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What is Bioethics? + History of Bioethics, Normative Ethics, and Principlism

What is Bioethics?

  • BioethicsBioethics$$Bioethics$$- a field that helps us to better understand, analyze, and respond to ethical quandaries faced in medicine and medical research

    • study of value-laden issues in health and biomedicine

    • Multi-disciplinary field drawing on philosophy, theology, law and social sciences

  • ClinicalethicsClinical ethics$$Clinical ethics$$- applying ethics to understanding and resolution of healthcare dilemmas

  • ResearchethicsResearch ethics$$Research ethics$$- study of ethical issues in carrying out scientific research

    History of Bioethics, Normative Ethics, and Principlism

    History of Bioethics
    • HippocraticoathHippocratic oath-$$Hippocratic oath-$$ set of rules about ethical practice

    • parts of these have changed

    • Do not prescribe lethal substances → this has also changed

    • Do not perform abortions → this has changed

      • Change is based on medical progress  & changing philosophy on abortion

    • Keep patients’ privacy

    • Maintain high moral character → clinicians posting on social media?

    • Do not perform proper surgery without proper training

    • Bioethics as an academic discipline is somewhat new

    • Arose w/ scientific medicine

    • Based on ethical issues in mid-20th century

      • Nazi and Japanese medical experiments in WWII

      • Tuskegee syphilis experiment

      • study abt syphilis in black men, people wanted to see if it went untreated

      • Researchers withheld available treatments from them

    • 1960s forward- bioethics solidified as an academic field in response to these problems

    • Now bioethics is in

    • Academic departments

    • grad/undergrad/professional programs

    • Clinical ethics in hospitals

    • Institutional review boards

    Normative Ethics
    • NormativeethicsNormative ethics$$Normative ethics$$- a branch of philosophy concerned with the formulation of criteria for what is morally right and wrong

    • Based on philosophical theory

    • Need to make generalizable principles guiding ethical behavior

    • Different approaches

      • DeontologyDeontology$$Deontology$$- what is “inherently” right?

      • TeleologyTeleology$$Teleology$$- what “good” will come from certain actions?

      • UtilitarianismUtilitarianism$$Utilitarianism$$- what actions will do the “most good” for the greatest number of people?

    • Critiques

      • doesn’t take into account specific cultural contexts bc different cultures/social groups have distinct beliefs about what is “moral”

      • Can be exclusionary/problematic

    Principlism
    • PrinciplismPrinciplism$$Principlism$$- approach in normative biomedical ethics where 4 key principles are used to resolve and better understand particular cases

    • RespectforautonomyRespect for autonomy$$Respect for autonomy$$

      • Respecting that individuals have the right to make their own decisions around their health

      • Clinicians can’t make these choices for patients

      • ConsentConsent$$Consent$$- informing patients of all aspects of treatment to enable them to make the most informed decision

    • NonmaleficenceNon-maleficence$$Non-maleficence$$

      • “Do no harm” to patients

      • Treatments shouldn’t lead to undue harm to a pt

      • Inform patients of risks if harm may occur

    • BeneficenceBeneficence$$Beneficence$$

      • Acting in best interests of a patient’s health; striving to “do good” on their behalf

      • Best interests may have some level of risk

    • JusticeJustice$$Justice$$

      • Ensuring medical decisions are fair

      • Ensuring distribution of scarce medical resources is fair across populations

      • Making difficult decisions about how to best distribute limited resources


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What is Bioethics? + History of Bioethics, Normative Ethics, and Principlism

What is Bioethics?

  • BioethicsBioethics- a field that helps us to better understand, analyze, and respond to ethical quandaries faced in medicine and medical research

    • study of value-laden issues in health and biomedicine
    • Multi-disciplinary field drawing on philosophy, theology, law and social sciences
  • ClinicalethicsClinical ethics- applying ethics to understanding and resolution of healthcare dilemmas

  • ResearchethicsResearch ethics- study of ethical issues in carrying out scientific research

    History of Bioethics, Normative Ethics, and Principlism

    History of Bioethics

    • HippocraticoathHippocratic oath- set of rules about ethical practice
    • parts of these have changed
    • Do not prescribe lethal substances → this has also changed
    • Do not perform abortions → this has changed
      • Change is based on medical progress  & changing philosophy on abortion
    • Keep patients’ privacy
    • Maintain high moral character → clinicians posting on social media?
    • Do not perform proper surgery without proper training
    • Bioethics as an academic discipline is somewhat new
    • Arose w/ scientific medicine
    • Based on ethical issues in mid-20th century
      • Nazi and Japanese medical experiments in WWII
      • Tuskegee syphilis experiment
      • study abt syphilis in black men, people wanted to see if it went untreated
      • Researchers withheld available treatments from them
    • 1960s forward- bioethics solidified as an academic field in response to these problems
    • Now bioethics is in
    • Academic departments
    • grad/undergrad/professional programs
    • Clinical ethics in hospitals
    • Institutional review boards

    Normative Ethics

    • NormativeethicsNormative ethics- a branch of philosophy concerned with the formulation of criteria for what is morally right and wrong
    • Based on philosophical theory
    • Need to make generalizable principles guiding ethical behavior
    • Different approaches
      • DeontologyDeontology- what is “inherently” right?
      • TeleologyTeleology- what “good” will come from certain actions?
      • UtilitarianismUtilitarianism- what actions will do the “most good” for the greatest number of people?
    • Critiques
      • doesn’t take into account specific cultural contexts bc different cultures/social groups have distinct beliefs about what is “moral”
      • Can be exclusionary/problematic

    Principlism

    • PrinciplismPrinciplism- approach in normative biomedical ethics where 4 key principles are used to resolve and better understand particular cases
    • RespectforautonomyRespect for autonomy
      • Respecting that individuals have the right to make their own decisions around their health
      • Clinicians can’t make these choices for patients
      • ConsentConsent- informing patients of all aspects of treatment to enable them to make the most informed decision
    • NonmaleficenceNon-maleficence
      • “Do no harm” to patients
      • Treatments shouldn’t lead to undue harm to a pt
      • Inform patients of risks if harm may occur
    • BeneficenceBeneficence
      • Acting in best interests of a patient’s health; striving to “do good” on their behalf
      • Best interests may have some level of risk
    • JusticeJustice
      • Ensuring medical decisions are fair
      • Ensuring distribution of scarce medical resources is fair across populations
      • Making difficult decisions about how to best distribute limited resources