Introduction of Bioethics

What is Bioethics
“Bioethics” was born in climate in which new
and revolutionary development in biomedical
sciences and clinical medicine, technological
breakthroughs, issues about “patient’s right”
and the rights of community as whole to
involved in decision that effect them,
increasing of awareness and critical question
of value-laden nature of medical decision
making
• “Science of survival” was the first proposed
term by Van Rensselaer Potter that in the
ecological sense is an interdisciplinary study
aimed at ensuring the preservation of the
biosphere (Potter 1970)
• “Bioethics” term is new, however it is also can
be seen as modern version of medical ethics
• Bioethics claims medical ethics as part of its
province
• Medical ethics more focused on doctor-
patient and doctor-doctor relationship
• Bioethics goes beyond the scope of traditional
medical ethics
• Bioethics goal is not the development of, or
adherence to, a code or set of precepts, but a
better understanding of the issues
• Bioethics prepared to ask deep philosophical
question about the nature of ethics, the value
of life, what it is to be a person, the significance
of being human
• Bioethics embraces issues of public policy and
the direction and control of sciences
 Medical Ethics
• One of the earliest written provision relating to
medical practice is from Code of Hammurabi,
written in Babylon in about 1750 BC
• The ancient ethical codes were often expressed in
the form oaths
• The best-known medical oath and often regarded
as the foundation of Western medical ethics is the
Oath of Hippocrates (500 BC)
• The oath establishes the principles of
beneficence and nonmaleficence that doctor
must act so as the benefit their patients and
seek to prevent harm
• The oath’s prohibition on giving a potion for
abortion, or to end the life of a patient.
• The oath’s is consonant with the view of
sanctity of human life that dominated medical
ethics under Christendom
• Medical ethics intertwined by prevailing
religious trends and teaching
• Gregory 18th Century Scottish doctor-
philosopher reflect that doctor must
“sympathetic”. Doctor have to develop “that
sensibility of heart which makes us feel for
distresses of our fellow creatures, and which, of
consequence, incites us in the most powerful
manner to relieve them” Gregory 1817:22)
 Nursing Ethics
• The serious discuss of nursing ethics starts at
early 1890s
• Until 1960s with vast majority of doctor are
men and vast majority of nurses are woman,
the nurse’s primary responsibility was to
doctor prevailed rather then to the patients
and it’s reflected in the 1965 version of the
International Code of Nursing Ethics.
“The nurse is under an obligation to carry out
the physician’s orders intelligently and loyally”
(Item 7 of the 1965 International Code of Nursing Ethics)
• With the revival of feminist thinking in late
1960s paralleled with the developing of self-
consciousness and self-assertiveness of
nurses, in 1973 version of International Code
of Nursing Ethics the nurses “primary
responsibility” is no longer seen to be to
doctor but to patients
• Jean Watson, an nurse and prominent
proponent of nursing ethics of care said that
an ethics of care “ties us to the people we
serve and not to the rule through which we
serve them” (Watson 1988:2)
 Bioethics
• Moral and Medicine by Joseph Fletcher’s published
in 1954 is known as the first “modern” work of
bioethics
• Bioethics start to take shape as a field of study in
1960s
• In 1970s moral philosophers began to address
themselves to practical ethical issues as abortion and
euthanasia, the ethics of war and of capital
punishment, the allocation of scarce medical
resource, animal right, and so on.
• The movement in philosophy in some issue
that related to practices in health care and the
biological science helped to establish bioethics
as a critical discipline.
• The founding of first dialysis machine, heart
transplant, decision of life-prolonging
treatment for severely ill or disabled infants,
are some of the high-profile bioethical issues
that widely publicized
• Bioethics was an interdisciplinary enterprise
• It is the combination of philosophy, religious
view, medicine, nursing, biomedical science,
law, economic, public policy, etc