What is Bioethics? Theoretical bases and objectives
Throughout the history of humanity, human rights have been violated on many occasions, negative and positive repercussions have occurred on the scientific advances of biomedicine in human life, and the advancement of industrial society has been prioritized at the expense of damage that could be generated in ecosystems. In response, by way of awareness, a new area was created a few decades ago within the general ethic: bioethics .
As we will see, defining bioethics is not something simple. There is a large number of guidelines that make up bioethics, which nourish it for the analysis and resolution of problems that have justified its appearance.
Definition of Bioethics
Bioethics is a branch of ethics, responsible for providing and examining the principles of behavior best suited to the human being in relation to life (human, animal and plant life). Among the many definitions that exist of bioethics, we can say that it is the systematic study of human behavior in the field of life sciences and health care, examined in the light of values and moral principles .
We must clarify that unlike medical ethics, bioethics is not limited to the medical environment, but addresses multiple issues (eg, environment and animal rights).
In short, it is about the ethical reflection of the moral problems of the contemporary plural society in which we are immersed. Above all it is focused on the professions that are registered in the field of health, such as Clinical Psychology.
Some of the most well-known topics in applied bioethics are:
- Abortion and the status of the embryo
- Euthanasia
- Genetics and human cloning
- Research and clinical trials
- Environment and animals (within this area highlights the author Peter Singer)
- The relationship between doctor and patient
- Organ donation
- Pain treatment
Brief historical evolution
It is a relatively young discipline, it has less than half a century of history . In addition, it has become an area of compulsory study within research and medicine, and over the last 30 years its body of knowledge has expanded, becoming one of the most up-to-date branches of ethics.
The author of the origin of the term is somewhat controversial: some advocate the German theologian and philosopher Fritz Jahr (1927), who used the term Bio-Ethik in an article related to ethics for plants and animals. Other authors highlight the oncologist biochemist Potter, who in the year 1970 used the term bio-ethics within an article, and a year later published a text entitled "Bioethics: bridge to the future".
But if we have anything to emphasize in the history of bioethics, it is the Belmont Report (1978). It was born following the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in the United States, after the ravages of the well-known Tuskegee experiment (on syphilis not treated in African-American people). This text includes the principles or criteria to guide research with human beings in biomedicine. Today the Belmont Report is still considered a reference text for researchers.
Great principles of Bioethics
Next, we will explain the four great principles of bioethics, proposed by Beauchamp and Childress (1979):
1. Autonomy
Autonomy reflects the ability of the person to make decisions about oneself without external influence, their privacy and self-determination. This principle will be susceptible of not being applied when situations occur in which the person can not be 100% autonomous or have reduced autonomy (eg, vegetative state).
The maximum expression of this principle would be the informed consent of the patient. It is a right of the patient and a duty of the professional who attends it. In this sense, the patient's preferences and values must be recognized and respected. In Psychology this principle is also applied, and the informed consent of patients, whether adults or children (through their parents or legal guardians) must always be obtained.
2. Beneficence
It is the obligation and duty of the professional to act for the benefit of the patient or others. It aims to promote the legitimate interests of the patient and suppress their prejudices to the maximum. It would be like "doing what's best for the patient."
The problem that arises from this principle is that sometimes the patient's benefit is promoted but without taking into account his opinion (p.eg, the doctor has training and knowledge that the patient does not have, so the doctor freely decides what is best for the person). That is, in these cases the opinion of the patient or patient is ignored due to lack of knowledge.
The principle of beneficence depends on the autonomy It would be like doing the good that the patient consents or requests.
3. Justice
This principle seeks equality and reduces discrimination for ideological, social, cultural, economic, race, gender, sexual orientation, etc. . It is recognized that all people are entitled to the benefits of medicine, or psychology, for example. It seeks to provide all patients the same quality, care and services in all interventions.
In psychology, for example, no discrimination or prejudice of any kind is accepted.
This principle is applied qualitatively differently depending on the countries. For example, in the United States, medical care is based on insurance contracted with private companies, so there may be discrimination for economic reasons. In Spain, healthcare is free and universal, based on a principle of need.
4. No maleficence
This principle is based on the failure to perform intentionally harmful acts to the person. That is, not unreasonably or unnecessarily harming the other. In some disciplines this principle can be interpreted with nuances, for example:
In medicine, sometimes the medical actions generate harm in the patient but the purpose is to obtain their well-being (eg, a surgical intervention). In Psychology, asking the patient to expose himself in a systematic and gradual way to situations that generate anxiety, fear, anger, etc., can be a harm or a pain for him, but the ultimate goal is his psychological well-being and overcoming the problems.
There are other considerations in this principle: the professional must commit to having a solid and scientific knowledge based education , must update their knowledge (based on evidence and not on pseudoscience) permanently to practice at a professional level, and should investigate new treatments or therapies in order to improve and offer their patients the best care.
As the code of ethics of psychologists says, "Without prejudice to the legitimate diversity of theories, schools and methods, the Psychologist will not use means or procedures that are not sufficiently contrasted, within the limits of current scientific knowledge. In the case of research to test new techniques or instruments, not yet contrasted, it will inform its clients before its use "(...)" The ongoing effort to update its professional competence is part of its work. ".
