Good medical ethics, justice and provincial globalism

Bioethics: No Method-No Discipline?

This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as "a field of study following specific and well-established methodological rules" bioethics is not a specific discipline as there are no explicit "well-established methodological rules." The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological rules within subdisciplines or for specific tasks. As this does not appear to be the case, the article examines whether bioethics' adherence to specific quality criteria (instead of methodological rules) or pursuing of a common goal can make it qualify as a discipline. Unfortunately, the result is negative. Then, the article scrutinizes whether referring to bioethics institutions and professional qualifications can ascertain bioethics as a discipline. However, this makes the definition of bioethics circular. The article ends by admitting that bioethics can qualify as a discipline according to broader definitions of discipline, for example, as an "area of knowledge, research and education." However, this would reduce bioethics' potential for demarcation and identity-building. Thus, to consolidate the discipline of bioethics and increase its impact, we should explicate and elaborate on its methodology.

In pursuit of goodness in bioethics: analysis of an exemplary article

BACKGROUND

What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Second, we want to illustrate the added value of a novel method: in-depth analysis of a single article with the aim of deriving quality criteria. The third and ultimate goal is to stimulate a broad and vivid debate on goodness in bioethics.

METHODS

An initial literature search reveals a range of diverse quality criteria. In order to expand on the realm of such quality criteria, we perform an in-depth analysis of an article that is acclaimed for being exemplary.

RESULTS

The analysis results in eleven specific quality criteria for good bioethics in three categories: argumentative, empirical, and dialectic. Although we do not claim that the identified criteria are universal or absolute, we argue that they are fruitful for fueling a continuous constitutive debate on what is "good bioethics."

CONCLUSION

Identifying, debating, refining, and applying such criteria is an important part of defining and improving bioethics.

Nursing Ethics and the 21st-Century Armed Conflict

The purpose of this article is to call attention to the lack of caregiver safety in conflict settings; to bring awareness to nurses and health care professionals of new challenges, specifically the deliberate targeting of health care professionals, that they may encounter in local armed conflict situations; and to address a gap in knowledge about the social and cultural factors surrounding 21st-century armed conflict that directly affect the provision of health care. I argue that these are of interest to transcultural nursing in that violent actors belong to a dangerous subculture, the understanding of which is important to transcultural nursing practice and caregiver safety. The article calls for increased focus on the protection of the nursing workforce and renewed attention on international humanitarian law and the Geneva Conventions that mandate the safety of global health care workers.

Bioethics meets Ebola: exploring the moral landscape

INTRODUCTION

The Ebola Virus Disease (EVD) outbreak in West Africa raised ethical issues about structural disadvantage; the duty to care of healthcare workers; the use and study of unregistered agents; the use of restrictive measures like mass quarantine and the importance of public trust.

SOURCES OF DATA

WHO reports, literature on EVD and ethics.

AREAS OF AGREEMENT

The use of restrictive measures and the testing of unregistered agents is ethical if support for individuals or communities is provided.

AREAS OF CONTROVERSY

Controversy exists over ethical trial design for the study of unregistered agents and over the limits of the duty to care.

GROWING POINTS

The role of the WHO in outbreak control and research oversight needs rethinking and further support. Solidarity in global health needs fostering.

AREAS TIMELY FOR DEVELOPING RESEARCH

Research is needed on how to restore and enhance health systems and public trust in EVD-affected countries.

Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics

This paper argues that the four prima facie principles-beneficence, non-maleficence, respect for autonomy and justice-afford a good and widely acceptable basis for 'doing good medical ethics'. It confronts objections that the approach is simplistic, incompatible with a virtue-based approach to medicine, that it requires respect for autonomy always to have priority when the principles clash at the expense of clinical obligations to benefit patients and global justice. It agrees that the approach does not provide universalisable methods either for resolving such moral dilemmas arising from conflict between the principles or their derivatives, or universalisable methods for resolving disagreements about the scope of these principles-long acknowledged lacunae but arguably to be found, in practice, with all other approaches to medical ethics. The value of the approach, when properly understood, is to provide a universalisable though prima facie set of moral commitments which all doctors can accept, a basic moral language and a basic moral analytic framework. These can underpin an intercultural 'moral mission statement' for the goals and practice of medicine.