1. Definition and history
Bioethics
Definition and history

2. 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

3. “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

4. 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

5. Pre-1960s Paternalistic medicine Utilitarian thinking
Not focused on individual/human rights
World of medicine sacrosanct
Cultural and political authority

6. 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

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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 with new book; criticized for abuses in Middle Ages

14. Sources http://www.bucklin.org/bioethics-history.htm
Fall%202008%20pdfs/HISC116FA2008.pdf
Bioethics: an introduction to the history, methods, and practice
By Nancy Ann Silbergeld Jecker, Albert R. Jonsen, Robert A. Pearlman