Bioethics

"There is," says the biblical book of Ecclesiastes, "no new thing under the sun." Those words are worth pondering in light of the emergence of the field of bioethics since the 1950s and 1960s. From one perspective it is a wholly modern field, a child of the remarkable advances in the biomedical, environmental, and social sciences. Those advances have brought a new world of expanded scientific understanding and technological innovation, seeming to alter forever what can be done about the vulnerabilities of nature and of the human body and mind, and about saving, improving, and extending human lives. Yet from another perspective, the kinds of questions raised by these advances are among the oldest that human beings have asked themselves. They turn on the meaning of life and death, the bearing of pain and suffering, the right and power to control one's life, and our common duties to each other and to nature in the face of grave threats to our health and well-being. Bioethics represents a radical transformation of the older, more traditional domain of medical ethics; yet it is also true that, since the dawn of history, healers have been forced to wrestle with the human fear of illness and death, and with the limits imposed by human finitude.

It is wholly fitting that an encyclopedia of bioethics devote some of its space to defining and understanding the field that it would examine in both breadth and depth. Yet that is not an easy task with a field that is still evolving and whose borders are hazy. The word bioethics, of recent vintage, has come to denote not just a particular field of human inquiry—the intersection of ethics and the life sciences but also an academic discipline; a political force in medicine, biology, and environmental studies; and a cultural perspective of some consequence. Understood narrowly, bioethics is simply one more new field that has emerged in the face of great scientific and technological changes. Understood more broadly, however, it is a field that has spread into, and in many places has changed, other far older fields. It has reached into law and public policy; into literary, cultural, and historical studies; into the popular media; into the disciplines of philosophy, religion, and literature; and into the scientific fields of medicine, biology, ecology and environment, demography, and the social sciences.

The focus here will be on the broader meaning, place, and significance of bioethics. The aim will be to determine not only what the field means for specific ethical problems in the life sciences, but also what it has to say about the interaction of ethics and human life, and of science and human values. Bioethics is a field that ranges from the anguished private and individual dilemmas faced by physicians or other healthcare workers at the bedside of a dying patient, to the terrible public and societal choices faced by citizens and legislators as they try to devise equitable health or environmental policies. Its problems can be highly individual and personal—what should I do here and now?—and highly communal and political—what should we together do as citizens and fellow human beings?

While the primary focus of this entry will be on medicine and healthcare, the scope of bioethics—as the encyclopedia as a whole makes clear—has come to encompass a number of fields and disciplines broadly grouped under the rubric the life sciences. They encompass all those perspectives that seek to understand human nature and behavior, characteristically the domain of the social sciences, and the natural world that provides the habitat of human and animal life, primarily the population and environmental sciences. Yet it is the medical and biological sciences in which bioethics found its initial impetus, and in which it has seen the most intense activity. It thus seems appropriate to make that activity the center of attention here.

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