The American influence
Definitions and approaches
In the United States, the Belmont Report of 1978 on ethical principles and guidelines for the protection of human subjects of research was influential in defining bioethics. The report came in response to public concern over the Tuskegee study which ran from 1932 to 1972. The study involved over 400 poor African-American men who were denied treatment in order to monitor the natural course of a disease. The Belmont Report outlined 3 principles – respect for persons (i.e. autonomy), beneficence and justice. In 1983, Beauchamp and Childress published a text book on the principles of biomedical ethics in which they adopted the three principles of the Belmont Report and added a fourth principle, that of non-maleficence. Some of these principles can be traced back to the Hippocratic tradition, which in turn is reflected in many European codes of deontology. They are also reflected in the Council of Europe’s Convention on Human Rights and Biomedicine.
The principles of biomedical ethics of Beauchamp and Childress have become one of the most widely used frameworks for considering bioethical issues. Nevertheless, some authors have criticised the American approach for placing too much emphasis on individual rights:
“European authors tend to emphasize the social and cultural context of many ethical debates. They are focusing attention on the structure and organisation of the health care system, as well as the network of social values in which the moral problems are presented. They criticize the individualistic focus of dominant bioethical discourses and the relative negligence of community values, interpersonal relationships and solidarity. Individualistic ethics in their view should be complemented with social ethics.” (Ten Have, 2001, p. 8)
Last Updated: Monday 29 March 2010