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WHAT IS BIOETHICS?

CONCEPTUAL FOUNDATIONS

In our days, Bioethics represents that encounter and dialogue space, that bonds between knowledge and wisdom–humanistic, scientific, practical, specialized and general–that demands the objective need of convergence and cooperation among diverse and different cultures, with dissimilar faces and backgrounds, around essential matters that affect the entire society: peace, health, present local, national and global participation on the environment and natural resources protection, informed and agreed-upon control of the development and use of technological innovations–with no detriment of the freedom of research, creative imagination and foreshadowing of original and according alternatives aimed towards the common good–, the transparency of interests and economies involved in the scientific and technological development, the consideration of distributive justice, the self-preservation of species.

All the topics mentioned previously are analysed on the basis of the unavoidable principles based on respect for dignity, the safeguard of the people’s rights and their autonomy, tolerance, inclusion and solidarity. From this standpoint, the democratic platform and the secular character of the Mexican State acquire a special dimension to cast a conception of bioethics that, in practice, overcomes borders that oppose localisms, nationalisms, or even particular assumptions of ideological, religious, or political source.

Nowadays, as before, the words of Koïchiro Matsuura, Director General of UNESCO, pronounced just before the adoption of the Universal Declaration on Bioethics, in Paris 2005, and captured in the Preface are still in force: the strong bond that unites the ethical question with the concern for the welfare of future generations…evokes with greater accuracy the approaches regarding the access to health care with the adequate quality, nutrition and water, the reduction of poverty or the improvement of the environmental conditions, thus, opening action perspectives that go beyond medical ethics alone and reiterates the need to include bioethics in an open reflection context about the political and social world.

In the center of the COUNCIL of the NATIONAL BIOETHICS COMMISSION, far from adopting a complex, always rigid and, with no doubt, provisory definition of the Bioethics concept, it was considered appropriate to work on the basis of a notion that even if it was theirs, it was still related to the thoughts of the most renowned specialists, and national and international institutions on this matter.

BIOETHICS NOTION

Bioethics is a branch of applied ethics that reflects, deliberates, and makes normative and public policies proposals, to regulate and solve social life conflicts, especially regarding life sciences, medical practice and research, which currently affect life in the planet, and for the future generations.”

This approach, useful as a guide for actions not only on the conceptual and educational fields, but also on its practical exercise, takes into account the considerations of professionals that are dedicated to this field of knowledge. Both at the international and national levels, and beyond the initial–already classic–approaches of the last decades of the past century, bioethics has been considered a trans-disciplinary speech, without losing the status of a philosophical discipline by its own nature and without being considered a “second rank philosophy”, and not losing its identity in the context of the multiple knowledge and applications of science and technology, whose advancement is extremely dynamic.

Either way, its sense has experienced changes along time and for some specialists, its conceptual evolution will continue going through transformations, which may have an imprecise meaning during an indefinite lapse of time, which does not limit its commitment to continue devising and applying solutions in favor of survival, for the improvement of the quality of every form of life, and, of course, of our natural habitat.

In fact, for many specialists, the reference to the term Bioethics comes from the 1971 proposal made by Van Rensselaer Potter to refer to the discipline that combines biological knowledge with human values: the science of survival and a bridge to the future. Potter thought that bioethics was a new culture, the necessary encounter between life and values; between sciences and humanities.

However, it is necessary to take into account that Fritz Jahar, protestant pastor, theologian, philosopher and German educator in Halle an der Saale, was in fact the creator of the term Bio-Ethik in 1927. He imprinted it and captured it in the article Bioethics: a panoramic view of the ethical relationship of men with animals and plants, published in the Kosmos magazine. Jahr’s concept alludes to a wider vision in terms of the moral relationship between the human being and the rest of the living beings, human and non-human. He spoke about a “bioethical imperative” which, of course, follows Kant’s thought, and pointed towards the ethics regarding animals used for experimentation, a necessary deliberation regarding the intentions of scientific research and the diverse aspects of the spread of science among the general population, with the aim of making it participant.

Either way, with Potter’s influence, later, in 1978, the Kennedy Institute of the Jesuit University in Georgetown, in the USA, published the first Bioethics Encyclopedia in four volumes, directed by Warren Reich, a catholic theologian, where Bioethics is defined as the “systematic study of human behavior in life sciences and the health field, examined in the light of values and moral principles.”

In 1979, bioethicists, T.L. Beauchamp and J.F. Childress, defined the four principles of bioethics: autonomy, non maleficence, beneficence and justice. At a first stage, they established that these principles were prima facie, i.e., that they are always bound as long as they do not collide with each other, and in such case, priority must be given to one or the other, depending on the case. Nonetheless, in 2003 Beauchamp considered that the principles must be specified in order to apply them on concrete cases, i.e., that they must be discussed and defined for a concrete case at casuistic level.

These four principles were captured in the Belmont Report –drafted by the National Bioethics Commission for the Protection of Persons object of Biomedical and behavioral - Experimentation– which at the beginning made reference to the following:

  1. Respect for the autonomy: regarding the capacity of people to decide on the choice of treatments and the access to clinical information
  2. Beneficence: Considers the assessment of the advantages of treatments and the benefits granted to patients.
  3. Non-maleficence: Obliges professionals not to harm or to endanger the patient.
  4. Justice: Guarantees equity on assistance, costs and benefits.

After this first conceptual generation, so to speak, several approaches of bioethical thinking have been developed and current trends have even been mentioned: Anglo-Saxon, European, Latin American. One of these perceptions is, for example, the one adopted by the Bioethics Regional Unit of the PAHO, with its headquarters in Santiago de Chile and that, modified by S.J. Alfonso Llano Escobar in a specialized magazine, defines Bioethics as “the creative inter and trans-disciplinary use of life sciences and human values in order to formulate, articulate, and, to the extent possible, to solve some issues posed by the research and intervention on life, the environment and the planet Earth.”

In summary, beyond the general conceptual approach, bioethics, in a simplified manner, operates at three levels where techno-sciences have evident effects related to nature, biomedicine and the social aspects. From this viewpoint, bioethics is considered to be a field of knowledge that comprehends –multidisciplinary- research, speeches and practices, with the aim of clarifying and, to the extent possible, solving questions of ethical nature, that arise from research and biomedical developments in the context of a society which, at different levels, include an individualist nature and also the distinctive feature of being multicultural, and constantly evolving.

The noted aspects lead us to emphasize the need of a progressive development for the State and society to have enough competences at their disposal and to undertake the dialogue that demands the discussion of the several bioethics dilemmas, in the framework of a society where science, technology and economy development have been globalized, linked to such aspects, but, at the same time, where respect and protection to local, regional and national differences must be taken into account.

All the above mentioned, addressing the central object of the National Bioethics Commission which is to promote bioethical culture in the country, which involves establishing that it is about boosting ethical development of the society as a whole, encouraging a thoughtful awareness in both individuals and society towards uncertainty situations that techno-scientific advancements entail, as well as looking for a greater engagement in the context of a plural and respectful discussion, and regulations that look after the social benefit without damaging social groups that are in a vulnerable position.

It involves the encouragement of a responsible attitude regarding the potential consequences of the decisions made by citizens, health professionals, institutional authorities, social organizations and governments in their three fields of action, based on a secular and respectful platform about viewpoints diversity that arise or may arise from bioethical topics, overall linked to human life and health protection of individuals and groups.

Likewise, promoting a bioethical culture means strengthening and opening the social tissue to knowledge, with the aim of improving social conditions and general welfare from an ethical point of view. This should also be captured by laws, norms and regulations drawn up in a more comprehensible manner towards plurality, social diversity and respect for human rights, having as foundation the preservation of the environment and health protection, emphasizing two aspects: the quality of health care –with the corresponding and indispensable informed knowledge of citizens regarding this matter– and the distributive justice as the basis of the right to health protection.


Última modificación :
Viernes 22 de Noviembre del 2013 por Centro del Conocimiento Bioético
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