Bioethics and Law

When does life begin and end?  Who should make medical decisions for a person who cannot make them themself?  Should medical technology always be deployed to preserve and extend life?  When medical resources are scarce, who should receive them?  

These questions raise important ethical issues in the life sciences, health care, and health and science policy.  The interdisciplinary field known as “bioethics” is devoted to studying and answering these types of questions.  We describe bioethics as “interdisciplinary” because when we consider questions like those above, we draw on bodies of knowledge beyond ethics, including public policy, religion, science, philosophy, and, finally, law.  

Bioethics and law both seek to guide behavior but do so differently.  Law is a system of rules set by legislatures, agencies and courts and enforced by civil and criminal authorities.  Law tells us if an action is lawful or unlawful - whether we “can” do it.  However, law does not necessarily tell us if a lawful action is the right thing to do in a particular situation – if we “should” do it.  

Whether or not to do something lawful just because we are allowed to do it may present an ethical dilemma.  When facing an ethical dilemma arising out of the use of science, medicine, and technology, we look to bioethics.  When studying bioethics, we explore and understand the importance of values.  We think about when to treat others as we would have them treat us (Golden Rule), and when to treat others as they wish to be treated (Platinum Rule).  We use principles and decision-making frameworks to think about the possible consequences of different actions (or inactions).  These tools help us decide whose needs and/or what values should take precedence when making difficult decisions.    

Bioethics has made valuable contributions to laws, regulations and common (case) law.  Bioethics-based advocacy and scholarship have led to enactment of federal and state laws and agency regulations to protect people who participate in scientific research, determine when and how human organs can be obtained and transplanted, and prohibit certain types of discrimination based on genetic information, to name just a few.  Courts have addressed bioethical issues as part of their resolution of legal disputes.  Rulings by the New Jersey Supreme Court in cases involving the right of surrogate decision-makers to refuse life-saving medical treatment for incapacitated patients, the (un)enforceability of gestational surrogacy contracts, and the viability of claims for “wrongful birth” and “wrongful life” broke new ground and stimulated robust bioethical and legal discussion and debate not just around the United States, but around the world. 

As scientific and medical advances are made, new laws will be required, and new ethical issues will arise.  Bioethics and law must continue to evolve to help us know what is lawful and answer the question “just because we can, should we?” in ways that protect rights, respect dignity, and promote safety and flourishment for all.