BIOETHICS

'Bioethics' is the ethics of biological science and medicine. Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, philosophy, and theology.

Contents

Scope

Why bioethics?

Ideology and methodology

Issues

List of notable bioethicists

References

Further reading

External links

Scope

Disagreement exists about the proper scope for the application of ethical evaluation to questions involving biology and medicine. 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 and pain, and include within bioethics all such actions if they bear a relation to medicine and biology.
Bioethics is a growing academic and professional area of inquiry, and within a thirty year history as an academic discipline, more than one dozen English language journals have emerged. In addition, many academic medical centers and some schools of law, engineering and the liberal arts offer degree programs with a specialization in bioethics. Such programs train physicians and nurses, attorneys, philosophers, theologians, health services researchers and even bench scientists. As a field of inquiry, bioethics received a boost in 1989 from the funding of the U.S. Human Genome Project, today known as the NHGRI, referred to by Arthur Caplan as the "full employment act" for bioethicists. With those funds, in the 1990s a group of social scientists created an academic mode of discourse on bioethical issues as they are encountered and resolved in society, culminating in a more rigorous social science approach to the field.

Why bioethics?

The issues raised by bioethics as a distinct area of academic inquiry (why must it exist apart from philosophy? isn't everyone an 'ethicist'?) are largely answered by the needs of institutions. Bioethicists today are not hired or engaged in conversation (and thus "named") because of their opinions or because they have special skills of reasoning, but because they know and can put to work the enormous body of research and history of discussions about bioethics in a fair, honest and intelligent way, using tools from the different disciplines that "feed" the field. Training programs in bioethics differ in skill sets of faculty and size of program, but across the US, and increasingly globally, they do seem to share a commitment to that goal with few exceptions.
As a result, bioethics has been distinctively created, by institutions, specifically the multi-million dollar commitment of major and minor medical centers to the study of medical ethics as part of the development of curriculum and research efforts. Today it is all but impossible to create a major medical research effort without ethicists to assist. First in the regulatory review of research, the responsibility of the IRB, which can be staffed by persons not trained in ethics in any rigorous way, or trained specifically in the ethical and regulatory aspects of research with human subjects, rather than more comprehensively in bioethics. The second form of assistance is by those who can think in advance of the onset of research about its social, ethical and economic implications. A shrinking number of those who would say that they "work in bioethics" are actually employed in other academic disciplines, because so many such disciplines reject as credible or important the work of bioethics in journals that are outside the methods of the traditional discipline within which such a person would work. A publication in JAMA would be meaningless to a tenure committee in most philosophy departments. A publication in the Journal of Philosophy would be meaningless to the same committee in a medical school. Seven articles would be sufficient for promotion in many philosophy departments, where 37 might be closer to the typical number of peer-reviewed publications for bioethicists, but of much shorter length, and philosophers would contest the possibility of rigor at that level of productivity. A book is a primary credential in the liberal arts and law. A book is virtually meaningless in medicine. So, as institutions employing bioethics change, the jobs change, and thus the training changes.
Nonetheless, many claim to work in bioethics, and indeed can feel free to do so, in just the same way that self-help book authors claim to work in philosophy. However, those not working in and trained in bioethics in the now fairly well established range of ways typical of bioethicists, demonstrated by, e.g., publishing in AJOB, Hastings Center Report, Journal of Medical Ethics, etc., will be perceived as amateurs by those in the field per se, again for the same reason that while Einstein did fabulous work as a patent clerk, he would not have been properly considered a physicist (and was not) until he joined the academic community, because without such standards universities and their growth in terms of new disciplines would spiral out of control.

Ideology and methodology

Bioethicists often focus on using philosophy to help analyze issues, and philosophical ethicists such as Peter Singer tend to treat the field as a branch of moral or ethical philosophy. However, this approach is sometimes challenged, and bioethics is becoming increasingly interdisciplinary. Many bioethicists come from backgrounds outside of academic philosophy, and some even claim that the methods of analytic philosophy have had a negative effect on the field's development. The percentage of bioethicists with professional backgrounds in health care, especially physicians, has been steadily increasing over time. In fact, the last two Presidents of the primary academic society for bioethicists in the U.S. (the American Society for Bioethics and Humanities) have been physicians. Some bioethicists, especially those who perform ethics consultation in clinical settings, emphasize the practical aspects of bioethics, and view the field as more closely related to clinical practice or public health than philosophy.
Religious bioethicists have developed rules and guidelines on how to deal with these issues from within the viewpoint of their respective faiths. Many religious bioethicists are Jewish, and Christian scholars. Since the Indian traditions of Hinduism, Buddhism, and Jainism considers the sanctity of all life, there is much literature related to the philosophy and ethics related to life in each of these traditions. A growing number of religious scholars from Islam have also become involved in this field. There has been some criticism by liberal Muslims that only the more religiously conservative voices in Islam are being heard on this issue.
Although there are a number of eminently qualified philosophers who approach bioethics from a religious perspective, some Western secular bioethicists are critical of the fact that religious bioethicists are often religious scholars without an academic degree or training in disciplines that pertain to the issues, such as philosophy (wherein the formal study of ethics is usually found), biology or medicine. From the standpoint of bioethicists whose work is secular, the central cause for caution as regards religious bioethics work is that tools and methods should be brought to bear on problems, rather than starting with conclusions, and then looking for justifications. Of course, this criticism does not apply solely, of even to all, forms of religious bioethical work.
In the case of most non-Western cultures a strict separation of religion from philosophy does not exist. In many Asian cultures, there is a lively (and often less dogmatic, but more pragmatic) discussion on bioethical issues. The discussion often refers to common demographic policies which are criticised, as in the case of China. 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 the leading bioethicist whose speaks from the Hindu tradition. In Africa, and partly also in Latin America, the debate on bioethics frequently focus on its practical relevance in the context of underdevelopment and (national or global) power relations.

Issues

Areas of health sciences that are the subject of published, peer-reviewed bioethical analysis include:

★ Abortion

★ Animal rights

★ Artificial insemination

★ Artificial life

★ Artificial womb

★ Assisted suicide

★ Biopiracy

★ Blood/blood plasma (trade)

★ Body modification

★ Brain-computer interface

★ Chimeras

★ Circumcision

★ Cloning

★ Confidentiality (medical records)

★ Consent

★ Contraception

★ Cryonics

★ Eugenics

★ Euthanasia (human, non-human animal)

★ Feeding tube

★ Gene therapy

★ Genetically modified food

★ Genomics

★ Great Ape Project

★ Human cloning

★ Human enhancement

★ Human genetic engineering

★ Iatrogenesis

★ Infertility (treatments)

★ Life extension

★ Life support

★ Lobotomy

★ Medical research

★ Medical torture

★ Moral obligation

★ Nanomedicine

★ Organ donation (fair allocation, class and race biases)

★ Pain management

★ Parthenogenesis

★ Patients' Bill of Rights

★ Placebo

★ Population control

★ Prescription drugs (prices in the US prices)

★ Procreative beneficence

★ Procreative liberty

★ Psychosurgery

★ Recreational drug use

★ Reproductive rights

★ Reprogenetics

★ Sperm and eggs (donation)

★ Spiritual drug use

★ Stem cell research

★ Suicide

★ Surrogacy

★ Transexuality

★ Transhumanism

★ Transplant trade

List of notable bioethicists

★ Jacob M. Appel

★ John D. Arras

★ Tom L. Beauchamp

★ J. David Bleich

★ Baruch Brody

★ Howard Brody

★ Arthur Caplan

★ Ronald A. Carson

★ Eric J. Cassell

★ R. Alto Charo

★ James F. Childress

★ Elliot Dorff

★ H. Tristram Engelhardt, Jr.

★ Ruth Faden

★ Joseph Fins

★ Joseph Fletcher

★ Robert P. George

★ Walter Glannon

★ Mordechai Halperin

★ James Hughes

★ Immanuel Jakobovits

★ Albert R. Jonsen

★ Leon Kass

★ Sir Ian Kennedy

★ Ken Kirkwood

★ Mark Kuczewski

★ John Lantos

★ Robert Levine

★ Bernard Lo

★ Alex John London

★ William F. May

★ Van McCrary

★ Glenn McGee

★ Gilbert Meilaender

★ Jonathan Moreno

★ Thomas Murray

★ E. Haavi Morreim

★ Lawrence J. Nelson

★ Bernard Nathanson

★ Onora O'Neill

★ Edmund Pellegrino

★ Gregory E. Pence

★ Thomas Percival

★ Stephen G. Post

★ James Rachels

★ John A. Robertson

★ Fred Rosner

★ Judith Wilson Ross

★ Hans-Martin Sass

★ Julian Savulescu

★ Harold Shapiro

★ Mark Siegler

★ Daniel Sinclair

★ Peter Singer

★ Wesley J. Smith

★ Moshe David Tendler

★ Etienne Vermeersch

★ Eliezer Waldenberg

★ William J. Winslade

★ Matthew K. Wynia

★ Stuart J. Youngner

★ Laurie Zoloth

References

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Further reading

★ Against Bioethics, , Baron, Jonathan, The MIT Press, 2006, ISBN 978-0-262-02596-6

★ Bioethics: Ancient Themes in Contemporary Issues, , Mark G., Kuczewski, The MIT Press, 2002, ISBN 978-0-262-61177-0

★ Pragmatic Bioethics, 2nd Edition, , McGee, Glenn (ed.), The MIT Press, 2003, ISBN 978-0-262-63272-0

★ Ethics for Life Scientists, , Michiel, Korthals, , 2004, ISBN 978-1-4020-3178-6

★ Case Studies in Biomedical Research Ethics, , Timothy, Murphy, The MIT Press, 2004, ISBN 978-0-262-13437-8

External links

★ International Association of Bioethics

★ WHO Global bioethics calendar

★ American National Reference Center for Bioethics Literature

★ Bioethics for Latin America and Colombia

★ EURETHICS (European database on ethics in medicine) and ENDEBIT (European database on ethics in non-medical technologies)

★ German Reference Centre for Ethics in the Life Sciences (DRZE)

★ BELIT: an extensive world-wide bibliographic directory of literature in the area of bioethics, containing references to monographs, grey literature, legal documents, journal articles, newspaper articles and book contributions

★ BEKIS The Bioethics Communication and Information System

★ Nutritional Genomics (NuGO) Bioethics Online Tool

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★ Universal Declaration on the Human Genome and Human Rights

★ International Declaration on Human Genetic Data

★ Universal Declaration on Bioethics and Human Rights

★ The Bio-Medical Ethics Reference Server at Stanford University

★ BioEthics Defense Fund, Human Rights from Beginning to End
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