Online Medical and Bioethics Resource Center
Nothing's black and white when deciding how, when and if to treat a patient. Advances in the fields of biology and medicine have created controversy in the newer study of bioethics. Medical ethics are generally determined in the practice of medicine in clinical settings. Bioethics is the philosophical attempt to define the relationships between life sciences, biotechnology, medicine, politics and law. It is a noble effort to develop a set of standards that can allow for research and the development of new and improved methods of treatment while still allowing for the human factor. Ethics are an intangible but intrinsic part of science and technology.
Values in Medical Ethics
Autonomy is the first of the six most common values discussed in medical ethics and addresses the patient’s right to refuse or choose available treatment. Beneficence indicates that the caregiver should act in the best interest of the patient and not necessarily do what the caregiver feels is best. Sometimes it isn’t just the caregiver that suggests treatment against a patient’s wishes, but well-intentioned family members. Non-maleficence, translated from the Latin "primum non nocere" as “First, do no harm” should give caregivers reason to think twice before utilizing treatment that may do more harm than good. Preventing the loss of dignity by valuing both the caregiver and the patient in the treatment situation is another balancing act. Tying the other five values together, truthfulness and honesty have actually grown in importance upon the discovery of historical distortions of medical treatments and studies. As revelations about past research and study practices come to light, a set of standard ethics have evolved to prohibit research and treatment regimens that cross ethical boundaries.
Conflicts of Interest in Medical Ethics
Today’s greatest ethical issues are still some of the oldest issues concerning caregiver/patient relationships and decision-making factors. Abortion and the age-old question of when life begins has been and continues to be a hotly debated issue. Online technology has illuminated some of the areas where disclosure of information can create ethical questions. Information availability has given a public that demands to know the details another way to fill that need for information. Informed consent and privacy issues are top concerns with the online availability of information formerly relegated to filing cabinets and medical libraries. Self-diagnosis and general mistrust of healthcare professionals can cause individuals to second-guess diagnoses. End-of-life issues are prevalent, with both sides of the debate passionate about their stance. Quality of life at the end vs. quantity of days can cause caregiver, patient and the patient’s family to have differences of opinions on how treatment should or should not continue.
Medical Ethics Resources
World Medical Association: The WMA provides medical ethics guidance to physicians, governments, and international organizations worldwide. This includes an International Code of Medical Ethics, patient rights and caring for the wounded and ill during wartime.
Ethics in Hand: American Medical Association (AMA) pocket guides regarding the AMA Code of Medical Ethics. Guides are available in physician and student .pdfs as well as hard copy versions.
Revised Medical Ethics: The revised version of the AMA Principles of Medical Ethics in a nutshell.
The Association for Medical Ethics: Promotes evidence-based medicine, a patient's right-to-know about their patient care. Provides for public awareness regarding the influence of industry on health care providers.
Virtual Mentor: The AMA's journal of ethics online includes podcasts and case indices.
American Psychiatric Association: The resources and standards applicable to the American Psychiatric Association's principles of medical ethics.
The Hastings Center: Includes a non-partisan bimonthly health, medicine and environmental journal.
The American Journal of Bioethics: Latest news, employment, blogs and journal regarding important bioethical issues.
Biblical Bioethics: Baptist-based insights into abortion and end of life issues.
Presidential Commission for the Study of Bioethical Issues: Commission advises the Office of the President about emerging issues in bioethics, scientific research and health care delivery.
Development of Bioethics
History credits Fritz Jahr for the term “bioethics” a term coined in his 1927 paper “Bio-Ethics: A Review of the Ethical Relationships of Humans to Animals and Plants”. He wasn’t the first to struggle with defining this puzzling mix of science, theology and technology. Experimentation with the cures implicated by advancements in technology has historically caused concern between the scientific and the theologic communities. The crux being the research utilized to advance the knowledge of the scientific community. What was the moral and ethical cost of human and animal experiments to test procedures and pharmaceuticals that might ultimately ease pain and suffering?
Bioethics began developing as a discipline in the 1960s. Rapid advancements in technology in the early 1970s fostered an urgent need for developing bioethics guidelines. When James F. Childress and Tom Beauchamp authored the first American textbook on bioethics, the publication of Principles of Biomedical Ethics gave credence to the discipline. Since the President’s Council on Bioethics was created in 1995, the discipline has been used to help settle issues on abortion, organ donation, euthanasia and other end-of-life issues. Bioethics continues to be relatively well-known, albeit hard to define.
ISSUES IN BIOETHICS
GENERAL
Human Genome Project:The complete history of the project and a broad array of links to quality research on Ethical, Legal and Social Issues concerning the study of the human genome.
PEW Charitable Trust: Provides analytical data to the public concerning ethical issues surrounding medical technologies.
Global Bioethics: Provides a pathway to current and past news and issues concerning bioethics in an easily searchable format.
National Institute of Health: A compilation of reliable web-based resources for medical and bioethical research
Center for Ethical Solutions: Dedicated to finding practical solutions to serious health and medical concerns.
ABORTION
University of San Diego Ethics Updates: Maintains latest scholarly and public policy updates
Guttmacher Institute: Contains four decades worth of research in sexual and reproductive health with a focus on the moral issues surrounding abortion.
Internet Encyclopedia of Philosophy: An in-depth review of both sides of the question on the ethics of abortion, cites useful resources.
CLONING
Solhaam Organization: Research and discussion on the scientific ability to create, reconstruct or reconfigure plant, animal and human life and the ethical ramifications to consider.
University of Utah Genetics: discusses basic concepts in cloning, debunks cloning myths and contains links to pertinent information.
American Assn. for the Advancement of Science: explores history of cloning and provides insight to governmental oversight into issue.
EUTHANASIA
Physician Assisted Death: Illuminating article on Physician Assisted Death and ethics surrounding the decision making process.
California Conference on Aiding Death: Article explores how guidelines for aiding death can be established using ethics committees.
Stanford University: Site provides provocative points from scientific and theological viewpoints on voluntary euthanasia.
Reproductive Rights/Sperm & Egg Donation
Marketing Motherhood: Journal article focuses on the rights and responsibilities of egg donors within the context of reproductive technology agreements.
Reproductive Technologies: Definition, facts, statistics, ethical issues and links highlight this University of Minnesota Center for Bioethics paper.
Reproductive Technology and Women's Rights in France: French bioethical issues regarding new genetic and reproductive technologies and French feminist approaches to those issues.
Stem Cell Research
Stem Cell Bioethics: "Ethics and Policy-Making in Stem-Cell Research" PowerPoint presentation by UC Berkeley's 2007 STELA working group.
Ethical Issues in Human Stem Cell Research: Report and recommendations given by the National Bioethics Advisory Commission in 1999.
Do No Harm: The Coalition of Americans for Research Ethics on the dignity and status of human embryos and stem cell research brought on by medical advancement.