Education in ethics has long been a part of the medical curriculum; it is only in the last 30 years, however, that ethics education has been done overtly. Prior to the 1970s, physicians in training learned ethics by watching their mentors at work and by immersing themselves in the humanities.
Those who applied to medical school in the 1950s, 60s, and 70s prepared for their admission interviews by spending countless hours reviewing current events, art history, literature and classical music. The model of medical ethics that prevailed then was an Aristotelian “virtue ethics.” Ethical behavior was assumed to flow from virtuous individuals—in the case of medical school applicants, from individuals well schooled in the humanities and attentive to the world around them—not from training in the responsible conduct of research, review of conduct by ethics committees and institutional review boards, or oversight by professional ethicists. Beginning in the late 1960s, in response to some very public ethical lapses, this model was turned on its head: rather than ethics guiding action, actions were subject to the review of professional ethicists who were called on to assess and direct the behavior of clinicians and researchers.
Is this the best way to do ethics in a medical setting? Here is where the research and teaching we are doing at the University of Michigan can help. Our work goes beyond answering questions brought to us by care providers and bioethicists; we also study the way bioethics gets done and how it does (or does not) change the practices of medicine. You might say we are interested in the ethics of bioethics.
One example will illustrate the value of our approach. In a recent issue of a leading ethics journal, a team of bioethicists published their review of the propriety of ethics consultation for corporate clients and issued a set of guidelines for the proper conduct of these consultations. In spite of the fact that there were several empirical questions about the nature and influence of ethics consultations – What is the extent of paid bioethics consultation? What sort of companies are likely to seek consultation and for what kind of “problems?” Which ethicists are called on to proffer advice? How is bioethical advice used? Does (level of) remuneration influence the sort of advice ethicists offer? – no social scientists were invited to comment on their guidelines.
Our research is guided by a desire to understand the social forces that shape the way a society organizes moral advice giving and trains the next generations of physicians. We are deeply concerned about many of the issues that occupy bioethicists. In addition to helping physicians do the right thing, we want know, “Who gets to say what is the right thing to do?” Who defines moral problems? Who is empowered to resolve them? Why do certain moral issues have more salience than others do?
Simply put, the goal of our work is to examine and measure bioethics as a new way of being moral.
For more information, visit the Bioethics Web site
Contact: Raymond G. De Vries, Ph.D.