Accounting for context: Future directions in bioethics theory and research

Many physicians have found that the traditional approach to bioethics fails to account for important aspects of their moral experience in practice. New approaches to bioethics theory are challenging the traditional application of universal moral principles based in liberal moral theory. At the same time, a shift in both the goals and methods of bioethics education has accompanied its “coming of age” in the medical school curriculum. Taken together, these changes challenge both bioethics educators and theorists to come closer to the details and nuances of real clinical encounters. The emerging trend emphasizes the importance of context in bioethics education and in the moral theory and research under-girding it. This article introduces one research approach examining the practical life contexts of medical students' ethical experiences and learning. It calls for increased attention to research and theory in bioethics that more adequately accounts for the ways different contexts produce significant changes in meaning and understanding in medical encounters.     

Multiple roles and successes in public bioethics: a response to the public forum critique of bioethics commissions

National bioethics commissions have been critiqued for a variety of structural, procedural, and political aspects of their work. A more recent critique published by Dzur and Levin uses political philosophy to constructively critique the work of national bioethics commissions as public deliberative forums. However, this public forum critique of bioethics commissions ignores empirical research in political science and normative claims that suggest that advisory commissions can and should have diverse of functions beyond that of being public forums. The present paper argues that the public forum critique too narrowly considers the roles that bioethics commissions can play in public bioethics and ignores the moral obligation of commissions to fulfill their mandates. Evaluations of commissions must consider that these institutions can serve in capacities other than those of a public deliberative forum and use additional measures to evaluate the multiple roles and successes of bioethics commissions in public policy.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

Preachers and Prophets: Using Film to Teach American Religious History

Abstract. Can students learn religious history from movies? While using film as text is likely to attract students’ interest, will such a course be able to negotiate the complex intertwining of film with religion and history to provide students with more than mere entertainment? Will students respond to a challenge to move beyond a movie's surface visual experience to address the core lessons history posits: it's not always been this way, we are the product of what has come before us, I/we are being called to change? This article discusses one attempt to answer these questions and examines both the opportunities and difficulties of using movies to teach religious history.     

学校道德氛围知觉对道德发展影响的教育干预实验

目的 探讨学生的学校道德氛围知觉与其道德发展的关系。方法 采用学校道德氛围知觉问卷、SROM-SF问卷及自编情境故事,对100名中学生进行了干预实验,运用SPSS 15.0对数据进行统计分析。结果 通过干预,学生的学校道德氛围知觉水平有了不同程度的提高;学生对学校道德氛围的知觉水平提高后,其道德判断能力有了显著发展。结论 学生的学校道德氛围知觉影响其道德判断能力的发展。     

Whose tradition? Which Enlightenment? What content? Engelhardt, Hauerwas, Capaldo, and the future of Christian bioethics.

The development of a content-full Christian bioethics requires an analysis of the particular contents and traditions which different Christians bring to morality. For Hauerwas, the content of Christian ethics is the speech and practices of the community. For Engelhardt, only a content-full tradition, such as the Orthodox tradition, will be able to arrive at closure on the moral issues presented by the contemporary practice of medicine. Capaldi calls, in contrast, for a Kantian society of autonomous self-legislators whose responsible freedom is grounded in a cosmic order that must be explicated and retrieved in particular practices. The manner in which we view our own traditions and the shortcomings of modernity determine the content that Christianity brings to bioethics.     

Moral knowledge: some reflections on moral controversies, incompatible moral epistemologies, and the culture wars.

An authentic Christian bioethical account of abortion must take into consideration the conflicting epistemologies that separate Christian moral theology from secular moral philosophy. Moral epistemologies directed to the issue of abortion that fail to appreciate the orientation of morality to God will also fail adequately to appreciate the moral issues at stake. Christian accounts of the bioethics of abortion that reduce moral-theological considerations to moral-philosophical considerations will not only fail to appreciate fully the offense of abortion, but morally mislead. This article locates the bioethics of abortion within the theology of the Church of the first millennium, emphasizing that abortion was prohibited, whether or not one considered the embryo or fetus to be ensouled.     

青少年道德判断能力的研究

德国道德心理学家林德提出“道德行为与发展的双面理论”,并设计了著名的“道德判断测验”,在20多年的研究中取得了很多重要成果。我们以中文版的“道德判断测验”为测量工具,以724名12-27岁青少年学生为被试进行实证研究,研究结果表明:学生的C分数随年级提高而有所提高,但不同年级之间有一定波动,说明学校教育有助于提高学生的道德判断能力,但存在不稳定因素。男女生C分数不存在显著差异,学校内部各年级之间也不存在显著差异,不同性质的学生之间不存在显著差异;     

Christian bioethics, secular bioethics, and the claim to cultural authority.

Though the papers in this volume for the most part address the question, "What is Christian about Christian Bioethics", this paper addresses instead a closely related question, "How would a Christian approach to bioethics differ from the kind of secular academic bioethics that has emerged as such an important field in the contemporary university?" While it is generally assumed that a secular bioethics rooted in moral philosophy will be more culturally authoritative than an approach to bioethics grounded in the contingent particularities of a religious tradition, I will give reasons for rejecting this assumption. By examining the history of the recent revival of academic bioethics as well as the state of the contemporary moral philosophy on which it is based I will suggest that secular bioethics suffers from many of the same liabilities as a carefully articulated Christian bioethics. At the end of the paper I will turn briefly to examine the question of how, in light of this discussion, a Christian bioethics might best be pursued.     

Commentary: Moral growth in medical students

Knight has shown how the moral growth of medical students involves a spiritual journey. He may, however, present too sanguine a portrayal of the extent to which the medical education environment promotes this moral and spiritual growth. Medical school may indeed be more abusive than supportive. Admitting more women to medical school and teaching more humanities courses, while worthwhile, will not necessarily promote the goals that Knight appropriately advocates.     

The origins and evolution of bioethics: some personal reflections

Bioethics was officially baptized in 1972, but its birth took place a decade or so before that date. Since its birth, what is known today as bioethics has undergone a complex conceptual metamorphosis. This essay loosely divides that metamorphosis into three stages: an educational, an ethical, and a global stage. In the educational era, bioethics focused on a perceived "dehumanization" of medicine by the rising power of science and technology. Remedies were sought by introducing humanities, ethics, and human "values" into the medical curriculum. Ethics was one among the humanistic disciplines, but not the dominant one. In the second era, ethics assumed a dominant role as ever more complex dilemmas emerged from the rapid pace of biological research. As such dilemmas were applied to medical practice, the need for a more rigorous and more formal analysis of their moral status was clear. Philosophically-trained ethicists had an obvious role. They began to teach, write, and profoundly influence medical education and practice. In the third -- and present -- period, the breadth of problems has become so broad that ethicists must, themselves, draw on disciplines well beyond their expertise -- e.g., law, religion, anthropology, economics, political science, psychology, and the like. The era of bioethics as a global enterprise is upon us. The original hope for humanizing medicine has not been overtly successful; however, much has been accomplished of value to patients, the profession, and society. Medical morality has been transformed into a formal, systematic study of a whole range of issues of the greatest significance to humanity. Now the major challenge is one of identity, or inter-relationships and connections between the theoretical and the practical. Bioethics has outgrown its beginnings.     

大学生人格特质对道德认同的影响：法律意识的调节作用

为探讨大学生人格特质与道德认同的关系,及其法律意识在二者关系之间的调节作用,采用法律意识量表、道德认同量表和大五人格量表对1878名大学生进行了调查。结果显示：(1)尽责性、宜人性、开放性和外向性与道德认同、法律意识呈显著的正相关;神经质与道德认同、法律意识呈显著的负相关。(2)人格特质、道德认同、法律意识表现出了显著的性别差异,同时尽责性对道德认同的影响也存在着显著的性别差异。(3)法律意识在尽责性与宜人性对大学生道德认同的影响中起着负向调节作用。本研究结果提示,应该尊重人格特质的个体特异性,在高校进行专业的法制教育和法律意识培养,提高个体的道德认同水平。     

Differences from somewhere: the normativity of whiteness in bioethics in the United States

I argue that there has been inadequate attention to and questioning of the dominance and normativity of whiteness in the cultural construction of bioethics in the United States. Therefore we risk reproducing white privilege and white supremacy in its theory, method, and practices. To make my argument, I define whiteness and trace its broader social and legal history in the United States. I then begin to mark whiteness in U.S. bioethics, recasting Renee Fox's sociological marking of its American-ness as an important initial marking of its whiteness/WASP ethos. Furthermore, I consider the attempts of social scientists to highlight sociocultural diversity as a corrective in U.S. bioethics. I argue that because they fail to problematize white dominance and normativity and the white-other dualism when they describe the standpoints of African-American, Asian-American, and Native-American others, their work merely inoculates difference and creates or maintains minoritized spaces. Accordingly, the dominant white center of mainstream U.S. bioethics must be problematized and displaced for diversity research to make a difference. In conclusion, I give several examples of how we might advance the recommended endeavor of exploring our own ethnicity, class, and other social positioning and norms operating in U.S. bioethics, briefly highlighting "white talk" as one challenge.     

Contributions of moral education lectures and moral discussion in Hong Kong secondary schools

Moral education in the traditional form of classroom didactic lectures in secondary schools has been prevailing in Hong Kong since the initiation of moral education in the 1980s. However, such a traditional form has not received credit from research in the West. Instead, discussion of moral issues would be a more effective way of moral education than would didactic lectures. Because of the differential ways of moral education in Hong Kong, findings from other places can be subject to a test in Hong Kong. As such, this study employed panel data from 19,069 secondary school students in Hong Kong to analyze the impacts of moral education on moral commitment to sustain societal interests. Findings indicated a weak contribution of moral discussion and an even weaker contribution of moral education lectures to moral commitment. These findings therefore echo those in other places and suggest that real-life moral education contributes in the expected way, albeit weakly.     

The ecumenical and non-ecumenical dialectic of Christian bioethics.

Non-ecumenical Christian bioethics will seem a strange category for many. The category relies on the recognition that bioethics mediates morality and ethics in healthcare. As such bioethics will have particular content. It is the content of a moral vision that both divides and unites. The enterprise of non-ecumenical Christian bioethics explores how Christians are both divided and united on the issue of bioethics. Non-ecumenical Christian bioethics is opposed to a facile ecumenism that reduces the content of Christian morality to the lowest common denominator.     

The Buck Stops here: Why Universities Must Reclaim Business Ethics Education

Given the groundswell of corporate misconduct, the need for better business ethics education seems obvious. Yet many business schools continue to sidestep this responsibility, a policy tacitly approved by their accrediting agency, the Association to Advance Collegiate Schools of Business (AACSB). Some schools have even gone so far as to cut ethics courses in the wake of corporate scandals. In this essay I discuss some reasons for this failure of business school responsibility and argue that top university officials must go beyond weak accrediting standards to insist that ethics courses be required in business school curriculum. Otherwise, students will continue to get the message that practicing managers have little or no legal and ethical responsibilities to society.     

Gender and contextual differences in social responsibility in Thai schools: a multi-study person versus situation analysis

Social responsibility has been linked to the moral development of students, but little prior research has examined how personal and situational variables influence students’ willingness to show care and concern for social issues that reflect higher levels of moral development. We theorised and tested the hypotheses that females would endorse social responsibility to a greater extent than males, and that school/programme context would moderate this relationship. In Study 1, levels of social responsibility were greater for girls than boys and in academic versus vocational high schools, and school type moderated levels of social responsibility for boys. Study 2 replicated the male–female difference in social responsibility, and demonstrated greater differences in social responsibility across university academic programmes for female than male students. These studies expand the understanding of personal versus situational influences on social responsibility and their implications for moral education in schools.     

Human Rights,Cultural Pluralism,and International Health Research

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry.     

Another View of School Reform: Values and Ethics Restored

The article discusses a need for action in teaching values and morality in the public schools to gain control of the social problems that hinder school learning. Moral and ethical education are necessary to support parents and the community in teaching appropriate civic and moral values. Problems affecting school learning were substantiated by data collected from a national sample of public school principals reporting an alarming number of serious problems in the schools related to the home and society. Through teacher education programs, teachers must be prepared to provide moral education. Suggestions are offered to address the moral education of children and youth.