BIOETHICS: HISTORY, PRINCIPLES, STUDY SITUATIONS - PHILOSOPHY - 2024

The bioethics is a school of ethics that arose because of the need to properly guide human behavior towards all living beings. In other words, bioethics -through moral and ethical principles- regulates human interventions carried out on plants, animals and the human being himself.

The biochemist Van Rensselaer Potter (in 1970) was one of the first to use the word bioethics and defined it as a link between the life sciences and classical ethics. For these reasons, bioethics is multidisciplinary and works in a series of fields such as genetic engineering, biology, medicine, ecology and the environment.

Bioethics regulates the study and interventions that humanity carries out on living beings. Via: pixabay.com

For example, a topic of interest in bioethics is the concern about global warming and its consequences on living species. In this aspect, bioethics guides the decision-making of the States and the different associations in the rational use of natural resources, the protection of biodiversity and the well-being of living beings.

History of bioethics

Ethics in the area of ​​health goes back to the times of Hippocrates (460-371 BC). However, the first steps towards the conception of bioethics as a discipline began after the Second World War, within a panorama characterized by important scientific and technological developments.

This means that bioethics was born at a time of profound political and cultural changes, together with the discovery of a series of abuses committed especially in research with human beings.

The Nuremberg Tribunal

Nuremberg Trials. In front, from top to bottom: Hermann Göring, Rudolf Heß, Joachim von Ribbentrop, Wilhelm Keitel. Behind, top to bottom: Karl Dönitz, Erich Raeder, Baldur von Schirach, Fritz Sauckel.

In the late 1940s - when the world was barely emerging from the horror of World War II - the Nuremberg Tribunal, responsible for the trial of war criminals, exposed the horrors of some experiments carried out on humans during Nazi Germany.

This court showed that professional ethics, like the moral conscience of doctors and researchers, is not always reliable as an element of control in medical treatment or research.

Consequently, on August 20, 1947, the Nuremberg Tribunal issued a series of guidelines that were expressed in a historic document called the Nuremberg Code. The court indicated that these principles must be observed in all investigations involving human beings.

Later, in 1948, the United Nations General Assembly adopted another very important document: The Universal Declaration of Human Rights, which contains 30 basic articles on respect for human rights.

The Belmont Report

In 1978 the Belmont Report was published, listing three primary principles: respect for persons, beneficence and justice.

Later, in 1979, two professors and researchers, Tom Beauchamp and James Childress, reformulated the principles of the Belmont Report so that they could be applied to care ethics and published them in one of the most influential books in bioethics called Principles of Biomedical Ethics.

In this way, Beauchamp and Childress built a system that allows them to respond to the problems that the development of science and technology can cause. In addition, they provide guidance on how to establish an appropriate ethical relationship between the health professional and the patient.

Principles of bioethics

Bioethics is concerned with global warming and its consequences. Via: pixabay.com

The autonomy

This principle signals respect for people's decision-making capacity. In this way, autonomy implies recognizing the existence of different opinions, values ​​and beliefs in humanity.

An example of the application of autonomy is the protection of the rights and well-being of human participants in an investigation.

No maleficence

Non-maleficence is understood as the obligation not to intentionally harm or do evil. In addition, it implies the duty to notify, prevent or reject damages and to do or promote good.

As can be seen, this principle predominates over that of beneficence, because it does not allow to harm others to save lives and it prevents causing damages.

Charity

Beneficence implies preventing or eliminating harm. The word beneficence involves actions of goodwill, kindness, compassion, and disinterest towards humanity and all living beings. In this way, beneficence can be understood, in a general way, as any type of action that has as its purpose the good of others.

Justice

Through the principle of justice, bioethics ensures the attention of human needs. Via: pixabay.com

Through justice, social order, solidarity and peace are maintained. In addition, justice preserves human communities by meeting the needs of human groups without discrimination.

This principle of bioethics postulates that in order to apply justice, the place that each individual occupies in their community must be taken into account. Consequently, justice in bioethics is understood as what each person deserves according to their needs and their status in the community.

Study situations typical of bioethics

A series of situations have been established in which bioethics has its field of action as a regulatory agent. Some are described below:

Cloning

Cloning is isolating and multiplying a segment of the genetic material or the genome of an individual, so that the cloned species are almost identical to the original. But the implications of this activity are subject to a deep debate, since some experts indicate that this process can cause deaths and risk the social order.

Other researchers, on the contrary, highlight the benefits of therapeutic cloning; This occurs because by obtaining stem cells it would be possible to defeat many diseases such as cancer.

All these points of view are of interest to bioethics in the search for a solution that is framed in the defense of human rights and bioethical principles.

In vitro fertilization

This is a medical process of assisted reproduction, which allows the fertilization of an ovum outside the woman's body and then reimplants it in the uterus.

Although this process is widely used by couples who have not been able to reproduce naturally, it has been questioned in some circumstances, such as the maintenance of live embryos or their commercialization for cosmetic purposes.

Care of terminally ill patients

When treating a terminally ill patient, it is essential that there are no conflicts between bioethical principles.

The patient must be given a comprehensive solution to their problems; it should not be damaged unnecessarily. Likewise, it is necessary to respect their privacy and autonomy; His situation should also be reported, if he so wishes, and his opinion taken into account when deciding what is best for him.

Organ donation

Organ donation is a situation of great interest for bioethics, because in some cases the principles may not be fulfilled.

For example, when donation is made to help a loved one, uncertainties arise about the emotional pressure to which the future donor may be subjected.

On the other hand, in cases of altruistic donations (that is, no relationship between the donor and the patient) it is necessary to clarify whether the donor is psychologically capable of making the decision.

Child abuse

This is one of the problems of human behavior where bioethics has a wide field of action. In this aspect, bioethics encompasses complex actions that include citizen participation, health actions, and socioeconomic changes; this with the aim of protecting the child population.

Review of scientific designs

Before starting all scientific research should be reviewed in all its aspects, because it can expose participants to risks of harm without any possibility of benefit.

For these reasons, it must be guaranteed that the bioethical review of health research is supported by an adequate and independent legal framework such as bioethics committees.

Observation of newborn care practices

Many of the deaths that occur during the first year of life can be prevented by optimizing newborn care practices such as adequate breastfeeding, hygiene, and quick access to health facilities.

In this regard, health institutions have promoted the practice of bioethical guidelines to achieve the protection of the child population.

Actions on the environment

Bioethics is concerned with global warming and its consequences. Via: pixabay.com

Man, under the pretext of improving their living conditions, has harmed the environment or habitat, considerably deteriorating the quality of water and air, causing innumerable diseases and affecting the life of plants and animals.

In this sense, bioethics tries to regulate and guide all activities and decisions that endanger natural habitats and that lead to global warming.

Political decisions

The decisions made by governments and institutions are not alien to bioethics, since they have to do with the problems of overpopulation, poverty, food, health services, among others. For these reasons, the voice and principles of bioethics must be at the center of all these political decisions.

References

1. Siurana, J. (2010). The principles of bioethics and the emergence of an intercultural bioethics. Retrieved on April 4, 2020 from: conicyt.cl
2. Zuleta, G. (2014). The appearance of bioethics and the reason for it. Retrieved on April 4, 2020 from: scielo.org
3. Ramírez, N. (2013). Bioethics: its principles and purposes, for a technoscientific, multicultural and diverse world. Retrieved on April 3, 2020 from: redalyc.org
4. Lopes J. (2014). Bioethics - a brief history: from the Nuremberg code (1947) to the Belmont report (1979). Retrieved on April 3, 2020 from: rmmg.org
5. Council of International Organizations of Medical Sciences. (2016). International ethical guidelines for health-related research involving human beings. Retrieved on April 4, 2020 from: cioms.ch
6. World Health Organization., Pan American Health Organization. (2011). Guidelines and operational guidance for the ethical review of health research with human beings. Retrieved on April 4, 2020 from: paho.org