Exploring Bioethics - NIH Office of Science Education - National ...

2. The ability to distinguish an ethical question fromother kinds of questions, such as legal, scientific,or personal-preference ones. People often confusethese different kinds of questions, because they arerelated. For example, in deciding whether to bansteroids (an ethical question), one would want toknow how safe they are (a scientific question). Butfundamentally, scientific and ethical questions aredifferent, because they have different purposes andrely on different kinds of evidence for their answers.Ethical questions are also different from legal onesand from questions of personal preference, custom,or habit.People often have a particularly hard time discerninglegal from ethical questions—but keeping themseparate when undertaking an ethical analysis isimportant. Ethical analyses should take the legalcontext and local laws into consideration. However,something can be illegal yet ethical. Conversely,something can be legal but unethical. With respectto enhancement and sports, some interventionscould be considered unethical even if they are notyet illegal. Another difference is that the law typicallysets the minimum standards to which people mustadhere; ethical standards sometimes focus on ideals(more than the minimum), encouraging people to actvirtuously. Although they influence each other, thelaw and ethics are separate enterprises.Perhaps hardest of all to distinguish are personalpreferenceand ethical questions—indeed, thesetwo realms are often confused. The culture youlive in might prefer a high degree of privacy inthe doctor’s office, while your friend from anotherculture would be unaccustomed to a private officeand willing to discuss his medical affairs publicly.Your cultural attitudes toward privacy are mattersof preference, custom, or habit, but they are notethical matters. A key distinguishing feature ofan ethical question—as opposed to a question ofpersonal preference, custom, or habit—is that ittypically arises when individuals or groups might beharmed, disrespected, or unfairly disadvantaged.Ethical questions are different from scientificand legal ones and from questions of personalpreference, custom, or habit.If no one is harmed or disadvantaged by the two kindsof medical settings, then the amount of privacy ineach would not be an ethical issue; however, it couldbecome an ethical issue. For example, assume thereis a patient who values privacy and yet the healthcareproviders ignore this person’s wishes. Ignoring theprivacy wishes of someone who values privacy wouldtransform the matter from one of personal preferenceinto ethics, because disregarding what someone valuesis a form of disrespect.A key distinguishing feature of an ethical questionis that it typically arises when individuals orgroups might be harmed, disrespected, or unfairlydisadvantaged.Key Question:What Are the Relevant Facts?Once an ethical question has been chosen, students areasked to identify the facts necessary to think carefullyabout it. Which scientific facts are important? Whichsocial science facts? Are other facts needed to make abetter decision?Scientific facts are important, and they providea critical link between bioethics and the biologycurriculum. They are especially important for answeringquestions about harms and benefits. Before studentscan make a reasoned judgment about vaccinationpolicies, for example, they need to know about the risksof getting a disease, the magnitude of harm that couldoccur if the disease is contracted, and the risk of sufferingthat harm, as well as the efficacy and side effectsof the vaccines. When examining issues surroundinggenetic testing, students need to be able to understandfacts related to inheritance of traits and whether medicinehas anything to offer to prevent the diseases thatthe tests diagnose.Social science facts are equally important. Whatpsychological, sociological, anthropological, historical,and economic facts and concepts are needed to understandthe available choices? The social sciences can tellus how people may respond to disease, health-promotionmedicines, or their physician’s advice, and they canprovide insight into differences among groups in theview of what is ethically important and the impact of6 Exploring Bioethics