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Ethics in the Discipline(s) of Bioethics

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Abstract

The development of a code of ethics for a profession can be an indicator of the coherence and stability of a discipline as a unique and singular entity. Since “bioethics”, as a discipline, is not one profession but many, practiced by persons with not one but many varying responsibilities and training, it has been argued that no code of ethics is possible for the discipline(s) of bioethics. I argue that a code of ethics is possible for bioethics by looking at the nature of the various disciplines and noting necessary overlap between them, and deriving the ethics from the nature of the discipline(s) themselves. I show how this can be done by arguing that strict rules about funding and conflict of interest are necessary for bioethicists.

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Notes

  1. In what follows, I will only address bioethicists and not practitioners of medical humanities. I do this primarily for two reasons: first, I believe that roles in the medical humanities are not as well defined as are roles in bioethics, and secondly, for reasons elaborated below, I believe that the roles of medical humanists may well differ from those of bioethicists. If so, then the same ethical responsibilities may not apply to all those in the medical humanities. I may be incorrect in either or both of these views; if the latter is incorrect, then my conclusions here should apply to those in the medical humanities. If the former is incorrect, then others may be able to determine whether my conclusions should apply.

  2. It is worth noting that these practices are controversial, and not necessarily universally supported by regulatory or ethical argument (see e.g., Payne et al. 2010). The preceding argument is sound if these practices are ethically allowed; if they are not, then no argument which depends upon these exceptions being ethical, including the one being rebutted herein, can follow.

  3. Whether this would be worth doing, or preferable to deriving separate codes for various commonly represented roles, such as academic educators, clinical ethicists, etc., would then be distinct questions that would have to be answered by such an organization.

  4. Which, as far as I know, they do not.

  5. Although in many cases the resolution of a given case may actually be obtained by facilitating communication or directing persons to relevant hospital policies, in truly difficult cases the consultant is called upon to give ethical guidance. This is not the same as being a source of moral truths or even morally correct answers, and so does not run afoul of some of the concerns voiced in, e.g., Engelhardt 2009.

  6. Assuming that there was no other comparable source of conflict, such as ownership of a significant amount of stock, family members directly employed by a pharmaceutical company, etc.

  7. This has been seen by some as an argument against disclosure as a means of resolution of conflicts of interest, at least for ethics articles. See Rasmussen (2005, pp. 108–112) for a good analysis of this and defense of disclosure as appropriate.

  8. Rasmussen uses the term “for-profit consultation” as shorthand for “consultation activity on the part of bioethicists for for-profit biotechnology and/or pharmaceutical firms”, and I follow her in this use. See Rasmussen (2005, note 2).

  9. This can be seen by the fact that deacons and their families are also to be supported, unless the deacon draws an adequate salary from another job. Their financial support from the church changes dramatically depending upon their having an external source of income, but their job descriptions do not change. See Can. 281, Sect. 3. My thanks to Msgr. Bill Young for assistance with canon law.

  10. There could be circumstances where there was not much relevant literature, and so bioethicists would be valuable to do de novo analysis of new issues. These would be rare, but could still be grounds for needing bioethicists as consultants in those cases.

  11. A favorite example of mine of this phenomenon is displayed in Steinman et al. (2001), which shows in side-by-side pie charts that while almost no physicians (1%) think they themselves are strongly influenced by gifts from pharmaceutical companies, the same group of physicians perceive such strong influence on 33% of their colleagues (“Other doctors”).

  12. This ranges from $0 to $50 a day, depending upon the state and how many days of service are required, or $40–50 a day for federal jury duty. See http://www.matrixbookstore.biz/trial_jury.htm and http://www.uscourts.gov/jury/jurypay.html, each last accessed June 9, 2011.

References

  • ACGME. (2008). Program requirements for graduate medical education, effective 1/1/2008. http://www.acgme.org/acWebsite/downloads/RRC_progReq/220obstetricsandgynecology01012008.pdf. Accessed June 2008.

  • ASBH Advisory Committee on Ethics Standards (ACES), Report and Recommendations. (2006). http://www.asbh.org/membership/protected/pdfs/acesrprt.pdf. Accessed June 2008.

  • Baker, R. (2005). A draft model aggregated code of ethics for bioethicists. The American Journal of Bioethics, 5(5), 33–41.

    Article  Google Scholar 

  • Barnett, A. (2003). Revealed: How drug firms ‘hoodwink’ medical journals. The Observer. http://www.guardian.co.uk/society/2003/dec/07/health.businessofresearch. Accessed 21 July 2011.

  • Boseley, S. (2004). Junket time in Munich for the medical profession—and it’s all on the drug firms. The Guardian. http://www.guardian.co.uk/uk/2004/oct/05/highereducation.businessofresearch?INTCMP=ILCNETTXT3487. Accessed 21 July 2011.

  • Brody, H. (2003). Pens and other pharmaceutical industry gifts. The American Journal of Bioethics, 3(3), 58–60.

    Article  Google Scholar 

  • Brody, B. et al. (2002). Bioethics consultation in the private sector. Hastings Center Report, 32(3), 14–20.

    Google Scholar 

  • Donaldson, T. (2001). The business ethics of bioethics consulting. Hastings Center Report, 31(2), 12–14.

    Article  Google Scholar 

  • Elliot, C. (2004). Six problems with pharma-funded bioethics. Studies in History and Philosophy of Biological and Biomedical Sciences, 35, 125–129.

    Article  Google Scholar 

  • Elliot, C. (2005). Should journals publish industry-funded bioethics articles? Lancet, 366, 422–424.

    Article  Google Scholar 

  • Engelhardt, H. T, Jr. (1996). Foundations of bioethics (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Engelhardt, H. T, Jr. (2003). The bioethics consultant: Giving moral advice in the midst of moral controversy. HEC Forum, 15(4), 362–382.

    Article  Google Scholar 

  • Engelhardt, H. T., Jr. (2009). Credentialing strategically ambiguous and heterogeneous social skills: The emperor without clothes. HEC Forum, 21(3), 293–306.

    Article  Google Scholar 

  • Espey, E., Ogburn, T., Chavez, A., Qualls, C., & Leyba, M. (2005). Abortion education in medical schools: A national survey. American Journal of Obstetrics and Gynecology, 192(2), 640–643.

    Article  Google Scholar 

  • FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health. (October 2009). Recommendations on ethical issues in obstetrics and gynecology by the FIGO committee for the study of ethical aspects of human reproduction. Available in multiple languages at http://www.figo.org/miscellaneous-publications/ethics-guidelinestest/ethics-guidelines. Accessed 4 July 2011.

  • Goodman, B. (2003). All rationalizations large and small. The American Journal of Bioethics, 3(3), 57–58.

    Article  Google Scholar 

  • International Federation of Gynecology and Obstetrics. (2006). Resolution on conscientious objection. Adopted by the FIGO general assembly, 7th November 2006. http://www.figo.org/projects/conscientious. Accessed 14 July 2011.

  • Jonsen, A. R. (1998). The birth of bioethics. New York: Oxford University Press.

    Google Scholar 

  • Katz, D. Caplan, A. L, & Merz, J. F. (2003). All gifts great and small. The American Journal of Bioethics 3(3), 39–46; reprinted (2010) in The American Journal of Bioethics 10(10), 11–17.

    Google Scholar 

  • Kondro, W., & Sibbald, B. (2004). Drug company experts advised staff to withhold data about SSRI use in children. Canadian Medical Association Journal, 170(5), 783.

    Article  Google Scholar 

  • Libreria Editrice Vaticana. (1983). Code of canon law http://www.vatican.va/archive/ENG1104/_INDEX.HTM. Accessed 14 July 2011.

  • MacIntyre, A. (1984). After virtue: A study in moral theory (2nd ed.). Notre Dame: University of Notre Dame Press.

    Google Scholar 

  • Mundy, A. (2002). Dispensing with the truth: The victims, the drug companies, and the dramatic story behind the battle over Fen-Phen. New York: St. Martin’s Griffin.

    Google Scholar 

  • Payne, R., Evan, A., Robert, A., Lennie, D., Aaron, G., Green, C., et al. (2010). A rose by any other name: Pain contracts/agreements. American Journal of Bioethics, 10(11), 5–12.

    Article  Google Scholar 

  • Pellegrino, E. D. (2001). The internal morality of clinical medicine: A paradigm for the ethics of the helping and healing professions. Journal of Medicine and Philosophy, 26(6), 559–579.

    Article  Google Scholar 

  • Pellegrino, E. D. (2002). The physician’s conscience, conscience clauses, and religious belief: A Catholic perspective. Fordham Urban Law Journal, 30(1), 221–244.

    Google Scholar 

  • Pellegrino, E. D. (2006). Toward a reconstruction of medical morality. American Journal of Bioethics, 6(2), 65–71.

    Article  Google Scholar 

  • Rasmussen, L. (2005). The ethics and aesthetics of for-profit bioethics consultation. HEC Forum, 17(2), 94–121.

    Article  Google Scholar 

  • Steinman, M. A., Shlipak, M. G., & McPhee, S. J. (2001). Of principles and pens: Attitudes and practices of medicine housestaff toward pharmaceutical industry promotions. American Journal of Medicine, 110(7), 551–557.

    Article  Google Scholar 

  • Thompson, D. F. (1993). Understanding financial conflicts of interest. New England Journal of Medicine, 329(8), 573–576.

    Article  Google Scholar 

  • Watkins, T. (2005). Papers indicate firm knew possible Prozac suicide risk. CNN, January 3, 2005. http://articles.cnn.com/2005-01-3/health/prozac.documents_1_antidepressants-joseph-wesbecker-fda?_s=PM:HEALTH. Accessed 21 July 2011.

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Hanson, S.S. Ethics in the Discipline(s) of Bioethics. HEC Forum 23, 171–192 (2011). https://doi.org/10.1007/s10730-011-9163-8

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