Academic journal article UCLA Journal of Environmental Law & Policy

The Case for Integrating the Environment into the Definition of Bioethics

Academic journal article UCLA Journal of Environmental Law & Policy

The Case for Integrating the Environment into the Definition of Bioethics

Article excerpt

I. INTRODUCTION II. HOW A NARROW CONCEPTION OF BIOETHICS EMERGED       A. Bioethics Has Two Fathers       B. Birth-Father #1: Van Rensselaer Potter       C. Birth-Father #2: Andre Hellegers, Father of the           Georgetown Perspective       D. Georgetown's Dominance       E. The Georgetown Definition of Bioethics Takes Hold       F. Potter Attempts to Resuscitate His Bioethics Model III. INDICATORS OF THE GEORGETOWN VIEW'S PROLIFERATION       A. Bioethics Organizations       B. Bioethics Textbooks IV. THE TRUE SCOPE OF BIOETHICAL DILEMMAS       A. The Health Sector as a Porous System       B. The Human Connection to the Environment       C. Social Determinants of Health       D. Public Health       E. The Environment and Health V. POTTER'S VIEW IS BETTER ALIGNED WITH THE TRUE SCOPE       OF BIOETHICAL DILEMMAS       A. The Value of Theory       B. Complexity Theory Offers Support for Potter's View           of Bioethics           1. Complexity Theory--An Overview of its              Characteristics           2. Porous Boundaries           3. Emergence           4. Co-evolution        C. Biocentrism and Bioethics VI. A BROADER VIEW OF BIOETHICS IN PRACTICE        A. Expanding Bioethics Practice        B. Expanding Bioethical Tools            1. Principlism in Bioethics        C. Applying Potter's Bioethics Definition .            1. Air Pollution            2. The Impact of the Health Sector VII. CONCLUSION 



This broader discourse must reach beyond the bedside, beyond the hospital doors, and out into the world within which medicine is situated and which largely determines who stays healthy and who winds up sick. (2)

--Jessica Pierce

In 1971, Van Rensselaer Potter first coined the term "bioethics" to advocate for the exploration of medical science and values with the goal of protecting life on earth. (3) Historically, bioethicists have focused primarily on medical dilemmas and issues in health care more generally, and have paid scant attention to how environmental issues influence human health. (4)

Examining the history of the word "bioethics" illuminates why it was medicalized; however, the ethical decisions that permeate our lives today require broader contemplation of factors that influence human health. Failing to consider influences outside the health system is analogous to standing on a porch mulling over whether to use a rake or a broom to disperse a pile of leaves, while a tornado is bearing down on the house. Looking at the "bigger picture" provides important context for our ethical decisions.

Ethical issues relating to the maintenance and management of human health do not exist solely within hospitals and medical clinics. The environment in which people work, play, and carry out their lives significantly influences their health. Thus, ethical discussions within the health sector that are insulated from the broader world may not address important influences on human health. Potter's broader view of bioethics should be reexamined and adopted in light of growing knowledge regarding health and the environment.

This Note argues that ethical work that is limited to issues within the health system should be termed "medical ethics." Broader ethical issues that have links to the health care system as well as to public health, social determinants of health, and environmental health should be defined under the broader conceptualization of "bioethics."

The remainder of this Note proceeds as follows: Part II-How a Narrow Conception of Bioethics Emerged describes how bioethics came to focus on ethical issues that are largely confined to medicine. Part III--Indicators of the Georgetown View's Proliferation offers contemporary examples of the narrow scope of bioethics. Part IV--The True Scope of Bioethical Dilemmas discusses the value of broadening the definition of bioethics to include public health activities, social determinants of health, and the human connection to the environment. …

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