The Growth of Bioethics as a Second-Order Discipline

  • Loretta M. Kopelman
Part of the Philosophy and Medicine book series (PHME, volume 115)


This chapter offers a historically-grounded analysis of the nature of bioethics as a field of inquiry and practice. It begins with a detailed history of the evolution of early bioethics organizations, including the Society for Health and Human Values, the American Association of Bioethics, and the Society for Bioethics Consultation, and traces this history into the period in which these organizations merged as the American Society for Bioethics and Humanities. This rich recounting offers both first-person and third-person observations of these organizations’ development, membership, problems, and mergers. With this historically-informed background in place, the author proceeds analytically to consider four basic approaches to characterizing the nature of bioethics: (1) bioethics as pure public discourse, with no experts, core texts, common methods, or common standards; (2) bioethics as unique to a single existing discipline (e.g., philosophy, medicine, etc.), with bioethics expertise limited to those who have undertaken extensive study in that field; and (3) bioethics as evolving into a new, independent discipline with its own core texts, methods, area of expertise, and common standards for scholarship and consultation. These three views are rejected in favor of the view that (4) bioethics is an interdisciplinary and second-order discipline with no unique area of expertise. Four key pieces of evidence support this analysis: bioethicists (1) tend to expand their subject matter (unlike most new fields, which splinter off from, and narrow the subject matter of, existing disciplines), (2) think of bioethics problems as complex and solutions as interdisciplinary, (3) welcome various perspectives from different professions, and (4) allow those various professions to set their own standards of competency.


Public Discourse Core Curriculum Professional Code Philosophical Ethic Public Expectation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American Society for Bioethics and Humanities. 1998. ‘Task force on standards for bioethics consultation’, core competencies for health care ethics consultation. Glenview: American Society for Bioethics and Humanities.Google Scholar
  2. Baker, R. 2005. A draft model aggregate code of ethics for bioethics. The American Journal of Bioethics 5: 33–41.CrossRefGoogle Scholar
  3. Beauchamp, T. 2005. What can a model professional code for bioethics hope to achieve? The American Journal of Bioethics 5: 42–43.CrossRefGoogle Scholar
  4. Beauchamp, T., and J.F. Childress. 1979, 1983, 1989, 1994, 2001, 2008. Principles of biomedical ethics. New York: Oxford University Press.Google Scholar
  5. Blackburn, S. 1996. The oxford dictionary of philosophy. New York: Oxford University Press.Google Scholar
  6. Brody, B. 2003. Taking issue: Pluralism and casuistry in bioethics. Washington, DC: Georgetown University Press.Google Scholar
  7. Callahan, D. 1990. What kind of life: The limits of medical progress. New York: Simon & Schuster.Google Scholar
  8. Callahan, D. 1999. Ethics from the top down: A view from the well. In Building bioethics, ed. L.M. Kopelman, 25–35. London: Kluwer Academic Publisher.Google Scholar
  9. Callahan, D. 2005. Bioethics and the culture wars. Cambridge Quarterly of Healthcare Ethics 14: 424–431.CrossRefGoogle Scholar
  10. Childress, J.F. 1970. Who shall live when not all can live? Soundings 53: 339–354.Google Scholar
  11. Clouser, K.D. 1978. Bioethics. In Encyclopedia of bioethics, 1st ed, ed. W.T. Reich, 124–125. New York: The Free Press.Google Scholar
  12. Clouser, K.D., and B. Gert. 1990. A critique of principlism. The Journal of Medicine and Philosophy 15: 219–236.CrossRefGoogle Scholar
  13. Cooter, R. 2004. Historical keywords: Bioethics. The Lancet 364: 1749.CrossRefGoogle Scholar
  14. Daniels, N. 1985. Just health care. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  15. Elliott, C. 2001. Throwing a bone to the watchdog. The Hastings Center Report 31: 9–12.CrossRefGoogle Scholar
  16. Elliott, C. 2005. The soul of a new machine: Bioethicists in the bureaucracy. Cambridge Quarterly of Healthcare Ethics 14: 379–384.CrossRefGoogle Scholar
  17. Engelhardt, H.T. 1992. The search for a universal system of ethics: Post-modern disappointments and contemporary possibilities. In Ethical problems in dialysis and transplantation, ed. C.M. Kjellstrand and J.B. Dossetor. Dordrecht: Kluwer.Google Scholar
  18. Engelhardt, H.T., and S. Spicker. 1975. Evaluation and explanation in the biomedical sciences. Dordrecht: D. Reidel Publishing Company.CrossRefGoogle Scholar
  19. Faden, R., T.L. Beauchamp, and N. King. 1986. A history and theory of informed consent. New York: Oxford University Press.Google Scholar
  20. Fletcher, J. 1966. Situation ethics. Philadelphia: The Westminster Press.Google Scholar
  21. Fox, R.C., and J.P. Swazey. 2005. Examining American bioethics: Its problems and prospects. Cambridge Quarterly of Healthcare Ethics 14: 361–373.CrossRefGoogle Scholar
  22. Frankena, W.K. 1973. Ethics, 2nd ed. Upper Saddle River: Prentice Hall.Google Scholar
  23. Frey, R.G. 1978. Moral experts. The Personalist 59: 47–52.Google Scholar
  24. Gert, B. 1998. Morality: Its nature and justification. New York: Oxford University Press.Google Scholar
  25. Gustafson, J.M. 1973. Mongolism, parental desires, and the right to life. Perspectives in Biology and Medicine 17: 529–530.Google Scholar
  26. Holmes, R.L. 1990. The limited relevance of analytical ethics to the problems of bioethics. The Journal of Medicine and Philosophy 15: 143–159.CrossRefGoogle Scholar
  27. Hooker, B. 1998. Moral expertise. In Encyclopedia of philosophy, ed. Edward Craig, 509. New York: Routledge.Google Scholar
  28. Jaggar, A.M. 2000. Feminist ethics. In The Blackwell guide to ethical theory, ed. H. LaFollette, 348–374. Malden: Blackwell Publishing.Google Scholar
  29. Jahr, F. 1927. Bio-Ethik: Eine Umschau über die ethischen Beziehungen des Menschen zu Tier und Pflanze. Kosmos: Handweiser für Naturfreunde 24: 2–4.Google Scholar
  30. Jonsen, A.R. 1991. Of balloons and bicycles or the relationship between ethical theory and practical judgments. The Hastings Center Report 21: 14–16.CrossRefGoogle Scholar
  31. Jonsen, A.R. 1998. The birth of bioethics. New York: Oxford University Press.Google Scholar
  32. Jonsen, A.R., and S. Toulmin. 1988. The abuse of casuistry: A history of moral reasoning. Berkeley: University of California Press.Google Scholar
  33. Jonsen, A., M. Siegler, and W. Winslade. 1982. Clinical ethics. New York: Macmillan Publishing Company.Google Scholar
  34. Kipnis, K. 2005. The elements of code development. The American Journal of Bioethics 5: 48–50.CrossRefGoogle Scholar
  35. Kopelman, L.M. 1995. Philosophy and medical education. Academic Medicine 70: 795–805.CrossRefGoogle Scholar
  36. Kopelman, L.M. 1998. Bioethics and humanities: What makes us one field? The Journal of Medicine and Philosophy 23: 356–368.CrossRefGoogle Scholar
  37. Kopelman, L.M. 2006. Bioethics as a second-order discipline: Who is not a bioethicist? The Journal of Medicine and Philosophy 31: 601–628.CrossRefGoogle Scholar
  38. Kopelman, L.M., and J.C. Moskop (eds.). 1984. Ethics and mental retardation. Dordrecht: D. Reidel Publishing Company.Google Scholar
  39. Lantos, J. 2005. Commentary on “a draft model aggregated code for bioethicists”. The American Journal of Bioethics 5: 45–46.CrossRefGoogle Scholar
  40. Lewis, S. 1925. Arrowsmith. New York: Harcourt, Brace.Google Scholar
  41. MacDonald, C. 2003. Draft: Model code of ethics for bioethics. In The canadian bioethics societies and Ad Hoc Working Group on employment standards for bioethics [On-line]. Accessed Sept 20, 2012.
  42. McMahan, J. 2000. Moral intuitionism. In The Blackwell guide to ethical theory, ed. H. LaFollette, 92–110. Malden: Blackwell Publishing.Google Scholar
  43. Miller, F.G. 2005. The case for a code of ethics for bioethicists: Some reasons for skepticism. The American Journal of Bioethics 5: 50–52.CrossRefGoogle Scholar
  44. Nowell-Smith, P.H. 1957. Ethics. Oxford: Basil Blackwell.Google Scholar
  45. Parker, L.S. 2005. Ethical expertise, maternal thinking, and the work of clinical ethicists. In Ethics expertise: History, contemporary perspectives, and applications, ed. L.M. Rasmussen, 165–207. Dordrecht: Springer.Google Scholar
  46. Perlman, D. 2005. Bioethics in industry settings: One situation where a code for bioethicists would help. The American Journal of Bioethics 5: 62–64.CrossRefGoogle Scholar
  47. Rasmussen, L.M. (ed.). 2005. Ethics expertise: History, contemporary perspectives, and applications. Dordrecht: Springer.Google Scholar
  48. Regenberg, A.C., and D. Mathews. 2005. Resisting the tide of professionalization: Valuing diversity in bioethics. The American Journal of Bioethics 5: 44–45.CrossRefGoogle Scholar
  49. Reich, W.T. 1995. Introduction. In Encyclopedia of bioethics, vol. 1, 2nd ed, ed. W.T. Reich, xxi. New York: Simon Schuster Macmillan.Google Scholar
  50. Satel, S. 2000. How political correctness is corrupting medicine. New York: Basic Books.Google Scholar
  51. Schuklenk, U., and J. Gallager. 2005. Status, careers and influence in bioethics. The American Journal of Bioethics 5: 64–66.CrossRefGoogle Scholar
  52. Singer, P. 1972. Moral experts. Analysis 32: 114–117.Google Scholar
  53. Smith, W.J. 2000. Culture of death: The assault on medical ethics in America. San Francisco: Encounter Books.Google Scholar
  54. Toulmin, S. 1981. The tyranny of principles. The Hastings Center Report 11: 31–39.CrossRefGoogle Scholar
  55. United Nations Educational, Scientific and Cultural Organization (UNESCO). 2005. Universal declaration on bioethics and human rights [On-line]. Accessed Sept 20, 2012.
  56. Veatch, R.M. 1999. Contract and critique of principlism: Hypothetical contract or epistemological theory as method of conflict resolution. In Building bioethics, ed. L.M. Kopelman, 121–143. Great Britain: Kluwer Academic Publisher.Google Scholar
  57. Wittgenstein, L. 1953, 1961. Philosophical investigations. New York: The Macmillan Company.Google Scholar
  58. Wolf, S., and J. Kahn. 2005. Bioethics matures: The field faces the future. The Hastings Center Report 35: 22–24.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Department of Bioethics and Interdisciplinary Studies (Emeritus), Brody School of MedicineEast Carolina UniversityGreenvilleUSA
  2. 2.Kennedy Institute of EthicsGeorgetown UniversityWashingtonUSA

Personalised recommendations