A Very Brief History of Health Care Ethics: Four Decades from the Golden Age of Bioethics to the Dawn of Interprofessional Ethics

Abstract

An eighteen-month-old girl’s death from dehydration in 2010 at Johns Hopkins Hospital in Baltimore provides a sobering example of the need for interprofessional ethics training. In a New York Times interview, Dr. Peter Pronovost, medical director of the Quality and Safety Research Group at the hospital, admitted, “We had dysfunctional teamwork because of an exceedingly hierarchal culture. When confrontations occurred, the problem was rarely framed in terms of what was best for the patient” (March 9, 2010). Lives are lost sometimes, in other words, on account of poor teamwork. Hence, promoting effective teamwork is an ethical imperative. Teaching a coherent and consistent clinical and research ethics framework that is shared by all professions, in an interprofessional setting, will allow bioethics to be more successfully integrated into the work of all health care professionals. This chapter proposes a brief history of bioethics broken into three periods: a “golden age” when foundational texts and institutions first appeared, a “silver age” in which the ideas spread to all medical specialties and to all other health professions, and a new epoch of interprofessional healthcare ethics that began in the 21st century. This book is one of the first to explicitly address the outlines of interprofessional ethics, and propose cases to help develop understanding of the field.