Bioethics and professional medical ethics

mapping and managing an uneasy relationship

Laurence Mccullough

pp. 71-84

in: Tristram Engelhardt (ed), Bioethics critically reconsidered, Berlin, Springer, 2012

Abstract

Looking back on the development of the field of bioethics in the 1970s, one can now discern what was not so clear at the time: an uneasy relationship between bioethics and professional medical ethics, especially what Albert Jonsen (2000, 2009) has called the "long tradition" of medical ethics that preceded bioethics. On the one hand, there is a strand in early bioethics that treats bioethics as the application of ethical theory to problems in biomedical practice, research, and policy, a self-understanding of bioethics that deprofessionalized medical ethics. On the other hand, there is a strand in early bioethics that takes professional medical ethics seriously and includes professional medical ethics in the self-understanding of bioethics. In this chapter, I map this tension. In my judgment, the first strand has dominated the literature and its cutting-edge, reforming discourse continues to generate an excitement that draws students to undergraduate and graduate courses in bioethics in our colleges and universities. The second strand is less exciting, because it is conservative in that identifies what we should value in the history of medical ethics and therefore preserve and strengthen. This second strand properly shapes ethics teaching in our medical schools. I will propose to manage the uneasy relationship between bioethics and professional medical ethics, a problematic that we inherit from the early days of the field, by defending the second strand, by offering a defense of conservative, professional medical ethics.