A subdiscipline of ethics that studies the way we investigate with living beings.
Throughout the history of humanity, human rights have been violated on multiple occasions, there have been negative and positive repercussions in 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 within general ethics was created a few decades ago: bioethics.
As we will see, defining bioethics is not easy. There is a large number of orientations 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 most appropriate principles of conduct for human beings in relation to life (human, animal and plant life). Among the many definitions that exist of bioethics, we can affirm 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 part of the health field, such as Clinical Psychology.
Some of the best known topics within applied bioethics are:
- Abortion and the state of the embryo
- Genetics and human cloning
- Research and clinical trials
- Environment and animals (within this area the author Peter Singer stands out)
- The relationship between doctor and patient
- Organ donation
- Pain treatment
Brief historical evolution
It is a relatively young discipline, having 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 towards plants and animals. Other authors highlight the biochemist oncologist Potter, who in 1970 used the term bio-ethics in an article, and a year later published a text entitled “Bioethics: bridge to the future”.
But if we have to highlight something in the history of bioethics, it is the Belmont Report (1978). It was born as a result of 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 untreated syphilis in African-Americans). 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):
Autonomy reflects the ability of the person to make decisions about oneself without external influence, to their privacy and self-determination. This principle may not be applied when situations occur in which the person cannot be 100% autonomous or has reduced autonomy (eg, vegetative state).
The highest 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 her. In this sense, the patient’s preferences and values must be recognized and respected. In Psychology this principle also applies, and informed consent must always be obtained from patients, whether they are adults or children (through their parents or legal guardians).
It is the obligation and duty of the professional to act for the benefit of the patient or others. It is intended to promote the legitimate interests of the patient and to suppress their prejudices as much as possible. It would be like “doing what’s best for the patient.”
The problem that arises from this principle is that sometimes the benefit of the patient is promoted but without taking their opinion into account (eg, the doctor has training and knowledge that the patient does not have, so the doctor decides freely what is best for the person). In other words, in these cases the opinion of the patient or patient is ignored due to their lack of knowledge.
The principle of beneficence depends on that of autonomy, it would be like doing the good that the patient consents or requests.
This principle seeks equality and reduces discrimination for ideological, social, cultural, economic, race, gender, sexual orientation, and so on. It is recognized that all people are entitled to the benefits of medicine, or psychology, for example. It seeks to provide all patients with the same quality, care and services in all interventions.
In psychology, for example, discrimination or prejudice of any kind is not accepted.
This principle is applied in a qualitatively different way depending on the countries. For example, in the United States, medical care is based on insurance contracted with private companies, so there could be discrimination for economic reasons. In Spain, healthcare is free and universal, based on a principle of necessity.
This principle is based on refraining from performing acts intentionally harmful to the person. That is, not to unjustifiably or unnecessarily harm the other In some disciplines this principle can be interpreted with nuances, for example:
In medicine, sometimes medical actions cause harm to the patient but the purpose is to obtain their well-being (e.g., a surgical intervention) .In Psychology, ask the patient to systematically and gradually expose himself to situations that generate anxiety , fear, anger, etc., can cause damage or pain for him, but the final goal is his psychological well-being and overcoming problems.
There are other considerations in this principle: the professional must commit to having a training based on solid and scientific knowledge, must update their knowledge (based on evidence and not on pseudosciences) permanently to practice at a professional level, and must investigate about new treatments or therapies in order to improve and offer your patients the best care.
As the deontological code 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 investigations to test new techniques or instruments, not yet verified, he will let his clients know before use “(…)” The continuous effort to update his professional competence is part of his work ” .