Bioethics has brought about significant changes in standards for the treatment of the sick and for the conduct of research. Every health care professional now understands that patients have a right to know what is being done to them, and to refuse. Every researcher now understands that participants in their studies have the same rights, and review boards to evaluate proposed research on those grounds are almost universal.

Our understanding of what is ethical has grown, but it is never complete. Ethical advances open new questions: We now see that getting “informed consent” does not rule out exploitation (for instance, of the desperately poor or the desperately sick); exploitation is hard to define. Scientific and technological success also force new choices: What, for instance, do we do with “unused” embryos created in fertility labs?

Finally, political and economic facts are just as challenging: One example is the fact that we are able to hire doctors and nurses away from the world’s poorest countries – but should we? These are urgent, practical questions. Bioethics makes a difference; it advances slowly; and it is not finished.


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