A comprehensive analysis of the evolving conditions that provided for the emergence and autonomization of the field of bioethical inquiry, as well as the social, cultural and political background against which its birth can be set, should enlighten us about the problematic nature that characterises it from its very onset. Those conditions are: abuses in experimentation on human subjects, availability of new biomedical technologies, the challenging of prevalent medical paradigms and the ultimate meaning and purpose of medical care, new scientific (...) and social fields of concern dealing with ecology and environmental health, genetic engineering and biotechnologies, demographics, behavioural manipulation, reproductive medicine, etc., the upsurge of social movements raising issues of medical importance, and the need for an ethics for the technological age. The scope and meaning of bioethics is best defined by the overriding questions that open up the field of both theoretical and practical bioethical inquiry rather than by the individual responses given to such questions by the most prominent spokesmen in bioethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics in Azerbaijan:History and Development of Bioethics in AzerbaijanAdelia Avaz gizi Namazova (bio) and Tarana Qadir gizi Taghi-Zada (bio)HistoryAzerbaijan is a unique country with a centuries-old culture and history; it is a country located at the junction of Europe and Western Asia, uniting economic and cultural relationships between two continents and harmoniously combining the elements of various civilisations and cultures. Peculiarities of the historical development of Azerbaijan (...) and its geographical location, as well as the ethnic composition of the population created an opportunity for the flourishing of various religions. Idolatry, fire worship, Zoroastrianism, Judaism, Christianity, Islam and other religions were spread in the country during different periods. The multinational and confessional state (also known as a multicultural state), with its unique cultural inheritance, provided the opportunity not only to adhere to traditions and customs of previous generations, but also to develop spiritual-moral values that created respect and tolerance towards other religions. As a result of this cultural synthesis throughout the centuries, universal ethical values such as respecting the dignity of all persons, veneration of elderly people by youth, and principals of mercy, care and love to those in need and in the closing stages of life evolved. Numerous sources of ancient manuscripts bear witness that poetry, philosophy and the ethics of medical practice have always been part of the searching and thinking in medicine.One of the ancient religions, Zoroastrianism, begins from fire worship and was revealed to the religious teacher and prophet Zoroaster (seventh century BC, Holy Book Zend-Avesta). According to the basic understandings of Zoroastrianism, there are two principles which are always contradictory—Kindness and Evil. [End Page 433] Zoroaster called upon people to be fair and pure, to fight any kind of unfairness and disgracefulness.The name of the healer Logman is covered with legends and is well known among different nations of the East. Across generations in Azerbaijan the name Logman has been used, inspiring the sharing of medical secrets and advice, cure of different illnesses and their prevention.1 This is witnessed by the Logman Covenants. The first covenant warns of excessive consumption of alcohol and food, educating people in hygienic practices and developing that culture. Another covenant is dedicated to the high mission of the medic: “Every kindness on this planet created people. The kind beginning is there where you have a doctor.”The basic principles of humanitarian behaviour of the doctor have also been described in an ancient manuscript of Azerbaijani literature, the national epic “Kitabi-Dede Qorqud” (seventh century), which provides advice on how to maintain one’s health in good condition, and the importance of spiritual purity, health and morals.Outstanding philosophers, poets and scientists of the ancient land of Azerbaijan, such as Bakhmaniyar ibn Marzaban (eleventh century), Omar Osmanoglu (eleventh century), Khatib Tabrizi (1030–1109), Khagani (1120–99), Nizami Ganjavi (1141–1209), Nakchivani (thirteenth century), Makhmud Shabustari (1287–1320), Seid YakhyaBakuvi (1410–62), Fizuli (1498–1556), Vagif (1717–97) and many others, described in their doctrines the difficult, selfless activities of doctors and the positive results and outcomes.6Back in the eleventh2 century, when madrasas or spiritual schools, where theology and medicine were taught and, ecclesiastics and tabibs (medics) were prepared and educated, a medical school was established in Azerbaijan’s old capital Shamakha. Here, under the guidance of the most famous doctor and pharmacologist in all the East, Omar Osman oglu, training and education of medical workers took place. Having been widely educated, Omar Osman oglu was an adherent of the moral principles declared by Logman and taught his students that the main goal of any doctor’s activities should be based on love towards the other person. His understanding of a medic’s behaviour was contrary to major customs of that time, saying: “Don’t deny your enemy. Heal him.” Omar Osman oglu inspired his students to undertake spiritual pureness, patriotism and service to the nation. “Bring benefit to the nation, even if it is contrary with your personal benefit”, “do not be egotistical”, “do not try to find your way to heaven and do not be afraid of hell” were his slogans.The famous poet Khagani (1120... (shrink)

The first history of American medical ethics published in more than a half century, Before Bioethics tracks the evolution of American medical ethics from colonial midwives and physicians' oaths to current bioethical controversies over abortion, AIDS, animal rights, and physician-assisted suicide.

Standard bioethics textbooks present the field to students and non-experts as a form of "applied ethics." This ahistoric and rationalistic presentation is similar to that used in philosophy of science textbooks until three decades ago. Thomas Kuhn famously critiqued this self-conception of the philosophy of science, persuading the field that it would become deeper, richer, and more philosophical, if it integrated the history of science, especially the history of scientific change, into its self-conception. This essay urges a similar reconceptualization (...) for bioethics, arguing that the analysis of moral change ought to be integral to bioethics (and to ethics generally). It proceeds by suggesting the sterility of the ahistoric, rationalist applied ethics model of bioethics embraced by standard bioethics textbooks. It also suggests the fecundity of alternative conceptions of the bioethics that focus on the history of successful and failed attempts to negotiate moral change, and the history of multifaceted relations between moral philosophy and practical ethics. (shrink)

While functioning quite well for many years, the bioethics profession is in crisis. John H. Evans closely examines the history of the bioethics profession, and based on the sociological reasons the profession evolved as it did, proposes a radical solution to the crisis.

This paper considers the disciplines of literature and history and the contributions each makes to the discourse of bioethics. In each case I note the pedagogic ends that can be enacted though the appropriate use of the each of these disciplines in the sphere of medical education, particularly in the medical ethics classroom.1 I then explore the contribution that both these disciplines and their respective methodologies can and do bring to the academic field of bioethics. I conclude with (...) a brief consideration of the relations between literature and history with particular attention to the possibilities for a future bioethics informed by history and literature after the empirical turn. (shrink)

Slippery slope‐, taboo‐breaking‐ or Nazi‐analogy‐arguments are common, but not uncontroversial examples of the complex relationship between bioethics and the various ways of using historical arguments in these debates. In our analysis we examine first the relationship between bioethics and medical history both as separate disciplines and as argumentative practices. Secondly, we then analyse six common types of historical arguments in bioethics (slippery slope‐, analogy‐, continuity‐, knockout/taboo‐, ethical progress‐ and accomplice‐arguments), some as arguments within the academic debate of (...) bioethics, others as arguments within political and public debates over bioethical issues. We conclude by suggesting to bioethicists to better understand historical arguments as socially and culturally embedded practices of critical reflection of power, medical and government paternalism and possible future scenarios. More interdisciplinarity between ethicists and medical historians is needed to appropriately rationalize and understand the different legacies. (shrink)

Objective: To present a narrative review of the history of bioethics in Latin America and of scientific output in this interdisciplinary field. Methods: This was a mixed-methods study. Results: A total of 1458 records were retrieved, of which 1167 met the inclusion criteria. According to the Web of Science classification, the predominant topics of study were medical ethics, social sciences and medicine, and environmental and public health topics. Four themes of bioethics output in the Latin American literature have (...) emerged: issues involving the beginning and end of life, ethics in human research, patient–provider relationships, and ethics training for health professionals. Conclusion: Although bioethics is a growing interdisciplinary field in Latin America, its academic impact is still very low, and programmes are highly concentrated in large urban centres in a few countries. Challenges includes the regional and international impact of local scientific output. (shrink)

Cultural historians and historians of medicine are a rarity in bioethics. Even those who write histories of bioethics are philosophers, sociologists, or theologians. Where have all the historians gone? If bioethics is to contribute to the urgent work of addressing social justice, structural racism, and health inequity, we bioethicists need to embrace history as a fully constituent part of our field. Historians can help us apprehend the ideas that shaped bioethics, and health policy more broadly, and (...) discover the dissenting arguments that might inspire us now. Given our annus horribilis, history has become an instrumental necessity. It is only through the study of history that we can understand the past so as to reimagine how bioethics can influence health policy and work toward health equity. (shrink)

“Bioethics began in religion, but religion has faded from bioethics.” This interpretation is commonplace among many who have an opinion on bioethics. This chapter examines this.

The history of American medical ethics is a notoriously unwieldy field that encompasses an enormous amount of complex material. No single book can realistically analyze all of its dimensions in a genuinely scholarly fashion. But Robert Baker, one of the nation’s most distinguished professors in that field, has now provided the rest of us with an immensely helpful survey of one of its most important aspects: the evolution of what he terms “the formalized statements of medical morality” (164). Much of (...) Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution traces, in an almost genealogical manner, medicine’s shifting behavioral codes and ethical systems from .. (shrink)

The article presents and analyzes different approaches of U.S. bioethicists in comprehending the Nazi medical crimes after 1945. The account is divided into two sections: one dealing with discussions on research ethics and the Nuremberg Code up until the 1970s and the other ranging from the 1970s to the present and highlighting bioethics' engagement with Nazi analogies. The portrayal of different bioethical scholars, institutions, and documents—most notably Henry K. Beecher, Jay Katz, the Belmont Report, the Hastings Center, Arthur L. (...) Caplan, and Robert M. Veatch—provides a nuanced interpretation of the motives that bioethicists held and the strategies that they applied to establish an understanding of the Nazi medical crimes and their relation to contemporary bioethical issues. In this, the different approaches shared a common goal: To integrate the Nazi medical crimes into an ethical framework by means of selective acknowledgments and representation of their history. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Clinical Bioethics at NIH:History and A New VisionJohn C. Fletcher (bio)On July 3, 1995, Dr. John I. Gallin, Director of the Magnuson Clinical Center of the National Institutes of Health (NIH), convened a one-day "Conference on the Future of Clinical Bioethics at the National Institutes of Health Intramural Program." Conferees included NIH officials and a panel of consultants from bioethics programs around the nation.1 The subject (...) was the future of NIH's intramural bioethics program and specifically a vision of a new multi-component program, presented by Dr. Gallin, the first speaker. Dr. Harold Varmus, Director of NIH, was there to assure his support for Dr. Gallin's vision. This author, honored to be second speaker, was invited to sketch a brief history of bioethics at NIH. The present article reviews some of this history and then reports on Dr. Gallin's proposal, points of consensus among speakers and conferees, and the search for a Chief of the Clinical Bioethics Program.History of Bioethics at NIHIt is often said that NIH is a well-kept secret as the nation's leading biomedical research facility. Also, few people know that NIH has a long history in bioethics. Some key events in that history are shown in Figure 1, beginning with two that occurred prior to the birth of bioethics. NIH made an early policy response to protect human subjects of research and to find acceptable limits for scientific freedom. The Clinical Center (CC), a 550-bed research hospital, opened in 1953. A subcommittee of the Medical Board, the Clinical Research Committee (CRC), was formed for prior group review of all studies with normal volunteers. The traditional practice was for researchers themselves to decide when studies would begin, which subjects to recruit, and whether informed consent would be sought. The CRC intervention bit into this tradition. In addition, patient studies that posed significant risks or departed widely from medical practice were reviewed by referral from the Clinical Directors of the various Institutes. Was this CRC an early institutional review [End Page 355] board (IRB)? As a guest researcher, I was permitted to observe the CRCs meetings between 1966 and 1969. It functioned much like an IRB but had no community or non-scientist members. Other IRB-like review groups undoubtedly existed prior to the CRC. Robert Levine (personal communication, September 7, 1995) recalls that Beth Israel Hospital in Boston had one in 1938. Historical research is clearly needed on the earliest forms of research review.Table 1. Bioethics at NIHEventYearClinical Research Committee1953Surgeon-General's PPO #1291966NIGMS funds Hastings Genetics Group1973OPRR's Mission1974NLM's grant to KennedyInstitute for Bibliography of Bioethics1974Recombinant DNA Advisory Committee1974STEP Series Bioethics Speakers1975Pre-IRBs at the CC1975-76Assistant for Bioethics to Director, CC1977RAC-Human Gene Therapy Subcommittee1983Lipsett Proposal (ICD)1983Liaison Group, CC1983Bioethics Program, CC1985Durable Power of Attorney for Researchwith Incapacitated Subjects1985-86NLM funds National Reference Centerfor Bioethics Literature1985National Institute for Nursing Research1986Bioethics Post-Doctoral Fellows Program1989ELSI Program1989Bioethicists on CC-IRBs1989CC-Ethics Committee1990Office of Human Subjects Research1992 [End Page 356]Between 1963 and 1967, the media exposed instances of ethically troubling research, and Beecher (1966) and Pappworth (1967) published sharp criticisms of the weak state of research ethics. In 1966, Surgeon-General William Stewart and NIH Director James Shannon issued a policy requiring local group review of all research involving human subjects before making an application for NIH peer review (Surgeon General 1966). The policy was the first in any nation to mandate ethics committees for clinical research. However, it did not apply to the NIH intramural program until Congress passed the National Research Act in 1974 (Public Law 93-348; 202, 88 Stat. 342, 1974). This lag permitted NIH intramural investigators the luxury of feeling above the norms imposed on ordinary mortals and guaranteed more resistance to the inevitable change to come. Resistance to change marked the intramural program from the mid-1960s to the mid-1970s... (shrink)

This article details the relationship between history and bioethics. I argue that historians' reluctance to engage with bioethics rests on a misreading of the field as solely reducible to applied ethics, and overlooks previous enthusiasm for historical perspectives. I claim that seeing bioethics as its practitioners see it – as an interdisciplinary meeting ground – should encourage historians to collaborate in greater numbers. I conclude by outlining how bioethics might benefit from new histories of the field, (...) and how historians can lend a fresh perspective to bioethical debates. (shrink)

The Making of British Bioethics provides the first in-depth study of how philosophers, lawyers and other 'outsiders' came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists. It details how British bioethics emerged thanks to a dynamic interplay between sociopolitical concerns and the aims of specific professional groups and individuals who helped create the demand for outside involvement and transformed themselves into influential 'ethics experts'. Highlighting this (...) interplay helps us appreciate how issues such as embryo research and assisted dying became high-profile 'bioethical' concerns in the late twentieth century, and why different groups now play a critical role in developing regulatory standards and leading public debates. The book draws on a wide range of original sources and will be of interest to historians of medicine and science, general historians and bioethicists. (shrink)

In the paper, the author deals with the history of attempts to defame integrative bioethics by a group of Croatian philosophers and incidental media appearances in which the tendency was to slander the long-standing research concept of the Zagreb bioethics school. In the introduction, a historical overview of the basic qualitative and quantitative results of integrative bioethics in the Croatian and European context is given. This is followed by an analysis of the context of defamation of integrative (...) bioethics and the actors of defamation, separated according to “scientific” and media content. Finally, the attempt to compromise and profane integrative bioethics is interpreted as part of the destrolution phenomenon, the theory of post-communist chaos and the production of fake envy. (shrink)

When we go to the doctor, he or she will not begin to treat us without taking our history – and not just our history but that of our parents and grandparents before us. The doctor will not see us u...

In this chapter, I shall give an account of the emergence of bioethics as a field of study and then describe its common features in an international context. In the final section I shall suggest how some concept of public reason might be used to meet the challenges thrown up by the contentious nature of the field.

Part III: Now presents solely, clinical ethics. --.

Contemporary Bioethics: A Reader with Cases is the most cutting-edge bioethics anthology/casebook available. Incorporating introductions, readings, and cases that span the breadth of the discipline, this exceptional volume captures the spirit of bioethics as a rich, exciting, and continuously evolving field. Addressing all of the essential topics--including abortion, reproductive ethics, end-of-life care, research ethics, and the allocation of resources--it also moves beyond the "classic" approach of other books by extending into timely and provocative issues like terrorism, cosmetic (...) surgery, immigration, genetic manipulations, links between first- and third-world health, and--unique to this book--environmental sustainability and climate change. In addition, Contemporary Bioethics is the only book of its kind that includes both philosophical and religious perspectives.The text opens with a substantial introduction that presents key ethical principles, theories, and methods and shows students how to use these tools to frame and address ethical dilemmas in medicine. Covering the brief yet captivating history of the field, the introduction also considers the role of religion in the development of bioethics and examines differences between secular and religious modes of argumentation. Each of the seven topical chapters contains an in-depth introduction, a selection of concise readings representing a diverse range of moral perspectives, discussion questions, and a collection of full-length and provocative case studies that enable students to further explore the issues.Ideal for introductory courses in bioethics and biomedical ethics, Contemporary Bioethics is supplemented by a Instructor's Manual on CD and a Companion Website containing resources for both students and professors, including chapter summaries, additional cases with discussion questions, ideas for further reading, vocabulary flashcards, self-quizzes, and more. (shrink)

The papers in this number of the Journal originated in a session sponsored by the American Philosophical Association's Committee on Philosophy and Medicine in 1999. The four papers and two commentaries identify and address philosophical challenges of how we should understand and teach bioethics in the liberal arts and health professions settings. In the course of introducing the six papers, this article explores themes these papers raise, especially the relationship among professional medical ethics, the "long history" of medical ethics, (...) and bioethics. The tendency of bioethics to deprofessionalize medical ethics is rejected, in favor of an historically informed professional medical ethics. It is suggested that bioethics should be critically reconsidered from the perspective of medical ethics as professional ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 10.3 (2000) 265-281 [Access article in PDF] Scope Note 39 Genes, Patents, and Bioethics-Will History Repeat Itself? Susan Cartier Poland Gene patenting--the very notion sounds absurd! How can anyone claim to have invented the genes with which one is born? To make matters worse, genetic makeup precedes birth, meaning the existence of the invention predates the existence of the inventor. So, do we (...) really own our genes, or do they belong to our parents, or our governments, or a Supreme Being? Ownership is only one bioethical issue involved in gene patenting. But before looking at the issues, some essential and basic terms must be understood, namely genes and patents. Genes In his book On the Origin of Species, published in 1859, the biologist Charles Darwin proposed a theory called "natural selection," whereby living things changed over time or evolved through generations due to competition and variation. By experimenting with the garden pea in the 1860s, Gregor Mendel, a monk and accomplished horticulturalist, provided the mechanism of inheritance supporting the natural selection theory of his contemporary Darwin. That mechanism is the gene, or, as Mendel described it, a discrete "factor." The gene has also been defined as "the fundamental unit of heredity" (United States 1987, p. 157). Each individual has two copies of a gene, one from each parent, but that individual passes down to offspring only one of the two copies. Because of Mendel, the gene has become a scientific concept and the basis of a new scientific field: genetics.David C. Page (2000) of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology explained today's terms for genetics structures using an analogy taken from the home. In his view, the cell is a kitchen, the genome is a shelf in the kitchen, the chromosome is a cookbook on the shelf, the gene is a recipe in the cookbook, and a base-pair (either adenine with thymine or guanine with cytosine) is a single letter in the recipe. A protein, the [End Page 265] working molecule blueprinted by a gene, is a dish ready to eat, and an ingredient in the dish is an amino acid, which is a building block of the protein as specified by a string of base-pairs.Colin Tudge (1993), a British science journalist, would disagree with Page's description of the gene as a recipe. A recipe is like a blueprint: both are directions that precede the work. But a gene is not passive according to Tudge; it actively administers the cell's work, and it also responds to cellular events (Aldridge 1996).The current focus of scientific research and funding is on the gene and the completion of the sequencing of all the genes that comprise the human genome, portrayed in the press as a race between the U.S. government's Human Genome Project and the private corporation Celera Genomics. The real action, however, is at the protein level. The gene only holds the information to produce a protein; it is the three-dimensional shaped protein that does the work. In order to produce energy, eliminate waste, and perform other functions specific to a cell or tissue, proteins must bind, thus creating "biological pathways." Proteins bind (or not) and detach as a function of their shapes, which are determined by their precise chemical composition as spelled out in their genetic code. IBM will spend the next five years making one computer, Blue Gene, that will then take an entire year to come up with the chemical map for only one protein (Gillis 2000). It is estimated that there are about 40,000 proteins in the human body.Despite these overwhelming numbers, modern biology has been able to achieve significant results within the Human Genome Project's 15-year time frame, from 1990 to 2005. The genetic map was completed in 1993; the physical map was completed in 1995; and the genetic sequence is expected to be completed in 2002, with 97 to 99 percent completed as of 26 June 2000. This... (shrink)

This book explores and elaborates three theories of public reason, drawn from Rawlsian political liberalism, natural law theory, and Confucianism. Drawing together academics from these separate approaches, the volume explores how the three theories critique each other, as well as how each one brings its theoretical arsenal to bear on the urgent contemporary debate of medical assistance in dying. The volume is structured in two parts: an exploration of the three traditions, followed by an in-depth overview of the conceptual and (...) historical background. In Part I, the three comprehensive opening chapters are supplemented by six dynamic chapters in dialogue with each other, each author responding to the other two traditions, and subsequently reflecting on the possible deficiencies of their own theories. The chapters in Part II cover a broad range of subjects, from an overview of the history of bioethics to the nature of autonomy and its status as a moral and political value. In its entirety, the volume provides a vibrant and exemplary collaborative resource to scholars interested in the role of public reason and its relevance in bioethical debate. (shrink)

Introduction: making the invisible visible -- The nobility of the material -- Research at war -- The guilded age of research -- The doctor as whistle-blower -- New rules for the laboratory -- Bedside ethics -- The doctor as stranger -- Life through death -- Commissioning ethics -- No one to trust -- New rules for the bedside -- Epilogue: The price of success.

The coming of bioethics -- The coming of bioethicists -- "Choices on our conscience": the inauguration of the Kennedy Institute of Education -- "Hello, Dolly": bioethics in the media -- Celebrating bioethics and bioethicists -- Thinking socially and culturally in bioethics -- Reminiscences of observing participants -- Bioethics circles the globe -- Bioethics in France -- The development of bioethics in the Islamic Republic of Pakistan -- The coming of the culture wars to (...) American bioethics. (shrink)

Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and (...) revise the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)

Introduction -- Bioethics as scholarship -- Language, narrative and rhetoric in bioethics -- Euthanasia, the Nazi analogy and the slippery slope -- Heredity, genes and reproductive politics -- Human experimentation -- Thalidomide.

Over its short history, the young field of “neuroethics” has enjoyed remarkable public support within neuroscience. For instance, since 2006 the Annual Meeting of the Society for Neuroscience has h...