The concept of biomedicalethics is not a new term by any means. Ethics dates back all the way to the 1800swhen Thomas Percival published his own code of ethics. Following this was the AmericanMedical Association’s code of ethics created in 1847. While this code of ethicshas remained an integral part of regulated ethics, historical events andadvances in technology have caused the general code of ethics to change.Current ethical policy is full of regulation and specific requirements whendealing with biomedical advancements. It brings in the moral of the individualand the moral of a society as a whole.
Old ethical guidelines like the Nurembergcode, the Declaration of Helsinki, and the Belmont report have all paved theway to what the current guidelines look like. However, there are shortcoming tothese reports and shortcomings to current regulations. A major stepping stone inthe advancement of bioethics was the creation of the Nuremberg code. After theholocaust judges were faced with the difficulty of trying Nazi doctors who hadtortured and experimented on numerous prisoners. The trial was difficultbecause they had no precedent to follow other than the Hippocratic oath. Due tothese unprecedented issues the judges felt it was necessary to create a codethat specified research ethics; this lead to the creation of the Nurembergcode. The Nuremberg code consists of 10 codes to follow by that are centeredaround patient consent and combined principles from the protection of humanrights and Hippocratic ethics.
While the Nuremberg code is one of the mostimportant documents in bioethical conduct it has its flaws. One major flaw isits ambiguity. For example, part two which states that the experiment should be such as to yield fruitful results for the goodof society is a very vague statement that leaves for many differentinterpretations of what fruitful results would be. Another source of ambiguitycomes from statement six which states that the humanitarian importanceof research must be higher than the risk.
Again, this statement leaves fordifferent interpretations of what kind of research would be claimed as beinghigher than the risk and different people may view one experiment as being betterfor the society no matter the risk while another may disagree. The Nuremberg codealso leaves way for loopholes. The second half of principle five which statesthat no experiment that endangers the life of a subject should be conductedunless if the physicians also serve as subjects provides a major loophole. It couldbe understood by the researcher that it is okay to risk the life of another aslong as he or she is also risking their life which sounds like an unremorsefulexchange of one life for another life. The Belmont report whichwas published in 1979 further specifies three principles for ethical conduct. Thethree principles include beneficence,justice, and respect for persons. The report specifies that subjectsshould be protected in clinical trials and researchers should put the subject’ssafety first.
It further inspired following ethical guidelines; one example isthe creation of the common rule which guidelines research at universities. Whilekeeping the principles of the Belmont report in mind can help clear up researchissues, in some cases the principles can clash with each other and causefurther confusion. This confusion is mainly due to the vagueness of theprinciples in the report and how to apply them. While the report provides ageneral optimistic view of how research should be viewed it does not apply anyspecific ways to insure this is always the case.
Conflict can arise when theinterest of an individual participant interferes with the interest of thesociety. Lastly, nowhere in the report are the three principles tied in. Theirrelationship to each other is never clarified. For example, neurocognitive enhancementdrugs have been used widely and are increasingly becoming more popular.
Andrecently these drugs that were seen so unhealthy to be used by nonprescribedpatients are now being investigated for the use of surgeons to enhance theirfocus during long and tedious hours of surgery. If this controversial topic wasto be tackled by just the Belmont report it would be insufficient in providingenough background as to what the ethical choice would be. There would be no clear-cutright or wrong answer because while the use of these drugs by surgeons may beseen as inhumane the effects could produce extraordinary results and possiblysave the lives of thousands. Another doctrine that influences ethics inmedicine is the declaration of Helsinki. The declaration of Helsinki wasestablished by the world medical association and lays down ethical guidelines forphysicians in the practice of medicine. It sets guidelines for many aspects ofresearch. However, some of these guidelines are contradictory and the languagecan be confusing at times. One way that the declaration of Helsinki advances inthat it is regularly reviewed, keeping up with current biomedical issues andmolding to the new times.
Today, the Nurembergcode, the declaration of Helsinki, and the Belmont report still aid as relativeblueprints of ethical conduct. For a practice to be viewed as ethical it mustrespect the four principles of beneficent, non-maleficence, justice, andautonomy. Many more regulations are now put in place for ethical conduct duringresearch; not only is informed consent required but prior peer review from acommittee is also required. States also have their own rules set in place toprotect human rights. While these regulations are put in place, ethical conductin general is hard to lay down in specific play by play writing. Ethics isalways evolving and there are numerous unprecedented issues that requiredifferent aspects to be considered. This is especially relevant in all the newtechnologies that are being created and new advancements in biomedicalresearch.
General morals can also change over time leading to revisions neededin conduct. The only way to fulfill any time of research standard is bychanging ethical guidelines as new advancements are made. Sticking to just oneconcept or one code of ethics wouldn’t work in the long run and in many situations,it’s hard to say exactly what the so called right thing is to do. One issuethat seems solvable by one person may not be seen solvable by another.Biomedical research is ever changing and with this follows ever changingethics.