Doctors With Borders

Bioethics matures into a formal academic field—and faces an identity crisis

Some bioethicists have more faith in their own. "I think that any substantial bioethicist who would issue a faulty recommendation lays his or her reputation on the line," says Levine. As Caplan puts it, "There are plenty of people who say, 'They're not going away. Of course we'll help them, if we can help them do a better job.' " He believes there has been a small but distinct positive influence on the industry, such as more rigorous enforcement of informed consent and drug giveaways in developing countries. (Caplan has been criticized for consulting for pharmaceutical companies.)

Many hospitals, too, have ethics committees. Columbia bioethicist David Rothman's study Strangers at the Bedside (1992, reissued in 2003) examined how ethics committees, in government and hospitals, have taken discretion out of the hands of individual doctors. He sees advantages to the new system, but also losses, as doctors sacrificed their traditional reliance on case-by-case judgments. Dr. Levine is a member of the bioethics committee at the Yale–New Haven Hospital, whose advisory role is nonbinding but influential. When asked if the system works well, he laughs, "No," then adds, "Democracy in the U.S. is not a perfect system. Things go wrong. It may not be a perfect system, but it beats the second-best by a long shot."

No doubt bioethicists have the potential to effect good. When considering new scientific possibilities, the motto of bioethics, says Fischbach, is "Just because you can do it, doesn't mean you should do it." As bioethicists encounter more opportunities beyond the academy, some among their ranks would urge them to keep that motto in mind.

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    ***Correction: This article originally reported this name as Faris. It now appears correctly as Paris.

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