I.

Introduction

Medical Ethics or Bioethics, study and application of moral values, rights, and duties in the fields of medical treatment and research. Medical decisions involving moral issues are made every day in diverse situations such as the relationship between patient and physician, the treatment of human and animal subjects in biomedical experimentation, the allocation of scarce medical resources, the complex questions that surround the beginning and the end of a human life, and the conduct of clinical medicine and life-sciences research.

Medical ethics traces its roots back as far as ancient Greece, but the field gained particular prominence in the late 20th century. Many of the current issues in medical ethics are the product of advances in scientific knowledge and biomedical technology. These advances have presented humanity not only with great progress in treating and preventing disease but also with new questions and uncertainties about the basic nature of life and death. As people have grappled with issues on the frontier of medical science and research, medical ethics has grown into a separate profession and field of study. Professional medical ethicists bring expertise from fields such as philosophy, social sciences, medicine, research science, law, and theology.

Medical ethicists serve as advisors to hospitals and other health-care institutions. They have also served as advisors to government at various levels. For example, experts in medical ethics assisted the United States government from 1974 to 1978 as members of the National Commission for the Protection of Human Subjects of Medical Research. The commission was formed in response to several large-scale experiments that used human subjects who were tricked into participating. In the late 1990s the National Bioethics Advisory Commission, at the direction of President Bill Clinton, studied issues related to the cloning of human beings. Ethicists also serve as advisors to state legislatures in the writing of laws concerning the decision to end life support, the use of genetic testing, physician-assisted suicide, and other matters. Medical ethics has even become part of the landscape in the commercial world of science. An increasing number of firms involved in biotechnology (the business of applying biological and genetic research to the development of new drugs and other products) regularly consult with medical ethicists about business and research practices.

The field of medical ethics is also an international discipline. The World Health Organization founded the Council for International Organizations of Medical Sciences in 1949 to collect worldwide data on the use of human subjects in research. In 1993 the United Nations Educational, Scientific, and Cultural Organization (UNESCO) established an International Bioethics Committee to examine and monitor worldwide issues in medicine and life-sciences research. The UNESCO directory lists more than 500 centers outside the United States. The International Association of Bioethics was founded in 1997 to facilitate the exchange of information in medical ethics issues and to encourage research and teaching in the field.

In the United States and Canada more than 25 universities offer degrees in medical ethics. In many instances, the subject is also part of the curriculum in the education of physicians and other health-care professionals. Many medical schools include ethics courses that examine topics such as theories of moral decision-making and the responsible conduct of medical research.