Intended for healthcare professionals

Clinical Review Recent advances

Medical ethics

BMJ 2000; 321 doi: (Published 29 July 2000) Cite this as: BMJ 2000;321:282
  1. Peter A Singer, Sun Life chair and director
  1. University of Toronto Joint Centre for Bioethics, 88 College Street, Toronto ON, Canada M5G-1L4

    Recent advances in medical ethics? This may sound odd if your vision of medical ethics is the application to medicine of the Hippocratic oath. If, however, you believe that the goal of medical ethics is to improve the quality of patient care by identifying, analysing, and attempting to resolve the ethical problems that arise in the practice of clinical medicine,1 the concept of “recent advances” won't come as such a shock. In this article I review advances in medical ethics in five areas—end of life care, medical error, priority setting, biotechnology, and medical ethics education—and anticipate two future issues, “eHealth” and global bioethics.


    Any selection of “recent advances” in medical ethics will be somewhat arbitrary, but I took two steps to diminish this. Firstly, I selected topics featured in theme issues of major journals within the past two years. Of course, journals are inevitably “journalistic” about covering hot topics—especially where views are passionate and polarised. Secondly, to identify key articles, I searched the Science Citation Index, consulted with key informants, and attended international meetings. Although citation counts reflect influence on other publications, they may not reflect the clinical application of an idea.

    I have included both advances in medical ethics and advances in medicine and science with enormous ethical ramifications. The topics span clinical medicine (end of life care and medical error), healthcare management (priority setting), science (biotechnology), and education (of medical ethics).

    A discussion of common medical ethics topics for clinical readers can be found in the Canadian Medical Association Journal's series on bioethics for clinicians.2 Web pages on specific bioethics topics with links to online resources are available through the website of the University of Toronto Joint Centre for Bioethics.3

    End of life care

    The most important recent advance has been the emerging focus on the quality of …

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