
in medicine, the intersection of cultural
practices and medical care, and issues of
bioterrorism.
== Perspectives and methodology ==
Bioethicists come from a wide variety of backgrounds
and have training in a diverse array of disciplines.
The field contains individuals trained in
philosophy such as H. Tristram Engelhardt,
Jr. of Rice University, Baruch Brody of Rice
University, Peter Singer of Princeton University,
Daniel Callahan of the Hastings Center, and
Daniel Brock of Harvard University; medically
trained clinician ethicists such as Mark Siegler
of the University of Chicago and Joseph Fins
of Cornell University; lawyers such as Nancy
Dubler of Albert Einstein College of Medicine
or Jerry Menikoff of the federal Office of
Human Research Protections; political scientists
like Francis Fukuyama; religious studies scholars
including James Childress; public intellectuals
like Amitai Etzioni of The George Washington
University; and theologians like Lisa Sowle
Cahill and Stanley Hauerwas.
The field, once dominated by formally trained
philosophers, has become increasingly interdisciplinary,
with some critics even claiming that the methods
of analytic philosophy have had a negative
effect on the field's development.
Leading journals in the field include The
Journal of Medicine and Philosophy, The Hastings
Center Report, the American Journal of Bioethics,
the Journal of Medical Ethics, Bioethics,
the Kennedy Institute of Ethics Journal and
the Cambridge Quarterly of Healthcare Ethics.
Bioethics has also benefited from the process
philosophy developed by Alfred North Whitehead.Many
religious communities have their own histories
of inquiry into bioethical issues and have
developed rules and guidelines on how to deal
with these issues from within the viewpoint
of their respective faiths.
The Jewish, Christian and
Muslim faiths have each developed a considerable
body of literature on these matters.
In the case of many non-Western cultures,
a strict separation of religion from philosophy
does not exist.
In many Asian cultures, for example, there
is a lively discussion on bioethical issues.
Buddhist bioethics, in general, is characterised
by a naturalistic outlook that leads to a
rationalistic, pragmatic approach.
Buddhist bioethicists include Damien Keown.
In India, Vandana Shiva is a leading bioethicist
speaking from the Hindu tradition.
In Africa, and partly also in Latin America,
the debate on bioethics frequently focuses
on its practical relevance in the context
of underdevelopment and geopolitical power
relations.
Masahiro Morioka argues that in Japan the
bioethics movement was first launched by disability
activists and feminists in the early 1970s,
while academic bioethics began in the mid-1980s.
During this period, unique philosophical discussions
on brain death and disability appeared both
in the academy and journalism.
== Education ==
Bioethics is taught in courses at the undergraduate
and graduate level in different academic disciplines
or programs, such as Philosophy, Medicine,
Law, Social Sciences.
It has become a requirement for professional
accreditation in many health professional
programs (Medicine, Nursing, Rehabilitation),
to have obligatory training in ethics (e.g.,
professional ethics, medical ethics, clinical
ethics, nursing ethics).
Interest in the field and professional opportunities
have led to the development of dedicated programs
with concentrations in Bioethics, largely
in the United States and Europe, offering
undergraduate majors/minors, graduate certificates,
and Masters and Doctorate degrees.
== Criticism ==
As a study, bioethics has also drawn criticism.
For instance, Paul Farmer noted that bioethics
tends to focus its attention on problems that
arise from "too much care" for patients in
industrialized nations, while giving little
or no attention to the ethical problem of
too little care for the poor.
Farmer characterizes the bioethics of handling
morally difficult clinical situations, normally
in hospitals in industrialized countries,
as "quandary ethics".
He does not regard quandary ethics and clinical
bioethics as unimportant; he argues, rather,
that bioethics must be balanced and give due
weight to the poor.
Additionally, bioethics has been condemned
for its lack of diversity in thought, particularly
with regards to race.
Even as the field has grown to include the
areas of public opinion, policymaking, and
medical decisions, little to no academic writing
has been authored concerning the intersection
between race- especially the cultural values
imbued in that construct- and bioethical literature.
John Hoberman illustrates this in a 2016 critique,
in which he points out that bioethicists have
been traditionally resistant to expanding
their discourse to include sociological and
historically relevant applications.
Central to this is the notion of white normativity,
which establishes the dominance of white hegemonic
structures in bioethical academia and tends
to reinforce existing biases.
Some criticisms have been made about the experience
of disability.
Some people in the disabled community feel
that mainstream bioethics embraces ableist
premises about medical care and resources.
Thinkers such as Princeton's Peter Singer,
who has argued that parents have the right
to choose healthy children over disabled ones,
have upset people with disabilities, who feel
threatened by his position.
== Issues ==
Areas of health sciences that are the subject
of published, peer-reviewed bioethical analysis
include:
== See also ==
== References ==
== Notes ==
== External links ==
Bioethics entry in the Internet Encyclopedia
of Philosophy.
"Feminist Bioethics" at the Stanford Encyclopedia
of Philosophy
