Biomedical Ethics

Biomedical Ethics

Introduction

Ethics is the application of values and moral rules to human activities. Bioethics is a subsection of ethics, actually a part of applied ethics that uses ethical principles and decision making to solve actual or anticipated dilemmas in medicine and biology. Ethics seeks to find reasoned, consistent, and defensible solutions to moral problems. Clinical bioethical reasoning is primarily case based. Much like clinical practice that relies both on general rules and case-based experiences, bioethical reasoning relies on learned and accepted moral rules, prior bioethical decisions derived from thoughtful reflection, and recognition of unique factors in individual situations that differentiate one case from another. This method of case-based reasoning is termed casuistry, although physicians may better know it as clinical reasoning. When clinicians think of bioethics, they often think either of the legal bases for their actions both prescriptive and proscriptive or their religious background. Neither directly applies. Rather, clinicians are obligated to make patient-centered, value-driven ethical decisions. (Jonathan, 2006, 456-78)

Explanation

Bioethics and the law

How does bioethics differ from law? Both give rules of conduct to follow. Laws stem from legislative statutes, administrative agency rules, or court decisions and they often vary in different locales and are enforceable only in those jurisdictions where they prevail. Ethics incorporates the broad values and beliefs of correct conduct. Although bioethical principles do not change because of geography (at least not within one culture), interpretation of the principles may evolve as societies change. This same evolution occurs within the law. Good ethics often makes good law, whereas good law does not necessarily make good ethics. Although societal values are incorporated into both the law and within ethical principles and decisions, ethical principles are basic to society. Most laws, although based loosely on societal principles, are actually derived from other laws. (Jonathan, 2006, 456-78)

Significant overlap exists between legal and ethical decision making. Both ethical analysis (in bioethics committee deliberations) and the law (in the courts) use case-based reasoning in an attempt to achieve consistency. Legal and ethical dicta have existed since ancient time, have evolved over time, incorporate basic societal values, and form the basis for policy development within health care as well as in other parts of society. (Jonathan, 2006, 456-78)

The law and bioethics differ markedly, however, in some areas. For instance, the law operates under formal adversarial process rules, such as those in the courtroom, which allow little room for deviation, whereas bioethics consultations are flexible enough to conform to the needs of each institution and circumstance, and, rather than being adversarial, are designed to assist all parties involved in the process. The law also has some unalterable directives, sometimes called black-letter law, that require specific actions. Bioethics, although based on principles, is designed to weigh every specific situation on its own merits. Perhaps the key difference between bioethics and the law is that bioethics relies heavily on the individual person's values-the patients' or their surrogates'. Also, even without the intervention of trained bio ethicists, medical personnel can and often should be ...