Definition and history 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 Human reproduction 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 Principlism Casuistry 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

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