Why the Topic of Bioethics in Science
A New Look at an Old Debate
by Carolyn Csongradi
Factors Influencing The Way In Which Decisions
Looking at all sides of a conflict is not an easy task. Several
factors, which we may not be aware of, contribute to our understanding
(or misunderstanding) and hence, influence the final choice. Consequently,
people involved in the same conflict may arrive at different solutions
caused by any of the following:
- Context the circumstances surrounding the issue, influences
what parts are thought important or unimportant. For instance,
if the individuals in a conflict are acquainted, the nature of
the relationship matters. The bond between family members is very
different than the one between friends .Gender, past experiences,
education and age also act as a frame, modifying how the problem
and the consequences are understood.
- Values, which are derived from personal beliefs, are
grounded in traditional sources such as family, religion and school.
They form an underlying framework which focuses our attention
on certain aspects of a problem and may advocate for a particular
choice. Values vary from individual to individual reflecting cultural,
religious and other personal experiences and may play a greater
role in conflict solutions arising in situations where points
of law are not in question.
- Principles, which are sometimes derived from external
sources such as institutions or ethical theories, typically provide
guidance rather than specify an action. They can assist in prioritizing
values by lending greater weight to one value over another. Conflicts
which involve legal issues may be solved more readily by a direct
appeal to known principles. Professional codes of ethics and laws(rules),
then specify how principles are carried out.
The four major principles guiding many institutional practices
are: beneficence, non-maleficence, autonomy and justice (fairness).
From these, courses of actions are derived. Which principle has
priority in any one decision varies depending on personal beliefs,
facts and other contextual information.
- Ethical systems are an important part of the process
of justifying a particular action. The simple identification of
principles and values is typically not sufficient to make a complex,
difficult decision. At some point, justification for a particular
choice begins to take place. Three of the more common ethical
systems select different components of the conflict as a focal
point: a person's motives, the consequences of the action, or
an appeal to an external system of principles. As in the case
with perspective, the action chosen is influenced by a tension
between external forces such as obeying rules or finding a good
outcome, and the character of individual (integrity).
Some philosophers argue that there really are only two systems
for determining what is right or good. How "right" and
"good" are connected through a course of action is the
primary difference between two of the most common ethical systems
- Teleological Theories: Right is defined as that which
maximizes what is good or minimizes what is harmful for the greatest
number of people.(4) The focus is on the consequences or end. One
example is utilitarianism which advocates maximizing the amount
of "good" for the largest group. One problem with this
system becomes who decides what is beneficial or harmful for whom?
Good can be defined by the results of the final action chosen
or by following a rule which allows for the most favorable outcome.
Critics point out that a utilitarian philosophy can lead to behaviors
which are clearly unacceptable. Imagine a town where people enjoy
watching public hangings so much that the guilt or innocence of
the one hanged is unimportant.
- Deontological Theories: What is right and good are
separated - one is independent of the other. Right is not defined
in terms of what is good. These terms are not related in that
producing a favorable outcome is not the goal. Doing right means
avoiding actions which are said to be wrong by some external standard.(9)
For instance, if lying is wrong, then telling a lie to a person,
who wants to kill another, is wrong even if the lie would prevent
a death. Certain things are inherently right or wrong as often
defined by religious tenets or professional codes of behavior.
The Ten Commandments is an example of an external set of rules.
One limitation of these systems is that not much assistance is
offered when conflicts in stated principles arise. If principles
have equal weight, how do you prioritize?
The last major system looks at the individual's character and
does not rely on an external ethical set of guidelines:
- Virtue theory: This system focuses on the motives and
intentions of the individual and asks what a "good person"
would do in real-life situations.(34) Virtue is used in the same sense
as character traits or integrity. Virtue theory has its origins
in the writings of ancient Greeks, Thomas Acquinas
and Kant. Those who favor virtue ethics complain the other two
major theories ignore central and important questions about personal
integrity or character. The philosopher Alasdair MacIntyre says
that sources of virtue are based on a historical perspective which
allows society to look back and then forward to find standards
of excellence.(28) Those standards encourage an individual to commit
to a moral tradition found in certain practices such as medicine.
One defect of this system is that a person could appear to lead
a moral life, but inside have quite a different character. Two
morally behaving individuals could have very different thoughts
about how to deal with a conflict even while coming to the same
decision. It would be more virtuous to not have thought about
harming someone, whether the act was carried through or not.
Perspective is a way of viewing the world - a particular
frame of reference or "lens" through which certain principles
are filtered and applied to relationships between self and others.
Perspectives can represent a source of conflict between values
and principles. This is a key issue when examining how adolescent
moral thinking evolves.
The following are examples of perspectives which have been described
by psychologists after interviewing adolescents and adults. These
perspectives, which are practical rather than theoretical, may
co-exist in one individual and are not mutually exclusive. For
example, several artists may view the same scene and produce widely
varying interpretations as reflected in their paintings. This
may explain why individuals approaching the same conflict select
different solutions even if they have similar values and principles.(27)
- Perspective of justice:
Conflicts are viewed from the perspective in which you see yourself
as a person separate from others. You consider others as you would
like them to think of you; relationships are defined by rules
and obligations to a particular role in life. Solutions to conflicts
are approached by referring to impartial rules or standards. When
deciding on a course of action, you consider what your obligations
are and how you would like to be treated if in the other person's
- Perspective of care:
Conflicts are concerned with issues that involve maintaining
relationships. You view yourself connected to rather than separate
from others. You see others in their own situations and contexts.
Resolving the conflict involves approaching others on their own
terms; the welfare of others is emphasized. You would try to do
no harm and to relieve suffering.
- Perspective of fairness or equality:
Conflicts come from a need to balance resources or desires
among individuals or groups. One philosopher, John Rawls suggests
imagining how an ideal group of people, blind to their own needs
and desires, would determine what was fair when first faced with
a similar problem.(35) In principle, no one should benefit at the
expense of another, particularly if that person can least afford
the sacrifice. Justice, in this particular case, is defined in
terms of fairness.
How can you tell which perspective you are using? The answers
to these questions should help define your point of view.
- What is more important, my needs or the other person, group
- Is maintaining relationships or adhering to impartial standards
or rules more important?
- Are there inherently right and wrong choices or are the standards
for deciding what is fair purely arbitrary? What makes an action
right? By whose rules do we abide?
- Is equality the best definition of what is appropriate behavior
A story follows which illustrates how conflict arises and these
variables can enter into a decision. The way adolescents view
this scenario is somewhat related to their educational level.
Older students who better understand political institutions may
have a more global or collective view and be better able to trace
the long term consequences. Their view is more coherent than younger
students because more experience produces a greater awareness
of issues and risks which involve the whole community.
The setting is in California and the conflict about the use of
medicinal marijuana. In November of 1996, Californians were asked
to vote on a voter's initiated ballot measure. Among other things,
Proposition 215 exempted
patients and defined caregivers from criminal prosecution for
the possession and cultivation of marijuana for medical treatment
when recommended by a physician. As of November 6, 1996, with
78% of the precincts reporting, 56.1% of Californians voting,
said "yes" on Proposition 215. The results of court challenges
are not known as of the publication date (9/97) of this paper.
Jane, who is a law abiding, caring person, believes that people
should have access to drugs which provide relief to those suffering
from the side effects of chemotherapy used to treat cancer and
AIDS. Jane's friend, John is confined to bed while receiving intravenous
therapy for several days each month. He has nausea and weight loss from his chemotherapy and
he requests that Jane purchase some marijuana for him, as has
been recommended by his doctor.
Jane is genuinely concerned about her friend's physical health,
but she has observed what she believes is John's developing psychological
dependence on marijuana. To be consistent with her view about
access to drugs in the face of suffering, she feels obligated
to buy the marijuana for John. However, she is troubled by the
thought that giving drugs to her friend might also be harmful.
What if John were injured or injured someone else while driving
under the influence of marijuana?
Jane's values include honoring the quality of her friend's life,
responding to requests for help, and obeying the law. These values
are in conflict, creating a dilemma. Jane must set some priorities
and realize that a course of action can, on the surface, appear
contrary to her feelings about drug access, but at the same time,
be internally consistent with principles having higher priority
such as obeying the law or not harming others. Meeting her friend's
need for more marijuana does not have to outweigh all the other
values. Her perspectives may include both a belief in law and
order and a strong need to maintain her friendship.
How does she go about prioritizing the conflicting values and
arriving at a decision which honors her values and also respects
Teaching Moral Problem Solving Continued: