Encounters in Bioethics Research Programs

Encounters in Bioethics Theoretical Research Program

The CHCE professional ethicists represent most of the current approaches in bioethics. These include principlism, appealing to such moral principles and concepts as beneficence, nonmaleficence, autonomy, and justice. Our ethicists look behind these bioethical principles to the foundation and justification of such applied principles.

Justification may involve looking at the general consequences of applying these principles, i.e. the usefulness or utility of the application, accepting only those that have optimific consequences. The ethical theory here would be called “consequentialism” or “utilitarianism.”  There are, however, “competing” moral theories. Contractualism, for example, argues that we have accepted our moral rules through an implicit social contract of some sort. Other theories suggest that our moral rules and principles are justified by an appeal to a supreme principle of morality, which is itself discovered through pure practical reason, in secular moralities, or an appeal to the Divine in more religious based moralities.

The universalizability criterion is possibly the most popular example of a supreme principle of morality designed to justify practical rules or maxims: “Act only in accordance with that maxim through which you can at the same time will that it should become a universal law.” Recent research suggests that if we cannot resolve the disputes between these “competing” moral theories, then there “might be nothing that morality turns out to be, since morality might be an illusion” (D. Parfit, 2011, On What Matters, OUP, Vol. II, 155, emphasis in the original). To avoid this dangerous relativistic conclusion it has been argued that there are in actual fact no “deep disagreements” between the proponents of these seemingly incompatible moral theories. On the contrary it has been famously argued that: “These people are climbing the same mountain on different sides” (Parfit, 2011, On what Matters, Vol. 1, 419).

Recent research presents us with a supreme principle of morality, which is said to incorporate all three of these pervasive moral theories: “An act is wrong just when such acts are disallowed by some principle that is optimific, uniquely universally willable, and not reasonably rejectable” (Parfit 2011, Vol. 1, 413). The reference to “optimific” is supposed to satisfy the consequentialists, “universally willable” those who appeal to a universalizability criterion; and “not reasonably rejectable” is meant to cover contractualism.

As well as a number of outstanding principlists, CHCE has in house ethicists who are on the forefront of the narrative turn in applied ethics.  Narrative ethics asks why ethicists in this day and age insist on justifying moral decisions from the level of abstract principles rather than through reflection on specific problems. Stories and narratives, unlike moral principles, do not tell us what to do, rather, recognizing the moral complexity of the real world, they invite moral agents to work things out for themselves relying more on the moral imagination and emotion than on rules and reason. Narrative ethics privileges, story over ethical rules and moral principles, literature over logic, and favours metaphor and emotion over formal premises and conclusions.

Over the past fifteen years or so the CHCE Encounters in Bioethics series has been a friendly battle-ground on which principle based ethics and narrative ethics have been called upon to justify themselves in practice. Though this debate goes on just below the surface of the discussions, this too is an essential part of the research contribution of the CHCE. For example a perceptible move toward narrative ethics has been observed in the Encounters in Bioethics discussions over the past fifteen years. While a number of presenters still mention the standard bioethical principles of beneficence, nonmaleficence, autonomy, and justice, it has been observed that little or no use is made of them in resolving the issues under discussion. These observations have been written up and published in a book defending narrative ethics through literature and popular culture (J. D. Rabb and J. M. Richardson, Joss Whedon as Shakespearean Moralist: Narrative Ethics of the Bard and the Buffyverse, Jefferson NC: McFarland, 2015).

Encounters in Bioethics Applied Research Program

On several occasions we have been able to offer the Encounters in Bioethics program as a directed study course to senior undergraduate and graduate students through the Gerontology program, thus facilitating graduate and undergraduate research and allowing the students to earn a gerontology course credit.  We have also had students attend the sessions and write articles published in Lakehead University’s student newspaper, The Argus. CHCE also organizes workshops on clinical ethics and ethics of research with human subjects for health care professionals and researchers.

Each session of Encounters in Bioethics, besides educating the general public about issues in health care ethics, also functions as a mini workshop for the health care professionals participating. Not only are they given the opportunity to discuss the issues with trained bioethicists, but, more importantly, they are given the time and opportunity to talk to one another about such ethical issues which they inevitably confront in the workplace. This brings together our mentoring and applied research programs in that we are actively encouraging health care professionals to research issues in health care ethics. This is one of the ways in which Encounters in Bioethics fulfills our mission: “to foster the development of a vibrant research culture focused on enhancing the ethical quality of health care”. Issues and topics discussed over the years include: 

Euthanasia or Assisted Suicide? Substance, Sensitivity and Process

Ethical Issues in Genetic Screening and Testing

Clinical Ethics and Cultural Erosion: Violence and Racism in Health Care

Aboriginal Health Care and Bioethics: Challenges & Pathways

First Nations and Justice in Health Care Decision-making

Experimentation on a Canadian Aboriginal population: historical research

Principled Moral Outrage: An antidote to moral distress?

Challenging Misconceptions:  Clarifying the role(s) of substitute decision-makers in the context of human subjects research

Difficult decisions: Is spoon-feeding of the severely ill always required?

Nurses\\\' Ethical Decision Making Within Hierarchical Power Structures

Stories That Can Hurt, Stories That Can Heal: Applying Narrative Medicine

Vaccination: An Obligation or a Privilege?

Supporting People with Intellectual & Developmental Disabilities

Traditional Aboriginal Teachings & Health Care Ethics

Ethical Issues of Abortion: The problem that won\\\'t go away

Consent and Capacity Boards: Legal & Ethical Issues

Are Physicians Acting Under an Excessive Influence of Drug-Industry

Creating a Right to Health & Rehabilitation: Is International Law the Missing Piece?

Caring for People at Home: Ethical Issues in Community Health Care

The Challenge of Compassion Fatigue in Clinical Practice

Dual Loyalties of Health Care Professionals: Preventing and Managing Conflicts of Commitment

Some Ethical Issues in Complementary & Alternative Medicine

Ethics of prescribing, using & misusing opioids

Death at Home: Anticipation, Preparation and Execution

Health Care Ethics Behind Bars

Driving Ethics: When is it fair to take away driving privileges?

Getting Sick, Getting Well: An Understanding of Health from Asian Perspectives

Living Kidney Transplantation: Ethical approaches to enhance and evaluate donations

Being a good person or following rules: what counts more in health professions?

The Indispensable Place of Empathy for Right Relationship

Narrative Medicine as a Bridge to Aboriginal Cultures

At Risk: Relational Ethics in Clinical Care

Everyday Ethics in Long-Term Care Homes: Perspectives from the Front Lines

Caring for People with Alzheimer\\\'s Disease: The Ideal versus the Reality

I Agree to...: Informed Consent as Lived Concept

Why Does Research with Human Subjects Need Ethics Review and Approval?

From Lab to Village: Bioethics and Global Health

Ethics of Physiotherapy & Kinesiology

Ethics of Physiotherapy & Kinesiology

Ethical Decision Making with First Nations Patients

Dental, Medical and Nursing Ethics: Comparison and Contrast

History of Medical Ethics & Military Medicine, focusing on the Somalia Affair

Stopping Dialysis: Ethical Concerns

Nurse Practitioners - Searching for Best Fit for Benefit of Patients

Should Every Hospital Have Access to a Bioethics Consultant?

To Kill a Mocking Latimer: Disability in a Just Society

Ethical Issues in Emergency Medicine

Research Involving Cancer Patients: Does it Ever Amount to Using People as Guinea Pigs?

Pain Relief: An Ethical Perspective

Health Care in the Developing World: Is it our responsibility?

Could Citizen Engagement Make our Health Care More Accountable?

Determining Death: Ethical and Cultural Issues