All of the debates about the role of bioethics as social institution, if not discipline, come at times when the programs for conducting study of bioethics are in something of generational distce. The scholars who lead those bioethics centers and institutions in the United States, for example, are mostly age 60 or older. But there are comparatively fewer scholars well into the role of associate professor than there are scholars of recent appointment to assistant professor. One possible consequence may be that a remarkable number of young scholars with less scholarly and administrative standing than what is typical of directors of bioethics programs have assumed the reigns of some of the most-published and longest-standing bioethics organizations. Where their predecessors had been trained in the strictures of discipline and only came to bioethics at midcareer, these new leaders were trained to work in the field of bioethics from the beginning of their careers. It is too early to predict the effect of this very rapid transition, which is accelerating due to the efforts of dozens of medical, nursing, veterinary, and public-health schools that do not yet have a serious bioethics program, but want one, and quickly. And perhaps the most confusing part about the debates concerning the status of bioethics has to do with the relationship between scholars of bioethics and the rapidly multiplying armies of clinicians,clergy,politicians,researchers,and others who suddenly find themselves "working on bioethics" . On the one hand, academic specialists in bioethics and their institutes struggle to determine what "counts" for the success of the field: what kinds of publications, what kinds of skills (clinical ethics consultation? philosophical ysis? Etc.) and what kinds of activities. On the other hand, there are thousands of people whose job or volunteer life involves something they call bioethics. For example, most hospitals around the world are struggling to keep up with perceived needs for in-house ysis of the ethical implications of policies or cases. At times this takes the form. of an ethics committee grappling to craft policy about futility (不育症) or genetic testing or when not to resuscitate the patient. At times it takes the form. of an institutional review board, responsible for reviewing proposed research activities involving human subjects, and responsible for the ongoing monitoring of those activities. And at times this takes the form. of education for staff and patients about the various devices and procedures that have come out of bioethics over the past thirty years. Whatever the form. these activities take, there appears to be no more consensus about what counts as good "part-time" bioethics than there is about academic bioethics scholarship. This problem is made acute by the incredible growth of bioethics everywhere. And it is aggravated by the lack of consensus among professional bioethicists, about what counts as sufficient training to be an bioethicist
The debates about the role of bioethics occurred when