Bioethics Education: Expanding the Circle of Participants
Thronton, Barbara C., Callahan, Daniel, Nelson, James Lindemann, The Hastings Center Report
Bioethics education now takes place outside universities as well as within them. How should clinicians, ethics committee members, and policymakers be taught the ethics they need, and how may their progress best be evaluated?
Socrates, perhaps the West's first "applied ethicist," consistently pressed the question, Can virtue be taught? The Hastings Center has been much concerned with similar questions: What can education in bioethics realistically hope to achieve--improvement in practice and character, or merely in people's ability to talk about practice and character? How might bioethics education best be conducted--by didactic courses run by academics traditionally concerned with ethics, by mentoring and example provided by experienced practitioners, by some combination of both, or by some new structures altogether? What's the best way to assess how well various attempts at bioethics education are working--by having students write papers or by giving them "moral development" tests?
A good deal of work on these questions appeared in the early 1980s, but the constituency for bioethics education has grown so remarkably in the ensuing decade that the theme needs to be revisited. In the 1980s people with an interest in bioethics were primarily affiliated with academic institutions. While academics are still at the core of the study of bioethics, the field has become a rapidly "expanding circle," now including practicing health care professionals who have not had bioethics in their professional training, members of ethics committees who might or might not be professionals, and policy makers and interested citizens as well. Bioethics' expanding circle now embraces people who take part in an occasional lecture or discussion as well as scholars involved in graduate education and advanced research; bioethics training goes on in hospitals, nursing homes, and community centers, as well as universities. This outreach to new participants and expanded settings parallels a movement throughout the United States promoting lifelong learning. But the spirited interdisciplinary dialogue among widely varied people is so particularly characteristic of bioethics that it imparts a special feeling of excitement and nourishes continued curiosity.
A Core Curriculum
A natural starting point for research into the pedagogy of bioethics is to identify the areas of the field with which every serious student should be acquainted. Six such key areas are:
1. The History of Medical Ethics and Bioethics. From Greek medicine to contemporary health care, medical ethics draws on a rich heritage. Tracing the history of the practice of medicine, the development of codes of ethics, and the progression of ideas regarding such issues as reproduction and death and dying is necessary for an understanding of the field.
2. Theoretical Foundations and Methods of Analysis. Religious traditions and philosophical theories have significantly influenced bioethics. An appreciation of the nuances of moral argument as well as an understanding of standard moral theories and newer approaches such as communicative ethics, narrative ethics, and feminist ethics remain essential elements of understanding the field and taking part in its ongoing conversation. Students of bioethics should be acquainted with these resources, both against the backdrop of the concerns that originally prompted them and as tools that can be used to illuminate cases or policies.
3. Comparative Analyses and Scope of the Issues Encompassed by the Term 'Bioethics.' One problem in this field is first to distinguish and then to relate the perspectives provided by such areas as law, public policy, and religion, tracing both their differences and what they have in common. Abortion provides a handy illustration. If the approach to the issue is through analysis of Roe v. Wade, Webster, or Casey, one is attending to how the issue is configured in terms of the discourse and values of the law; if the focus is on how various resolutions of the issue might be implemented practically, a public policy perspective is employed. …