Introduction To Bioethics We know Bio = life Ethos = behavior/character ….but what is that really? Ethics is quite complicated.

How do you define Ethics? Many varied definitions… What does it mean to you? Ethics - sometimes used as synonyms for “morally correct” or justified - set of justified moral principles of obligation, rights, and ideals Ethics - can be particular beliefs or attitudes concerning morality Ethics - area of study or inquiry – an activity of understanding moral values, resolving moral issues, and justifying moral judgments

Values, Morals, Ethics Values signify what is important and worthwhile. They serve as a basis for moral codes and ethical reflection. Morals are codes of conduct governing behavior. They are values put into practice as actions. Ethics provide a systematic, rational way to work through dilemmas and to determine the best course of action in the face of conflicting choices.

Ethics is related to morals and values. What are moral values? What is morality? Dictionary says – concerns right and wrong, good and bad, the rules that ought to be followed. Latin MOS = custom Morality – about reasons centered in respect for other people as well as ourselves, reasons that involve their good as well as our own. Are everyone’s morals the same? (Guantanemo) Different cultures? (Persian King) Different times? (slavery)

Tuskeegee Experiment This study began with good intentions; it shifted from being about helping those afflicted with the disease to becoming a study about the effects of untreated syphilis on live patients. Free medical care, food and transportation, burial stipend (if autopsy was allowed), 1932 to 1972 !! (penecillin invented in 1947

Nazi experimentation and Eugenics movement Nazi scientists and doctors did all sorts of experiments done, mostly on Jews, to show effects of freezing, poisons, head trauma, malaria, and others involving twin studies. Eugenics was trying to make the genes of humans “better”, more “pure”.

DDTpesticide Banned in U.S. Concentrates in food chain (biological magnification Nerve toxin Causes cancer and other diseases Silent Spring by Rachel Carson

Why is bioethics important? Realization that ‘not everything goes’: –Tuskegee Syphilis Experiment ( ) –Nazi human experimentation (Nuremberg Trials, ) – Eugenics –DDT (Rachel Carson’s ‘Silent Spring’) Scientists did not necessarily feel they were being unethical in these incidences at the time. Therefore: need for justifications and shared guidelines

How are ethics and law related? Legal & Ethical Illegal & Ethical Illegal & Unethical Legal & Unethical

Developing a Well- Reasoned Response to a Moral Dilemma Moral dilemmas are situations in which two or more moral obligations, rights, or ideals come into conflict with one another. Figure out: Who are the stakeholders. What are the options? What are your justifications? Are they weak or strong reasons? How does one decide whether a response is well- reasoned? What criteria apply? How can we reliably judge?

Roles of Codes of Conduct Shared Standards Positive Support to Act Ethically Guidance Concerning Obligations Motivation to be ethical Education to be ethical Deterrence to being unethical Personal Discipline Professional Image

Basic Principles to be taken into consideration (can be at odds with each other) Non-maleficience (do no harm) Beneficence (do good) Justice (be fair) Truthfulness Confidentiality (doctor/patient) Autonomy ( capacity of a rational individual to make an informed, un-coerced decision)

How to solve an ethical problem…. Consensus?Consensus? –Based on reason –Genuine debate –Takes ethical traditions into account –Open to criticism, refutation and the possibility of change and exchange of ideas –It is not majority opinion as it often needs to protect the minority –Takes time –NOT SOLVED IN ISOLATION!

What is an Ethical Question? And what is not? Ethical questions have the following components: Ethical questions often involve the words ought or should. There are several alternate solutions, none of that is without some challenging or problematic aspect.

They contain conflicting moral choices and dilemmas, and the underlying values of the people involved may clash. They have no right or wrong answer which satisfies all parties, but better or worse answers based on well- reasoned justifications.

Are the following questions of law, science, personal preference, culture, religion, or ethics? a) Is it legal to sell human kidneys in the United States? b) How does a kidney function inside the body? c) What does my religion say about whether or not it is acceptable to donate a kidney? d) Should individuals who donate a kidney choose who their organ should go to?

e) What type of diet allows for the best athletic performance? f) Is killing someone always illegal? g) Should people select the sex of their child in advance? h) Are same-sex marriages constitutional? i) What is the most appropriate way to worship? j) Do kidneys taste good?

Practicing Reasoning and Justification In-Class Discussions How should we decide who receives organ transplants? Should a terminally ill patient be allowed to end his/her life with physician- prescribed medication? Who should get the limited flu vaccination? (worksheet)

Sample Cases Small Group Discussion: –Using the sample cases provided, fill out the in-class discussion worksheet and write any comments on the back –After groups have completed this exercise, groups will report back to the class on their findings

After the cases, can you define ethics and bioethics? have you tried one approach to developing a well-reasoned response to a moral dilemma? choose a bioethics topic and present information about it. Due Monday, January 14…see instructions with rubric