A Draft Model Aggregated Code of Ethics for Bioethicists

Bioethicists function in an environment in which their peers—healthcare executives, lawyers, nurses, physicians—assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists.     

Certifying clinical ethics consultants: who pays?

The movement advocating the formal certification of clinical ethics consultants may result in major changes to the field of clinical ethics consultation by creating a new standard of care. The actual certification process is still in the development phase, but unanswered questions include: What will certification cost, and, Who will pay? Currently there is little salary support for ethics consultants and no regulation requiring healthcare institutions to offer clinical ethics consultation. Without the support of healthcare administrators and accreditation bodies, this may remain unchanged. Healthcare administrators may be unwilling to pay for certification or professional services if accreditation bodies do not require healthcare institutions to provide certified ethics consultants' services. If consultants will not be reimbursed or paid, they may not seek certification. If certified consultants are required, healthcare administrators may look for ways to cover the costs for providing this service, including insurance or third-party reimbursement and direct billing of patients for consultations, which may affect who performs and who participates in ethics consultation. However, this is less than ideal, as bioethicists believe ethics consultation should be available to all as part of providing safe, quality ethical care and support and guidance for patients, families, and healthcare staff. Going forward, bioethicists should study quality improvement, patient safety, and cost-savings resulting from certification-eligible clinical ethics consultants' activities. Administrators and financial personnel can be surveyed regarding their support for the certification process. Bioethicists should enlist the help of patient rights and safety advocacy groups, professional medical associations, and healthcare administrators. Bioethicists should invite accreditation bodies, healthcare administrators, and financial personnel to collaborate in the development of the certification process. Without their support, certification may be of value only to the bioethics community, and may have little standing in actual clinical healthcare institution settings.     

The Clergyperson as Counselor: An Inherent Conflict of Interest

Counseling is a function performed by many clergypersons as part of their overall role of minister in a congregational setting. There is an inherent conflict of interest when a clergyperson seeks to be an objective and therapeutic counselor to members of the very group on which he or she depends for both material benefits and volunteer help. The authors provide illustrations of this conflict of interest and then examine it in the light of codes of ethics of several professional counseling organizations. Clergy who do counseling are urged to adopt a professional code of ethics and abide by it, even if this involves cessation of the counseling function.     

Taking Representation Seriously: Rethinking Bioethics Through Clint Eastwood��s Million Dollar Baby

In this article, I propose a new model for understanding the function of representation in bioethics. Bioethicists have traditionally judged representations according to a mimetic paradigm, in which representations of bioethical dilemmas are assessed based on their correspondence to the "reality" of bioethics itself. In this article, I argue that this mimetic paradigm obscures the interaction between representation and reality and diverts bioethicists from analyzing the tensions in the representational object itself. I propose an anti-mimetic model of representation that is attuned to how representations can both maintain and potentially subvert dominant conceptions of bioethics. I illustrate this model through a case study of Clint Eastwood's film Million Dollar Baby. By focusing attention on the film's lack of adherence bioethical procedures and medical science, critics missed how an analysis of its representational logic provides a means of reimagining both bioethics and medical practice. In my conclusion, I build off this case study to assess how an incorporation of representational studies can deepen-and be deepened by-recent calls for interdisciplinarity in bioethics.     

Academic Deans,Codes of Ethics,and……Fiduciary Duties?

College and university academic deans must comply with two sets of professional regulations. As faculty members, they must adhere to their institution's internally generated code of ethics. As administrators and agents of their institution, they must meet the fiduciary duties of diligence and loyalty. Both sets of regulations are similar in the obligations they impose on a dean, the degree of care they demand of a dean in the execution of those obligations, the nature of a breach of those obligations by a dean, the procedures by which the breach of an obligation is addressed, and the remedies available to the institution against a dean following a breach. Colleges and universities should develop and publish both an ethics code and a fiduciary code. Both sets of regulations, however, should avoid common shortcomings. Ethics codes should not be too specific or too general, overly simplistic or highly complex, or outstripped by the rapidly changing world of academia. A codification of fiduciary duties should avoid the problems of poor definition or ambiguity. Developing an institutional code of professional responsibility that incorporates both ethical and fiduciary responsibilities would provide an academic dean with a more comprehensive benchmark for professional expectations and responsibilities. The interplay between the two sets of complementary regulations would further clarify the professional expectation of an academic dean and may also ameliorate some of the shortcomings inherent in an ethics code.     

Engineering Codes of Ethics and the Duty to Set a Moral Precedent

Each of the major engineering societies has its own code of ethics. Seven “common core” clauses and several code-specific clauses can be identified. The paper articulates objections to and rationales for two clauses that raise controversy: do engineers have a duty (a) to provide pro bono services and/or speak out on major issues, and (b) to associate only with reputable individuals and organizations? This latter “association clause” can be justified by the “proclamative principle,” an alternative to Kant’s universalizability requirement. At the heart of engineering codes of ethics, and implicit in what it is to be a moral agent, the “proclamative principle” asserts that one’s life should proclaim one’s moral stances (one’s values, principles, perceptions, etc.). More specifically, it directs engineers to strive to insure that their actions, thoughts, and relationships be fit to offer to their communities as part of the body of moral precedents for how to be an engineer. Understanding codes of ethics as reflections of this principle casts light both on how to apply the codes and on the distinction between private and professional morality.     

Medical school oath-taking: the moral controversy

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some code or oath at their graduation. This article reports the findings of a study of one large medical class, asked upon entry to medical school and again at the beginning of their fourth term, which of 13 specified professional, religious, and secular codes of ethics they would turn to for moral guidance in their practice of medicine. The study finds great diversity in the students' choices and no clear pattern of change by their fourth term. Very few students chose the oath they would be asked to recite at their graduation. The article probes the problems this creates for school administrators and professors as well as students. It asks the implications for professional oath-taking at graduation and in the practice of the profession.     

Transatlantic Divergences in Citizen Science Ethics—Comparative Analysis of the DIYbio Code of Ethics Drafts of 2011

Codes of ethics were drafted by participants in the European and North American Congresses of DIYbio, a single global organization of informal biotechnology practitioners, in 2011. In general, the existence of a code of ethics amongst a community is itself significant. Codes of professional ethics are common in scientific and engineering fields, as well as in DIY communities. It is also significant, and highly unusual, that DIYbio has maintained two separate codes of ethics years after their drafting. While agreement was reached within the congress for each geographic region, with considerable commonality between the two codes drafted, they are far from identical. There are differences in the ordering of items, the wording of common items, and the presence/absence of items. I will argue that these differences are meaningful, and consider them with respect to cultural variation, ethics, and societal implications. Finally, I recommend that the entire DIYbio organization unite under a single code of ethics, and that one of the existing drafts is superior to the other for this purpose.     

A statement of principles for health care journalists

Many journalism organizations have published codes of ethics in recent years. The Association of Newspaper Editors, for example, lists 47 different codes on its website. But an organization of health care journalists felt that none of those codes addressed the unique challenges of covering complex health care topics. The Association of Health Care Journalists (AHCJ) is an independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ has written a statement of principles for its 750 members. In it, AHCJ states some of the unique challenges faced by journalists covering health care, and offers suggestions on how to face those challenges. Bioethicists are invited to comment on the statement, and to help generate continued discussion of the issues addressed therein.     

A Statement of Principles for Health Care Journalists

Many journalism organizations have published codes of ethics in recent years. The Association of Newspaper Editors, for example, lists 47 different codes on its website. But an organization of health care journalists felt that none of those codes addressed the unique challenges of covering complex health care topics. The Association of Health Care Journalists (AHCJ) is an independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ has written a statement of principles for its 750 members. In it, AHCJ states some of the unique challenges faced by journalists covering health care, and offers suggestions on how to face those challenges. Bioethicists are invited to comment on the statement, and to help generate continued discussion of the issues addressed therein.     

Christian bioethics and the Church's political worship.

Christian bioethics springs from the worship that is the response of the Church to the Gospel of Jesus Christ. Such worship is distinctively political in nature, in that it acknowledges Christ as Lord. Because it is a political worship, it can recognize no other lords and no other prior claims on its allegiance: these include the claims of an allegedly universal ethics and politics determined from outside the Church. However the Church is called not just to be a contrast society, but also to witness to the freeing of the world from salvific pretensions in order that it may embrace its proper temporality. The implications of this for the distinctiveness of Christian bioethics are brought out in three movements: first, the Church's itself learning how it is to conceive bioethics; second, the Church's role in unmasking the idols of secular bioethics; and third, the Church's witnessing to the freeing of medicine from idolatrous aspirations.     

Reverence and Ethics in Science

Codes of ethics abound in science, but the question of why such codes should be obeyed is rarely asked. Various reasons for obeying a professional code have been proposed, but all are unsatisfactory in that they do not really motivate behavior. This article suggests that the long forgotten virtue of reverence provides both a reason to obey a professional code and motivation to do so. In addition, it discusses the importance of reverence as a cardinal virtue for scientists drawing on the ideas of Paul Woodruff on the role of virtue in community.     

The rebirth of bioethics: extending the original formulations of Van Rensselaer Potter

Van Rensselaer Potter's original concept of bioethics as a global integration of biology and values was designed to guide human survival. His attention to the creation of human knowledge and the incorporation of ecological concepts and values into medicine and health remain important, yet largely neglected, contributions deserving of further elaboration. Bioethicists should heed his warning about unsustainable progress, particularly in health care systems, and work toward changing their behaviors. Incorporating life-affirming spiritual values and extending Potter's global bioethics to a deeper bioethics seem essential.     

Utilitarianism and the Evolution of Ecological Ethics

R.M. Hare’s two-level utilitarianism provides a useful framework for understanding the evolution of codes of professional ethics. From a Harean perspective, the codes reflect both the fact that members of various professions face special kinds of ethically charged situations in the normal course of their work, and the need for people in special roles to acquire various habits of thought and action. This highlights the role of virtue in professional ethics and provides guidance to professional societies when considering modifications to their codes. From a Harean perspective, a professional society should ask both “Are there kinds of situations that members of this profession will normally encounter which members of other professions and/or the general public will not?” and “What habits of thought and action would it be good for individuals encountering such situations to have?”     

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.     

Strange bedfellows? Reflections on bioethics' role in disaster response planning

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.     

Neuroethics and National Security

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.     

Slouching Toward Policy: Lazy Bioethics and the Perils of Science Fiction

Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies.     

Slouching toward policy: lazy bioethics and the perils of science fiction

Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies.     

Ethics Code Awareness,Perceived Ethical Values,and Organizational Commitment

This study examines the relationships among ethics code awareness, perceived corporate ethical values, and organizational commitment. Three key findings emerged. First, those aware of the existence of an ethics code in their organizations perceived their organizations as having more ethical values than those not aware of an ethics code in their organizations. Second, respondents exhibited higher levels of organizational commitment when they were aware of an ethics code in their companies. Finally, the relationship between ethics code awareness and organizational commitment was fully mediated by perceptions of an organization’s ethical values. The results suggest that ethics codes may lead to higher levels of organizational commitment by increasing the belief that their organizations have strong ethical values, as long as the existence of ethics codes are adequately communicated.