Distinctions Bioethics and Medical Ethics Ethics and Morality

The terms "bioethics" and "medical ethics" are frequently used interchangeably but they are distinct (Marshall & Koenig, 1996). Bioethics pertains to the ethical dilemmas and moral norms of health professionals (primarily physicians) emerging within contemporary biomedicine. In contrast, some scholars advocate a comparative approach to the study of medical ethics or "ethnoethics" that expands its purview beyond Western biomedical systems (Fabrega, 1990; Lieban, 1990). "Ethnoethics" is concerned with cross-cultural variations in ethical issues and moral norms within any health care setting or healing environment to illuminate their cultural underpinnings (Lieban, 1990, p. 223). Most anthropological research has concentrated on bioethics perhaps due to the breadth of compelling moral quandaries generated by biotechnology. Less work has been done on ethical issues arising outside of biomedicine (see Weisz, 1990), except for issues that more traditionally fall under the rubric of human rights, such as cliterodectomy (Gordon, 1991; Lane & Rubinstein, 1996).

There are multiple philosophical definitions of "ethics" and "morality." For instance, "ethics" refers to the theoretical, practical, and descriptive study of moral life: people's standards of good action (as in professional codes) and moral behaviors and beliefs; "morality" refers to socially shared worldviews or conventions about right and wrong human conduct (in the context of medical care) (Beauchamp & Childress, 1994, pp. 4-5). Moral values are shaped by socio-cultural values and beliefs. "Ethical dilemma" denotes a situation in which a clinical decision must be made but there are at least two valid, opposing options, which are informed by moral values. Anthropologists may find these distinctions useful so that they can determine which cultural activities to analyze: values or decisions or both. Anthropological distinctions emphasize the cultural basis of local moral worlds (Kleinman, 1995a, p. 42). Certainly, not all anthropological inquiry into bioethics focuses on decision-making; much work has sought to thickly describe cases and experiences of moral issues.

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