The Growth of the Bioethics Movement

The growth of the bioethics movement and the institutionalizing of bioethics in U.S. hospitals and universities have made ethical issues more visible than ever before. Articles on bioethics were virtually nonexistent before the 1960s but now appear routinely in medical journals, and ethics committees have proliferated in both the clinical and research worlds.

These developments have led some observers to conclude that the bioethics movement has fundamentally altered the nature of medical work. According to historian David Rothman: By the mid-1970s, both the style and the substance of medical decision- making had changed. The authority that an individual physician had once exercised covertly was now subject to debate and review by colleagues and laypeople. Let the physician design a research protocol to deliver an experimental treatment, and in the room, by federal mandate, was an institutional review board composed of other physicians, lawyers, and community representatives to make certain that the potential benefits to the subject patient outweighed the risks. Let the physician attempt to allocate a scarce resource, like a donor heart, and in the room were federal and state legislators and administrators to help set standards of equity and justice. Let the physician decide to withdraw or terminate life sustaining treatment from an incompetent patient, and in the room were state judges to rule, in advance, on the legality of these actions.

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