The growing importance of ethics in the ERA: From moral philosophy to integrated ethics

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The growing importance of ethics in the ERA
From moral philosophy to integrated ethics

• Prof. Margit Sutrop
• Director of the Centre for Ethics, University of
  Tartu, Estonia
• HEALTH-NCP-NET 1st Training, Brussels, 21.10.2008

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Outline

• Morality and ethics
• Reasons of the boom in ethics
• Ethics as an integral part of research
• Plurality of morals and unity of ethics In
  search of universal principles
• Changes in ethical frameworks new challenges to
  ethics

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The use of terms

• Morality is the embodiment of norms and values
  which have been collectively acknowledged as
  binding. Morality refers to historically emerged
  practices of people and cultures.
• Ethics refers to the whole domain of morality and
  to the theoretical reflection on moral values,
  norms and principles.

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Ethics

• Theoretical ethics
• Normative ethics (justification of norms)
• Metaethics (language of morals, nature of value
  judgements)

• Practical ethics
• Applied ethics
• ( moral issues of different fields of life)
• Professional ethics
• (values, obligations codified in professional
  practices)

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Practical ethics

• Medical ethics
• Bioethics
• Environmental ethics
• Public ethics
• Media ethics
• Business ethics
• Ethics of sports
• Research ethics

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Ethics boom in practical and professional ethics

• A search for shared values
• Institutionalization of ethics (first centre in
  1969 Hastings Centre on Hudson)
• More courses of ethics in university curricula
• Creation of special journals for ethics
• Ethical review system established
• Codes of ethics for different professions

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What makes this ethics boom so special? (M.
Davis,1999)

• Institutionalization of ethics neither of the
  previous booms produced centres for ethics
• Ethics is treated as a subject where
  controversies are normal (courses of ethics are
  problem-oriented)
• Philosophers not ministries leading the
  discussions
• Training in ethics for all professions required

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Possible reasons of ethics boom

• Fundamental changes in society (values under
  change, growing individual choices)
• Urbanization, huge cities
• Globalization
• Secularization of Western societies
• Diversity of religions
• Growth of individual autonomy
• People are more aware of their rights and less
  about their duties and responsibilities

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Ethics in science

• Research ethics a kind of professional ethics
  which sets and justifies the ethical standards of
  conduct in research
• Bioethics a kind of applied ethics which deals
  with ethical issues in biomedical research

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Research ethics

• Standards of ethical conduct in science honesty,
  carefulness, openness, freedom, credit, social
  responsibility, mutual respect,respect for
  subjects.
• Ethical standards of conduct in research play a
  key role in advancing the goals of science in
  promoting cooperation, collaboration, and trust
  among researchers and in attaining the publics
  trust and support.
• European Science Foundations Good scientific
  practice in research and scholarship, 2000

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Why has ethics become important in relation to
science?

• Advances in science and technology create new
  ethical issues of research. From the question
  what we can do? to the question what we
  should/may do?
• Max Weber the natural sciences can give us
  answers to questions about what we should do if
  we want to rule the world technologi-cally. But
  to answer the question whether we must or should
  rule the world technologically, we must step
  outside science.

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Continously pivoted, disputed concepts issues

• concept of human dignity
• the concept of personhood when does human life
  begin?
• the moral status of the human embryo (abortion,
  stem cell research)
• the right of the individual versus the right of
  the community
• respect for the human life versus beneficence
  (duty to alleviate the suffering)

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Attempts to formulate universal principles

• The Belmont Report (1979)
• Beauchamp and Childress Principles of Biomedical
  Ethics (1979)
• The Oviedo Convention on Human Rights
  Biomedicine (1997)
• UNESCO Universal Declaration on Bioethics and
  Human Rights (2005)

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Two different challenges

• The globalisation of medical resarch the need
  to capture universal values and formulate
  universal principles (global bioethics)
• The emerging reality of the diversity of moral
  cultures the need to respect plurality and
  ethical diversity (Asian, American, European
  bioethics)

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American versus European principles of bioethics

• Tom Beauchamp and James Childress (1979)
• autonomy
• beneficence,
• non-maleficence
• justice

• Peter Kemp, a.o Barcelona Declaration (2000)
• autonomy
• dignity
• integrity
• vulnerability

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Reasons of moral disagreement

• The disagreement is often not the result of the
  uptake of different values but of different
  interpretation or prioritization of values.
• Moral values depend on our self-understanding,
  conception of good life, which depend on
  historical and economic situation, cultural
  tradition, and religious convictions.

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New challenges to ethics

• Is there a need for changing ethical frameworks?
• From individual liberal ethics towards
  communitarian approach
• individual rights versus the common good?
• Individual interests versus public interest?

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Individualist framework in medical ethics

• Medical ethics, and more recently bioethics, have
  been guided by values of liberal individualism.
• Values of autonomy and privacy introduced later
  than beneficence and non-maleficence
• Principle of informed consent codified after
  World War II to denounce the practices of Nazi
  medicine (Nuremberg code etc)

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The Academy of Medical Sciences report, January
2006

• Report Personal data for public good using
  health information in medical research
• Overemphasis on privacy and autonomy, including
  an insistence on the need for explicit consent
  even though this may be impractical or
  undesirable for other reasons.
• The Academy invoked the public interest
  argument, suggesting that inhibiting the use of
  medical records for research is unethical because
  lives which could otherwise have been saved by
  epidemiological research were being lost.

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Reasons for re-thinking ethical frameworks

• Instrumental reasons
• epidemiological research is more difficult since
  without a subjects informed consent it is
  impossible to gather statistical data
• restrictions requiring new informed consent on
  the re-use of biological samples and data
  severely limit research
• Substantial reasons genetic information is by
  nature shared among others thus raising doubts
  about the traditional applicability of concepts
  like ownership and privacy .

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How to proceed? Arguing for a pluralist approach
to values.

• No need to see individual-interest based and
  collective-interest based ethical frameworks in
  opposition. This is not an either/or issue. An
  appropriate balance between the individual and
  public interests should be maintained.
• Values we care about are plural and contextual.
• There is no one overriding value, yet values are
  objective and not relative.
• Ranking of values only reasonable in particular
  settings.

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Thank you for your attention!