AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. May 2001, Volume 3, Number 5.

Journal Discussion

  • Print

Defining Ethical Problems in Medicine

The author describes some of the diverse training paths that may lead to becoming a bioethicist and how the breadth of this field is useful in exploring many ethical questions in the field of medicine.

Keith Bauer, PhD, MSW

Bioethics refers broadly to the ethical issues and conflicts that arise in health care and the biomedical sciences. There is no uniform curriculum or set of experiences required for becoming a bioethicist. Some bioethicists receive training in philosophy and theology, while others enter the profession by way of medicine, law, or the social sciences. More recently, persons can earn advanced degrees in bioethics from newly established interdisciplinary programs. As the protean field of bioethics takes shape, those within and outside bioethics have begun to raise questions about the relationship between moral theory and moral practice. Such questions, of course, have a history that reaches back to the days of Plato and Aristotle. This debate continues today, centering not only on the relationship between moral knowledge and moral action in clinical contexts, but also on the relationship between bioethicists and non-bioethicists in the medical profession.

In " What Makes a Problem an Ethical Problem? An Empirical Perspective on the Nature of Ethical Problems in General Practice," Annette Joy Braunack-Mayer argues that the mainstream bioethics literature defines ethical dilemmas and other ethical problems in a manner that fails to capture entirely the way that general practitioners often define and think of these problems. In support of this thesis, the author presents her findings from interviews with 15 general practitioners in Australia about what they consider to be ethical problems in medical practice. She concludes that even though there is considerable overlap in how bioethics and general practitioners conceptualize and resolve ethical problems, "the moral domain is wider and richer than mainstream bioethics definitions of the nature of moral problems have allowed."

Questions for Discussion

  1. Several of the "ethical issues" raised by physicians focus on concern for what patients will think or for their reputation in the community. Are these bioethical concerns?
  2. Is professionalism or professional ethics the same as bioethics? Should the interests and concerns of these 2 fields overlap?
  3. If physicians and bioethicists classify different sets of dilemmas and concerns under the concept of "ethical issues" is that a problem? Should bioethical concerns mirror physician concerns? Should bioethicists have clinical or health care training?
The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.