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BUDDHISM and BIOETHICS

Dec 27th, 2009 10:05:28 pm - Subscribe

Buddhism originated in India around 500 B.C.E. In the early twenty-first century Buddhist traditions exist in South, Southeast, and East Asia, as well as Australia, Western and Eastern Europe, and North and South America. The diversity found in these traditions makes it impossible to speak of
Buddhism in the singular or to assert an “official” Buddhist perspective. For the purpose of formulating an overview of Buddhist bioethics, however, Buddhist traditions can be categorized into two primary trajectories: Theravada and Mahayana. Theravada traditions are closely identified with he teachings of the historical Buddha, and include both early South Asian Buddhist traditions as well as contemporary South Asian traditions in Sri Lanka, Thailand, and
Myanmar (formerly Burma). Mahayana traditions include some later forms of Indian Buddhism, Tibetan and other Himalayan-region Buddhisms (also referred to as Tibetan, Vajrayana, Tantric, and Esoteric Buddhism), and Central and East Asian Buddhist traditions. Both Theravada and
Mahayana Buddhism are practiced in such places as Australia, Europe, and North and South America. Historically, bioethics has been a field of inquiry primarily in Western cultures and thus centers on Western cultural
assumptions and moral perspectives. Genetic engineering, cloning, and stem cell research—and the ethical dilemmas they engender—pivot on recent advances in biomedical
technology and Western emphases on the value of medical progress. However, moral issues raised by biomedical technology are no longer confined to Western cultural contexts. Predominately Buddhist countries have begun to confront the ethical implications of biomedicine.
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AGENCY, FREEDOM, AND DIGNITY

Dec 27th, 2009 12:20:21 am - Subscribe

Skinner sometimes writes as if inner conscious ideas, ideals, purposes, feelings, and choices simply do not exist (Blanshard and Skinner). At other times he makes an
epiphenomenal (causally ineffective) place for inner activities like self-control, choice, agency, or autonomy. He recognizes that freedom of action is important because it
allows individuals to avoid aversive or negatively reinforcing stimuli, but he can make no place for conscious moral agency.
In Skinner’s view, human dignity consists of behaviors that cultivate the positive reinforcement of praise or credit
from others for behaving well, or as others want them to behave. By contrast, most ethicists agree that human dignity
involves conscious self-awareness, self-control, and rational persuasion. They abhor manipulative techniques that bypass
these qualities, and they approve of educative and persuasive techniques that develop and appeal to them. Escaping aversive stimuli and cultivating social credit
have their proper place, but most moral philosophers would balk at Skinner’s behavioral reduction of freedom and
dignity to solicitous activity. Behavioral freedom means little without inner personal autonomy, and human dignity, however difficult to define, is something that persons constantly have as conscious persons; and it makes all people equals. Dignity is not just something that people possess during those rare moments when others credit them for behaving as they see fit.
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Behaviorism, Ethical Theory,

Dec 27th, 2009 12:18:27 am - Subscribe

Skinner often prescribes norms. He cannot resolve value disagreements about “good” and “ought” merely by describing what is positively reinforcing to individuals or to
their communities of value, which are groups of individuals who find similar things to be reinforcing. The behaviorist’s contention that psychology should be a strictly descriptive
behavioral science does not describe the beliefs and practices of most professional psychologists and psychotherapists. It is
a value prescription that, if analyzed in Skinner’s own terms, means merely that he and the few psychologists who agree with him find it positively reinforcing to practice psychology behavioristically. Most psychologists and philosophers have not been so conditioned, and they cannot accept the narrow strictures that behaviorism places on psychological inquiry and practice. Skinner’s program, which purports to eliminate purposes and prescriptive norms, can be advanced only purposively and as a prescriptive norm.
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Methods

Dec 24th, 2009 8:43:39 pm - Subscribe

Given the diverse objectives of ethics education, it is no
surprise that a variety of methods have been developed to
help students develop the knowledge, attitudes, and skills
needed to become proficient in dealing with ethical issues in
clinical practice. Teaching methods have ranged from large
group lectures providing conceptual and historical overviews
of issues in medical ethics, to seminar room discussions
of “paper cases,” to participation in discussions of
actual cases encountered during clinical rotations, to participation
in ethics consultation programs, with each of these
supplemented by readings and in some cases videotapes or
films. During the clinical years and the years of residency
training, there has been a slow but steady increase in the use
of practical teaching exercises, with an emphasis on the
communication skills deemed necessary for the identification
and resolution of ethical problems. Achieving a thorough
conceptual understanding of the doctrine of informed
consent, for example, is increasingly understood to be of
limited value if physicians are not able to explain information
clearly to patients. More recently, end-of-life ethics
education has been highlighted through the growth of
palliative care education, both at the medical school level
and during residency (EPERC).
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Goals

Dec 24th, 2009 8:42:15 pm - Subscribe

Ambitious and diverse goals have been proposed for medical ethics education, including increased awareness of ethical
issues; a cultivation of basic ethical commitments; more humane medical practice; tolerance of conflicting views;
development of analytic skill in moral reasoning; enhanced intellectual development in ethics and the humanities; positive
attitudes toward patients; less paternalism in clinical practice; higher professional conduct; and improved clinical decision making (Callahan; Miles et al.). Despite this dauntingly heterogeneous list, a consensus
has developed regarding some core objectives. First, the primary goal of clinical ethics education is to prepare physicians to deal effectively with ethical issues in clinical
practice. Accomplishing this requires that students learn to: (1) recognize ethical issues as they arise in clinical care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about ethical issues in ways that lead to an ethically justifiable course of action; and (3) apply
the practical skills needed to implement an ethically justifiable course of action. Each of these objectives in turn requires that the students possess specific knowledge, attitudes, and skills. To recognize ethical issues as they appear in clinical care usually requires a positive attitude concerning the importance of the humanistic and value-laden aspects of medical care. For example, a physician’s decision regarding chemotherapy
for a woman with breast cancer involves the physician’s awareness of the biomedical issues and of the morbidity and mortality of the disease, as well as of the patient’s own
views regarding continued life, her body image, and the morbidity of treatment. Recognizing the presence of an ethical issue also requires knowledge of the nature of common ethical issues and how they arise in clinical practice.
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