Examining american bioethics: Its problems and prospects

Cambridge Quarterly of Healthcare Ethics

Volumn 14, Issue 4, 2005, Pages 361-373

  Fox, Renée C ^a   Swazey, Judith P ^b  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b BOSTON UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BIOETHICS; BIOETHICS AND PROFESSIONAL ETHICS; CULTURAL FACTOR; EDUCATION; ETHICAL THEORY; ETHICIST; ETHICS; HEALTH; HUMAN; HUMAN RIGHTS; INTERDISCIPLINARY COMMUNICATION; MORALITY; PUBLIC HEALTH; REVIEW; SOCIAL JUSTICE; SOCIAL PSYCHOLOGY; UNITED STATES;

BIOETHICS AND PROFESSIONAL ETHICS;

BIOETHICAL ISSUES; BIOETHICS; CULTURAL CHARACTERISTICS; ETHICAL THEORY; ETHICISTS; HUMAN RIGHTS; HUMANS; INTERDISCIPLINARY COMMUNICATION; PRINCIPLE-BASED ETHICS; PUBLIC HEALTH; SOCIAL JUSTICE; SOCIAL VALUES; UNITED STATES; VIRTUES; WORLD HEALTH;

EID: 28644434283     PISSN: 09631801     EISSN: 14692147     Source Type: Journal    
DOI: 10.1017/S0963180105050504     Document Type: Review

References (53)

1. Gorovitz S. Baiting bioethics. Ethics 1986;96(Jan):356-74.
2. Bennett W. Getting ethics. Commentary 1980;Dec:62-5.
3. Fox RC, Swazey JP. Medical morality is not bioethics - Medical ethics in China and the United States. Perspectives in Biology and Medicine 1984;27(Spring):336-60.
4. See note 1, Gorovitz 1986:365.
5. See note 1, Gorovitz 1986:366, 367.
6. See note 1, Gorovitz 1986:372.
7. See note 1, Gorovitz 1986:356.
8. Chambers T. Centering bioethics. Hastings Center Report 2000;30(1):22-9, at 27.
9. The various historiographies of the beginning of bioethics are examined in an essay on "the coming of bioethics" in our forthcoming book on the development and role of bioethics in the United States. Some writers have assigned a "moment of creation" date, such as the Nuremberg Trials in 1947, the issuance of the Harvard Ad Hoc Committee's report on the definition of brain death in 1968, or the founding of the Hastings Center in 1969 and the Kennedy Institute in 1971. Other "origin stories" define a time period rather than a specific date of conception or birth, usually during the mid-1960s to early 1970s, or the late 1960s to mid-1970s. See, for example, Callahan D. The Hastings Center and the early years of bioethics. Kennedy Institute of Ethics Journal 1999;9(1):53-71;
10. Chambers T. Retrodiction and the histories of bioethics. Medical Humanities Review 1998;12(1):9-22;
11. Jonsen AR, ed. The birth of bioethics. Special supplement. Hastings Center Report 1993;23(6):S1-16;
12. Jonsen AR. The Birth of Bioethics. New York: Oxford University Press, 1998;
13. Reich WT. Revisiting the launching of the Kennedy Institute: Revisioning the origins of bioethics. Kennedy Institute of Ethics Journal 1996;6(4):323-7;
14. Rothman D. Strangers at the Bedside. New York: Basic Books; 1991;
15. Stevens T. Bioethics in America: Origins and Cultural Politics. Baltimore: Johns Hopkins University Press; 2000;
16. Veatch R. The birth of bioethics: Autobiographical reflections of a patient person. Cambridge Quarterly of Healthcare Ethics 2002;11:344-52.
17. The areas identified come both from our reading of the bioethics literature and from the interviews we conducted with bioethicists as part of the Acadia Institute study.
18. The best known exposition of principlism is Tom Beauchamp and James Childress' Principles of Biomedical Ethics (New York: Oxford University Press). First published in 1979, the book is now in its fifth edition; a sixth edition is in preparation, and the book has been translated into many languages.
19. Beauchamp TL. Does ethical theory have a future in bioethics? Journal of Law, Medicine & Ethics 2004;32:209-17, at 216.
20. Callahan D. Individual good and common good. Perspectives in Biology and Medicine 2003; 46(4):496-507.
21. Sugarman J, Sulmasy DP. Methods in Medical Ethics. Washington, DC: Georgetown University Press; 2001, at 4,10.
22. See note 12, Beauchamp 2004:216.
23. See note 13, Callahan 2003:498.
24. Callahan D. Bioethics and the American culture wars. Unpublished paper, 2003;
25. Callahan D. Bioethics and the culture wars. The Nation 1997;264(14):23-4.
26. Hedgecoe AM. Critical bioethics: Beyond the social science critique of applied ethics. Bioethics 2004;18(2):120-43, at 138-40.
27. Fox RC. Is medical ethics asking too much of bioethics? Teaching the "nonbiomedical" aspects of medicine: The perennial patterns. Daedulus 1999;128:1-25, at 8.
28. O'Neill O. Autonomy and Trust in Bioethics. Cambridge, UK: Cambridge University Press; 2002, at 1.
29. O'Neill O. Reason and passion in bioethics [review of L. Kass. Life, Liberty, and the Defense of Dignity. The Challenge for Bioethics. San Fransico: Encounter Books; 2002]. Science 2002;298(20):2335.
30. See note 12, Beauchamp 2004:216.
31. Moazam F. Foundational ethical concepts in Islam: The Qur'an, Imam al-Ghazali, and Muslim physicians. Plenary speech, Aga Kahn University Symposium on Clinical Ethics, October 7, 2004.
32. See especially Hoffmaster B. Can ethnography save the life of medical ethics? Social Science & Medicine 1992;35:1421-36.
33. The fall 2004 issue of the Hastings Center Report (35,4), for example, had a cluster of articles discussing ethical concerns associated with the influence of the pharmaceutical industry. Three of the four papers were written by members of the Princeton group: Lemmens T. Piercing the veil of corporate secrecy about clinical trials (pp. 14-18);
34. Elliot C. Pharma goes to the laundry: Public relations and the business of medical education (pp. 18-23);
35. and DeVries R, Bosk C. The bioethics of business: Rethinking the relationship between bioethics consultants and corporate clients (pp. 28-32).
36. The sociologists in the Princeton group (Charles Bosk, Joseph Davis, and Raymond De Vries), for example, were members of the program committee headed by sociologist John Evan that organized a two-day "Sociology of Bioethics" conference, held in March 2005 at Georgetown and the Eastern Sociological Society meeting. In his communication to prospective participants, Evans exuberantly described the conference as "a watershed event in the nascent history of the sociology of bioethics," designed to expand and transform the informal contacts between sociologists working on bioethical topics into a more formally organized group of scholars (Evans J. e-mail communication to possible conference participants, October 11, 2004).
37. Members of the Princeton group have drafted a research proposal to study firsthand how international guidelines for the protection of human subjects in the global marketplace are (and are not) implemented in the regulatory systems of a cross section of different societies, with special attention to the needs of multinational corporations and the rights of national citizens in the area of industrialized drug testing. Sociologist R. G. De Vries, anthropologist A. Petryana, jurist T. Lemmens, and sociologist C. Bosk from the Princeton group, joined by philosopher-bioethicist J. Kahn, will constitute the research team.
38. Bordieu P. Uniting to better dominate. Items and Issues (Social Science Research Council) 2001;2(3-4):1-6, at 3.
39. A number of doctoral programs, particularly in philosophy, offer a concentration in bioethics within the degree program field: for example, a Ph.D. in philosophy with a concentration in bioethics. At present, Case Western Reserve University's Department of Bioethics offers the only Ph.D. in bioethics per se. Its program contains some of the types of interdisciplinary training that we recommend, although it has a heavy emphasis on methodology and does not mention social science in its program statement. Its research-oriented program objective is "[t]o train scholars who will have specific expertise in the conceptualization, design, and conduct of empirical research concerning bioethics questions. Training and competency in the methodology of traditional bioethics (philosophy, religious studies, law, and medical humanities) will also be provided" (www.cwru.edu/med/bioethics/phd.htm).
40. The limitations inherent in a Master's program are even more acute in short, intensive bioethics courses, but here too we advocate including a block of materials that would at least begin to make attendees more aware of the knowledge bases that would enhance their work in bioethics.
41. Another model for furthering and deepening fruitful interdisciplinary relations, learning, and collaboration between members of different fields working in the area of bioethics is to bring them together for a period of time in a manner comparable to the experience that was provided for the group working in bioethics at Princeton.
42. Weber E. Time travelers' tales [review of Schivelbusch W. The Culture of Defeat: On National Trauma, Mourning, and Recovery. New York: Henry Holt]. The American Scholar 2003;72(3):142-4, at 142, 144.
43. Nussbaum MC. Patriotism and cosmpolitanism. In: Cohen J ed. For Love of Country. Debating the Limits of Patriotism. Boston: Beacon Press; 1996:2-16, at 9.
44. Much of the criticism of "conservative" bioethics and bioethicists by self-professed "liberal" or "mainstream" bioethicists has focused on Leon R. Kass, Chairman of the President's Council on Bioethics established by George W. Bush, and on the composition of the Council and the contents of its reports. A fresh round of controversy was unleashed in March 2005, when Kass, acting, he maintains, as a private citizen rather than as Chairman of the Council, distributed a document entitled "Bioethics for the second [Bush] term: Legislative recommendations," to members of the U.S. Congress. The position paper was developed during discussions of an informal group led by Kass and Eric Cohen, editor of the conservative bioethics journal, The New Atlantis. The "second term" agenda calls for the passage of laws banning the use of various types of novel biotechnological reproductive methods. "We have today," the document concludes, "an administration and a Congress as friendly to human life and human dignity as we are likely to have for many years to come. It would be tragic if we failed to take advantage of this rare opportunity to enact significant bans on some of the most egregious biotechnical practices." The Kass agenda: "Bioethics for the second term." http://www.blog.bioethics.net. March 9, 2005 [The American Journal of Bioethics editor's blog]; see also Kintisch E. Anticloning forces launch second-term offensive. Science 2005;307(Mar 18) at 1702-3.
45. See note 17, Callahan 2003.
46. A Google search on April 19, 2005, listed 5,620,000 entries for Terri Schiavo. For a small sample of the coverage of her case, see Brain-damaged Terri Schiavo dies. http://www.new.bbc.co.uk/1/hi/world/americas, March 31, 2005;
47. Cohen E. How liberalism failed Terri Schiavo. http://theweeklystandard. com, Vol. 10(27), March 25, 2005;
48. Feldman L, Richey F. The Terri Schiavo legacy. http://www.csmonitor.com/ 2005/0401/p01s01-ussc.htm;
49. Glantz LH. The Schiavo tragedy. http://www.boston.com/news/globe/ editorial opinion/op-ed/articles/2005/03/22;
50. Quindlen A. The culture of each life. Newsweek April 4, 2005 at 62;
51. Timeline: Terri Schiavo case. http://www.new.bbc.co.uk/1/hi/world/ americas. March 31, 2005.
52. Steinfels P. Beliefs: Voters say values matter, but it's important to find out what reality is behind this convenient catchall. New York Times 2004 Nov 6:A15.
53. It is significant that Tom Beauchamp expressed his concern about the gravity of the partisan divisions in bioethics, and the importance of bridging them, in his acceptance speech, when he, along with James Childress, received a Lifetime Achievement Award at the October 2004 annual meeting of the American Society for Bioethics and Humanities.