Conflict of interest statement: No conflicts declared
THE NEED FOR SYSTEMATIC REVIEWS OF REASONS
Version of Record online: 27 APR 2011
© 2011 Blackwell Publishing Ltd.
Volume 26, Issue 6, pages 315–328, July 2012
How to Cite
SOFAER, N. and STRECH, D. (2012), THE NEED FOR SYSTEMATIC REVIEWS OF REASONS. Bioethics, 26: 315–328. doi: 10.1111/j.1467-8519.2011.01858.x
Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms.
- Issue online: 12 JUN 2012
- Version of Record online: 27 APR 2011
- review literature as topic;
- systematic review;
- policy making;
- delivery of health care;
- human experimentation
There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews.