1 - Eubios Ethics Institute

1. Making Choices, Diversity and Bioethics
Chapter objectives
Bioethics could be defined as the study of ethical issues and decision-
making associated with the use of living organisms.
This chapter is an introduction with aims to show that:
1. Bioethics is not about thinking that we can always find one correct
solution to ethical problems. There can be different choices made
after ethical reflection.
2. Bioethics includes both medical ethics and environmental ethics, and
problems of different scales.
3. Basic ethical principles can aid decision-making.
4. Bioethics is learning how to balance different benefits, risks and
duties.
5. Concepts of bioethics can be seen in literature, art, music, culture,
philosophy, and religion, through history. |1.1. Did you make any difficult choices recently? |
| |
|Society is facing many important decisions about the use of science and |
|technology. These decisions affect the environment, human health, |
|society and international policy. In order to resolve these issues and |
|to develop principles for decision making. We need to involve wisdom |
|from many fields such as anthropology, sociology, biology, medicine, |
|religion, psychology, philosophy and economics. We must try to |
|understand that the science of biology occurs in the context of |
|societies that have different philosophical and religious values. |
| |
|The term bioethics reminds us of the words biology and ethics. New |
|technology can be a catalyst for us to think about life issues. Some |
|examples include organ transplantation, genetic engineering, and |
|assisted reproductive technologies. These have stimulated research into|
|bioethics in the last few decades. |
| |
|We cannot avoid making decisions about these issues due to the rapid |
|development of science and technology as well as the increasing |
|deterioration of our environment. These decisions must be made by |
|everyone regardless of their social or economic status in life. The |
|more possibilities we have, the more decisions we make. A good |
|education is no guarantee that we can make better decisions. We often |
|do not use what we have learned in textbooks in real life. It is also |
|important to look at how we can find some balance when faced with |
|conflicting ideals. |
|1.2. Principles of Bioethics: Autonomy |
| |
|Q1. Look around the class and see something each person has done to |
|make them look different to other persons? What have they done to look |
|the same? |
| |
|It is easy to see that people are different, if we look at our faces, |
|sizes and the clothes that we wear. This is also true of the personal |
|choices that we make. We may decide to play soccer, read a book, or |
|watch television. We may be pressured by people around us to behave in |
|one way, but ultimately it is our choice. There is a duty to let people|
|make their own choices. |
|Autonomy is also expressed in the language of rights, by recognizing |
|the right of individuals to make choices. The challenge of respecting |
|people as equal persons with their own set of values is a challenge for|
|us all. |
|One of the assumptions of bioethics is that all human beings have equal|
|rights. There are universal human rights, which should be protected, |
|and recognized. We can argue for the foundation of human rights from |
|secular philosophy or religion. This is different from saying everyone |
|is of equal use to the world. The concept of human rights tries to |
|separate human beings from the concept of how useful a person is. | Q2. How can you respect the autonomy of others more?
Q3. What are the limits to personal choice? What factors could we use
to make such
decisions in your daily life?
|1.3. Principles of Bioethics: Justice |
|Our own autonomy is limited by respect for the autonomy of other |
|individuals in society, and in the world. Those who claim that |
|individual autonomy comes above societal interests need to remember |
|that a major reason for protecting society is because it involves many |
|lives. We should give every member in society equal and fair |
|opportunities in life: this is justice. |
|The ethical principle of justice and legal justice may be different |
|because legal justice has to define the minimum common norms to stop |
|the abuse of people. We may be ethically expected to do better than |
|that. |
|Different people have different goals and can have different values. |
|Diversity is part of what we call being human. We should never expect |
|all people to balance the same values in the same way all the time. |
|Diversity of attitudes and characters of human individuals are |
|represented in any one society. It is a paradox that although not |
|everyone has the same opinion, we are in fact not that different. A |
|failing of human thought is that people view their society as being |
|different from another, with sweeping generalizations. Such thinking is|
|often tied to discrimination. |
|Future generations are also an essential part of society. People's |
|well-being should be promoted, and their values and choices respected |
|but at the same time, limits must be placed on the pursuit of |
|individual autonomy. This is called intergenerational justice. |
Q4. Do you agree or disagree with the statement, "All human beings have
equal rights"?
Q5. Choose one example of a technological advancement, and in a class
group, identify the benefits and risks of this new technology. Have
different people say one benefit and one risk, going around the class.
How many can you think of?
|1.4. Principles of bioethics: Benefits versus risks |
|Many medical and environmental technologies are challenging because |
|they involve technology with both benefits and risks. A fundamental |
|way of reasoning that people have is to balance doing good against a|
|risk of doing harm. Human beings are spiritual beings, sharing |
|emotions such as love and hate, greed and generosity. One of the |
|philosophical ideas of society is to pursue progress. This is a |
|powerful argument for further research into ways of improving health|
|and agriculture, and living standards. This is called the principle |
|of beneficence. |
|The benefits are great, but there are many possible risks - |
|including doing nothing. A failure to attempt to do good, is a form |
|of doing harm. The precise outcome of what we do in nature or |
|medicine is not always certain. This uncertainty can be called a |
|risk of failure or chance of success. Ignorance of the consequences |
|should make us act with caution in using new techniques. In our |
|actions we try to minimize or avoid doing harm. Balancing the |
|benefits and risks of scientific technology are not always easy, but|
|a first step is to identify the possible benefits and risks to |
|different people and parts of our world. |
1.5. Theories of bioethics
How do we balance protecting one person's autonomy with protecting
everyone else's autonomy? Utilitarianism is one ethical theory that makes
us think about the greatest good (pleasure) for the greatest number, and
the least harm (pain) for the least number. However, sometimes it is very
difficult to assign values to these pains and pleasures for different
people.
Sometimes if we perform some action, we will find it easier to perform
another. There is the idea of a slippery slope. This expression envisages a
slope where once footing is lost it cannot be regained. While we may not do
any direct harm with the application we have now, once we accept doing one
thing and drawing a line from another, later on we may find an inability to
draw a line. Considering the boundary between treating short persons to
become average height and making people tall to play basketball easier.
Despite the scientific world view that is prevalent among academics,
many other people find religions to be a much more important source of
guidance in life than science. In questions of ethics, this is true of most
people. Any theory of bioethics that will be applied to peoples of the
world must be acceptable to the common trends of major religious thought,
and must also be tolerant of differences.
Q6. Do you think that "the greatest good for the greatest number" can
be achieved?
1.6. Global and Local Ethics There are large and small problems in ethics. We can think of
problems that involve a single person. We can think of global problems.
One example is the depletion of the ozone layer. This causes increased
UV radiation which affects all living organisms. This problem could be
solved by individual action to stop using ozone-depleting chemical