Anshu

Phi/19/46
Question: Define Bioethics and define relation between bioethics and medical ethics. 
(*similarities and differences between both) ?

 DEFINATION
 INTRO (bio ethics)
 MEDICAL EHTICS
 NURSING ETHICS
 SIMILARITIES
 DIFFERENCES

Bioethics:

Bioethics, branch of applied ethics that studies the philosophical, social, and legal

issues arising in medicine and the life sciences. It is chiefly concerned with human
life and well-being, though it sometimes also treats ethical questions relating to the
nonhuman biological environment.

Introduction:

 As the discipline we now call bioethics emerged in the early 1970s. Though it has
roots tracing back decades or generations earlier, modern bioethics is widely held
to have arisen in the late 1960s. Since the 1960s ethical problems in health care
and the biomedical sciences have gripped the public consciousness in
unprecedented ways. In the climate of new ethical issues and choices that the field
of inquiry now known as “bioethics” was born. The word was not originally used
in this sense. Van Rensselaer Potter first proposed the term for a “science of
survival” in the ecological sense – that is, an interdisciplinary study aimed at
ensuring the preservation of the biosphere (Potter 1970). This terminology never
became widely established, however, and instead “bioethics” came to refer to the
growing interest in the ethical issues arising from health care and the biomedical
sciences.
The first “modern” work of bioethics was Joseph Fletcher’s Morals and Medicine,
published in 1954. In the 1960s that bioethics really began to take shape as a field
of study. This period was one of important cultural and social changes. The other
major impetus to the growth of the field was the development of new medical
technology that threw up questions no one had needed to answer before.

Bioethics is the result of, on the one hand, new developments in biomedical
sciences and clinical medicine, (like Dialysis machines, artificial ventilators, and
organ transplants offer the possibility of keeping alive patients who otherwise
would have died. In vitro fertilization and related reproduction techniques allow a
range of new relationships. Development of modern contraceptives, prenatal
testing, and the availability of safe abortions, etc has given women and couples
increased choices.)

On the other hand, the growing concern about the power of medical professionals.
This is evident in ‘patent rights’ groups and community rights that aim to affect
medical professionals’ decisions.

Bioethics provides a disciplinary framework for the whole array of moral questions
and issues surrounding the life sciences concerning human beings, animals, and
nature. It is a particular way of ethical reasoning and decision making that :

(i) Integrates empirical data from relevant natural sciences, most notably medicine
in the case of medical ethics, and (ii) considers other disciplines of applied ethics
such as research ethics, information ethics, social ethics, feminist ethics, religious
ethics, political ethics, and ethics of law in order to solve the case in question.

And also offers ethical guidance in a particular field of human conduct, and even
points to many novel complex cases, for example, gene technology, cloning, and
human-animal chimeras and facilitates the awareness of the particular problem in
public discourse.
The combination of bioethics and new data that stem from the natural sciences may
influence−in some cases −the key concepts and approaches of basic ethics by
providing convincing evidence for important specifications, for example, the
generally accepted concept of personhood might be incomplete, too narrow, or
ethically problematic in the context of people with disability and, hence, need to be
modified accordingly.
In other words, bioethics is concerned with a specific area of human conduct
concerning the animate (for example, human beings and animals) and inanimate
(for example, stones) natural world against the background of the life sciences and
deals with the various problems that arise from this complex amalgam.
Furthermore, bioethics is not only an inter-disciplinary field but also
multidisciplinary since bioethicists come from various disciplines, each with its
own distinctive set of assumptions. While this facilitates new and valuable
perspectives, it also causes problems for a more integrated approach to bioethics.

Bioethics owes much to recent developments in the biomedical sciences; bioethics

can also be seen as a modern version of a much older field of thought, namely
medical ethics. Bioethics claims medical ethics as part of its province, but in many
ways it takes a distinctly different approach. Traditionally, medical ethics has
focused primarily on the doctor–patient relationship and on the virtues possessed
by the good doctor. It has also been very much concerned with relations between
colleagues within the profession. Bioethics, on the other hand, is not limited to
questioning the ethical dimensions of doctor–patient and doctor–doctor
relationships, it goes beyond the scope of traditional medical ethics in several
ways.

First, its goal is not the development of, or adherence to, a code or set of precepts,
but a better understanding of the issues.

Second, it is prepared to ask deep philosophical questions about the nature of

ethics, the value of life, what it is to be a person, the significance of being human.
Third, it embraces issues of public policy and the direction and control of science.

In all these senses, bioethics is a novel and distinct field of inquiry. Nevertheless,
its history begins with the history of medical ethics.

Medical ethics:
Medical ethics has a long and varied history. While it is often thought that it had its
beginning in the days of Hippocrates, in ancient Greece. The oldest sub-discipline
of bioethics is medical ethics can be traced back to the introduction of the
Hippocratic Oath (500 B.C.E.). Of course, medical ethics is not limited to the
Hippocratic Oath; rather that marks the beginning of Western ethical reasoning and
decision making in medicine. The Hippocratic Oath is a compilation of ancient
texts concerning the proper behaviour of physicians and the relationship between
physician and patient. It also contains some binding ethical rules of utmost
importance such as the well known principle of non-maleficence (“primum non
nocere”) and the principle of beneficence (“salus aegroti suprema lex”);
furthermore, doctor-patient confidentiality and the prohibition on exploiting the
patient (including sexual exploitation) are important rules that are still valid.

Other more critical elements of the Hippocratic Oath such as the strict prohibition
of euthanasia and abortion seem to be rather debatable and raise the vital question
of how to distinguish between valuable and less valuable principles it proposes. In
contemporary bioethics, euthanasia is—in general—widely regarded as an eligible
autonomous decision of the patient that must be respected. With regard to abortion,
most bioethicists believe that it should be allowed, at least, under certain
circumstances, but this issue is still hotly debated and causes many emotional
responses. The upshot is that one needs a more fundamental theoretical analysis of
the particular elements of the Hippocratic Oath in order to determine
possible traditional shortcomings in more detail before one accepts them as a fixed
set of unquestionable professional rules. Furthermore, the idea that “the physician
knows best” and should be able to act against the will of the patient for the benefit
of the patient also originated in ancient times. The competence of the physician
was too overwhelming for most people so that they almost always complied with
the physician’s advice.
In medical ethics, one is concerned with the general ethical question of “what
should one do” under the particular circumstances of medicine. In this respect,
medical ethics is not different from basic ethics but it is limited to the area of
medicine and deals with its particular state of affairs.

There are a number of important traditional issues in medical ethics that still need
to be solved. These include beginning- and end-of-life issues (notably abortion,
euthanasia, and limiting therapeutic treatments), the doctor-patient relationship,
research on human beings (including research ethics and human genetics). More
recent medical issues include reproductive decision making, organ transplantation,
just distribution of healthcare resources, access to healthcare, and most recently
vital issues concerning healthcare systems and public health.
Nursing ethics:
Medical ethics has not been the only source of ethics relating to health care.
Professional nursing had its beginning in nineteenth-century England, where
Florence Nightingale established the first school of nursing and laid down some
of the ethical precepts that would shape the practice of nursing for a long time.
Emphasis was placed on the character of the nurse. Above all else, a good nurse
must be a good woman, as Florence Nightingale put it.

In 1899 the International Council of Nurses was established, and professional

journals, “The American Journal of Nursing” was published and in 1901 the first
books on nursing ethics, entitled “Nursing Ethics for Hospitals and Private Use”
was written by Isabel Hampton Robb.

At this point the gendered division of medical labour was already deeply
established, with woman-nurse/ man-doctor and nurse is responsible to doctor. The
view that the nurse’s primary responsibility was to the doctor prevailed until the
1960s, and was still reflected in the 1965. The physician’s orders intelligently and
loyally.” The revival of feminist thinking in the late 1960s paralleled the
developing self-consciousness and self-assertiveness of nurses and in the 1973
International Council of Nurses’ Code for Nurses, the nurse’s “primary
responsibility” is no longer seen to be to doctors but to patients – “to those people
who require nursing care.”

Further, a movement by feminist philosophers challenged the traditional (and

therefore male-dominated) view of ethics as a matter of abstract, impartial, and
universal principles or rules.

Jean Watson, a nurse and a prominent proponent of a nursing ethics of care,

applies to the nursing situation Noddings’s view that an ethics of care “ties us to
the people we serve and not to the rules through which we serve them.”

Similarities between bioethics and medical ethics:

Both concepts of morality – medical ethics and bioethics ensure that quality
medicine, medical treatment and responsible medical rights are offered to the
people and their medical protected during the research participation and health
 morality is irrespective of gender, age, community, race, colour, religion etc.
Medical Ethics and Bioethics are closely associated. The latter is a branch of, or
field within, the former.

Difference between Bioethics and Medical Ethics

Definition:
Bioethics

Bioethics is normative ethics applied to applied to moral principles of all

biomedical sciences (philosophy, history, law, nursing, medicine and

biotechnology). It emphasizes on multidisciplinary realms of philosophy of applied

and practical biomedical scientific technologies.

Medical Ethics

Medical ethics is a system of moral principles that apply values and judgments to

the practice of medicine. It involves actions based on ethical principles in human

healthcare.

The principles of medical ethics involve morals and values that people and

healthcare professionals need to take into consideration in case of any conflict or

any confusion.

Principle:
Bioethics

The four principles of bioethics include:

 Autonomy – Respect for people. Humans are a mean unto themselves and not a
means to an end. This encompasses the right to be free to make choices about your
body.
 Beneficence – Obligation to contribute to person’s welfare. Interventions and
provisions should provide benefit directly to the patient. This focuses on doing
things that are of benefit to another. It requires positive steps to help, and not
merely avoiding doing harm.
 Justice – For health care, this is the distribution of health (and health care) in a fair
and equitable manner. This requires attention to prioritization and rationing. There
is no one just way to allocate resources, and most systems utilize several
prioritization schemes in concert to attempt to achieve a just distribution. 
 Non-maleficence – Obligation not to inflict harm on other persons. Harm is to be
avoided or minimized. Underlying tenet of medical professional mission
statements (Hippocratic oath).

Medical Ethics

The principles include;

 Principle of respect for autonomy – It is also called principle of human dignity and
involves obligation to show respect towards the autonomy of other people. As per
this principle, competent adults have the right to make informed decisions about
their own health interventions.
 Principle of nonmaleficence – One ought not to inflict evil or harm on patients
 Principle of beneficence – A positive duty to contribute to the welfare of patients
 Principle of justice – Justice or fair treatment of patients

Conclusion:
Bioethics involves medical ethics and studying about equilibrium between
benefits, harm and duties. It does havean influence both on patients and health
professionals. Relevance of bioethics varies from birth to end of life. Bioethics not
only provides a guideline to medical professionals about clinical decision-making,
advancements in medical technologies, but also playing vital role in policy
changes and legislation in recent years. Bioethics is a blend of scientific and
humanistic constituent and does not have need of the recognition of certain long-
established standards that are basic to medical ethics. Bioethics contributes to
the rights and responsibilities of patients as persons. Its significance replicates in
various divisions e.g. medical care, researches and overall community.

Almost from the beginning, bioethics was an interdisciplinary enterprise. While

ethics had been the near-exclusive domain of moral philosophers and religious
thinkers, bioethics crossed the boundaries not only of medicine, nursing, and the
biomedical sciences, but of law, economics, and public policy as well. Bioethics in
this broad, interdisciplinary sense has since become firmly established as a field of
inquiry and of learning – first in the United States, and since then in many other
countries as well. It is now a global field of inquiry