Upside down ethics

That last post definitely points out the mess of current bioethics: Autonomy as the first principle, before the more traditional "Heal when possible, but first do no harm."

Is the purpose of medicine to give the patient what he or she wants, or is it to save lives and restore or maintain health?

As I've noted (see my profile statement at the right of this post), "bioethics" is not strictly medical ethics. In fact, it does entail science, research, public policy and politics and public funding as well as, and sometimes more than, the ethics of medicine. The problems of limited funds - or the act of providing and/or limiting funds - from government resources along with political and philosophical divisions in our United States debates drives those debates more than the traditional weighing of physical health and risks to life and health.

Questions I'm asking these days:

Why include "ethics" in "bioethics," at all? Why not just skip to public policy and public health?

What sort of person practices anything - or even lives - without "integrity," if the conscience is over-ruled by outside forces?