Concepts principles one by Kelly

Bioethics: Basic Concepts and Principles â&#x20AC;˘ Bioethics is a branch of applied ethics that addresses practical issues in the pursuit and application of bioscientific knowledge, in various fields. â&#x20AC;˘ Bioethics includes or overlaps with Medical Ethics, Animal Ethics, Environmental Ethics, and Public Policy Ethics, as individual fields of applied ethics.

Bioethics: Basic Concepts and Principles • Bioethics is a branch of applied ethics that addresses practical issues in the pursuit and application of bioscientific knowledge, in various fields. • Bioethics includes or overlaps with Medical Ethics, Animal Ethics, Environmental Ethics, and Public Policy Ethics, as individual fields of applied ethics. • Applied Ethics (as a branch of Philosophical Ethics) is the attempt to “apply” the concepts, theories and methods of ethics (as a branch of philosophy) to concrete, practical issues in a specific domain of practice (like clinical medicine, nursing, or biomedical research).

Bioethics: Basic Concepts and Principles • Philosophical Ethics includes: – General normative ethics, or ethical theory: an attempt to articulate and defend a general conception of the good, the right, and the just, and to elucidate how we ought to live, act, respond: “ought” vs. “is” – Metaethics: the attempt to clarify the basic language and concepts of ethics—including theories of value (Is “goodness” an objective quality or a subjective projection? Etc.); and theories of human action (Is human action a matter of free will or a matter of causal determinism? Are we really “responsible” for our conduct? Etc.)

Bioethics: Basic Concepts and Principles • Bioethics and General Normative Ethics: – Various theoretical perspectives have been offered, as philosophical bases for practical or applied bioethics, and we could spend the entire semester on theory (but we won’t); – Despite the ongoing theoretical debates, the American medical establishment has achieved consensus around a handful of guiding ethical principles, which themselves might be justified by various theories; – This consensus is typically expressed as the “Four Principle Approach” (or “Principlism”), and it is the underlying source of the “Four Topics” or “Four Box” approach presented in our text, Clinical Ethics, by Jonsen, Siegler, and Winslade.

A PrincipleBased Approach to Biomedical Ethics • The Principles of Biomedical Ethics, by Beauchamp and Childress, 1979. Result: “Four Principles” approach • Dilemmas and issues are clarified, analyzed, and resolved via reference to four principles: – Respect for autonomy (HCP should be guided by patient preferences and should not interfere with patient autonomy); – nonmaleficence (HCP must not act in ways that entail harm or injury to patients);

– Respect for autonomy (HCP should be guided by patient preferences and should not interfere with patient autonomy); – nonmaleficence (HCP must not act in ways that entail harm or injury to patients); – beneficence (HCP must act in ways that promote patient welfare);

A PrincipleBased Approach to Biomedical Ethics • The Four Principles stake out “prima facie” duties/values— i.e., “first glance” or “first surface” duties that we should attempt to follow, all at once… • Principles might come into conflict; how, then, to rank/re order/set aside different principles in different contexts? (Casestudies will exemplify many such conflicts.)

A PrincipleBased Approach to Biomedical Ethics • One example: Conflict between respect of pt autonomy and beneficent, humanitarian values of the provider: the question of medical paternalisminterfering with the pt’s liberty “for her own good”… • The tension between these principles is often presented in medical decisionmaking discussions; thus, in the next weeks of class, we’ll consider the concepts of autonomy and paternalism more carefully… • …along with related considerations of decisionmaking capacity, truthfulness, confidentiality, and so forth.