The first history of American medical ethics published in more than a half century, Before Bioethics tracks the evolution of American medical ethics from colonial midwives and physicians' oaths to current bioethical controversies over abortion, AIDS, animal rights, and physician-assisted suicide.

This piece offers a retrospective review of a plenary speech at the 1969 Annual Meeting of the American Public Health Association by the leading environmentalist of the Nixon administration, attorney and judge Russell Train. Train's talk, titled “Prescription for a Planet,” can be seen as an early argument for uniting environmental health and public health as the two main determinants of both individual and population health and for the inclusion of these fields in the then‐new field of “bioethics.”.

This essay, published shortly before the 2020 U.S. presidential election (mired in controversy over a potential judicial appointment to the Supreme Court), celebrates Daniel Callahan's prescient book Abortion: Law, Choice and Morality. Nothing could be timelier. Callahan's central question was the “moral and social” struggle requisite for coherent policies and laws regulating abortion. He rejected “one‐value” positions and strove to develop an expansive middle ground. He decried emotion untutored by reason, crude polemics, and bludgeoning: his recipe for a “noxious brew.” (...) Callahan's way of thinking preceded the development of a critical health humanities, the advent of moral foundations theory in psychology, and the philosophical concept of a moral imagination. Each of these inheres in his rigorous approach to the abortion problem. His honesty and humility led to a sea change in his position on abortion. Fifty years later, much can still be learned from Callahan's arguments—about abortion and other bioethics issues—most importantly, in how we address wider social issues in these polarized times. (shrink)

Extensive historical sleuthing reveals that the word "bioethics" and the field of study it names experienced, in 1970/1971, a "bilocated birth" in Madison, Wisconsin, and in Washington, D.C. Van Rensselaer Potter, at the University of Wisconsin first coined the term; and André Hellegers, at Georgetown University, at the very least, latched onto the already-existing word "bioethics" and first used it in an institutional way to designate the focused area of inquiry that became an academic field of learning and a movement (...) regarding public policy and the life sciences. A further comparison of the Potter and the Hellegers/Georgetown understandings of bioethics and the relative acceptance of the two views will appear in the March 1995 issue of this journal. (shrink)

The Hastings Center was founded in 1969 to study ethical problems in medicine and biology. The Center arose from a confluence of three social currents: the increased public scrutiny of medicine and its practices, the concern about the moral problems being generated by technological developments, and the desire of one of its founders (Callahan) to make use of his philosophical training in a more applied way. The early years of the Center were devoted to raising money, developing an early agenda (...) of issues, and identifying a cadre of people around the country interested in the issues. Various stresses and strains in the Center and the field are identified, and some final reflections are offered on the nature and value of the contributions made by bioethics as an academic field. (shrink)

Rereading Renée C. Fox's “A Sociological Perspective on Organ Transplantation and Hemodialysis,” published in 1970, one is likely to be struck more by continuity than by change. The most pressing of the social, policy, and ethical concerns that Fox raised remain problematic fifty years later. We still struggle with scientific and clinical uncertainty, with the boundary between experimentation and therapy, and with the cost of organ replacement therapies and disparities in how they are allocated. We still have an imperfect understanding (...) of transplant immune responses. We still debate when a potential donor “actually” dies, and we still seem to think better empirical criteria could harmonize the diverse religious, cultural, and socioeconomic values of patients, providers, third‐party payers, and policy‐makers. Organ transplantation was for Fox both a particular case unfolding in time and an entryway for discussing the difficult moral questions presented by many new medical technologies in a context of high demand and limited resources. (shrink)