Bioethics is the philosophical study of the ethical Ethics is a branch of philosophy that addresses questions about morality—that is, concepts such as good vs. bad, noble vs. ignoble, right vs. wrong, and matters of justice, love, peace, and virtue controversies brought about by advances in biology Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy and medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions. Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy, biotechnology Biotechnology is a field of applied biology that involves the use of living things in engineering, technology, medicine, and other useful applications. Modern use similar term includes genetic engineering as well as cell- and tissue culture technologies. The concept encompasses a wide range of procedures for modifying living organisms according to, medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions, politics Politics is a process by which groups of people make collective decisions. The term is generally applied to behavior within civil governments, but politics has been observed in other group interactions, including corporate, academic, and religious institutions. It consists of "social relations involving authority or power" and refers to, law Law is a system of rules, usually enforced through a set of institutions. Laws can shape or reflect politics, economics and society in numerous ways and serves as a primary social mediator of relations between people. Contract law regulates everything from buying a bus ticket to trading on derivatives markets. Property law defines rights and, and philosophy Philosophy is the study of general and fundamental problems concerning matters such as existence, knowledge, values, reason, mind, and language. It is distinguished from other ways of addressing fundamental questions by its critical, generally systematic approach and its reliance on rational argument. The word "philosophy" comes from the.

Contents

History

Terminology

The term Bioethics (Greek Greek , an independent branch of the Indo-European family of languages, is the language of the Greeks. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. In its ancient form, it is the language of classical ancient Greek literature and the New Testament of bios, life; ethos, behavior) was coined in 1927 by Fritz Jahr, who "anticipated many of the arguments and discussions now current in biological research Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy involving animals" in an article about the "bioethical imperative," as he called it, regarding the scientific use of animals and plants.[1][2] In 1970, the American biochemist Van Rensselaer Potter also used the term with a broader meaning including solidarity towards the biosphere, thus generating a "global ethics," a discipline representing a link between biology, ecology, medicine and human values in order to attain the survival of both human beings and other animal species.[3][4]

Development of a discipline

Although bioethical issues have been debated since ancient times, and public attention briefly focused on the role of human subjects in biomedical experiments following the revelation of Nazi experiments conducted during World War II, the modern field of bioethics first emerged as an academic discipline in Anglophone societies in the 1960s. Technological advances in such diverse areas as organ transplantation An organ transplant is the moving of an organ from one body to another, or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of Regenerative medicine is allowing scientists to engineer organs to be re-grown from the patient's own cells and end-of-life care, including the development of kidney dialysis and respirators, posed novel questions regarding when and how care might be withdrawn. Furthermore, as philosophy in Britain and elsewhere moved away from the influences of logical positivism and emotivism, the development of theories of ethics and their application to practical problems gained in interest. These questions were often discussed by philosophers and religious scholars; in England, there were notable contributions from GEM Anscombe G. E. M. Anscombe , born Gertrude Elizabeth Margaret Anscombe, but better known as Elizabeth Anscombe, was a British analytic philosopher. A student of Ludwig Wittgenstein, she became an authority on his work and edited and translated many books drawn from his writings, above all his Philosophical Investigations. She wrote on the philosophy of and RM Hare. By the 1970s, bioethical think tanks and academic bioethics programs had emerged. Among the earliest such institutions were the Hastings Center The Hastings Center, founded in 1969, is an independent, non-partisan, non-profit bioethics research institute based in the United States. It is dedicated to the examination of essential questions in health care, biotechnology, and the environment. The center has over 200 fellows, including many physicians, attorneys, PhDs and bioethicists (originally known as The Institute of Society, Ethics and the Life Sciences), founded in 1969 by philosopher Daniel Callahan and psychiatrist Willard Gaylin, and the Kennedy Institute of Ethics, established at Georgetown University Georgetown University is a Jesuit private university located in Georgetown, Washington, DC. Father John Carroll founded the school in 1789, though its roots extend back to 1634. While the school struggled financially in its early years, Georgetown expanded into a branched university after the American Civil War under the leadership of university in 1971. The publication of Principles of Biomedical Ethics by James F. Childress and Tom Beauchamp—the first American textbook of bioethics—marked a transformative moment in the discipline.

During the subsequent three decades, bioethical issues gained widespread attention through the court cases surrounding the deaths of Karen Ann Quinlan Karen Ann Quinlan was an important person in the history of the right to die controversy in the United States, Nancy Cruzan Nancy Beth Cruzan was a figure in the right-to-die movement. After an auto accident left her in a persistent vegetative state, her family petitioned in courts for three years, as far as the U.S. Supreme Court (Cruzan v. Director, Missouri Department of Health), to have her feeding tube removed. The Court initially denied the family's request, and Terri Schiavo The Terri Schiavo case was a seven-year long legal case that revolved around whether Terri Schiavo — diagnosed as being in a persistent vegetative state (PVS) for several years — could be disconnected from life support. As early as 1993, Michael, as Terri's guardian, had entered a do not resuscitate order for her but was convinced by the. The field developed its own cadre of widely-known advocates, such as Al Jonsen at the University of Washington, John Fletcher at the University of Virginia, Jacob M. Appel Jacob M. Appel is an American author, bioethicist and social critic. He is best known for his short stories, his work as a playwright, and his writing in the fields of reproductive ethics, organ donation, neuroethics and euthanasia at Brown University, Ruth Faden at Johns Hopkins University, and Arthur Caplan Arthur L. Caplan PhD, is Emanuel and Robert Hart Professor of Bioethics and director of the Center for Bioethics at the University of Pennsylvania. Prior to coming to Penn in 1994, Caplan taught at the University of Minnesota, the University of Pittsburgh, and Columbia University. He was the Associate Director of the Hastings Center from 1984-1987 at the Center for Bioethics at the University of Pennsylvania. In 1995, President Bill Clinton William Jefferson "Bill" Clinton was the 42nd President of the United States from 1993 to 2001. At 46 he was the third-youngest president. He became president at the end of the Cold War, and was the first baby boomer president. His wife, Hillary Rodham Clinton, is currently the United States Secretary of State. Each received a Juris established the President's Council on Bioethics, a sign that the field had finally reached maturity and acceptance in the United States of America. President George W. Bush George Walker Bush ( /ˈdʒɔrdʒ ˈwɔːkər ˈbʊʃ/ ; born July 6, 1946) was the 43rd President of the United States, serving from 2001 to 2009, and the 46th Governor of Texas, serving from 1995 to 2000 also relied upon a Council on Bioethics The President's Council on Bioethics was a group of individuals appointed by United States President George W. Bush to advise his administration on bioethics. Established on November 28, 2001, by Executive Order 13237, the Council was directed to "advise the President on bioethical issues that may emerge as a consequence of advances in in rendering decisions in areas such as the public funding of embryonic stem-cell research.

Purpose and scope

The field of bioethics has addressed a broad swath of human inquiry, ranging from debates over the boundaries of life (e.g. abortion Abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death. An abortion can occur spontaneously due to complications during pregnancy or can be induced, in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health, euthanasia Euthanasia (from the Greek εὐθανασία meaning "good death": εὖ, eu + θάνατος, thanatos (death)) refers to the practice of ending a life in a manner which relieves pain and suffering. According to the House of Lords Select Committee on Medical Ethics, the precise definition of euthanasia is "a deliberate) to the allocation of scarce health care resources (e.g. organ donation Organ donation is the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting. Organs and tissues are removed in procedures similar to surgery. People of all ages may be organ and tissue donors, health care rationing) to the right to turn down 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 Technology is a term referring to whatever can be said at any particular historical period, concerning the state of the art in the whole general field of practical know-how and tool use. It therefore encompasses all that can be said about arts, crafts, professions, applied sciences, and skills. By extension it can also refer to any systems or 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 of a bear in relation to medicine and biology. However, most bioethicists share a commitment to discussing these complex issues in an honest, civil and intelligent way, using tools from the many different disciplines that "feed" the field to produce meaningful frameworks for analysis.

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 The Belmont Report is a report created by the former United States Department of Health, Education, and Welfare entitled "Ethical Principles and Guidelines for the Protection of Human Subjects of Research" and is an important historical document in the field of medical ethics. The report was created on April 18, 1979 and gets its name (1979)--namely, autonomy In the subfield of Sociology called Sociology of knowledge, controversy over the boundaries of autonomy stopped at the concept of relative autonomy , until a typology of autonomy was created and developed within science and technology studies (MARANHÃO, 2005; 2006; 2007; SOBRAL & MARANHÃO, 2008). According to it, the contemporary form of, beneficence Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology and justice Justice is the concept of moral rightness based on ethics, rationality, law, natural law, religion, fairness, or equity, along with the punishment of the breach of said ethics--have influenced the thinking of bioethicists across a wide range of issues. Others have added non-maleficence, human dignity Dignity found its way into English through French from Latin before the Renaissance. At that time, dignity was a quality akin to nobility, majesty, and wonderfulness, and philosophers granted dignity to assorted ideas and to various beings. In the 1700s, Immanuel Kant said dignity was being granted to too many ideas and beings. He insisted that a and the sanctity of life to this list of cardinal values.

Medical ethics

Main article: Medical ethics Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as they apply to medicine. 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 is the study of moral values Value theory encompasses a range of approaches to understanding how, why, and to what degree humans should value things, whether the thing is a person, idea, object, or anything else. This investigation began in ancient philosophy, where it is called axiology or ethics. Early philosophical investigations sought to understand good and evil, and the and judgments as they apply to medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions. 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 appears to have worked more expansive concerns, touching upon the philosophy of science The philosophy of science is concerned with the assumptions, foundations, methods and implications of science. In addition to these central problems for science as a whole, many philosophers of science consider these problems as they apply to particular sciences . Some philosophers of science also use contemporary results in science to draw and issues of biotechnology Biotechnology is a field of applied biology that involves the use of living things in engineering, technology, medicine, and other useful applications. Modern use similar term includes genetic engineering as well as cell- and tissue culture technologies. The concept encompasses a wide range of procedures for modifying living organisms according to. Still, 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 Health care or healthcare is the treatment and prevention of illness. Health care is delivered by professionals in medicine, dentistry, nursing, pharmacy and allied health ethics, such as nursing ethics Nursing ethics is a branch of applied ethics that concerns itself with activities in the field of nursing. Nursing ethics shares many principles with medical ethics, such as beneficence, non-maleficence and respect for autonomy. It can be distinguished by its emphasis on relationships, maintaining dignity and collaborative care.

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 Peter Singer Peter Albert David Singer is an Australian philosopher. He is the Ira W. DeCamp Professor of Bioethics at Princeton University, and laureate professor at the Centre for Applied Philosophy and Public Ethics (CAPPE), University of Melbourne. He specialises in applied ethics, approaching ethical issues from a secular preference utilitarian of Princeton University, Daniel Callahan of the Hastings Center The Hastings Center, founded in 1969, is an independent, non-partisan, non-profit bioethics research institute based in the United States. It is dedicated to the examination of essential questions in health care, biotechnology, and the environment. The center has over 200 fellows, including many physicians, attorneys, PhDs and bioethicists, 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 Jacob Appel and Wesley J. Smith Wesley J. Smith is a lawyer and an award winning author, a Senior Fellow in Human Rights and Bioethics at the Discovery Institute, associate director of the International Task Force on Euthanasia and Assisted Suicide, and a special consultant for the Center for Bioethics and Culture. In 2004 he was named by the National Journal as one of the, political economists like Francis Fukuyama Yoshihiro Francis Fukuyama is an American philosopher, political economist, and author, and theologians including James Childress. The field, once dominated by formally trained philosophers, has become increasingly interdisciplinary An interdisciplinary field is a field of study that crosses traditional boundaries between academic disciplines or schools of thought, as new needs and professions have emerged, 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 American Journal of Bioethics, Hastings Center Report Since 1971, the Hastings Center Report has been one of the leading journals of bioethics in the United States. It is published six times each year by the Hastings Center in Garrison, New York. Gregory Kaebnick is the current editor, the Journal of Medical Ethics The Journal of Medical Ethics has been a leading journal in the field of bioethics since its founding in 1975. The journal is based in England. Its editors, as of 2010, are Søren Holm of Cardiff University and John Harris of the University of Manchester and the Cambridge Quarterly of Healthcare Ethics The Cambridge Quarterly of Healthcare Ethics is a leading journal in the field of bioethics. The current editors are Thomasine Kushner of the University of California at Berkeley and Steve Heilig of the San Francisco Medical Society.

Many religious communities have their own histories of inquiry into bioethical issues and have developed rules A moral is a message conveyed or a lesson to be learned from a story or event. The moral may be left to the hearer, reader or viewer to determine for themselves, or may be explicitly encapsulated in a maxim. As an example of the latter, at the end of Aesop's fable of the Tortoise and the Hare, in which the plodding and determined tortoise wins a and guidelines A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, on how to deal with these issues from within the viewpoint Perspective in theory of cognition is the choice of a context or a reference from which to sense, categorize, measure or codify experience, cohesively forming a coherent belief, typically for comparing with another. One may further recognize a number of subtly distinctive meanings, close to those of paradigm, point of view, reality tunnel, umwelt, 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 the leading bioethicist speaking from the Hindu tradition. In Africa, and partly also in Latin America, the debate on bioethics frequently focusses on its practical relevance in the context of underdevelopment and geopolitical power relations.

See also

Issues

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

References

  1. ^ Lolas, F. (2008). Bioethics and animal research: A personal perspective and a note on the contribution of Fritz Jahr. Biol. Res., Santiago, 41(1), 119-123. Available in <http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-97602008000100013&lng=es&nrm=iso>, accessed on Jan 15, 2010. doi: 10.4067/S0716-97602008000100013.
  2. ^ Sass, H. M. (2007). Fritz Jahr's 1927 concept of bioethics. Kennedy Inst Ethics J, 17(4), Dec, 279-295.
  3. ^ Lolas, F., op. cit.
  4. ^ Goldim, J. R. (2009). Revisiting the beginning of bioethics: The contribution of Fritz Jahr (1927). Perspect Biol Med, Sum, 377-380.

Further reading

General bioethics

Christian bioethics

Jewish bioethics

Muslim bioethics

Buddhist bioethics

Hindu bioethics

Legal cases in medical ethics
Andrew Bedner · Betancourt v. Trinitas · Tony Bland · Mordechai Dov Brody · Coleman v. Lantz · Betty and George Coumbias · Dax Cowart · Carol Carr · Nancy Cruzan · Doctors' Trial · Eluana Englaro · Tirhas Habtegiris · June Hartley · Rom Houben · Sun Hudson case · Baby K · Jack Kevorkian · Jesse Koochin · Robert Latimer · Moore v. Regents of the University of California · Spiro Nikolouzos · Giovanni Nuvoli · Karen Ann Quinlan · Sue Rodriguez · Ramón Sampedro · Terri Schiavo case · Tuskegee syphilis experiment · Jana Van Voorhis · Piergiorgio Welby Willowbrook State School ·
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A. "Bioethics as a distinct field of academic study has existed only since the early 1960s, and its history can be traced back to a cluster of scientific and cultural developments in the United States during that decade. The catalysts for the creation of this interdisciplinary field were the extraordinary advances in American medicine during this period coupled simultaneously with radical cultural changes. Organ transplantation, kidney dialysis, respirators, and intensive care units (ICUs) made possible a level of medical care never before attainable, but these breakthroughs also raised daunting ethical dilemmas the public had never previously been forced to face, such as when to initiate admission to an ICU or when treatments such as… [cont.]
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