Synopsis
This course provides an overview of bioethics as it applies to health care and nursing in the United States. It begins by describing the historical events and forces that brought the bioethics movement into being and goes on to explain the concepts, theories, and principles that are its underpinnings. It shows how ethics functions within nursing, as well as on a hospital-wide, interdisciplinary ethics committee. The course also explains the elements of ethical decision making as they apply to the care of patients and on ethics committees. The course concludes with a look at the ethical dilemmas involved in physicianassisted suicide, organ transplantation, and genetic testing.
CHAPTER 1: THE HISTORY OF BIOETHICS IN THE UNITED STATES
After studying the information presented in this chapter, you will be able to —
- Discuss changes in medical decision making since 1940.
- Explain the role of human experimentation in the U.S. during World War II.
- Name two events that drew bioethics to medical decision making.
- Name the legislation that resulted from the Nancy Cruzan decision.
Twenty-five years ago, few nurses had heard the word bioethics. Now nurses serve on ethics committees, articles about ethics appear in nursing publications, and the number of universities with advanced degrees in ethics — and the number of nurses who pursue those degrees — continues to expand. How did bioethics become such an integral part of healthcare in the United States?
The answer is that no single event created bioethics. Instead, a cascade of events created the discipline and changed healthcare decision making. These events brought lawyers, legislators, philosophers, and theologians to the bedside with the physician and insist on collective decision making, guidelines, and regulations to enhance patient autonomy.1 These same events thrust nurses into the role of patient advocate and brought to nursing a new emphasis on respect for patient autonomy and the promotion of patient’s rights in healthcare institutions.2
