45 Introduction to Bioethics for

Pharmaceutical Professionals

Andrew J. Fletcher

45.1 Introduction

Discourse on ethics dates back at least as far as the
Ancient Greeks and Romans and undoubtedly has
much earlier origins, in both religious and secular
systems of thought. Bioethics may be viewed as a
subdivision of ethics, from which it borrows most
of its tools and concepts, albeit with refinements.
Bioethics developed rapidly during the twentieth
century, corresponding with the recent era of
growth in medical technology and research, and
has been defined as:
‘A discipline dealing with the ethical implications
of biological research and applications, especially
in medicine’^1
‘The study of moral issues in the fields of medical
treatment and research’^2
‘The study of ethical issues concerning the life
sciences and the distribution of scarce medical
resources’^3
‘The branch of ethics that studies moral values in
the biomedical sciences’^4

Most people in clinical research and medicine

think that they have a good grasp on ethics and

ethical principles, and that acting ethically is sim-

ply a matter of doing ‘the right thing’. Thus, those

with little formal training in bioethics (probably

most people) feel perfectly capable, most of the

time, of making appropriate ethical decisions in the

conduct of pharmaceutical medicine. Personal and

professional ethics probably derive from a variety

of sources, for example

One’s personal beliefs

One’s professional code of practice

State or federal law

Intuition – one’s innate sense of ‘the right thing’

Most bioethical decisions are of the straightfor-

ward ‘right versus wrong’ type. These decisions

usually require no formal tools of bioethics. But

decisions are more difficult when they involve

‘right versus right’ (dilemmas). Parsing the notions

of ‘right’ and ‘wrong’, four broad categories of

bioethical dilemma have been listed^5 :

Principles and Practice of Pharmaceutical Medicine, 2nd Edition Edited by L. D. Edwards, A. J. Fletcher, A. W. Fox and P. D. Stonier
#2007 John Wiley & Sons, Ltd ISBN: 978-0-470-09313-9

(^1) Merriam-Webster at http://www.m-w.com/.
(^2) Many sources, including http://www.bioethics-singapore.
org/resources/body_useful.html.
(^3) Adapted from the University of Penn, Center for Bioethics,
http://www.bioethics.upenn.edu/.
(^4) WordWeb Online: http://www.wordwebonline.com.
(^5) Modified from Rushworth Kidder, in ‘How Good People
Make Tough Choices’ at http://www.globalethics.org/pub/
toughchoices.html.