Ethics is a philosophical discipline pertaining to notions of good and bad, right and wrong—our moral life in community. Bioethics is the application of ethics to the field of medicine and healthcare. Ethicists and bioethicists ask relevant questions more than provide sure and certain answers.
What is the right thing to do and the good way to be? What is worthwhile? What are our obligations to one another? Who is responsible, to whom and for what? What is the fitting response to this moral dilemma given the context in which it arises? On what moral grounds are such claims made?
Bioethicists ask these questions in the context of modern medicine and healthcare. They draw on a pluralistic plethora of traditions, both secular and religious, to spawn civil discourse on contentious issues of moral difference and others on which most people agree. Bioethicists foster public knowledge and comprehension both of moral philosophy and scientific advances in healthcare. They note how medical technology can change the way we experience the meaning of health and illness and, ultimately, the way we live and die.
Bioethics is multidisciplinary. It blends philosophy, theology, history, and law with medicine, nursing, health policy, and the medical humanities. Insights from various disciplines are brought to bear on the complex interaction of human life, science, and technology. Although its questions are as old as humankind, the origins of bioethics as a field are more recent and difficult to capture in a single view.
When the term “bioethics” was first coined in 1971 (some say by University of Wisconsin professor Van Rensselaer Potter; others, by fellows of the Kennedy Institute in Washington, D.C.), it may have signified merely the combination of biology and bioscience with humanistic knowledge. However, the field of bioethics now encompasses a full range of concerns, from difficult private decisions made in clinical settings, to controversies surrounding stem cell research, to implications of reproductive technologies, to broader concerns such as international human subject research, to public policy in healthcare, and to the allocation of scarce resources. This array of interest is neatly summarized under the rubric of the Center for Practical Bioethics’ four domains: Aging and End of Life, Clinical and Organizational Ethics, Life Sciences, and Disparities of Health and Healthcare.
Interdisciplinary dialogue contributes to the field’s unique merit by applying the foundational disciplines of philosophy and theology, and incorporating perspectives from various other disciplines including sociology, medicine, nursing, anthropology, and law. Significant questions are addressed in bioethics: the ends and purposes of the life sciences and healthcare, the meanings and implications of distributive justice, and issues in global healthcare. Bioethicists explore even deeper issues such as the meaning of life and death, pain and suffering, and rights and responsibilities.
As the field continues to evolve, bioethics has become a prominent force in legislation and public policy, and in other practical applications of theoretical principles. The Center’s PAINS project is a case in point, along with C-TAC (Coalition to Transform Advance Care), KC-4-Aging, the TPOPP (Transportable Physicians Orders for Patients Preferences) project, Sabbaths of Hope, and the development and implementation of MetroCARE.
Some would argue that what began as a multi-disciplinary field of study is now a full-fledged discipline in its own right. Bioethics has a burgeoning literature, with journals and publishers. There are hundreds of vocational specialists in clinical ethics consultation, and others in bioethics departments within traditional academia. There now are many programs of training and education, ranging from certificates to Masters degrees and even a few PhD programs in Bioethics. There are guilds and societies for bioethicists, the largest being the American Society of Bioethics and Humanites. ASBH has commissioned a standing committee to address the lack of a code of ethics for clinical ethicists, and it is developing a certification process, as well.
Bioethics may well have grown up.