1: Definition and scope

Section 1: Introduction to Ethics

1: Definition and Scope

Ethics, fundamentally, is the systematic study of moral values, principles, and conduct. It asks: What ought one to do? and What constitutes a good or right action? In medicine, ethics provides the critical framework for navigating complex moral dilemmas inherent in healthcare practice. It moves beyond personal beliefs or cultural norms, demanding reasoned justification for decisions that profoundly impact human life, dignity, and well-being.

The scope of ethics is traditionally divided into key branches:

1. Normative Ethics: Establishes theories and principles defining right action (e.g., utilitarianism, deontology, virtue ethics). These theories provide the foundational justifications for moral rules.
2. Metaethics: Examines the nature of ethical concepts themselves (e.g., "What is goodness?" or "Can moral truths be objective?").
3. Applied Ethics: Uses normative theories to address practical moral problems in specific domains.

Medical ethics is a primary field of applied ethics. Its scope encompasses the entire spectrum of healthcare delivery and research:

• Micro-level decisions: Direct interactions between healthcare providers, patients, and families. This includes obtaining informed consent, maintaining confidentiality, disclosing diagnoses truthfully, and respecting patient autonomy in treatment choices.
• Meso-level challenges: Institutional policies and practices within hospitals or clinics, such as resource allocation within a unit, establishing ethics committees, or managing conflicts of interest.
• Macro-level issues: Broader societal and systemic questions. Examples include designing equitable healthcare systems, setting priorities for public health initiatives, regulating emerging biotechnologies (like gene editing), and addressing global health disparities.

Crucially, medical ethics grapples with recurring tensions between core principles:

• Autonomy (patient self-determination) vs. Beneficence (acting in the patient's best interest) or Paternalism (overriding autonomy for perceived benefit).
• Justice (fair distribution of resources and care) vs. individual needs or market forces.
• Confidentiality vs. duties to protect third parties or public health.

The scope extends beyond immediate clinical encounters to include research ethics (protecting human subjects), public health ethics (balancing individual liberties with community welfare), and the ethical implications of technological advances (AI in diagnostics, reproductive technologies). It requires constant reflection on the duties of healthcare professionals within evolving scientific, cultural, and political landscapes. Understanding this definition and expansive scope is essential for recognizing the pervasive role of ethical reasoning in every facet of medicine.