by Carolyn N. Kinder
Bioethics is a study of moral conduct, of right and wrong in problems dealing with biology or medicine. Bioethics inquires about the rightness or wrongness of various actions, character traits, and social policies. Bioethicists ask questions such as: Can euthanasia be morally justified? And whether such practice would be good social policy. Bioethicists are interested in questions on the nature of moral justification and the kind of thinking that supports it. For example, justifiability of physician-assisted suicide must be sought in the articulation and application of various moral theories or principles. Others might claim that justification must proceed the other way around, beginning with concrete and unmistakable instances of good and bad behavior, and then gradually developing principles that seek out and capture our most fundamental moral response! It is a question of whether ethical thought should proceed from the top down or bottom up.
Narratives of Moral Dilemmas
The Constitution of this United States of America clearly expresses a desire to promote the general welfare of its citizens. It is hard to imagine that all Americans have the same availability to the health care system. Some people are born with good health and live a long happy life. Others are born unhealthy and need health care to sustain quality of life.
Yes, it is hard to deny that we do not all have equal availability to health care, so an analysis of our medical care system can serve to illuminate our moral theories and applied ethical practices. Some people are rich or middle class and have the money to pursue life, liberty and happiness. Other people are poor and cannot afford expensive medicines and other health care needs to pursue life, liberty and happiness. The common focus of health care is money and resources are scarce and health care is expensive. There are not enough resources to satisfy everyone’s preferences and needs for health care. Even if we can reach consensus that a right to health care exists, priorities must still be assigned. The question is who should be saved, when we cannot save all? Which group of people and which treatments and diagnostic techniques should have highest priority?
Most of us can recognize good or bad moral reasoning. However, it becomes more difficult for us to deal with real complicated situations, such as, Is assisted suicide wrong because it helps someone to kill him or herself, and killing is wrong? Or is it right because it helps someone to do what he or she reasonably wants to do, and thus promotes autonomy? To answer such questions, we need a framework to reflect on the acceptability of actions and evaluate moral judgments and character. These frameworks are called ethical theories.