The article investigates the extent to which recent developments in both the medical and the philosophical world have impacted on the nature and scope of medical ethics. A central question of the article has to do with the extent to which medical ethics itself is being transformed by that which it investigates. The author comes to the conclusion that these developments precipitate an ethics of responsibility. Such an ethics has the following characteristics: 1. It is a model according to which (...) people accept responsibility for all their actions, rather than hide behind heteronomous rules and regulations. 2. People are morally accountable in terms of the universal moral claim or appeal on us (in the Levinasian sense of the word). 3. Moral responsibility is also a responsibility toward future generations. 4. An ethics of responsibility must come to terms with the moral ambivalence of phenomena and developments. 5. It is an ethics that requires imaginative steps to empower people for the acceptance of their responsibilities, particularly in the higher education sector. S. Afr. J. Philos. Vol.21(1) 2002: 35-43. (shrink)

Autonomy has been hailed as the foremost principle of bioethics, and yet patients’ decisions and research subjects’ voluntary participation are being subjected to frequent restrictions. It has been argued that patient care is best served by a limited form of paternalism because the doctor is better qualified to take critical decisions than the patient, who is distracted by illness. The revival of paternalism is unwarranted on two grounds: firstly, because prejudging that the sick are not fully autonomous is a biased (...) and unsubstantial view; secondly, because the technical knowledge of healthcare professionals does not include the ethical qualifications and prerogative to decide for others.Clinical research settings are even more prone to erode subjects’ autonomy than clinical settings because of the tendency and temptation to resort to such practices as shading the truth when consent to participation is sought, or waiving consent altogether when research is done in emergency settings.Instead of supporting such dubious practices with unconvincing arguments, it would seem to be the task of bioethics to insist on reinforcing autonomy. (shrink)