Bioethics

Ethics describes a system of moral principles (i.e. the categorisation of right behaviours versus wrong behaviours)

  • Bioethics describes the application of these moral principles to the field of biological sciences


Approaches to Bioethics

There are three major approaches to resolving an ethical issue that could be considered in terms of (or applied to) a biological context

  • These approaches allow for different perspectives to be identified before choosing a rational position based on reasoned reflection


Consequence-based

A consequence-based approach places central importance on the consideration of the consequences of an action 

  • The overall aim of this approach is to achieve the maximisation of positive results, with the minimisation of negative results
  • In other words, the focus is on the eventual outcome as opposed to the process taken to reach it (i.e. the ends justify the means)


Duty-based / Rules-based 

A duty-based approach is concerned with how people act and prioritises the idea that people have a duty to act in a particular way 

  • The core concept is that certain ethical rules must be followed, regardless of the eventual consequences that may be produced
  • In other words, it is not acceptable to cause immediate or temporary harm in the pursuit of a potential ‘greater good’


Virtue-based

A virtues-based approach gives consideration to the moral character of the person carrying out the action (rather than focus on the action) 

  • It recognises that people of different cultures and backgrounds might be guided or influenced by the same actions in different ways
  • The aim is to focus on the characteristics and behaviours a ‘good' person would seek to achieve to then be able to act in the right way


ethics approaches


An example of the differences between the ethical approaches can be seen in the consideration of gender-based quotas within society:

  • Consequence-based: Gender quotas are good if it ultimately results in equal representation within an industry or workplace
  • Rules-based: Gender quotas are bad as positive discrimination is still discrimination (selections should be based on merit, not sex)
  • Virtue-based: Gender-based segregation may be okay in certain societies if undertaken for virtuous reasons (e.g. single-sex education)


Another example of the differences between the ethical approaches can be seen in the consideration of compulsory vaccine mandates:

  • Consequence-based: Vaccine mandates are good because high levels of vaccination prevent potential future outbreak
  • Rules-based: Vaccine mandates are bad because individuals should have a choice with regards to undertaking medical procedures
  • Virtue-based: A good person would take any action to protect other people (or would a good person seek to defend civil liberties?)


Ethical Concepts

There are five main ethical concepts that should be applied when considering a position with regards to a biological issue

  • These concepts structure the issue from different angles to allow for parallel thinking processes (similar to De Bono’s thinking hats)


Integrity 

The commitment to searching for knowledge, as well as the honest reporting of all sources of information and communication of results 

  • This includes publishing all findings (favourable or unfavourable) in ways that permit scrutiny and contribute to public understanding


Justice

A moral obligation to ensure there is fair consideration of competing claims, as well as fair distribution and access to an action's benefits

  • This requires that there is no unfair burden placed on a particular group as a result of a specific action


Non-maleficence

A commitment to avoiding the causations of harm or any detrimental consequences 

  • If an outcome cannot avoid some degree of harm, then the harm should not be disproportionate to the benefits gained from the action


Beneficence

The commitment to maximising the benefits (and minimising risks and harms) involved in taking a particular position or course of action

  • Unlike non-maleficence, the focus is on the prevention of harm (and promotion of good outcomes) as opposed to the causing of harm


Respect 

The consideration of the extent to which living things have an intrinsic value and/or instrumental value 

  • Due regard is given to the welfare, liberty, beliefs, perceptions, customs and cultural heritage of the individual and the collective
  • Consideration is also given to the capacity of living things to make their own decisions 
  • When living things have diminished capacity to make decisions, they are empowered where possible and protected as necessary


ethical concepts


An example of how ethical concepts may be considered can be seen by exploring the issues involved in prescribing new medications:

  • Integrity: How do we know what the medication does and from what source? (is the data independent or from the drug company?)
  • Justice: Who gets access to the medication? (is it solely based on diagnosis, or is age or socioeconomic factors a consideration?) 
  • Non-maleficence: What are the side effects associated with the medication? (does the cost outweigh any potential benefits?)
  • Beneficence: What are the benefits of taking this particular medication? (is there another medication that might be more effective?)
  • Respect: Has the patient given informed consent based on sufficient data? (if the patient is a minor, who advocates on their behalf?)