Medical technological advances such as those mentioned above were initially viewed as scientific breakthroughs that solved baffling medical problems. As time went on physicians, as well as other people, began to realize these medical advances were also creating baffling ethical dilemmas – for which physicians were unprepared.
Medicine had been concerned with ethical issues and practices from the time of Hippocrates (400 B.C.) and Maimonides (1200 A.D.). Ethics is very simply defined by Webster’s Dictionary as “the discipline dealing with what is good and bad and with moral duty and obligation”, a “theory or system of moral values” and “the principles of conduct governing an individual or a group”. Ethics is also defined as the study and philosophy of human conduct with emphasis on the determination of right and wrong.
As medicine’s ability to intervene with and redefine life and death increased, physicians, patients, and others became concerned with such accompanying issues as
1) when is it appropriate to use available technologies (for example, to create life, to sustain life, and/or to preclude death);
2) who are the decision-makers, and
3) how should limited resources be used. The media, the public, ethicists, and physicians called for ethical responses to these new and more complicated issues raised by modern medicine.
The media exposed abuses and potential abuses in medical research. The public reacted to such cases as the Karen Anne Quinlan case and the story of Baby M and expressed concerns about ethical issues in medicine that impacted personal medical care or the medical care of loved ones. In the 1970s a small group of philosopher-ethicists (mainly Beauchamp & Childress) was the first to formally respond to the growing number and complexity of ethical issues raised in medical practice. They crafted four formal ethical rules for use in medical research settings: autonomy, beneficence, non-maleficence, and justice.