The evolution of caring within bioethics: provision for relationship and context.

Given the complexity of modern health care, there exists an urgent need to discover how best to resolve complex bioethical issues. Traditionally, principle based ethics provided the benchmark for guiding ethical decision-making. More recently, however, it has become apparent that this traditional approach is often inadequate in dealing with current health care dilemmas. The notion of caring was advanced initially as an alternative to, then as a complement to, principle based ethics. In this article, caring is conceptualized as an attitude and is viewed as integral to the advancement of a coherent and integrated moral approach to ethical decision-making. First, a brief historical description of bioethics is presented. Next, an evolutionary account of caring within bioethics is described. Four fundamental problems associated with the use of caring within bioethics are then outlined. Finally, caring as an attitude is delineated and a case study is used to illustrate the proposed conceptualization of caring. The case study demonstrates that a caring attitude provides for relationship and context, which are elements often neglected by traditional approaches.