Bioethics: What we lost …and what might be gained

Abstract

It is five decades and more since a group of moral philosophers declared a traditional medical ethic, stable for perhaps two millennia, would no longer serve. In its place they proposed a Bioethics with principalism as its primary tool to guide the future of medical practice and organization. While many remain satisfied with its success others, today, question its efficacy and limits in the arenas of medical care, delivery, and organization. Given those concerns it is perhaps time to ask what was lost when bioethicists insisted on an ethic grounded in patient autonomy and set within the limits of a neoliberal market ethic. In doing so existentialism and feminist ethics are introduced as alternate philosophies permitting a critique of the individualism of Bioethics rather than the relational perspective that grounded the Hippocratic doctrine. A balance of all three perspectives—bioethics, existentialism, feminist ethics and Hippocratic ethics—suggests both the limits of Bioethics and approaches to a better ethic of medical organization and practice.