Facts and Issues: What is the Ethical Difference Between Fact Patterns?

Thinking like a lawyer can help with some bioethics approaches. When given a fact pattern, lawyers tend to zero in on the issues. Some people spend more time on the facts and others move toward identifying issues and applying or suggesting rules that might be generalizable. Both ways of thinking are valuable. A handle on the facts is a must. Manipulating the facts allows for developing reasoning. In bioethics, the facts are a start, the reasoning is key, and the conclusion should be reached based on logic and critical analysis.

The procedure of identifying ethical issues can be avoided when medical or scientific solutions present themselves. Avoiding a bioethical dilemma by providing an alternate solution or by a plan in place (for example, in the common Jehovah’s Witness blood transfusion refusal, there is a medical alternative and, when that is not available, there may be a standing court order) does not cancel the educational benefit of the analysis, even if the deep dive into the analysis and reasoning happens before and after yet not during the emergency circumstances. Thinking like a lawyer helps people move through hypotheticals and prepare to justify or defend their reasoning. Bioethics calls for this theoretical examination. Preventing a shutdown of reasoning because a practical solution presents itself is important to the theoretical field. My big takeaway from that realization is that clinical ethics, to be sound, has to rely on knowledge of theoretical approaches and moral philosophy. A simple medical fix can rightly avoid the ethical issue in the clinical setting (a great use of science), but the bioethical issue is sure to arise again in a circumstance where a practical solution is not available.

Sometimes I think an approach that says disease x, rather than a real condition, (or that hypothetically says a one click human genetic alteration, or a hypothetical environmental technology that would mitigate climate change by doing x) would help people flesh out exactly what sacrifices and goals make ethical sense. Some of the best scholarly work draws attention to thinking outside the box. For example, why do we analyze a duty to rescue those close to us differently from those in need of humanitarian aid. (See Singer, P. (1972) Famine, Affluence, and Morality. Philosophy and Public Affairs 1(3): 229-243 https://www.jstor.org/stable/2265052?seq=1) What is the ethical difference?

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