Biomedical Ethics Introduction201 2.pptx

1. Biomedical Ethics: Introduction
Steinbock, Arras, & London

2. • In Philosophy we make a distinction between
positive and normative statements. A positive
statement is a factual statement that describes
a fact or event in the external world.
• A normative statement expresses an “ought” or
“should” question.
• Biomedical ethics deals with normative
questions, or questions that are in the form of
“ought” or “should”.

3. • An ought question in Biomedical Ethics can be of
the following form: Should physicians always be
healers, or can they be sometimes killers or
participate in a process that ends someone’s life?
• All “ought” questions have to do with right or
wrong or the morality of an action.
• Other questions in Biomedical Ethics are how
participants are shaped by age, class, race, and
gender.

4. • Some of the central questions in Biomedical
Ethics is how to practice morally as a Health
Care Professional? What is the good character
of a physician and how to carefully resolve a
practical moral issue.
• There are different ways in which an action can
be justified; one is to apply top down theories
to concrete cases, the other is to go case by
case and do bottom up judgment concretely.

5. Top Down Versus Bottom Up
• In top down cases one may apply an abstract theory like
Rule Utilitarianism: for example, one ought to act
according to that Rule that promotes the greatest
happiness of the Greatest number of people; next, one
may apply this rule to the action of a health care
professional and determine the morality of that action.
• On the other hand, one may also go from the concrete
to the abstract, that is, see what are the different
aspects of this specific case and then proceed to make a
judgment.

6. The Origin Of Bioethics
• Bioethics was born in the 1970s from a “blip in
the radar” of public consciousness to a proper
academic and service oriented profession with
its own discourse, journals, conferences, and
degree programs.

7. Technological Innovation & Civil Rights
Movement
• One of the most important reason for
Biomedical Ethics to come into existence is
due to technological advancement.
• Life sustaining of terminally ill patient, fetal
abnormalities, in vitro fertilization, facilitating
conception for infertile couples are important
medical practices that came into existence as
a result of technical innovation.

8. The Scope & Extension Of Biomedicine Over
The Past Years
• 1. Originally Cardiopulmonary resuscitation was
intended for otherwise healthy victims of drowning
or electrocution; gradually it has become a violent or
final “rite of passage” for many aged moribund
patient in the nation’s hospital.
• Artificial nutrition and hydration that was originally
intended as a temporary bridge to the restoration of
patients digestive functioning is now routinely
delivered to thousands of patients who have
irreversibly lost all brain functions.

9. • Prenatal diagnosis, which was originally
intended for fetuses at high risk of a metabolic
or genetic disorder is now routinely offered to
and sought by many woman in their late 20s
or early 30s who are no special health risk; the
availability of this technology has expanded
choice, while imposing new pressure on many
woman by altering their definition of an
“acceptable risk” during pregnancy.

10. • IVF which was originally developed to aid
infertile married couple are now being offered
to single women, to adult daughters who
volunteer to serve as surrogate mothers for
their own mothers’ children (to be mothers of
their own siblings), to post menopausal
women in their late 40s and 50s.

11. • In conjunction with the newly developed
techniques of “embryo splitting” a kind of
cloning IVF might make it possible for a
woman to give birth from her previously
frozen embryo.
• Each technological innovation has a social and
moral component.

12. • When anesthesia was introduced to ease the pain of
childbirth it was considered unnatural as women
were supposed to bear the pain of childbirth, slowly
society accepted the use of anesthesia in childbirth.
• Moral reservations about heart transplant raises
questions about social policies such as
contraception, abortion, the sanctity of life, and
others think that some of these involve minority
target group; development in genetics made possible
by the human genome project, in vitro

13. • Fertilization in women and considering how ethical it
is for elderly women to do this.
• With the change in technology our values have also
changed and such things as short stature, crooked
teeth, obesity, small breasts have become medical
conditions.
• Further questions about in vitro fertilization,
cosmetic personality altering drug and new
knowledge about critical care has opened up new
dimensions and new values about life & death.

14. • The whole controversy between “higher” and “lower”
brain functions in determining death.
• Determining the real “mother” in the carrier gene
associated development of coronary and artery
development.
• The question as to who should get treatment, and
who deserves to live?
• One important ethical question about rationing scarce
medical commodities is, who can we morally ration
out in advanced bone marrow transplant?

15. • Further questions are which deserves more
macro allocation, food, shelter, clothing, or
“basic” services like health care for all without
disrupting the physician patient relationship.

16. Other sources Of Biomedical Problem
• 1. What are the other factors that contributed to the
growth and expansion of biomedical Ethics apart from
the change in technology?
• Limits of patient confidentiality
• Truth telling
• Euthanasia
• Demands coming from civil rights movements such as
the right to information, health care, women’s critique
of male dominance in medical practice, assimilation of
medicine in a consumerist culture.

17. • Further, some issues such as can we reveal
some genetic disease to patients?
• Highly controversial practices such as artificial
insemination with donated sperm, surrogate
motherhood, institution of marriage, using
someone’s sperm to give birth.