BIOETHICS

Definition and history

Our bioethics projects end in… An analytical ESSAY.

How does the field of bioethics shape the world today? Make an analytical assessment 4 – 5 pages Specific evidence from presentations Reference history and general field of bioethics Bibliography only for sources outside of class Due at the end of presentations: TBA

“Bioethics”

Coined in 1970 by Van Rensselear Potter Atomic bomb & human genome

developments: social implications? Became a narrower field: ethical analysis

of moral questions posted to medicine by biomedical advances

Expectations of Moral Physicians What are the general duties and

decorum expected of moral physicians? Competent Dedicated Kept confidences Cared for sick poor without charge

Pre-1960s

Paternalistic medicine Utilitarian thinking Not focused on individual/human rights World of medicine sacrosanct

Cultural and political authority

Mid-20th century changes

Science brings more effective treatments More people have access to physicians Physicians more competent, educated

Earned more $$ Rights-based movements

Civil Rights Movement Second Wave Feminism War protests

Challenge old ideas about medical morality & patient rights

Advances: life sustaining technology Artificial ventilators 1950s

Pope Pius XII weighs in 1957 Artificial kidney 1961

“God Committee” social utility vs lottery

Chronic dialysis Finances, quality of life questions, public

policy Federal legislation: financial support for end

of life treatment

1970s, national attention:

1973: information surfaces about immature newborn infants with dim prognosis allowed to die

1973: 21 year old in coma with respirator whose parents want to disconnect; hospital refused—went to NJ Supreme Court

Karen Ann Quinlan

Other Bioethics topics arise

1950s: human medical research topic explodes (Rebecca)

1956: double helix structure of DNA – “secret” of life—modification of human genes? Cloning? (designer babies: Sophia)

1970s: genetic testing (Jackie)

And…

1989: program to map the human genome initiated

1997: Dolly, the cloned lamb born

By 2000: stem cell isolated from human embryos (Rachel) Bush, 2001: Bioethics

Advisory Council to advise on cloning and stem cell research

More bioethics topics!

1968: first heart transplant Ethical issues?

Human reproduction Artificial insemination: 1884 Chemical contraceptives: 1950s In vitro fertilization: 1979

Then other manipulations of embryo

Bioethics field

By end of the 1980s, developed field of bioethics: centers, curricula in universities, journals, courses, conferences, ethics committees in hospitals, etc.

Now: political role of bioethics? Harrison & Ben: AIDS Lucas & Aaron: Alternative Health Chloe: Conscience Clause Skyler: Biochemical Warfare Zur & Elliana: Healthcare Ethics

Current debate: bioethics

System of ethics based on the four moral principles of: 1. Autonomy 2. Beneficence 3. Nonmalficence 4. Justice

Formalized by the Belmont Report in 1979, cause of origin from Nuremberg Trials

Case-based reasoning Applies theoretical rules to

specific instances, but then bends rules if case justifies it Utilitarianism form of casuistry

Often sees how closely a case matches a paradigm, then applies rules based on match

Dates from Aristotle, revival in 1988 with new book; criticized for abuses in Middle Ages

Principlism Casuistry

Sources

http://www.bucklin.org/bioethics-history.htm

http://historyweb.ucsd.edu/pages/undergraduate/Fall%202008%20pdfs/HISC116FA2008.pdf

http://en.wikipedia.org/wiki/Casuistry http://en.wikipedia.org/wiki/Principlism Bioethics: an introduction to the

history, methods, and practice By Nancy Ann Silbergeld Jecker, Albert R.

Jonsen, Robert A. Pearlman