Methodology In Bioethics Research Articles

Testing Design Bioethics Methods: Comparing a Digital Game with a Vignette Survey for Neuroethics Research with Young People

Background Over the last decades, the neurosciences, behavioral sciences, and the social sciences have all seen a rapid development of innovative research methods. The field of bioethics, however, has trailed behind in methodological innovation. Despite the so-called “empirical turn” in bioethics, research methodology for project development, data collection and analysis, and dissemination has remained largely restricted to surveys, interviews, and research papers. We have previously argued for a “Design Bioethics” approach to empirical bioethics methodology, which develops purpose-built methods for investigation of bioethical concerns. In this paper we compare a research tool created using a design bioethics approach to a “methods-as-usual” approach in empirical bioethics. Methods Our study compared dimensions of engagement with a digital game we created, called “Tracing Tomorrow,” to a standard vignette survey. The two tools investigated the same subject matter, digital phenotyping for mental health, in a sample of 301 UK adolescents. Results Participants who played the game reported a greater sense of presence, emotional engagement, cognitive absorption, and mental health ethics insight, compared to participants who completed the vignette survey. Perceived authenticity and curiosity/motivation to learn more was equivalent for both methods. Conclusion The results of this study highlights the importance of purpose-built methodology for empirical bioethics research.

The thorny way of European Bioethics

The ambiguity of the term bioethics has brought different views and has resulted in the development of European bioethics, which relies on the postulates of Fritz Jahr. The intention of this paper is to follow the development of the idea of European Bioethics by analyzing the growth of the journal Jahr – European Journal of Bioethics. Undoubtedly, Jahr had to counterbalanced mainstream bioethics (medical ethics) with the emerging European Bioethics based on Fritz Jahr’s and Van Rensselaer Potter’s original teachings, Euro-Mediterranean (and other non-Anglo-American) values, and the Integrative Bioethics methodology. Due to the broadness of the pluri-perspective approach, Jahr slipped into »thematic inconsistency« and its epistemological »rebelliousness« certainly will remain a problem for a long time.

Procedural justice and the individual participant in priority setting: Doctors' experiences

In this study we describe, synthesise, and discuss the experiences and views of doctors who participate as technical experts in health care priority setting, reflect on the ethical significance of the challenges to procedural and distributive justice they encounter, and propose an empirically derived practical approach to improving the fairness of the process.Between August 2015 and July 2016 we conducted semi-structured face-to-face interviews with 20 doctors in NSW, Australia, purposively selected on the basis of their participation in macroallocation. Participant selection, data collection, and analysis were carried out according to the principles of grounded moral analysis, an empirical bioethics methodology closely based on grounded theory.The doctors we interviewed attached ethical significance to a broad range of procedural concerns that militated both against the prospect of distributive justice and against their own wellbeing: unfair access to opportunities to participate in macroallocation, sexist behaviours and structures, rewards for rule-breakers, cynical and insincere practices, waste, duplication, and inefficiency, and being taken for granted.On the basis of our data, we hypothesise that the institutional conditions for macroallocation do not support the care of medical participants in deliberations. Evaluating our findings against the ‘accountability for reasonableness’ framework of Daniels and Sabin, we expose as incompatible with the conditions for procedural justice processes that treat participants in macroallocation unfairly or cause them to have moral unease about the justice of the enterprise. We suggest a supplementary procedure that positions commitment to the care and just treatment of participants as a foundation of any macroallocation procedure.

The values and ethical commitments of doctors engaging in macroallocation: a qualitative and evaluative analysis

BackgroundIn most socialised health systems there are formal processes that manage resource scarcity and determine the allocation of funds to health services in accordance with their priority. In this analysis, part of a larger qualitative study examining the ethical issues entailed in doctors’ participation as technical experts in priority setting, we describe the values and ethical commitments of doctors who engage in priority setting and make an empirically derived contribution towards the identification of an ethical framework for doctors’ macroallocation work.MethodWe conducted semi-structured interviews with 20 doctors, each of whom participated in macroallocation at one or more levels of the Australian health system. Our sampling, data-collection, and analysis strategies were closely modelled on grounded moral analysis, an iterative empirical bioethics methodology that employs contemporaneous interchange between the ethical and empirical to support normative claims grounded in practice.ResultsThe values held in common by the doctors in our sample related to the domains of personal ethics (‘taking responsibility’ and ‘persistence, patience, and loyalty to a cause’), justice (‘engaging in distributive justice’, ‘equity’, and ‘confidence in institutions’), and practices of argumentation (‘moderation’ and ‘data and evidence’). Applying the principles of grounded moral analysis, we identified that our participants’ ideas of the good in macroallocation and their normative insights into the practice were strongly aligned with the three levels of Paul Ricoeur’s ‘little ethics’: ‘aiming at the “good life” lived with and for others in just institutions’.ConclusionsOur findings suggest new ways of understanding how doctors’ values might have procedural and substantive impacts on macroallocation, and challenge the prevailing assumption that doctors in this milieu are motivated primarily by deontological considerations. Our empirical bioethics approach enabled us to identify an ethical framework for medical work in macroallocation that was grounded in the values and ethical intuitions of doctors engaged in actions of distributive justice. The concordance between Ricoeur’s ‘little ethics’ and macroallocation practitioners’ experiences, and its embrace of mutuality, suggest that it has the potential to guide practice, support ethical reflection, and harmonise deliberative practices amongst actors in macroallocation generally.

Queering bioethics: A queer bioethical inventory of surrogacy

Summary Queer bioethics is a latterly explicated field of bioethics developed by Lance Wahlert and Autumn Fiester, focusing on gender nonconformity and sexual diversity. Queer bioethical inquiries often involve people identifying as lesbian, gay, trans, queer or intersex (= LGBTQI) to name some of the established identity categories of such nonconformity and diversity. Topics of queer bioethical interest can include, for example, issues discussed in mainstream bioethics as gender reassignment or sex affirmation of trans- and intersex people respectively, or reproductive justice for same-sex couples accessing assisted reproduction technology. Further, however, queer bioethics interrogates the basis on which certain socio-medicalized views on gender and sexuality are justified in medical ethics, wishing to critically renegotiate these justifications to allow more human flourishing. This is also a call for dismantling the cis- and heteronormative bioethical foundations of public health. This article offers an introduction to queer bioethics accompanied by the queer bioethics inventory (QBI) formulated by Wahlert and Fiester for bioethical methodology, by focusing on the case of surrogacy in Finland. The case is selected neither because it is the most queer bioethically appalling nor because it is a rare one. On the contrary: the case has nothing explicitly to do with LGBTQI people, and allowing surrogacy as treatment is not globally uncommon. To subject a seemingly non-queer, common bioethical practice, for a queer bioethical analysis reveals the need for queer bioethics.

Who gets the gametes? An argument for a points system for fertility patients.

This paper argues that the convention of allocating donated gametes on a ‘first come, first served’ basis should be replaced with an allocation system that takes into account more morally relevant criteria than waiting time. This conclusion was developed using an empirical bioethics methodology, which involved a study of the views of 18 staff members from seven U.K. fertility clinics, and 20 academics, policy‐makers, representatives of patient groups, and other relevant professionals, on the allocation of donated sperm and eggs. Against these views, we consider some nuanced ways of including criteria in a points allocation system. We argue that such a system is more ethically robust than ‘first come, first served’, but we acknowledge that our results suggest that a points system will meet with resistance from those working in the field. We conclude that criteria such as a patient's age, potentially damaging substance use, and parental status should be used to allocate points and determine which patients receive treatment and in what order. These and other factors should be applied according to how they bear on considerations like child welfare, patient welfare, and the effectiveness of the proposed treatment.

Integrative Pedagogical Bioethics as Prospect of Educational Discourse

The given article is devoted to author's impressions about The Sixth National Congress from Bioethics, which took place in Kyiv on 27-29 September, 2016. Reveals the theme of the plenary and breakout sessions of Congress, which was devoted to discussion of topical issues related to the development of new biomedical technologies and nanotechnology; legal structures in the field of bioethics; bioethical education and training; environmental bioethics; philosophical generalizations contemporary issues of bioethics. The members of the Congress are identified including generally domestic and foreign specialists: scientists, medicians, biologists, philosophers, lawyers, psychologists, educators, representatives of different religious confessions, practitioners and social workers. Updated transdisciplinary nature of modern bioethics. It is analyzed as different areas of bioethics differentiated education. The author calls for a creative rethinking of the structure and methodology of bioethics. Implementation and development of integrative pedagogical bioethics allow Ukraine to become a leader in the development of bioethics to make a qualitative leap in education reform in general.

Integrative Bioethics: A Conceptually Inconsistent Project.

This article provides a critical evaluation of the central components of Integrative Bioethics, a project aiming at a bioethical framework reconceptualization. Its proponents claim that this new system of thought has developed a better bioethical methodology than mainstream Western bioethics, a claim that we criticize here. We deal especially with the buzz words of Integrative Bioethics - pluriperspectivism, integrativity, orientational knowledge, as well as with its underlying theory of moral truth. The first part of the paper looks at what the claims of a superior methodology consist in. The second reveals pluriperspectivism and integrativity to be underdeveloped, hazy terms, but which seem to be underpinned by two theses - the incommensurability and the inclusiveness theses. These theses we critically scrutinize. We then consider strategies the project's proponents might apply to curb these theses in order to acquire minimal consistency for their framework. This part of the article also deals with the conception of moral truth that drives the theory, a position equally burdened with inconsistencies. In the last part of the article, we observe the concept of orientational knowledge, and develop two interpretations of its possible meaning. We claim that, following the first interpretation, Integrative Bioethics is completely descriptive, in which case it is informative and important, but hardly bioethics; if it is normative, following the second interpretation, it is bioethics as we already know it, but merely clad in rhetorical embellishments. We conclude that there is nothing new about this project, and that its inconsistencies are reason enough for its abandonment.

Scaling ethics up and down: moral craft in clinical genetics and in global health research

This paper engages with the question of what it is to ‘do good medical ethics’ in two ways. It begins with an exploration of what it might mean to say...

Methodology in Bioethics (in Polish)

The issues presented in this article bear on (1) the status of bioethics as an academic discipline and (2) research methods employed in it. With regard to the status of bioethics, I discuss problems related to the definition of bioethics, the ways of addressing bioethical issues (interdisciplinary discourse, applied ethics, an extension of medical ethics) and the choice of the discipline within which bioethics should be developed (law, theology, philosophy). The presented methods of bioethics have been divided into normative and non-normative. The non-normative methods are empirical, both qualitative and quantitative, whereas normative methods have been divided into three groups: methods based on principles (the application method and coherentism), casuistry, and alternative methods (virtue ethics, the ethics of care, communitarianism, and the narrative perspective). Since alternative ways of addressing bioethical issues are not always sufficiently developed from the methodological point of view, I have introduced, apart from the concept of method, the concept of research perspective (used, in the literature on the subject, interchangeably with the concept of research approach).

Bioethics and Culture: Understanding the Contemporary Crisis in Bioethics

LANGUAGE NOTE | Document text in English; abstract also in Chinese.生命倫理學與文化的關係是晚近生命倫理學討論的熱點話題。圍繞着布什生命倫理委員會 (President’s Council on Bioethics or Bush Bioethics Council) 的種種風波和爭議，使生命倫理學中的文化權威問題尤為突顯。本文將審查布什生命倫理委員會的性質，並從新的視角解釋為什麼圍繞該委員會的爭論會陷入如此激烈、不可調和的分裂中。我的新解釋是這些分裂與其說是生命倫理學政治化的結果，毋寧說是文化深層分歧在生命倫理學和道德哲學領域中的表達。Much attention has been paid to the relation of bioethics and culture in recent years among those who primarily work in bioethics and also among those whose primary concerns are with matters of culture.1 Why? There are a number of reasons for this widespread interest, and in what follows I hope to explore the variety of these reasons and to suggest some ways of assessing the present state of this discussion. Among the conclusions of my discussion will be that the interplay between purely philosophical considerations bearing on contemporary discussions in bioethics and more general cultural considerations has been of the first importance in shaping recent developments in the emerging academic discipline of bioethics. One cannot ignore developments in academic moral philosophy if one hopes to understand why relations between bioethics and culture have been at the center of so many recent discussions. Also, I will suggest (but hardly establish) that the current unrest in bioethics centered on matters of its relation to culture grows ultimately out of deep cultural divisions and will not be easily resolved by mere adjustments in the methodology of bioethics or by “repackaging” bioethics.My strategy in this paper will be first to distinguish two quite difference sets of issues in the broad area of bioethics and culture and then discuss in some detail the second of these sets of issues. After exploring the second set of issues in a preliminary way I will relate them to some recent episodes in bioethics, in particular the vicious disagreements and lack of civility involved in the reaction of some establishment bioethicists to the deliberations of the Bush Bioethics Council.2 The depth of the disagreement and rancor in this case has led some to speak of a crisis in the field and of a need for some new methodological orientation for bioethics. Turning to a discussion of some general features of the history of bioethics since its creation half a century ago, I will suggest that these recent disturbances are rooted in features of bioethics present from its beginning. There has never been, as some suppose, a golden age when agreement was easy and mainstream bioethicists spoke with a single voice that commanded universal—or even near universal—assent. I will finally turn very briefly at the end of the paper to two important recent developments in the effort to reorient bioethics--the movement on the part of a number of establishment bioethicists to develop what they call Progressive Bioethics 3 and the sociologist John Evans’s recent proposal to draw on sociological insights to address the crisis in bioethics. I will argue that neither of these reforming proposals is adequate to resolve the difficulties in bioethics that elicited them.DOWNLOAD HISTORY | This article has been downloaded 78 times in Digital Commons before migrating into this platform.

Wide reflective equilibrium as a method of justification in bioethics

Carson Strong has recently argued that wide reflective equilibrium (WRE) is an unacceptable method of justification in bioethics. In its place, Strong recommends a methodology in which certain foundational moral judgments play a central role in the justification of moral beliefs, and coherence plays a limited justificatory role in that the rest of our judgments are made to cohere with these foundational judgments. In this paper, I argue that Strong's chief criticisms of WRE are unsuccessful and that his proposed alternative is in fact just another version of WRE. In the course of doing so, I specify which theses are central to WRE and which are not, and thus, provide a response to an additional objection, advanced by Peter Singer, that WRE is vacuous. I conclude by arguing that there may be better prospects for advancing the debate regarding methodology in bioethics if we focus on restricted epistemic and methodological theses rather than broad approaches, such as WRE, that come in many different varieties.

A new teaching methodology in Bioethics: experience of the application of portfolios with medical students

Nowadays the necessity of dedicating time to curricular education in bioethics in medical schools is undeniable. Curriculathat opens for Bioethics teaching in medical schools should impregnate the whole technical education and the development of skillsby students, going thus beyond theoretical aspects. A portfolio system applied to bioethics is a simple, useful methodology both forteaching and for evaluating students, and makes possible to discuss ethical questions students face in their daily lives. For this reason,it may be applied during the entire medical education program. By means of examples collected using the portfolio in a project with 64students of 8 Brazilian medical schools, it was possible to see how the students become aware of ethical questions and begin to studyand reflect about them, building this way their own knowledge.

Single‐Principle Versus Multi‐Principles Approaches in Bioethics

abstractThe so‐called Principlism of Beauchamp and Childress is one of the most prominent approaches in bioethics. It has, nevertheless, given rise to an ongoing debate on methodology in bioethics. At the bottom of this debate lies the question whether a multi‐principles approach or a single‐principle approach is more convincing in bioethics. In this paper I shall propose a ‘third way’ of bioethical reasoning that is committed neither to a multi‐principles nor to a single‐principle approach. In contrast, I will take up the Kantian differentiation of formal and material principles. This differentiation permits combining the strengths of multi‐principles as well as of single‐principle approaches.

AGREEING TO DISAGREE: Indigenous Pluralism from Human Rights to Bioethics

ABSTRACTDavid Hollenbach, working within the context of human rights theory, has developed the notion of “indigenous pluralism” as a means of coping with the problems that arise when different religious traditions hold distinct or incompatible interpretations of human rights. It will be argued that indigenous pluralism is a theoretically and practically useful concept for bioethics as well and hence should be incorporated into bioethical methodology and processes of bioethical policy formation. Subsequently, the notion of indigenous pluralism will be discussed in relation to determinations of death as a means of illustrating this concept's applicability to bioethical inquiry.

Bioethics in a pluralistic society: bioethical methodology in lieu of moral diversity

In an attempt to promote in-depth dialogue amongst bioethicists coming from distinct disciplinary and religious backgrounds this essay offers a critical analysis of a number of the leading methods of addressing pluralism in bioethics and. Exploring the critiques and methodological proposals coming from the social sciences, the contract theorists, and the pragmatists, this study describes the problems which arise when confronting moral diversity in a bioethical context and examines the ability of these various methodologies to adequately resolve these matters. Finally, the foundations of a new conceptual framework for bioethical methodology will be developed. It will be argued that these new methodological insights are able to overcome the problems facing other methodologies and may provide a viable means for adequately addressing issues of pluralism in bioethics.

Book Review: Moral Acquaintances: Methodology in Bioethics

Book Review: Moral Acquaintances: Methodology in Bioethics

Can context justify an ethical double standard for clinical research in developing countries?

BackgroundThe design of clinical research deserves special caution so as to safeguard the rights of participating individuals. While the international community has agreed on ethical standards for the design of research, these frameworks still remain open to interpretation, revision and debate. Recently a breach in the consensus of how to apply these ethical standards to research in developing countries has occurred, notably beginning with the 1994 placebo-controlled trials to reduce maternal to child transmission of HIV-1 in Africa, Asia and the Caribbean. The design of these trials sparked intense debate with the inclusion of a placebo-control group despite the existence of a 'gold standard' and trial supporters grounded their justifications of the trial design on the context of scarcity in resource-poor settings.DiscussionThese 'contextual' apologetics are arguably an ethical loophole inherent in current bioethical methodology. However, this convenient appropriation of 'contextual' analysis simply fails to acknowledge the underpinnings of feminist ethical analysis upon which it must stand. A more rigorous analysis of the political, social, and economic structures pertaining to the global context of developing countries reveals that the bioethical principles of beneficence and justice fail to be met in this trial design.ConclusionWithin this broader, and theoretically necessary, understanding of context, it becomes impossible to justify an ethical double standard for research in developing countries.

Book Review: Moral Acquaintances: Methodology in Bioethics

Book Review: Moral Acquaintances: Methodology in Bioethics

La comparsa della bioetica nei Codici di Deontologia medica italiani: profilo storico e analisi dei contenuti

Negli ultimi anni è divenuto sempre più evidente il legame tra la deontologia medica e la bioetica. La deontologia ha recepito i messaggi della bioetica ed ha abbandonato la funzione di puntuale inventario delle leggi e delle regole attinenti la professione, mentre essa ha acquisito dignità di sostegno e di guida ad una buona pratica medica. Ma questa attenzione è recente, oppure è rintracciabile anche nei vari codici di deontologia medica pubblicati in Italia nel corso del XX secolo?
 L’analisi dei Codici di Deontologia medica italiani ha messo in evidenza uno specifico interesse per i temi propri della bioetica a partire dal Codice del 1978. Non si tratta, però, solo della scelta dei temi. La riflessione deontologica ha fatto propria anche la metodologia bioetica. Per cui i Codici danno indicazioni sull’agire del medico partendo da un ben preciso riferimento antropologico: il rispetto della persona umana e dei suoi diritti. Ciò nonostante, la soggettività dei diritti non è riconosciuta prima della nascita, quindi sono giustificati sia l’aborto sia le tecniche di fecondazione artificiale. Inoltre, la dignità professionale del medico non è sempre salvaguardata, infatti, in nome del rispetto dell’autonomia, essa viene subordinata alle decisioni del paziente. Questo rappresenta un paradosso dei Codici deontologici, i quali hanno come scopo principale quello di vietare i comportamenti dannosi per il “buon nome” della categoria.