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Food for Thought in Bioethics

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The term bioethics was first used in the early 1970s to address the ethical implications of genetic and ecological interventions. But it was soon applied to all aspects of biomedical ethics, including health care delivery, research, and public policy. 


Its literature draws from disciplines as varied as clinical medicine and nursing, scientific research, theology and philosophy, law, and the social sciences -- each with its own distinctive vocabulary and expressions.

History of bioethics
In 1970, Van Rensselaer Potter II, an American biochemist and professor of oncology, created the term bioethics to describe a new philosophy integrating biology, ecology, medicine and human values (Bioethics: Bridge to the Future, Prentice-Hall, 1971). It covered, in his mind, what we now call environmental ethics and biomedical ethics. 

Because of the appropriation of the term bioethics in medicine, Potter chose to use the term global bioethics in his book, Global Bioethics: Building on the Leopold Legacy, published in 1988.

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Recommended readings in bioethics
For a broad overview of the history of medical ethics, one can benefit from A.R. Jonsen's book, A Short History of Medical Ethics (Oxford University Press, 2008). He tells the story of more than 2,000 years of moral discourse about medicine, covering traditions in both the East and West. 

The book highlights particular events and persons, showing that even though there are some cultural differences, common themes coalesce in a long tradition of the ethics of medicine.

If you like story telling or enjoy our Difficult Case Reviews, you will be interested in the book from P.J. Ford and D.M. Dudzinski (eds.) called Complex Ethics Consultations: Cases that Haunt Us (Cambridge University Press, 2008). Twenty-eight detailed cases explore the ethical reasoning, professional issues and emotional aspects of these impossibly difficult consultations. The cases are grouped by theme to aid teaching, discussion and professional growth.

Additional resource
bioethics.jpgIf you prefer encyclopedias, dictionaries and glossaries, then A Handbook of Bioethics Terms by JB Tubbs (Georgetown University Press, 2009) could be a good introduction to the field with over 400 entries on the significant terms, expressions, titles, and court cases that are most important to the field. It is surely more user friendly than the 3000 plus page Encyclopedia of Bioethics edited by SG Post (Macmillan Reference USA, 3rd edn., 2003)!

If you prefer "classics" in the field, try reading T. Beauchamp and J. Childress': Principles of Biomedical Ethics (6th edn., Oxford University Press, 2008). It teaches the widely-known "Four Principles Method": beneficence, nonmaleficence, autonomy and justice. No one can understand the field of bioethics in the United States apart from this volume. The latest edition integrates case studies throughout the text, rather than presenting them in an appendix as in previous editions.

If you are looking for practical guides to help you at the bedside, two short books can be recommended. The first is Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine by AR Jonsen, M Siegler and WJ Winslade (7th edn., McGraw-Hill, 2010). Clinical Ethics presents the, "Four-Topics Method" to help you make the right choice when facing complex ethical questions and dilemmas encountered during everyday patient care. It goes beyond theory to offer a solid decision-making strategy applicable to real-world practice. The second, Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians (Oxford University Press, 2008) written by PC Hebert, offers a variety of clinical vignettes and concise teaching.

Finally, on-going discussions in bioethics and useful information can be found in The American Journal of Bioethics (AJOB).




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