Biomedical Ethics Research Example
Principal ism, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values. How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative? Refer to the lecture and topic readings in your response.Biomedical Ethics Research Example
Introduction
The reality of religious pluralism (the view that there are many different religions with different teachings) does not logically imply any sort of religious relativism (the view that there is no such thing as truth, or that everything is a matter of opinion). There are genuine distinctions between religions and worldviews. Given this fact, it is imperative that one be tolerant of differences and engage civilly with those of different religions or worldviews. It might be tempting to think that one is being tolerant or civil by simply rolling all religions into one sort of generic “spirituality” and to claim that all religions are essentially the same. But this is simply false. Once again, there are genuine and important differences among religions; these differences are meaningful to the followers of a particular faith. To simply talk of some sort of a generic “spirituality,” while maybe properly descriptive of some, does not accurately describe most of the religious people in the world. Furthermore, this terminology often reduces religion to a mere personal or cultural preference, and it ignores the distinctions and particularity of each. The point is that such a reduction ism is not respectful of patients. It should also be noted that atheism or secularism are not simply default or perfectly objective (or supposedly scientific) starting positions, while religious perspectives are somehow hopelessly biased. Every religion or worldview brings with it a set of assumptions about the nature of reality; whether or not a particular view should be favored depends upon whether or not it is considered true and explains well one’s experience of reality.Biomedical Ethics Research Example
Biomedical Ethics
Bioethics is a sub field of ethics that concerns the ethics of medicine and ethical issues in the life sciences raised by the advance of technology. The issues dealt with tend to be complex and controversial (i.e., abortion, stem cell research, euthanasia, etc.). In addition, bioethics usually also involves questions of public policy and social justice. As such, the complexities of bio ethical discussion in a pluralistic society are compounded. There have been several different approaches to bio ethical questions put forth that have to do with the theory behind ethical decision making. Three positions have been prominent in the discussion principal ism (also known as the four principle approach), virtue ethics, and casuistry. For this lecture, it will be useful to outline principal ism and to describe the general contours of a Christian approach to bio ethical issues.Biomedical Ethics Research Example
Principal ism is often referred to as the “four-principle approach” because of its view that there are four ethical principles that are the frame work of bioethics. These four principles are the following, as spelled out by Tom L. Beau champ and David De Grazia (2004):
- Respect for autonomy − A principle that requires respect for the decision making capacities of autonomous persons.
- Non maleficence − A principle requiring that people not cause harm to others.
- Beneficence − A group of principles requiring that people prevent harm, provide benefits, and balance benefits against risks and costs.
- Justice − A group of principles requiring fair distribution of benefits, risks and costs.
(p. 57)
For every bio ethical question, one must seek to act according to these principles. For each case there will be details, circumstances, and factors that must be taken into account. The process of applying these principles to each unique case is referred to as specification and balancing. That is, these principles in and of themselves are abstract with no particular content or concrete application. One must specify the particular context and details of a case or dilemma in order to concretely apply these principles and arrive at concrete action guiding results (i.e., individuals need to know how to apply these principles to specific cases and circumstances). But secondly, the task of balancing involves figuring out how each of the four principles ought to be weighted in a particular case. One needs to determine which of the four principles deserves the most priority in any given case, especially in cases in which there are conflicts between the principles.
Though there is disagreement and diversity about whether or not principal ism is the best theory and method of addressing bio ethical questions, these four principles and this methodology have become foundational for bio ethical reflection. One common misunderstanding about these principles, and most other bio ethical methodologies or theories, is that they can stand on their own and comprise a neutral or secular system of solving ethical issues. However, this is a serious misunderstanding. Though these principles describe well much of the current cultural consciousness about right and wrong (and so describe what Beau champ and Childless call the “common morality” that all human beings ought to hold to), they do not have enough moral or concrete content on their own apart from prior assumptions and worldview considerations.Biomedical Ethics Research Example
Thus, one might come at the four principles from a Buddhist perspective, or an Islamic perspective, or an atheistic perspective and achieve vastly different results. The moral content and concrete application of the four principles would not simply depend on the particular details of a case, but also on the worldview from which one is approaching the moral question to begin with. The same is true of causticity as well. The point is that when one utilizes the principality approach to bio ethical dilemmas, it will always also incorporate broader worldview considerations and never be purely neutral or unbiased.
The Christian Narrative
While it is not possible to survey every possible religion, the description below will at least attempt to do justice to the biblical narrative and Judaeo-Christian tradition.
The Bible is a collection of 66 books written over thousands of years in several different languages and in different genres (e.g., historical narrative, poetry, letters, prophecy), yet there is an overarching story, or big picture, which is referred to as the Christian biblical narrative. The Christian biblical narrative is often summarized as the story of the creation, fall, redemption, and restoration of human beings (and more accurately this includes the entire created order). Concepts such as sin, righteousness, and shalom provide a framework by which the Christian worldview understands the concepts of health and disease.Biomedical Ethics Research Example
Briefly, consider the following summary of each of the four parts of the grand Christian story:
Creation
According to Christianity, the Christian God is the creator of everything that exists (Gen 1-2). There is nothing that exists that does not have God as its creator. In Christianity, there is a clear distinction between God and the creation. Creation includes anything that is not God–the universe and everything in it, including human beings. Thus, the universe itself and all human beings were created. The act of creating by God was intentional. In this original act of creation, everything exists on purpose, not accidentally or purely randomly, and it is good. When God describes his act or creating, and the creation itself as good, among other things, it not only means that it is valuable and that God cares for it, but that everything is the way it is supposed to be. There is an order to creation, so to speak, and everything is how it ought to be. This state of order and peace is described by the term “Shalom.” Yale theologian Nicholas Wollstonecraft (1994) describes Shalom as, “the human being dwelling at peace in all his or her relationships: With God, with self, with fellows, with nature” (p. 251).
Fall
Sometime after the creation, there occurred an event in human history in which this created order was broken. In Genesis 3, the Bible describes this event as a fundamental act of disobedience to God. The disobedience of Adam and Eve is referred to as the Fall, because, among other things, it was their rejection of God’s rule over them and it resulted in a break in Shalom. According to the Bible, the Fall had universal implications. Sin entered into the world through the Fall, and with it, spiritual and physical death. This break in Shalom has affected the creation ever since; death, disease, suffering, and, most fundamentally, estrangement from God, has been characteristic of human existence.Biomedical Ethics Research Example
Redemption
The rest of the story in the Bible after Genesis 3 is a record of humanity’s continual struggle and corruption after the Fall, and God’s plan for its redemption. This plan of redemption spans the Old and New Testaments in the Bible and culminates in the life, death, and resurrection of Jesus Christ. The climax of the Christian biblical narrative is the atoning sacrificial death of Jesus Christ, by which God makes available forgiveness and salvation by grace alone, through faith alone. The death of Christ is the means by which this estrangement caused by sin and corruption is made right. Thus, two parties, which were previously estranged, are brought into unity (i.e., “at-one-ment”). For the Christian, salvation fundamentally means the restoration of a right and proper relationship with God, which not only has consequences in the afterlife, but here and now.
Restoration
The final chapter of this narrative is yet to fully be realized. While God has made available a way to salvation, ultimately the end goal is the restoration of all creation to a state of Shalom. The return of Jesus, the final judgment of all people, and the restoration of all creation will inaugurate final restoration.Biomedical Ethics Research Example
The Christian Ethical Approach − An Outline
While the principality approach may be used by the Christian as a general methodological tool for bio ethical reflection, the general contours of a Christian approach to ethics (not only bioethics) may be described as a mix of gerontology and virtue ethics (Rae, 2009, p. 24). Given the reality that there is a God who exists and has created the world with a moral structure and and purpose, what is truly right and good is a reflection of the character and nature of the God of the Bible. The ethic that follows from the holy and loving nature of God is de ontological because it will include principles and rules regarding right and wrong.
These principles can be known in two main ways: in the form of divine commands, as recorded in the Bible (take for example the 10 commandments), and in the structure of the world, from which a natural law (about right and wrong, not legal matters) can be detected. The biblical ethic will also involve elements of virtue ethics. The perfect man and moral exemplar (though much more than only a man and an exemplar) in the Christian tradition is Jesus Christ himself. The Christian is to not only obey God’s commands, but to be transformed into his image. Jesus Christ is the perfect representation of such a life; Christian’s thus ought to embody the virtues and character of Jesus himself. The attaining of these virtues will not only be a matter of intellectual knowledge of right and wrong, but an active surrender and transformation by means of God’s own Holy Spirit. Furthermore, the wisdom to navigate all the complexities of ethical dilemmas and apply biblical and natural law principles appropriately will be a consequence of a person’s character and the active guidance of the Holy Spirit.Biomedical Ethics Research Example
Worldview and the Christian Narrative
The way in which Christianity will answer the seven basic worldview questions will be in the context of the above narrative. In the same vein, a Christian view of health and health care will stem from the above narrative and God’s purposes. Of course, the pinnacle of this framework is the person of Jesus Christ. Thus, for Christianity, medicine is called to serve God’s call and purposes, and everything is done in remembrance of, and in light of, Jesus’ ultimate authority and kingship.
Reference
Beau champ, T. L., and DeGrazia, D. (2004). “Principles and principalism” in Philosophy and medicine vol. 78. Handbook of bioethics: Taking stock of the field from a philosophical perspective. Rerecord: Kluwer Academic Publishers.
Rae, Scott B. Moral (2009). Moral choices: An introduction to ethics. (3rd ed.). Grand Rapids, MI: Zondervan.
Wolterstorff, N. (1994). “For justice in Shalom.” In W. G. Boulton, T. D. Kennedy, & A. Verhey (eds.), From Christ to the world: Introductory readings in Christian ethics. Grand Rapids, MI: Wm. B. Eerdmans Publishing Company.
According to Raw bone (2015), principal ism is also referred to as the four-principal approach which refers to the four principles that are discussed in bioethics. These principles include:
Respect for patient autonomy; this requires that patients are given the chance to decide on the treatments they want, the right to refuse treatment, surgical procedures or medication. Despite the fact that the decision a patient makes may not be in his best interest, it should be respected by everyone.
Non-maleficence- this principle requires healthcare providers to do no harm. It can best be achieved through making medical decisions with the guidance of the rules and regulations that promote patient safety (Raw bone, 2015). Simple tasks such as observing standard operating procedures when nursing wounds, hand washing, wearing protective clothing and observing the 7 rights when administering medications are examples in this case.Biomedical Ethics Research Example
Beneficence- is a principle that emphasizes on the need to promote all that is good. This includes supporting religious practices such as praying before an operation to promote a patients spirituality, well-being and hope for recovery.
Justice- is a principle that talks about the need for fairness when administering treatment and patient care. It also emphasizes on the need for equal distribution of resources.
From a christen narrative, these principles should be considered as they appear: autonomy, non-maleficence, beneficence and lastly justice. As supported by Rawbone (2015), the most significant issue is giving patients the opportunity to actively participate in their care and make individualized decisions. This ensures a collaborative approach to healthcare. The Christian narrative of creation, fall, redemption and restoration would still give utmost consideration to the principal of autonomy. These narratives clearly illustrate that, despite the fact that God may not agree with all our decisions, he gives mankind the opportunity to decide the paths that we shall take in life.
References
Raw bone, R. (2015). Principles of Biomedical Ethics. Occupational Medicine, 65(1), 88-89.Biomedical Ethics Research Example