Chapter: Introduction

 Section 2.  Social Context

If we pay attention to what goes on around us in our social setting we can not help but notice that there are reports of situations involving medical procedures or services wherein serious questions are raised about the correctness of what was done or what should be done. The number of such reports is almost too much for most handle in any sensible manner. When the situations do not involve ourselves or our family members we are inclined to reduce their importance. However, there are many reports of situations involving medical care that we can not dismiss as not involving us at least potentially. Should HMO's make certain eligible to be covered under the plan? Should people be respected and their wishes followed concerning their medical care even when it might mean that their lives would be shortened by their refusal of medical treatments?

When considering issues such as the right to die, parental consent for abortion, genetic screening, cloning the entire matter might be seen as quite abstract and remote for most of us. When it becomes a matter of whether or not a family member is to have the mechanical life sustaining support systems terminated then it is another matter. If we hear of a doctor who performed an operation on the wrong person we might respond with disbelief or disgust but when it is a member of our family who is injured by a doctor or when a doctor has prescribed the wrong medication for ourselves then it is certainly a matter that has our attention.

As we consider cases such as the first three presented in this module we might wonder if there are rules or codes or procedures or something that exists to answer the questions involved and to resolve the situations. When people search for the standards or principles that would serve to set rules and procedures then they are engaged in a search for ethical principles to set moral rules or guides for conduct. In Philosophy the search for the principles that make an action right or wrong is known as Ethics. In Biomedical Ethics the concern is with those basic principles and how they relate to the practices , policies and research procedures of the social institution known as medicine. The medical institution includes the physicians, nurses, technicians, assistants and other health care providers as well as the hospitals, clinics, long term care facilities, out-patient care programs and the like. It also includes pharmacies, mental health workers, public and private laboratories, public and private research facilities and universities conducting research on humans. It also includes the programs that prepare people to become members of the health care institution and those that provide for financial support for the services of the health care providers and their institutions, e.g., insurance companies, HMO's and managed care programs.

There are moral problems that arise in situations involving health care. Many of those are quite complex. Thinking about the right thing to do becomes very difficult. Having an awareness of what the specific moral problems are and the principles that might be applied in thinking about making a decision concerning moral dilemmas is the aim of a study of Biomedical Ethics.  Any consideration of moral rules or moral dilemmas will lead thoughtful people to consider the basic principles for morality itself. Philosophers have developed a few general theories about what makes any action a good action versus a bad one. Such theories that include such basic principles that serve as the foundation for ethical thought..

In the next module of this course there will be a presentation of the basic and major theories as developed by philosophers over the last 2500 years. Each theory represents the attempt of a philosopher to use reason in order to arrive at some idea of what idea can serve as the basis for moral reflection and which can serve to assist humans in making moral decisions. Each theory will be presented in a manner that indicates why people would be attracted to them and using their principles in decision making. Each theory will be presented along with some of its weaknesses or difficulties or flaws.

This chapter will present a quick overview of those theories. It will also present a brief introduction to some of the basic principles involved with medical dilemmas. After the first three chapters that focus on the basic ideas, concepts and principles of ethics and medical ethics the remaining chapters will each focus on specific problems or areas in medicine and medical research that present moral difficulties.

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Copyright Philip A. Pecorino 2002. All Rights reserved.

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