BIOETHICS
Hospitals and other healthcare
institutions consult with ethicists. They've also advised federal and state
governments on issues including ending life support, genetic testing,
physician-assisted suicide, and other issues. Even in the commercial realm of science,
bioethics has become a part of the landscape.
Biotechnology companies are
increasingly consulting with biomedical ethicists about their business and
research methods. More than 25 universities in the United States and Canada
offer medical ethics degrees. In many cases, the subject is also covered in
physician and other healthcare professional education programs. Many medical
schools provide ethics courses that cover issues including moral
decision-making theories and the ethical conduct of medical research.
MANY DIFFERENT DEFINITIONS
Bioethics is defined as follows,
depending on who created the definition:
·
The study of the ethical
and moral consequences of new biological discoveries and biomedical
breakthroughs, such as genetic engineering and drug development.
·
The branch of ethics,
philosophy, and social commentary concerned with life sciences and their
possible social implications.
·
In the fields of biology
and biotechnology, the study of value judgments relating to human behavior.
·
The investigation and
evaluation of what is right and wrong in biological advances and activities
such as genetic engineering, organ transplantation, and end-of-life care.
·
The study of the moral and
ethical decisions that scientists and doctors must make in medical research and
patient care.
·
Biology is linked with a
variety of humanistic knowledge to form a science that establishes a system of
medical and environmental goals for acceptable survival.
·
The study of moral and
ethical issues relating to life, health, science, medicine, and the
environment.
There is no easy definition for
this extremely complicated issue. Even though there appear to be as many
definitions as definers, most scientists and ethicists believe that bioethical
debates revolve around the concept of "right vs. right," rather than
"right vs. bad."
FRAMEWORKS OF ETHICS
Medical ethics can be traced back
to several early codes of ethics, including the ancient Greek Hippocratic Oath
for physicians and the Caraka Samhita, a Sanskrit text written in India around
2,000 years ago that urged physicians to "strive for the relief of the
patient with all your heart and soul, day and night, however, you may be
engaged." The code of ethics written by English physician Thomas Percival
in the 18th century served as the foundation for the first code of ethics,
established in 1846 by the founders of the American Medical Association; and
the Nuremberg Code for research ethics on human subjects, which was established
during the Nuremberg Trials.
This was founded at the end of
World War II during the war crimes trials. The introduction of new medical and
reproductive technology after the 1950s further compounded the moral and
societal challenges surrounding scientific research and practice
Medical ethicists have attempted
to build distinct ethical frameworks and methods to properly analyze medical
issues and make decisions. Principles, or the Four Principles Approach, is a
theory developed in the late 1970s by American philosopher Tom Beauchamp and
American theologian James Childress.
In this system, biomedical
ethical decisions are made by weighing the importance of four separate
elements: (1) individual autonomy and the right to make their own decisions and
beliefs; (2) the principle of beneficence, with the primary goal of helping
people; (3) the related principle of nonmaleficence, or refraining from harming
people; and (4) justice, or distributing burdens and benefits fairly. Beauchamp
and Childress were also members of the 27-member committee that drafted the
Department of Health and Human Services' major historical paper Ethical
Principles and Guidelines for the Protection of Human Subjects. The Belmont
Report (named after the conference center where it was created) was published
in 1979 and established the values of respect, beneficence, and justice as the
cornerstones for rules involving human participants in medical research.
While some medical ethicists
adhere to principles, others use a case-based approach known as casuistry. When
faced with a difficult bioethical situation, casuists try to imagine a similar
but simpler scenario in which almost anybody could agree on a solution.
Casuists work their way through a hypothetical issue by weighing solutions. There
are numerous bioethical systems, including casuistry and principles. Each
approach has its supporters, and disagreements and debates are common among the
various schools of thought. Nonetheless, each strategy is an attempt to address
sensitive, conflicting concerns that occur frequently in the complex and
contentious field of medicine.
Medical advances have presented
individuals, their families, and the health professionals who care for them
with new and challenging moral choices. Scientists and physicians are
confronted with new and exciting alternatives for saving lives, transferring
organs, and expanding research, but they must also grapple with new and
unpleasant decisions, such as who should receive scarce and critical treatment
and how we define when life ends.
THE BIOETHICIST'S POSITION
While bioethics has its roots in
philosophy, it now encompasses a wide range of disciplines, including law,
medicine, biology, genetics, environmental toxicology, public health,
pharmaceuticals, stem cell research, biotechnology, politics, sociology, and business.
Bioethical challenges have become more widespread in recent years because new
medical technology has overtaken his ability to comprehend their ramifications.
Bioethicists have traditionally
dealt with tough medical issues, but their role has increased as an understanding
of genetics and biotechnology has grown.
Cloning, the use of fetal
tissues, and crop genetic engineering are all concerns that need ethical
considerations. The recent explosion in biomedical, bioengineering, and biotechnology
research has generated an unprecedented necessity for our society to tackle the
new and difficult ethical issues that have arisen.
Bioethics is the study of growing
moral dilemmas involving human health and biological systems and their analysis
using the principles established by the community's value system. These
principles don't always demand a single "moral" course of conduct,
but they do provide a framework for weighing and deciding between competing
possibilities.
DECISION-MAKING IN BIOETHICS
In bioethics, decision-making
happens when an individual or group of individuals is faced with a bioethical
issue that necessitates a choice between two or more seemingly opposing
outcomes. Each of these conceivable possibilities frequently has both positive
and bad implications. Bioethicists examine the following paradigms when making
decisions:
Community versus. Individual
Individual wants and interests
are measured against the needs and interests of the community under this
paradigm.
Long-Term vs. Short-Term
The costs and benefits that will
come in the short term are compared against the costs and advantages that will
arise in the long run in this paradigm.
Mercy vs. Justice
The need for appropriate justice
is evaluated against the need for appropriate charity in this paradigm.
Each of these paradigms denotes a
distinct conflict between opposing values. The majority of decision-making
strategies fit into one of three general categories:
·
Ends-Based Reasoning is
based on the premise of "doing the most good for the most people."
·
Rule-Based Reasoning: Is
guided by the rules that govern how people in the community act in general.
·
Concern for others serves
as the guiding concept for making moral decisions.
CONSIDERATIONS OF ETHICS AND SOCIETY
Why should we be concerned with
bioethical concerns? The rapid advancement of biotechnology is exceeding our
ability as a society to comprehend how these new technologies will affect our
lives. Cloning, stem cell research, in vitro fertilization, and prenatal
diagnosis of genetic diseases are just a few of the important and wide-ranging
concerns we're dealing with right now. Biotechnology advancements will have a
significant impact on what it means to be human and how we spend our lives.
Politics (public policy, law, and resource control), spirituality ("What
is life?" and "What does it mean to be human?") and culture
("What implications do our genetic makeups reveal?" and "What
are the implications of new technology for culture?") will all be
affected.
The necessity for thoughtful
engagement in bioethical decision-making has become increasingly urgent as a
result of these recent, unprecedented advancements. Because the burden of
creating accepted procedures lies on all of us, this need extends beyond the
professional communities of the bioengineering and biotechnology industries to
encompass all parts of society. Our society’s citizens must be intellectually
prepared to tackle this challenge.
In its National Science Education
Standards, the National Academy of Sciences has highlighted this obligation in
a wide sense:
1. Science and technology are vital social businesses, but they can
only predict what might happen, not what should. The latter entails human judgments
regarding the use of knowledge.
2. Understanding basic scientific anciency concepts and principles
should come before engaging in the active debate regarding the economics,
policies, politics, and ethics of many science and technology-related concerns.
Understanding science, on the other hand, will not solve local, national, or
global problems.
3. Social difficulties and obstacles can have an impact on
scientific and technological progress. Examples of how social issues influence
science and technology include funding priorities for specific health problems.
4. Individuals and society must make decisions about ideas
including new research and the adoption of new technology. Decisions entail
weighing alternatives, risks, costs, and advantages, as well as determining who
benefits and who suffers, who pays and who gains, and who bears the risks.
5. Ethical decision-making requires us to consider the advantages
and disadvantages of a situation from several perspectives. There is no
"correct" or "incorrect" response. The focus is on the
process of arriving at an acceptable solution that allows all stakeholders to
participate.
A CONTINUAL CHALLENGE
Biotechnology issues can
challenge profoundly held ethical, spiritual, and cultural ideas and
traditions. Risk is linked to some ethical concerns. "What amount of
danger is acceptable?" and "Who decides?" are two examples. and
"Whose risk is it? “Individuals, as well as public health and ecosystems,
are affected by these risks and benefits. What are the best uses for genetic
alteration technology? Who, and under what circumstances? Are there certain
activities that should never be permitted, even if the safety concerns can be
addressed? Issues can also test our social and cultural beliefs about the
intrinsic value of organisms, as well as our decisions about having children
and starting families.
Throughout the twenty-first
century, medical ethicists will encounter a variety of concerns, including
developments in cloning technology, new knowledge of the human brain, and the
amount of genetic data from the Human Genome Project. Global population shifts
will have an impact on medicine and pose questions about medical ethics. The
number of Americans over the age of 65 is predicted to double by 2020. The aging
of the population is almost guaranteed to increase demand on the United States'
healthcare system, and thus healthcare costs. And, as the population of elderly
people grows, ethical challenges around end-of-life issues are likely to become
increasingly common.
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