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The bioethics is part of the ethical . As such, it is a search for Norme S Morale S applicable to the Sciences of alive the, including the Médecine. The “ethical” term comes from the Greek êthos who, like Latin mores , returns to the behavior, with manners. It thus acts, in a strict sense, of the behaviors which it is necessary to have in the field of the health and life sciences. Moreover, the bioethics have vocation to be multi-field, since its range extends as well to medicine and biology as with philosophy, the right, theology, etc

Science in itself does not have as a task to define the human values. It must thus be confronted with other sciences, in particular with the social sciences, and the man must tackle the question of the direction and the consequences of scientific progresses. The bioethics are the research of the answers to these questions. While seeking to define the borders of possible and legitimate, it remains in the tradition of the ethical reflections of our past.

Fields of the bioethics

Biotechnologies applied to the man

The bioethics became a subject of topicality, following the handling Génétique S carried out on the food plants, with the Clonage and the use of human embryo S.

Human procreation

One can quote all the questions having milked with (nonexhaustive list):

  • the medical help with procreation was one of the first objects of reflection of the bioethics, because of its potential eugenist. Thus, in France, the national Advisory committee of ethics for the health and life sciences (CCNE) was created in 1983 after the first birth by Fivete in 1982.

  • the Contraception;
  • the Abortion;
  • gift of gamètes or embryos;
  • the assumption of a gestation of the human embryo by nonhuman Species S;
  • questions of human Cloning;
  • the prenatal diagnosis or préimplantatoire;
  • genic therapies;
  • the Eugénisme (sterilization of mentally handicapped persons and people at the genetic risk…) ;
  • legal status of the embryo and the fetus, related to the dignity of the human life…

Genetic engineering

If the Transgénèse poses the problem of the bioethics, the most frequent reactions vis-a-vis the genetic Engineering are largely function of the final objective, more than of the organization concerned, all at least when this organization is not human origin.

Thus, the genetic Engineering having medical and pharmaceutical goals (manufacture of Vaccine S, genic Therapy, Prenatal diagnosis) it is perceived better than handling having food or ludic goals (GMO, cloning of familiar animals) which raise much more problems. But this assertion is not always true, since the system of Clerc's Office on the plants exists since more than one millenium and is décrié by nobody (a branch is taken on a plant has, is stuck to a plant B and the fruits which result from it show hybrid genetic characteristics). One can quote as example the Clémentine.

The development of the Génétique is so fast that the majority of the changes at the origin of monogenic affections are known, and it is probable that one will quickly know a very great number of genes of predisposition to other diseases. One thus has to expect the appearance of genetic tests of predisposition for an increasingly large number of diseases. If these tests are invaluable allies as regards Public health and of prevention of the risks, they make fear the appearance of discriminations, for example for the access to the insurance or the job market. The film of anticipation Bienvenue in Gattaca denounces the misdeeds of a society based on these values.

Human handling (genetic profile, reproductive cloning, improvement) is discussed more and more by the scientific community.

Brevetage of the alive one

The problem of the Brevetage of alive the consists in knowing if a gene sequence is patentable and if applications of its discovery, Médicament S, tests, etc, are it also. It is a stake of first importance for the companies which invested considerable money sums in the decoding of the human Génome, but also for possible progress of knowledge induced by the discovery of these Gène S. Moreover, the question of the Brevet S of Médicament S poses the problem of the access to the care for poorest. A badly adapted legislation could lead to the Biopiraterie.

According to a declaration of UNESCO of November 11th, 1997, the human genome is an inheritance of humanity and it cannot be the subject of marketing. The decoding of the genome cannot be patented; but starting from this decoding, the therapeutic applications can the being.

Interventions on the body and the human spirit

  • taking away of bodies and fabrics: the Sale of body being prohibited in many countries, the legislators had to define how the shortage of bodies was to be managed. In France, in 1992 a register of the refusal was created, which consigns all the refusal to the donation of organs. The gift of original cells and the Therapeutic cloning are also prone to controversies.

See also: Donation of organs, Sale of body

  • Prosthesis S;

  • management of the organ banks;
  • Neurosurgery: in Russia, for example, it is legal to operate (even on minors) the brain of people, in order to limit their behaviors violent one;
  • Psychotropic use of the S…

To age and die it

  • therapeutic eagerness (as from which moment should it be considered that the treatment becomes too heavy?) ;
  • active euthanasia or passivates (assistance with the suicide);
  • palliative care;
  • control of the senescence (people reached of the Parkinson's disease…)

The experimentation

  • experimentation with therapeutic aiming or of research;
  • which are the allowed people (voluntary, captive, people healthy, sick, mentally handicapped persons…) ;
  • supernumerary embryos used for research;
  • the use of the data of health in personal matter in research…

Interventions on the nonhuman beings and mediums

  • experimentation on the animals;
  • safeguarding of the species (animal or vegetable), question of the biodiversity: recent studies show that the biodiversity of the aquatic environments helps with the faster reconstitution of fish stocks;
  • incidences of the industrial society on the biosphere (new mutagen products, genetically modified Organizations…) ;
  • biological weapons;
  • cloning on the plants (since more than one millenium in China) or the animals;
  • transgénèse…

Bioethics and nature

The bioethics also raise the question of the sex with the animals, the zoophilie being a prohibited act whereas the man must control his bestial impulses resulting from his environment of life.

From the start, it should be noticed that the appropriation even natural concept of is already a phenomenon of most revealing dogmatism than raises the questions which worry the bioethics. Indeed, demagogs (like the sects, unquestionable politicking…) a vision manichéenne life, their own morals present separating the Good from the Evil. What is natural is presented like concerning first category, while at the same time they are often cultural phenomena of which he is question.

Today, the man would have acquired the technical capacity to create the new one in nature and the mankind. It should however be moderated this position since the selection by the man of the genetic characteristics which were appropriate to him on the plants and the animals have dated for several millenia (grafted plants, creation of races of animals…). This direct capacity of the individuals on the Genome, to satisfy their interests, makes us carry a new glance on the evolution of the life such as we know it (Théories of the evolution). The question of the benefit and the implied risks arises.

Many people fear a Appropriation of nature by the man and claim to it (Re) definition of the rules current morals.

The vision more the traditionalist remains enough anthropocentrist and poses like requirement the minimization of the impact of the man on his environment, in order to be able to preserve it intact and clean at the human life (life of the future generations). This vision is that usually followed to France.

A different approach seeks to replace the man within the Biosphère. It rests on the concept of major ecology and supports that the man does not have more rights than the other alive species and must respect nature, was this with its costs. It should be noted however, that the activities of alive contribute to modify its environment, like made for example, the first plants which colonized planet, by modifying the composition of the terrestrial atmosphere by their rejections of Oxygène and Carbon dioxide.

Critical of the anthropocentrism by the utilitarian bioethics

The Anglo-Saxon utilitarian current, mainly developed by the english-speaking Jeremy Bentham and John Stuart Mill, redefines the people who are the subject of the bioethics; it is the definition actualist people. For them, only those are people which show certain characteristics, in particular the self-awareness, the capacity to communicate, the possession of interests, projects, a Rationalité…

The human beings which would not bring up to date not these conditions are thus not regarded as people, such as for example: embryos, new-born babies, demented people, the comatose ones, etc

Contrary, there are people who are not human beings, like certain higher animals (large monkeys anthropoïdes…), to which some precisely allot the characteristics of the person.

The stake of the bioethics is then any more neither obligations neither duties, nor values in oneself, but the satisfaction of the interests of the various people, human or animal. It is l'" ethics of the intérêts". All the interests are worth and must be taken into account in equal manner; they are not judged in themselves. The guiding principle of this ethics is thus the principle of distributive justice: it is necessary to satisfy as much as possible interests of the greatest number of people, whatever they are. The two principal interests are the research of happiness and to avoid the suffering; the morality of an action is a reality which can be shown and measured, starting from these elementary motivations of the sensitive living beings.

To this end, the utilitarian bioethics introduce the ethical concept of assessment . Thus, a life can be saved at the expense of an other if the quality of the saved life exceeds that of the sacrificed life. For example, a pig (species biologically very near to the man and similar size, therefore potentially interesting for Clerc's Offices of bodies) is generally judged to have a life less rich, less opened out, and thus of less quality that of human. The sacrifice of the pig to save the human one would be thus morally justifiable.

However, the utilitarian ones also state that certain human lives can be if degraded (people " légumes" , irreversible deep comas, people whose sufferings are extreme and incurable) that their quality is lower than the quality of life of certain animals. Thus, to be coherent, one would not only have to allow the use of xénogreffes, but also not to reject a priori the use of the organs of unquestionable human grabataires.

The utilitarian step is a rational step which consists in putting out of balance the positive one and the negative one of an action have regard to its total consequences. In other words, an action is considered to be morally acceptable as from the moment when it is more useful than harmful, not only point of view of the person who acts but from the point of view of the community property of the whole of the people that this action affects. All the ethical questioning lies then in the evaluation of the assessment of an action, and many debates and polemics are born from the difficulty of this evaluation.

Nevertheless, this current is the subject of many criticisms, in particular because it opens the way with many drifts. Thus, some would evaluate for example that the euthanasia of the elderly would be overall useful, because on a side it would make make substantial economies benefitting everyone, and other side it would be according to them only not very prejudicial with the people concerned who would lose only a few years of a life of forfeiture and suffering.

Moreover, in right, any human being is holder of rights (Human rights); it is not possible of the enfreindre, when well even one would be comatose or defective intellectual. This position should be moderated, however, since it partly amounts deferring the debate on the qualification of human being. One could thus say that the embryos would not be human beings.

Evolution of the legal framework

The first regulations on the bioethics go back to 1931 and result from German circulars on the medical ethics, which will be taken again as bases legal for the experiments in the concentration camps Nazi S . It is thus advisable to be careful in the approach of these bioethics.

The first rules of bioethics, such as this term today is defined, will be the work of the court of Nuremberg, charged to judge the doctors Nazis. Initially, the court will note the absence of standards to be able to carry out this judgment. It could have condemned these doctors to the title which they exerted with an aim other than curative (there already had been such judgments for doctors practitioner of the experiments, but never on such a scale). However, the court decided to recognize the legitimacy of the tests, since science advances only by experiments on the man. It is only in the second time of its reasoning that it poses the rules to be followed to frame this activity. Thus, it will state a code deontologic called the Code of Nuremberg, composed of ten rules on the human experimentation. The first of these rules is the assent of the people; the experimentation must be necessary; one must evaluate the proportionality between the risks for the patient and the benefit for science; the goal of the experimentation must be scientist… They are for this reason that the doctors Nazis will be condemned, the court judging that these rules that it had just worked out held with the human dignity and thus that the principle of nonRétroactivité of the criminal law did not apply.

The assembly of the world medical Association in Helsinki in 1964, then the International Conference of Manila of 1981, taking as a starting point the work of Nuremberg, will put forth international declarations on the experimentation.

Following Nuremberg and Manila, the countries little by little will frame the experiments.

In France, it will be necessary to await the law of December 20th 1988 so that one sees appearing a regulation, which is not planned whereas for the experimentation on agreeing Cobaye S. This law poses the general principle of the not-remuneration of the experiments. Thereafter, the laws of July 29th 1994 on the human body, the gift and the use of the elements and products of the human body, will pose the bases of the current right as regards bioethics. With the laws of August 6th 2004 modifying those of 1994, the term of bioethics will appear for the first time in positive Droit. They deal with two major topics: the question of the Cloning of the Embryo and the taking away of bodies.

The attitudes vis-a-vis the debate of the bioethics are very varied: some not perceiving the least moral stake there, since the safety of the mankind is assured; others perceiving the current evolutions like an ultimate transgression with respect to the human nature.

On the Political level, it acts to arbitrate and control the Recherche on the alive one and the commercial exploitation of its results. The goal of this control is to make sure that the practices induced by these technological advances will remain morally acceptable by the company.

In practice, it is very difficult to restrict research by the law: nothing prevents a team from settling in a permissive country more . The risk for the countries prohibitionnists being to lose competences in technologies interesting their future. It is an argument proposed by the partisans of the GMO which agitate the spectrum of a technological delay of Europe in this field. This risk is all the more great as the play of the Brevet S can lock whole pieces of research.

Morals in science

Religious morals

Works such as the Bible or the Coran fix limits morals as for the behavior which the man should adopt vis-a-vis the other men.

However, there do not exist such limits with respect to the other species. It is difficult to define the rules morals connecting the man and the other alive species. Certain people perceive the Vivisection like morally unacceptable. But of other activities (Xénogreffe S) are evoked still little.

As of the Middle Ages, Christian priests and scientists also refused to admit the argumentation according to which it was useless to too much seek to look after the patients, human lives depending on the will of God. One cannot make God responsible for the inaction of the doctor: all must be implemented, within the limits of scientific progresses, to look after the human beings. Before relying on the grace of God, it is advisable to do everything to look after itself.

Personal positions of certain scientists

Scientists, who had authority on the scientific world, very early adopted personal positions on science and the religion:
  • Hippocratic oath;
  • Rabelais : " Science without conscience is only ruin of the âme" ( Pantagruel , chapter VIII);
  • Albert Einstein: " Science without religion is lame, the religion without science is aveugle".

Conflict of interests

According to Trudo Lemmens, bioethician in the joint Center of bioethics of the University of Toronto, a conflict of interests occurs when the professional judgment as for an interest first, like a research or the care with the patients, can be unduly influenced by a secondary interest, like a financial profit or personal prestige. The strategies to face these situations include the disclosure of the conflict, the establishment of a system of examination and authorization, and the prohibition of the activities which lead to the conflict.

This question of the conflict of interests recalls that the bioethics are before a a whole branch of ethics. Two recent businesses testify owing to the fact that it does not go from there inevitably thus, at least in the spirit to the political directors:

During the famous business Hwang Woo-suk, a person in charge Korean for the bioethics was co-signatory of one of the articles of which the data had been falsified. She explained to the review Nature why she had not contributed in experiments to work and that its role had been restricted to deliver an opinion of bioethics. While accepting the idea that it could not suspect the fraud, it is obvious that the concept of conflict of interests as problem of ethics had escaped him.

One can also quote Axel Kahn (which was member of the national Advisory committee of ethics): as a President of the Commission of the biomolecular genius, it had given an favorable opinion with the culture of the genetically modified organizations in France (and this against the opinion of thirteen of the ministers of environment for the European Community). Having obtained in 1997 only the authorization to import GMO but not to cultivate them, it had left the Commission. A few months later, however, it was employed by Rhône-Poulenc, while at the same time this company was interested by its favorable opinion in the GMO, since it had been implied in the creation of GMO for ten years ( she was thereafter condemned to the United States to withdraw sale her corn transgenic for pollution with the weedkillers ).

See too

Related articles

External bonds

General bonds:
  • Section Bioethics of UNESCO
  • the Declaration of Helsinki, emitted by world medical Association
  • Site of information and analysis of the topicality bioethics

French official sites:

  • the secretariat of State to Health and the Social action
  • the national Advisory committee of ethics for the health and life sciences
  • the file “Laws of bioethics” of the National Assembly
  • the Academy of ethical medicine
  • Space of the Public assistance - Hospital of Paris

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