The statement that clinical scientists must respect the rights of human and animal subjects has been suggested, as ethical values lie at the heart of medicine. Clinical ethical strategies are preceded by historical methodologies which one finds in religious ethics. Research involving human subjects inevitably raises ethical questions that profoundly influence the design and conduct of clinical trials. Not unlike science, medical ethics must weigh, assess, analyze and study the relationships of empirical data.
Unlike many schools of philosophical ethics, applied philosophy, in the form of medical ethics, is grounded in the concrete life situations where people and animals do their living and their dying. Consequently, the practicing clinical ethicist, like the scientist, must first be a fact gatherer, and then proceed systematically to the assumptions and presuppositions at work even in this initial fact gathering stage. Objectivity is a goal in medical ethics, but it is an informed rather than a simple minded objectivity; one which takes account of the subjective dimensions even in observation and description.
No strategy or methodology can compensate for retarded ethical development or character flaws on the part of decision makers. Impulse-ridden persons or anti-social or narcissistic personalities cannot distance themselves sufficiently from their own interest to gather objective data for evaluations, let alone to initiate actions for the benefit of patients. Persons of goodwill, including committed clinical scientists, can come to agreement in most scientific situations.
Given an all important commitment to doing what is right and a fairly wide agreement about guiding ethical principles, the critical issue comes down to competent moral thinking: moving through disciplined intellectual steps before arriving at a decision. The uncertainties associated with modern medical practice can be ‘tamed – if not broken,’ to use an equine metaphor. A value should always be placed on features of human and animal experience: consciousness, relationship, pain, function. In any event, ethics will continue to be a major concern for clinical scientists.