Essay On Bioethics

I’ve been considering writing a reflective piece about the general quality of bioethics papers in medical journals, focusing on how the medium (the audience and the severe word limits) impacts on the message and its quality – possibly as a bit of a moan since I’ve not yet managed to get a medical journal to accept one of my papers (my favourite rejection from an editor yet being “nice try, but too philosophical – maybe try the journal of medical ethics?”). Furthermore publication pressures tend to select for particular styles of pieces – I’ve remarked to people in the past that the way to get published in the BMJ is to write a piece critical of research ethics review – preferably with an anecdote  Then this morning on twitter I saw this lovely funny piece by James Lenman of the University of Sheffield on how to write a crap essay in philosophy which contains gems such as:

 “Whenever in any doubt as to what to say about X, say, apropos of nothing in particular and without explanation, that X is extremely subjective.

When that gets boring, try saying that X is all very relative. Never say what it is relative to.”

And I decided to just borrow and extend the idea in this piece. So take James’ rules as given and add these rules to enable the reader to write a crap piece of work in bioethics:

1. Unreflectively copy a piece of work by a philosopher. If they wasted time qualifying their view or noting it only applies in a limited situation make sure you strip that out.

2. Remember if you are a doctor you don’t need good arguments – you have authority… Remember if you are a philosopher you don’t need to know the context to write authoritatively about it.

3. Never use an argument where an anecdote will do. A homily is worth a thousand arguments.

4. Instead of making an argument, say “I will argue”. Then don’t, an assertion will do. No one will notice.

5. Don’t ever make a modest claim when you can make a bold assertion. Only extremes can be correct.

6. According to the OED it is important to define your terms using the dictionary not how they have been defined in the relevant literature.

7. Please do begin your paper with a vaguely relevant quote from “Literature” this shows that you are well read and thus quite clearly correct. As D’Israeli said: “The wisdom of the wise, and the experience of ages, may be preserved by quotation.”

8. If empirical evidence is relevant to your paper make sure you either don’t find any or you just run a google search and then cherry pick the evidence to support your case without considering its quality.

9. Remember the is/ought problem is a philosophical problem not a bioethical problem so you don’t need to worry about it when making grand assertions from tiny bits of empirical evidence.

10. Ad hominem is a valid argument structure.

11. All slopes are slippery. If its bad and it is remotely possible let us assume that it will happen.

12. There are no principles/theories but the four principles.

13. Obviously the four principles approach is the only one worth considering. Make sure you refer to all four principles (but nothing other than them) especially if several of the principles are irrelevant to the situation you are discussing – before concluding that autonomy trumps the others.

14. Remember the more arguments/assertions you can give the better – why waste time on critical reflection and depth when you can squeeze in more arguments/assertions. Especially ensure that there is no methodological or theoretical consistency about the position you advance.

15. If your argument gets into trouble you can save it by referring to Nazi Germany and implying that your opponents view would have been looked on kindly there.

Please suggest more rules in the comments…  

Journal of the History of Medicine and Allied Sciences 56.2 (2001) 168-175

[Access article in PDF]

The History of Bioethics:
An Essay Review

Robert Martensen

ROBERT B. BAKER, ARTHUR L. CAPLAN, LINDA L. EMANUEL, and STEPHEN R. LATHAM, eds. The American Medical Ethics Revolution. How the AMA’s Code of Ethics has Transformed Physicians’ Relationships to Patients, Professionals, and Society. Baltimore, Maryland, The Johns Hopkins University Press, 1999. xxxix, 396 pp., illus. $59.95.
ALBERT R. JONSEN. A Short History of Medical Ethics. New York, Oxford University Press, 1999. xi, 153 pp. $34.95.

According to Sargent Shriver, he invented the word "bioethics" in his own Bethesda, Maryland, living room one night in 1970. 1 That evening he and his wife, Eunice Kennedy Shriver, met with physician Andrée Hellegers, the president of Georgetown University and a Jesuit philosopher,and others to discuss Kennedy family sponsorship of an institute for the application of moral philosophy to concrete medical dilemmas. Now bioethics is thirty years old, the traditional span of a generation, and has reached an anniversary that invites reflection.

No one has been assessing the first generation of bioethics more diligently than Al Jonsen, who studied moral philosophy and religion as a Jesuit priest before leaving the church in the mid-1970s for full-time work as a professor of bioethics. Like many foundational figures who have been present at the creation of their fields, Jonsen can recall reams of useful detail about his subject’s early life, which he did in his Birth of Bioethics (Oxford University Press, 1998). More recently, he goes backward in time, offering readers A Short History[End Page 168]of Medical Ethics, which ends just when his first book begins. To those who might wonder why Jonsen, who makes no pretense of being a trained historian, would write a historical survey, he explains in the introduction that he intends Short History as a stop gap, an initial treatment of a field that, surprisingly, has not received sustained historical analysis.

The editors of The American Medical Ethics Revolution provide quite a different rationale for their compendium. The year 1997 marked the 150th anniversary of the Code of Ethics of the American Medical Association. To celebrate, the AMA funded a conference in Philadelphia, in collaboration with the Center for Bioethics of the University of Pennsylvania and the College of Physicians of Philadelphia, to review the past and present of American medical ethics. This volume serves as the conference proceedings. It contains twenty short chapters and an extensive appendix that includes iterations of AMA ethical codes and other AMA ethics texts from 1847 to the present. The chapters are organized into four sections, the first devoted to historical reflections on the AMA Code, and the balance dealing with the present and future of bioethics.

Taken together, these heterogeneous texts provide a wealth of information and viewpoints concerning the history, content, and professionalization of medical ethics and bioethics, primarily in an American context. Jonsen’s survey is short, and so are the chapters in AMA Revolution. Sixteen of the twenty-one authors (Jonsen’s work appears in both books) are leaders in the bioethics community, and some of them, like Jonsen, were active from the 1970s. The five other contributors, four prominent historians of medicine and an influential sociologist, provide external perspectives. The essays’ number, brevity, and diversity make detailed commentary impossible within the limits of this review; nonetheless, some interesting themes emerge.

One theme is that bioethicists and historians view the bioethics universe in ways that verge on the incommensurable. For example, one of the axioms of bioethics history according to bioethicists is that physicians, especially those doing research on humans, had few ethical standards until medical ethicists began developing some from the mid-1960s onward. According to the introduction to AMA Revolution, medical ethics were but the "personal character" of physicians until the 1847 code, for the eighteenth-century British university was not concerned with moral matters. When human experimentation [End Page 169] became professionally important in the twentieth century, medicine had a "poverty...

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