Tuesday, January 3, 2017

What is Bioethics?

Image Source: Center for Bioethics and Human Dignity


The CRISPR Drawer is a bioethics blog. But what is bioethics? 

First and foremost, bioethics is a subfield of ethics, which is a branch of philosophy concerned with determining what kinds of human conduct are right/wrong, moral/immoral, permissible/impermissible, or justified/unjustified. Its concerned with what humans "should" or "should not" do.

Stick "bio" to the front of "ethics," and you have "bioethics." "Bio" comes from the Greek bíos meaning "life," and can pertain to living organisms (like in biology), or to the course of human life (like in biography). (1)

If bioethics somewhat-literally translates to "the ethics of life," wouldn't that just be. . . ethics? Not quite, because bioethics, as an academic discipline, has a more particular meaning.

Defining bioethics and its issues
Philosophy writer Lewis Vaughn, in the textbook Bioethics: Principles, Issues, and Cases, defines bioethics as: "Applied ethics focused on health care, medical science, and medical technology." (2)

The Center for Bioethics and Human Dignity defines bioethics as "a branch of ethical inquiry that examines the nature of medical, scientific, and technological discoveries and their subsequent responsible use, with particular emphasis upon their moral implications for individuals and our common human humanity" [sic] (3).

Monash University's bioethics program describes bioethics as ethics that focuses on "the growth of scientific knowledge and technical ability in medicine, genetics and the biological sciences" as well as "the healthcare field." (4)

Based on the above, bioethics can be understood as a discipline concerned with ethical questions in medicine, biological research, genetics, biotechnology, and healthcare.

Ethical issues in medicine and healthcare can include questions about who can make medical decisions on behalf of patients, questions about the limits of patient autonomy, or questions about the scope of a doctor's oath to "do no harm." Beyond the clinic or hospital, there are also bigger societal questions about healthcare and medicine, such as questions about what kinds of medical procedures people should have a right to access or questions about how healthcare should be paid for.

Ethical issues in biological research or biotechnology can include the use of genome editing and cloning in organisms, experimenting with human embryos or stem cells, or designing clinical trials for new medicines. These concerns often focus on the bigger impact to humanity, and how such research or technological developments will benefit or harm society.

While attempting to define bioethics, its important to note that its not easy to conclusively draw defining lines between what "is" or "isn't" bioethics. Bioethics can concern itself with issues that don't fit neatly into the above categories, such as animal rights. (5)  There are also issues not generally considered to be covered by bioethics, such as climate change, that some argue should be included. (6)  Bioethics is an umbrella category that can cover or partially-cover many different topics, and the boundaries of bioethics can be always be expanded into new territory.

(For more examples of issues of interest in bioethics, the list of issues in the Bioethics article on Wikipedia and the blog archive at Bioethics.net can be helpful starting points!)

So now that bioethics has been somewhat defined, how do bioethicists ultimately decide what is right or wrong? A lot can go into ethical analysis, but here I will focus on two parts: moral theory, and research.

Moral theory
A moral theory, simply defined, tries to define or outline right or wrong action by providing a kind of moral criteria.

Utilitarianism focuses on the consequences of actions, and says that right or wrong action depends on whether the consequences maximize overall well-being in the world. (7)

Principlism focuses on four principles—autonomy, beneficence, non-maleficence, and justice—and argues that right action is guided by adherence to these principles. (8)

Deontological theories focus on moral duties or moral norms, and argues that right action is determined by acting in accordance with these duties or norms. (9)

There are other many other moral theories in addition to those mentioned above, and there can also be multiple versions of a single moral theory.

Research in bioethics
Ethical analysis relies strongly on philosophical inquiry and theory, but examining the ethics of an issue wouldn't be complete without additional background research.

If the ethical concern is a technology, understanding how it works, how it would be used, and how safe or effective it is matters a great deal when we question whether its use should or shouldn't be permitted.

If the ethical concern is a hospital policy towards patients, understanding the needs of the patient, the doctor, the healthcare provider, and the hospital could help determine whether the policy is fair.

If the ethical concern is a proposed bill regulating some aspect of medicine or healthcare, knowing the legal context, the detail and scope of the bill, and the potential consequences of its implementation could offer insight when asking whether the bill should or shouldn't be endorsed.

The additional background and contextual questions surrounding ethical issues can sometimes only be answered by science, law, history, medicine, or social science, which can make bioethics somewhat interdisciplinary in practice.

What is bioethics?

  • Bioethics is concerned with answering ethical questions in biological research, medicine, biotechnology, and healthcare.
  • Bioethics can be defined by its tradition, but can always expand into new areas.
  • Bioethics often uses moral theories to analyze the ethics of a given issue.
  • Bioethics may incorporate research from many different fields in order to formulate a fully thought-out ethical analysis.

This concludes my brief introduction to bioethics, but since this is a bioethics blog, there will certainly be more to come!

Have anything to add? Additional sources, helpful and relevant resources, and professional insights are welcome! Share in the comments below.


SOURCES

(1) Dictionary.com. [Online]. (n.d.). Bio-. [Accessed Jan 03, 2017]. Available at: http://www.dictionary.com/browse/bio-.

(2) Vaughn, L. (2013). Bioethics: Principles, Issues, and Cases. Second Edition. Oxford: Oxford University Press. 

(3) Center for Bioethics and Human Dignity. (n.d.). FAQs. [Online]. [Accessed Jan 03, 2017]. Available at: https://cbhd.org/about-cbhd/faqs.

(4) Monash University. (2016). Bioethics. [Online]. [Accessed Jan 03, 2017]. Available at: https://www.monash.edu.au/pubs/handbooks/aos/bioethics/ug-arts-bioethics.html.

(5) Blumenthal-Barby, J. S. (2014). Philosopher Calls for End to Animal Experimentation (And More): Is There a "Reasonable" Conception of Animal Rights? Bioethics.net Blog. [Online]. [Accessed Jan 03, 2017]. Available at: http://www.bioethics.net/2014/05/philosopher-calls-for-end-to-animal-experimentation-and-more-is-there-a-reasonable-conception-of-animal-rights/.

(6) Macpherson, C. C. (2013). Climate Change is a Bioethics Problem. Bioethics. [Online]. 27(6), pp. 305-308. [Accessed Dec 30, 2016]. Available at: http://onlinelibrary.wiley.com/doi/10.1111/bioe.12029/full.

(7) Savulescu, J. and Birks, D. (2012). Bioethics: Utilitarianism. eLS. John Wiley & Sons, Ltd: Chichester, pp. 1-7. [p. 1]

(8) Beauchamp, T. L. (2010). The Four Principles Approach to Health Care Ethics. In: Beauchamp, T. L. ed. Standing on Principles: Collected Essays. Oxford: Oxford University Press, pp. 35-49.

(9) Alexander, L. and Moore, M. (2016). Deontological Ethics. In: Zalta, E. N. ed. The Stanford Encyclopedia of Philosophy. 2016 Winter Edition.  [Online]. [Accessed Jan 03, 2017]. Available at: https://plato.stanford.edu/entries/ethics-deontological/#DeoThe.