SETTING THE STAGE

"Bioethics did not begin with a Big Bang" writes Albert R. Jonsen (1983; 3) delving into origin stories of bioethics . The stage was set against multiple backdrops. A landmark event was the Nuremberg Trial in Germany in 1947, where 23 Nazi physicians and medical administrators were charged with murder, torture and other atrocities committed in the name of medical science. The unethical war crimes captured public imagination. A few years later, the Tuskegee revelations in 1972 in the United States, where 600 poor and uneducated blacks were used as guinea pigs in a clinical trials to test syphilis, exposed by the New York Times, laid the stage for debates on the ethics of medical research across the developing world (Jonsen, 2000). 

1947 onwards, were also marked by a series of biological and medical advances. Innovations like the dialysis machine and assisted reproductive technologies, developments in eugenics, advances in organ transplantation, debates on defining 'death', on abortion and a host of other issues. The engagement with the morality posed by some of these issues, the ethical dilemmas and the legal challenges they stood for, paved the way for a new engagement with medical ethics (Jonsen, 1998; 2000). 

The space provided by the media had a string role to play in taking the issues to the common people who got involved in it as well, and took stands, thereby leading to increased public consciousness. The war crimes, illegal clinical trials, medical advancements that invoked questions of justice, patients autonomy and informed consent, the re-emphasis for doctors to 'first do no harm' - medical beneficence - all together prompted a review of the constituency of the term 'medical ethics'. 

"Answers are needed for personal choices and for policy decisions. These events took place in a cultural, and a social environment that fostered", explains Jonsen (2000;115). And the traditional domain of philosophy, with its already existing theories on ethics, provided material for the disclosure to shape up. This new theatre of bioethics thus had roles and opportunities for doctors, lawyers, sociologists, policy makers, and philosophers and theologists alike. The cast was large and the audience wide. 

The stage was set. 

Rimali Batra