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Why the Topic of Bioethics in Science Classes?

A New Look at an Old Debate

by Carolyn Csongradi

One Strategy For Solving A Moral Problem:

In his book on life in the face of death, ethicist Ernle W.D Young describes an approach which has application outside of the hospital setting.(42) When dealing with a moral problem, it is helpful to have a strategy to apply in resolving the conflict. There are many examples of moral problems and numerous approaches which can be used to engage students in discussions. As is often the case, the analytical process, which needs to be developed within a meaningful context, is the critical component. Young's strategy follows:

  • Step 1. Define the problem so the dilemma is clearly understood by all parties: Determining whether a problem is on the one hand a matter of poor communication, failure to appreciate cultural or religious differences, or represents a genuine difference in values and principles means closely examining the issues involved. Some issues are readily addressed simply by clarifying the nature of the disagreement. There may also be more than one problem, which means prioritizing.
  • Step 2. Collect as much information about the problem as you can before beginning to think about a solution: Accurate, comprehensive information is important and seems at the outset like it should be a straightforward task. However, even the facts can prove to be contentious. Consider how different witnesses view the same automobile accident.(1) Equally important is to understand personal, religious, economic and cultural beliefs which are key components of the context framing the conflict.
  • Step 3. Identify the important values and principles for you and the others who are involved: Values are grounded in beliefs which may be held consciously or unconsciously and are sometimes highly charged with emotion. For instance, a belief in God may predispose one to value human life as the most important value. Though sometimes difficult to articulate and not necessarily derived from a reasoning process, beliefs have a legitimate place in making a decision.
  • Step 4. Reflect on personal motives and intentions in light of different courses of action and consequences to self, others and society. Motive can be distinguished from intention in that motive can be thought of as the "why", and intention the "what". What outcome is wanted and why is this desirable? Both of these questions apply to the individual's character.
  • Step 5. Prioritize conflicting values and make a responsible decision. Consider that deciding to NOT make a decision represents one form of choice which has real consequences. This is best demonstrated by an example illustrating how the information is integrated and a course of action might be chosen.

Making decisions: An example

Edward Hundert, a psychiatrist and ethicist, developed a model to assist physicians in making life and death decisions involving patients.(21) Hundert describes a practical technique for complex problems: He believes that each new dilemma represents a set of conflicting values. Making a list of these relevant values helps clarify what is important. Utilizing a scale which attempts to equate values, a decision can be made as to whether one side has more "weight" than the other. An example follows:

Problem: A psychiatrist must decide if a patient's mental illness warrants being committed to a psychiatric hospital. The moral principles involved are part of a physician's code of conduct stating that: the primary duty of a physician is to benefit the patient; to enable a patient to be a self-determining agent; to do no harm. A potential list of conflicting values follows:

To Commit against the patient's will versus to Not Commit the patient:

  1. Concern for the patient's welfare and safety versus patient's right to individual liberty
  2. Need to relieve patient's suffering versus patient's right to privacy
  3. Concern for safety of others versus modesty concerning one's own ability to predict patient's furture actions i.e. suicide or homicide

Most professional codes are deontological in nature. The physician integrates a prescribed code of behavior and weighs personal values, such as honoring the values of others, in the final choice. One principle illustrated in this example is the concern for the patient's welfare and safety or non-maleficence.

In the final analysis, the physician, guided by a code for ethical behavior, decides by being consistent with personal beliefs, perspective and professional ethical codes, which course of action is best. Should the patient remain free and subsequently commit suicide, this result might modify the physician's confidence in predicting a patient's future behavior and may change the priority given to that particular belief. The process of modifying future courses of action is called reflection or reflective equilibrium.(35) Such experiences may change the physician's future decisions, but not necessarily alter the fundamental principles involved such as beneficence and non-maleficence. The change would only be in the prioritizing process

Teaching Moral Problem Solving Continued:

Why The Topic Of Bioethics In Class?

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