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...focused describing particular state of affairs that has some moral or ethical relevance. For example, empirical research can help to describe cultural beliefs about the appropriateness of providing health-related information, such as the diagnosis of a life-threatening illness, which informs deliberations about the extent to which it is morally important for clinicians to provide comprehensive information to patients in different cultural contexts. Similarly, empirical research can delineate popular attitudes and experiences related to contentious issues such as abortion, cloning, stem-cell research, and physician-assisted suicide to enlighten discussions and policy formulations regarding them. In addition, empirical research can map the effects of particular interventions aimed at improving how clinicians or policy makers attempt to meet an ethical obligation, such as whether a computer-assisted device improves the quality of informed consent. Thus, empirical research in bioethics stands in contrast to other major approaches to ethics, namely normative ethics and metaethics, which rely primarily on philosophical reasoning and argument. Normative ethics aims towards understanding how moral agents should behave and what attitudes and dispositions they should have; whereas metaethics aims at delineating moral concepts and the nature of justification in moral theory. (2)
In this paper, I review the nature of empirical research in bioethics, specifically what has been examined and what methods have been employed. Next, I discuss the relationship of empirical to non-empirical research in bioethics as well as the importance of applying rigorous methods to this empirical work. Based on scholarship on two selected issues, I demonstrate how the appropriate use of these methods can contribute to enhancing the approach to important topical issues in bioethics. Following this discussion, I describe some opportunities for empirical research in bioethics. Finally, I depict some of the potential barriers to meeting these opportunities.
THE NATURE or EMPIRICAL RESEARCH IN BIOETHICS.
A comprehensive review of the empirical research published during the 'first decade' of modern bioethics (1980-1989) indicated a growing incidence of this research as well as information about the nature of this work. (3) In this appraisal, the authors retrieved postings from BIOETHICSLINE; reviewed published reports to ensure that they represented empirical research; and then coded them according to a uniform set of topics examined, the participants, and the methods employed. At the time of their search, 3.4% (n=663) of the postings in BIOETHICSLINE represented empirical research. Empirical research experienced growth over the decade studied and 50 topics were examined; however, "four topics together--informed consent, research ethics, mental health, and Do Not Resuscitate orders--accounted for almost 26 percent of the topic assignments." Surveys were the predominate method employed in this research.
In order to assess the nature of the more recently published empirical research in bioethics, a new search was conducted. Because BIOETHICSLINE is now subsumed in MEDLINE, a new set of search criteria was developed to identify empirical and ethics postings (See Table 1) The results of this search are displayed in Table 2 and in Figures 1 and 2. While overall ethics postings account for less than 1% of all postings in MEDLINE, there has been a trend towards increased representation of these postings in MEDLINE. Empirical research in ethics represents approximately 25% of these postings, which also seems to be increasing over time.
[FIGURES 1-2 OMITTED]
The list of topics that were developed inductively in the review- described above was used as a reference point for delineating the topics studied, but was modified as needed to capture the use of particular terms now used in MEDLINE. For example, for "DNR," the new topic search used the search terms "Resuscitation Orders OR Cardiopulmonary Resuscitation." Similarly, to be consistent with the earlier set of terms, it was sometimes...
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