Dramatic Scientific Advances Spur a Resurgence in the Study of Ethics
A year after a leaking gasoline line caused his car to explode, 25-year-old Donald Cowart remained so severely burned that he would die without long and painful treatment. Cowart asked to be allowed to die.
Question: Should the hospital grant his request?
The increasing frequency of questions like this has led to a national resurgence in the study of ethics, according to Preston K. Covey, director of Carnegie-Mellon University’s Center for the Advancement of Applied Ethics, which opened in June.
Ethicists say the number of such centers has been increasing in the last decade, especially at medical schools.
“If your medical school or center doesn’t have a serious program to address the ethical as well as the scientific, you are kind of behind the times,” said Bruce Jennings, associate for policy studies at New York’s Hastings Center, perhaps the oldest ethics research institute, founded in 1969.
“I would say there has been a change in attitudes since the 1950s and 1960s when philosophers felt the study of ethics was not very interesting,” he said. “Now it’s one of the most vital areas in academic philosophy.”
‘New Priority’
Carnegie-Mellon decided to open an ethics center because, like many other universities, “we felt that a new priority should be given to ethics and values,” Covey said. “Instead of just caring about them, we should start doing something about them.”
The university expects that its center will help students and professionals deal with a wide range of ethical issues, including insider trading, influence peddling, managing AIDS in the workplace, sexual harassment, South African divestment, whistle-blowing, fetal tissue research, abortion, organ transplants and affirmative action, Covey said.
A Carnegie-Mellon videodisc telling the story of Cowart’s 1973 accident and subsequent medical care, called “The Right to Die,” is used to guide businessmen, government officials and health care professionals through the complexities of moral questions that didn’t exist 20 years ago, Covey said.
At certain points in the story, the videodisc is stopped to allow seminar participants to debate the ethical issues and make their own decisions about what should have been done.
Cowart was not allowed to die, and today he is married and a practicing attorney in Texas, Covey said.
The Kennedy Institute of Ethics at Georgetown University in Washington, D.C., lists 56 U.S. ethics centers or programs in its International Directory of Bioethics Organizations, many of them formed in the last few years.
Spectacular science-fiction-like news stories about new medical techniques and capabilities have helped glamorize ethics, said Albert Jonsen, who heads the University of Washington School of Medicine’s new department of Medical History and Ethics.
“The first heart transplant was done in the late 1960s and that captured the attention of everyone,” Jonsen said. “Everyone was asking: ‘Is that right? Taking the heart out of one person and putting it in another?’ The media played that up in a big way and got a big response.”
Enlivened Debate
The reaction also enlivened debate among philosophers, scientists and doctors, he said.
“The reactions to that within medicine was to say: ‘This is fantastic technology--what’s its best use? It may have adverse consequences.’
“In medicine you’re supposed to benefit your patients. That’s the first rule. The ethical question we are asking is can this . . . benefit my patient?”
The University of Pittsburgh’s Center for Medical Ethics, which opened in February, 1987, was formed after administrators and faculty began reflecting on medical cases that grabbed the public’s attention, said center director Alan Meisel.
“One day in 1984, I picked up the paper and found a front-page story on Baby Faye, the little girl who received a baboon’s heart at Loma Linda University Medical Center in California. I reflected about that every day for a week, and I thought of similar stories,” Meisel said.
“Finally, we said that this is an important topic and we should do something about it.”
Kidney dialysis and organ transplantation sparked ethical debates in the 1970s, said LeRoy Walters, director for the Kennedy Institute’s biomedical ethics center.
“Today the new developments are in genetics and reproduction,” he said. “Also, with the emphasis on the civil rights movement and the women’s movement, more patients have been demanding more information from doctors about themselves, about their conditions, and there has been more emphasis on the patient’s right to determine what treatment he or she should have.”
‘Rapid Change’
The University of Minnesota’s year-old Center for Biomedical Ethics also was formed after medical school administrators, students and doctors agreed that more attention should be paid to ethics, said center director Arthur Caplan.
“You need new ethical norms at a time of rapid change,” Caplan said.
Although only a few weeks old, the Carnegie-Mellon center already has been busy conducting seminars for the Edison Electric Institute, the Pittsburgh office of the Internal Revenue Service, the federal Department of Agriculture and a number of other groups and agencies.
Advances in medical technology have led to perhaps the most uncomfortable, most highly publicized ethical questions, but difficult issues also arise in other areas, ethicists say.
“Suppose you sat down and thought about rearranging your investment portfolio to avoid businesses and investments in South Africa,” Covey said. “Could you come out just as well? And if you could and it doesn’t cost you anything, wouldn’t that be a good thing to do?
“For a variety of reasons, the business world is becoming more alert to ethical issues--either to keep out of trouble or make their operations run more smoothly or because they simply want to be more responsible ethically to their employees and to society,” Covey said.
Like other ethics centers, the Carnegie-Mellon center does not advocate particular moral values, however.
“The idea is not to sell ethics consulting, but to help people come to grips with ethical issues on their own,” Covey said.
