Bioethics - a discipline that studies the moral problems of modern medicine arising from the rapid development of the biomedical sciences and the application of the latest biomedical technologies. The applied value of bioethics is the development of a system of moral and legal norms that ensure the protection and safety of human health and life in these conditions.

It is rather difficult to establish the exact date of the emergence of bioethics, some authors believe that it originated in 1962. in the USA. In Seattle, a medical center began using a new life-saving technology for kidney dialysis, which raised the question, “Which patients should have access to this procedure?” and it was clear that it was not possible to meet the needs of all those in need. Under these conditions, a committee was created, which included not only doctors, but also lawyers, and members of the public, it was dubbed the “Divine Committee” in the media, an article “They decide who lives and who dies” was published in Life magazine, which caused a wide public outcry.

There is an opinion that bioethics originated during the Nuremberg trials, when the facts of the atrocities of fascist doctors in concentration camps were revealed. Both points of view are characterized by something in common; they take as a starting point the facts of medical activity that stirred up the public and actualized the obvious need for a broad public discussion of the situations that have arisen.

Nevertheless, these facts are more likely still at the level of accumulation of empirical experience that requires scientific understanding, and by the end of the 60s, a sufficient number of such facts had already accumulated, which led to the emergence of an independent discipline in the United States in the 70s - bioethics. In the 1970s, the first research and educational centers of bioethics were created in the USA, the Hasting Center in 1969. and a little later, the Kennedy Institute of Ethics, and the problems she studies begin to attract the closest attention of politicians, journalists, religious figures, and the general public in general. There is the term "American bioethics", which implies that it was in the USA that the prerequisites and causes of occurrence, as well as specific features of bioethics, were first and fully manifested.

The term "bioethics" was introduced into the scientific lexicon by the American oncologist Van Renseler Potter in 1971. in his book "Bioethics-Bridge to the Future", where he defined the goal: "Humanity needs a combination of biology and humanistic knowledge, from which the science of survival is to be forged and with its help to establish a system of priorities." “The science of survival should not be just a science, but a new wisdom that would combine the two most important and extremely necessary elements - biological knowledge and universal human values. Proceeding from this, I propose the term Bioethics for its designation.

However, pretty soon the meaning of the term changes significantly. The interdisciplinary study of anthropological, moral, social and legal problems caused by the development of the latest biomedical technologies (genetic, reproductive, transplantation, etc.) comes first. Van Rensselaer Potter originally introduced the term bioethics to denote a special version of environmental ethics. The term "bioethics" was coined around the same time by the American physician André Helleghers, who used the term to refer to interdisciplinary research into the moral problems of biomedicine related to the need to protect the dignity and rights of patients.

Today in scientific circles there are two approaches to the definition of the subject of bioethics, the term "bioethics" is used in a "broad" and "narrow" sense. In the first case, the subject of bioethics is considered to be a set of ethical problems related to the attitude to all living things, while biomedical ethics is singled out as an integral part of bioethics. The second position is based on the unity of the terms bioethics and biomedical ethics, the subject of which is a set of ethical problems related to the attitude of the medical community and society as a whole to a person, his life, health, death during various medical and biological interventions. In what follows, we will use the second point of view, because it actualizes the specifics of the bioethical problems of medical practice to a greater extent.

Prerequisites for the emergence of bioethics:

The first one can be called development of the ideology of the environmental movement. The 20th century, especially its second half, is the century of scientific and technological progress, which has generated not only a myriad of benefits for mankind, but also threats to its very existence and its environment. Problems have arisen in connection with the "danger of knowledge" possessed by modern man, who has created numerous biomedical, biochemical, military-industrial, agricultural technologies that allow interfering with the very foundations of life on earth. However, knowledge in and of itself is neither good nor bad. They become such only in the process of applying them in practice. Even the successful use of scientific discoveries can be dangerous and act as a basis or a kind of total risk. A striking example is nuclear physics, one of the results of which was the invention of the nuclear bomb. The environmental movement aims above all to make people think about the consequences of their activities.

The influence of ecological thinking on biomedicine has especially accelerated due to the numerous facts of the adverse effects of traditionally used drugs on the human body. The thalidamide catastrophe became widely known, in the 60s pregnant women were prescribed thalidamide as a sleeping pill, a side effect manifested itself in children - focolimia - underdevelopment of the limbs. The goal of biomedical science has become not only the development of new therapeutically effective drugs or medical technologies, but also the prevention of their negative side effects. Moreover, the achievement of the latter goal is given no less, and sometimes much more time and money. As a result, the time between the synthesis of a new therapeutically active substance and the beginning of its clinical use has increased dramatically. If in the early 60s it was a few weeks, then in the early 80s it reached 10 years. At the same time, the cost of development has increased by 20 or more times.

The second reason, but not the least, is development of medical science and practice, bringing medicine to a new level, of course, medicine has developed before, but the pace of development was hundreds of times slower than in the second half of the 20th century and especially in the 21st century. There is an opinion that if the 20th century is considered the century of technology and computerization, then the 21st century will be recognized as the century of medicine and biology. We are witnessing the rapid development of fundamental biomedical sciences, new discoveries are changing our understanding of a person and opening up new perspectives in the treatment of previously incurable diseases - these are genetics and genomics, cytology, immunology, etc. The second half of the 20th century was marked by the widespread use of biomedical technologies - transplantation, resuscitation, artificial insemination, etc., the border between experimental and practical medicine has become conditional. These achievements not only exacerbated the traditional ethical problems in medicine, but also gave rise to a number of new ones, in general, the danger of treating a person as an object of observation, experimentation and manipulation was clearly demonstrated. There is a need and a need for understanding and moral assessment of rapidly developing research in the field of biology and medicine.

Case of Christian Barnard. December 3, 1967 South African surgeon Christian Barnard was the first in the world to transplant a heart from one person to another. He saved the life of a terminally ill patient by removing a beating heart from a woman whose brain had been irreversibly damaged in a car accident. The public reaction to this revolutionary event was extremely controversial. Barnard was hailed by some as a hero who created a method for saving hundreds of thousands of terminally ill patients. Others, on the contrary, accused him of murder: after all, he removed the still beating heart! Ended one life to save another! Did he have the right to do so? Or was there no murder, because if a person's brain is dead, then he is actually already dead, regardless of whether his heart is beating or not?

Human rights movement- the third most important cultural prerequisite for the formation of bioethics. In the context of the humanization of public morality, attention to human rights is constantly increasing. The fundamental problem of modern biomedicine is the protection of human rights when it comes into contact - forced or voluntary - with biomedical influences and manipulations. Caring for life and health is beginning to be seen as the right of every person. There are situations when medicine has any possibilities, but the question arises whether the person himself wants this. Bioethics began to develop rapidly as a result of the threat to human moral identity emanating from technological progress in the field of biomedicine. The fact is that a person in biomedicine acts both as the main goal and as an inevitable "means" of scientific study. For a medical scientist, each person exists, on the one hand, as a representative of "humanity as a whole", and on the other hand, as a specific individual who is guided by his own, and not by universal human interests.

Until the 1960s, the medical community as a whole held the view that the good of "humanity" could almost always be sacrificed for the good of the individual. National interests or the interests of humanity in obtaining scientific knowledge, as well as corporate medical interests, often prevailed over the interest in maintaining the health of an individual. The reaction to this situation was the development of a special direction in the human rights movement, which aims to uphold the rights of patients.

The fourth factor is recognition in society of value and worldview pluralism, the peculiarity of which lies in the variety of different forms of worldview and recognition of the equality of various value systems. Differences in ethical, religious and ethnic ideas and traditions can make dialogue difficult, create problems of mutual understanding between the doctor and the patient, medicine and society. In modern society, there are no universally recognized "experts" in resolving moral problems. People are guided by different systems of moral norms. Therefore, it is simply impossible to call for consultation some expert endowed with special authority.

The Quinlan Case is a unique case of clinical medicine that happened to an American student, Karen Quinlen, more than 20 years ago. Under the influence of alcohol and LSD, she lost consciousness, was taken to the hospital and connected to the "artificial lungs-heart" apparatus. After some time, doctors recorded the death of the brain, but the equipment was not turned off. A month later, when a council of reputable doctors confirmed the irreversibility of the changes that had occurred, and the “vegetative existence” continued only due to the equipment, the girl’s parents asked to turn off the device and allow death to complete its work, and they were asked to bury and mourn their daughter. However, the hospital administration refused them, citing the fact that neither relatives, nor doctors, nor the patient himself have the right to decide the issue of life and death of a person. The parents filed a lawsuit, and the first trial of its kind in the history of medicine began, which lasted more than a year. The most sensational thing was that when the equipment was turned off by the decision of the US Supreme Court, Karen's body continued to function on its own, but still in a "vegetative" state, with a zero encephalogram.

Obviously, a one-sided medical interpretation of bodily well-being as the goal of healing is not enough; a dialogue between physicians and representatives of a wide range of the public is necessary. Only through such a dialogue can a certain consensus be reached, and on this basis a modern understanding of the idea of ​​the good will be developed both as the goal of healing for an individual and as a goal of public health in general. Situations often arise that force us to rethink traditional ideas about good and evil, about the good of the patient, about the beginning and end of human existence. Bioethics provides the intellectual justification and social shaping of public discussions in which society makes its decisions about where the boundaries of human existence lie. These decisions are usually not final.

Also among the reasons are commercialization of medicine When relations in the field of medicine are increasingly built on the principles of the “free market”, in the lexicon “medical care” is increasingly replaced by “medical service”, this means not just a formal change, but also a meaningful one. A patient, turning to a doctor, purchases a service (goods) and can get whatever he wants for his money. A prime example is plastic surgery or dentistry. The doctor sells his services and sets a price for his work, and the patient becomes a source of income for him, it is logical to conclude that the more patients and the longer they are sick, the more profitable it is for the doctor, this is the essence of the conflict of ends and means in private medical and pharmaceutical activities. The economic aspect also contributed to the awareness of patients of their rights and the development of skills to protect them in court and the rejection of the paternalistic model of doctor-patient relations.

Also, as a prerequisite, it is necessary to mention the medicalization of modern life - this is a process during which the influence of medicine spreads to all new areas of public life. Medicalization is characterized by the penetration into the mass consciousness of the medical language and style of thinking, medical concepts and ideas about the causes, forms of the course and treatment of diseases, an increase in dependence on medicine in everyday life and people's activities.

And the development of the mass media and means of communication, in particular, television in the second half of the 20th century, played its role.

The specifics of bioethics.

· Medical ethics has traditionally considered ethical problems arising in the course of professional medical activity in the system of relations "doctor-patient" and "doctor-colleagues". Bioethics expands these frameworks, including questions about the beginning and end of human life (criteria for death, the status of an embryo), about the essence of a person (clinical and biological death, a vegetative state), and the moral assessment of the actions of doctors and patients in specific situations depends on the answers to these questions. situations.

· In addition, bioethics solves its problems, unlike medical ethics, not on a highly specialized, corporate, but on a broader scientific and social basis. Bioethics is distinguished by the awareness of the need for an interdisciplinary approach in understanding and practical solution of problems generated by scientific and technological progress in medicine. Bioethics is a new interdisciplinary scientific direction that combines biomedical knowledge and universal moral values. The interdisciplinarity of bioethics is manifested in the constant expansion of its problematic field due to the inclusion of moral, philosophical, legal components; doctors, lawyers, philosophers, religious figures, psychologists, and politicians are involved in discussions.

Functionally, the difference lies in the fact that bioethics highlights the protection of human life and health, and medical ethics establishes the principles and norms of relations in medicine between interacting subjects - a doctor and a patient. At the same time, bioethics considers the patient as an active equal participant in relationships, and in traditional medical ethics it has always been only about the doctor as an active subject, while the patient was a passive ward element.

Modern bioethics includes a number of closely related forms of activity.

Firstly, it is a multidisciplinary field of scientific research on the conditions and consequences of scientific and technological progress in biomedicine.

Secondly, it is the sphere of academic and educational activities. Various bioethics courses are taught in kindergartens, schools and lyceums, universities (at medical, biological, philosophical, theological and other faculties). Since 2000, bioethics has been introduced as a subject of compulsory teaching in medical universities in Russia.

Thirdly, it is a rapidly developing social institution. It includes a complex system of international (at the level of the UN, UNESCO, WHO, Council of Europe, etc.), national (in the system of state and professional organizations), regional and local (in the structures of research and practical organizations) ethical committees. Bioethics in a certain aspect is part of the human rights movement in the field of health.

The main issues in bioethics include the following:

• protecting the rights of patients (including those infected with HIV, psychiatric patients, children and other patients with limited competence);
• health equity;
• relationships with wildlife (environmental aspects of the development of biomedical technologies);
• abortion, contraception and new reproductive technologies (artificial insemination, in vitro fertilization with subsequent implantation of the embryo in the uterus, surrogate motherhood);
• conducting experiments on humans and animals;
• development of criteria for diagnosing death;
• transplantology;
• modern genetics (gene diagnostics, gene therapy and engineering);
• stem cell manipulation;
• cloning (therapeutic and reproductive);
• care for dying patients (hospice and palliative care organizations);
• suicide and euthanasia (passive or active, voluntary or forced).

Thus, bioethics equips physicians with knowledge of both specific issues of medical ethics and the ability to systematically analyze, develops the habit of considering problems in an interdisciplinary and sociocultural context, while developing imagination, practical skills and moral responsibility for ethical decisions, as well as feelings of empathy. and compassion for people.

BIOETHICS

BIOETHICS

BIOETHICS is an area of ​​interdisciplinary research aimed at comprehending, discussing and resolving moral problems generated by the latest achievements in biomedical science and healthcare practice. At the same time, in modern society, bioethics also acts as an emerging social institution designed to regulate conflicts and tensions that arise in the relationship between the sphere of development and application of new biomedical knowledge and technologies, on the one hand, and the individual and society, s.

The term “bioethics” was first used in 1970 by the American physician Van Rensselaer Potter, who understood bioethics as a field of research designed to combine biological sciences with ethics in order to solve the long-term problem of human survival as a biological species while ensuring a decent quality of life. At the same time, two structures are emerging in the United States - the Hastings Center and the Institute of Ethics. Kennedy (The Kennedy Institute for Ethics) of Georgetown University, which was aimed at studying the problems of bioethics, which, however, was understood at the same time significantly differently than in Potter, relating not so much to biology as to biomedical sciences and healthcare practice. During the first decade of its existence, bioethics developed mainly in the United States, then gradually began to take root also in Western Europe and other regions of the world. The now rapidly developing bioethics has become a global phenomenon, as evidenced, in particular, by the creation in 1992 of the International Association of Bioethics, which organizes World Congresses on Bioethics every two years.

In a sense, bioethics can be understood as a continuation and modern of traditional medical (or medical) ethics, dating back to Hippocrates; its main difference from the latter, however, is that the traditional medical one was corporate (for example, in the famous Hippocratic oath, the obligations of a doctor in relation to his teacher and his profession are in the first place, and only then it is said about obligations in relation to patients) and proceeded from the fact that in the interaction of a doctor and a patient, only the doctor is, in fact, a morally responsible agent. Bioethics, on the contrary, is characterized by the fact that both the doctor and the patient are involved in making morally significant and vital decisions, which means that the burden of responsibility is distributed between both partners. Moreover, in many cases, a third party is also involved in the development of such decisions. So, some experts believe that the origin of bioethics was what happened in a hospital in Seattle (Washington) in the early 1970s. When the first “artificial kidney” device appeared in the hospital, it was about which of the patients it should be connected in the first place, that is, who should be saved and who will be doomed. The hospital doctors felt they were not in a position to take responsibility for these decisions and proposed that a committee of respected citizens of the respective district be set up to set the order. This one also demonstrates another important difference between bioethics and traditional medical ethics: many of the problems of bioethics arise as regards the moral dilemmas generated by the scientific and technological achievements of biomedicine. For example, historically, one of the first problems of bioethics was, in connection with the emergence of effective life-supporting technologies (devices "artificial lungs", "artificial heart", etc.), the question of how long should the patient's life be extended, in particular if it is irretrievably lost. This often gives rise to interests between doctors, on the one hand, and patients or their relatives, on the other. In some cases, patient representatives may insist on continuing life-sustaining treatment, which, according to doctors, is useless; in other cases, on the contrary, patients (their representatives) demand an end to medical manipulations, which they consider humiliating the dying. This raised the question of modifying the previously accepted criteria that should guide the determination of the moment of death. In addition to the traditional criteria - irreversible cessation of breathing or circulation (which can now be maintained artificially) - brain death began to be used.

The severity of this problem has increased with the success of transplantation: transplantation of such organs as the heart, liver, lungs, involves their removal from a donor who has a brain; at the same time, successful transplantation is the higher, the less time has passed since the moment of death. Concerns began to arise in society that the extension of the recipient's life could be ensured at the cost of accelerating (or hasty ascertaining) the death of the donor. As for these fears, it was accepted that brain death should be ascertained by a medical team independent of those involved in the harvesting and transplantation of organs. Another source of difficult moral dilemmas has been since Ser. 1970s technology of artificial human reproduction. These technologies, on the one hand, cause difficulties in establishing family relationships - up to the point that one child can have five parents, and the woman who carried him (“surrogate mother”) can be his grandmother at the same time, if the child was conceived with her daughter's egg. On the other hand, artificial insemination technologies often include manipulations with human embryos, up to the so-called embryo reduction, when part of the developing (and viable) embryos have to be killed in a test tube or even in the womb. As a result, the establishment of criteria for accurately determining the moment of the beginning of human life becomes relevant, which imposes certain moral obligations on others. The main interests of bioethics are the moral relationship between the doctor and the patient or, in the context of biomedical research conducted on humans, between the researcher and the subject. At the same time, it is recognized that the interests (and in a modern pluralistic society - and values) of the parties do not always and not always coincide in everything. Moreover, this discrepancy is not necessarily determined by the evil will of the participants in the interaction. Thus, the conflict of interest between the researcher and the subject is of an institutional nature: for the first, it is important, first of all, to obtain new scientific knowledge, while for the second, it is important to improve or maintain one's own health. At the same time, the relations of the parties are significantly asymmetrical: the doctor or researcher has special knowledge and skills that the patient (subject) usually does not have; at the same time, it is precisely the latter that bears the risk with which any (and especially experimental) medical intervention is inevitably associated.

The rapid development and unprecedented power of biomedical technologies in recent decades have led to the fact that the natural life of an individual from birth (and even from conception) to death becomes more and more mediated and controlled, i.e. organized and controlled socially and technologically. At the same time, in relation to the patient (subject), medical interventions are becoming more and more invasive, deep, and often aggressive, and their cost, as well as the total costs of the individual and society for maintaining and improving health, are steadily increasing. Under these conditions, the task of bioethics is to protect life, health, bodily and personal integrity, rights and dignity of the patient (subject). In other words, the entire field of medical practice and biomedical research is considered in bioethics as one of the areas in which the vital ones are realized (or violated) in the literal sense of the word - up to the right, which causes especially heated discussions, to independently accept death when the disease is incurable and associated with severe physical and mental suffering (see Euthanasia).

The most developed protection of the rights and dignity of the patient is informed consent, according to which any medical intervention should be carried out only on the basis of the competent, voluntary, informed and express consent of the patient (subject); the latter should be provided in a form understandable to him everything necessary about the objectives of the intervention, the risk associated with it and possible alternatives. Initially, the norm of informed consent was applied in the practice of biomedical experiment; in most countries, including Russia, this norm is institutionalized, that is, it is fixed not only ethically, but also legally for both research and therapeutic interventions. All deviations from this norm (not the patient himself, but his representatives, when the patient is incompetent; interference without consent in an emergency, etc.) are also legally fixed.

Another institutional mechanism, developed and substantiated within the framework of bioethics, is designed to protect subjects - participants in biomedical research. Its essence lies in the mandatory ethical examination of each application for biomedical research, which involves experiments on humans. Such an examination is carried out by a committee, which must guarantee it from the administration of the laboratory in which the study will be carried out, from the researchers themselves and from those who finance the research. Conducting a study without the approval of the ethical committee is not allowed; In addition to this mechanism, most of the leading biomedical journals do not accept articles about research that have not passed ethical review. Characteristically, during the examination, not only the actual ethical side of the project is assessed (for example, the proportionality of the risk to which the subjects are exposed to the expected benefits for them), but also its scientific validity, since it is considered unacceptable to expose the subjects to any risk, as long as the implementation of the project will not give a significant scientific result. It is also worth noting that the ethical review operating in the United States applies not only to biomedical research, but also to any research in general (sociological, anthropological, psychological, etc.) involving a person.

In general, bioethics currently exists and functions more as a constantly expanding and more complex field of problems that have both cognitive and technical, as well as ethical and value content, and therefore, as having no simple and unambiguous solutions, than as a scientific discipline with strict and generally accepted conceptual apparatus. There are versions of bioethics that are fundamentally different from each other in the most essential points. In this sense, bioethics is similar to a number of other modern fields of knowledge, for which a strict theoretical substantiation and design of the array of knowledge produced and used within their framework is not paramount.

Of the theoretical concepts of bioethics, the most popular (and at the same time the sharpest criticism) was the one proposed by the American philosophers T. Beechamp and J. Childress. It includes four principles and rules based on principles. Rules, in turn, serve to provide moral justification for decisions and actions in specific situations. The main principles of bioethics, according to Beechamp and Childress, are respect for the autonomy of the patient, which justifies, in particular, the concept of informed consent; the principle of “do no harm” dating back to Hippocrates, which requires minimizing the damage caused to the patient during medical intervention; the principle of "do good" (beneficence), emphasizing the doctor to take positive steps to improve the patient's condition; finally, the principle of equity, emphasizing both the fair and equal treatment of patients and the fair distribution of resources (which are always limited) in the provision of medical care.

When justifying moral choice in specific situations, the requirements arising from these principles can come into contact with each other. Thus, the principle of respect for autonomy requires that the patient be truthfully informed about the diagnosis and prognosis of the disease, even if this is extremely unfavorable. However, the communication of such information to him can entail the most difficult psychological, undermine the body's resistance to the disease, which will be a violation of the principle of "do no harm." In such cases, one has to go to the violation of one of the principles; therefore it is said that principles are effective not in an absolute sense, but only prima facie: one has to deviate from them in specific situations, realizing, however, the moral inferiority of such an act; in other words, a departure from principle leaves a moral imprint.

The subject of heated debate in bioethics is the question of which of the ethical theories is the most appropriate in the search for answers to the moral dilemmas that arise in modern biomedicine. In traditional medical ethics, the individual moral qualities of the doctor (the so-called virtues) were invariably emphasized. The ethic of principles opposes it to a certain extent.

As the globalization of bioethics begins to come under the universality of the emphasis on autonomy and the individual, which is characteristic of bioethics in Western countries, especially in the United States. It is argued that it reflects those individualisms that are inherent in the culture of these countries, and does not pay enough attention to the values ​​of living together, the principles of solidarity. Emphasizing precisely these values ​​is especially characteristic of bioethics, which is developing in the countries of the East.

Lit.: Bioethics: problems and prospects. M., 1992; Bioethics: principles, rules, problems. M., 1998; Introduction to bioethics. M 1998; Konovalova L. V. Applied (based on Western literature). Issue. 1: Bioethics and Ecoethics. M., 1998. Beauchamp T. L, Childress J. F. Principles of Biomedical Etics. N.Y., 1994; The Birth of Bioethics.-“Hastings Center Report”, Special Supplement, 1993, v. 23, no. 6; Callahan D. Bioethics as a Discipline.- “Hastings Center Studies”, v. 1, no. 1, p. 66-73; Idem. Bioethies.-The Encyclopedia of Bioethics, v. 1. N.Y., 1995, p. 247-256; Darner ClouserK. Bioethics.-The Encyclopedia of Bioethics, v. 1, 1978, p. 115-127; Encyclopedia of Bioethics, f. Revised edition, 5v. N.Y., 1995; Wstram E. H. Jr. The Foundations of Bioethics. Oxf., 1986; Potter fail. Renssclaer Bioethics: Bridge to the Future. En^lwood Cliffs-N.J., 1971; Kothman D. J. Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making. N.Y., 1991.

V. N. Ignatiev, B. G. Yudin

New Philosophical Encyclopedia: In 4 vols. M.: Thought. Edited by V. S. Stepin. 2001 .

See what "BIOETHICS" is in other dictionaries:

bioethics- BIOETHICS (from the Greek bios life and ethos habit, disposition) is the sphere of interdisciplinary research related to the understanding, discussion and resolution of various moral problems that give rise to the latest achievements of biomedical science and ... ... Encyclopedia of Epistemology and Philosophy of Science

The system of ideas about the moral limits and boundaries of human penetration into the depths of the environment; is currently constituted as a special area of ​​interdisciplinary research, the focus of which is determined depending on the type of ... The latest philosophical dictionary

Exist., number of synonyms: 1 ethics (11) ASIS synonym dictionary. V.N. Trishin. 2013 ... Synonym dictionary

bioethics- — EN bioethics The study of ethical problems arising from biological research and its applications in such fields as organ transplantation, genetic engineering, or artificial… … Technical Translator's Handbook

Bioethics- * bioethics * bioethics is a discipline that studies the philosophical, social, moral and ethical aspects of using the achievements of biology, genetics and medicine. For example, discussions about human cloning... Genetics. encyclopedic Dictionary

BIOETHICS is an area of ​​interdisciplinary research aimed at comprehending, discussing and resolving moral problems generated by the latest achievements in biomedical science and healthcare practice. At the same time, in modern society, bioethics also acts as an emerging specific social institution, designed to regulate conflicts and tensions that arise in the relationship between the sphere of development and application of new biomedical knowledge and technologies, on the one hand, and the individual and society, on the other.

The term "bioethics" was first used in 1970 by the American physician Van Rensselaer Potter, who understood bioethics as a field of research designed to combine biological sciences with ethics in order to solve the long-term problem of human survival as a biological species while ensuring a decent quality of life. At the same time, two structures are emerging in the United States - the Hastings Center and the Institute of Ethics. Kennedy (The Kennedy Institute for Ethics) of Georgetown University, whose activities were aimed at studying the problems of bioethics, which, however, was understood at the same time significantly differently than in Potter, correlating not so much with biology as with biomedical sciences and healthcare practice. During the first decade of its existence, bioethics developed mainly in the United States, then gradually began to take root also in Western Europe and other regions of the world. The now rapidly developing bioethics has become a global phenomenon, as evidenced, in particular, by the creation in 1992 of the International Association of Bioethics, which organizes World Congresses on Bioethics every two years.

In a sense, bioethics can be understood as a continuation and modern form of traditional medical (or medical) ethics, dating back to Hippocrates; its main difference from the latter, however, lies in the fact that traditional medical ethics was of a corporate nature (for example, in the famous Hippocratic oath, the obligations of a doctor in relation to his teacher and his profession are in the first place, and only then it speaks of obligations in relation to patients ) and proceeded from the fact that in the interaction between a doctor and a patient, only the doctor is, in fact, a morally responsible agent. Bioethics, on the contrary, is characterized by the attitude that both the doctor and the patient are involved in making morally significant and vital decisions, which means that the burden of responsibility is distributed between both partners. Moreover, in many cases, a third party is also involved in the development of such decisions.

Thus, some experts believe that the origin of bioethics was an event that took place in a hospital in Seattle (Washington) in the early 1970s. When the first “artificial kidney” device appeared in the hospital, the question arose of which of the patients should be connected in the first place, i.e. who should save a life, and who will be doomed. The hospital doctors felt they were not entitled to take responsibility for these decisions and proposed that a committee of respected citizens of the respective district be formed to establish the order. This example also demonstrates another important difference between bioethics and traditional medical ethics: many problems of bioethics arise as a reflection on the moral dilemmas generated by the scientific and technological achievements of biomedicine. For example, historically, one of the first problems of bioethics was, in connection with the emergence of effective life-supporting technologies (devices "artificial lungs", "artificial heart", etc.), the question of how long should the patient's life be extended, in particular if his consciousness is irretrievably lost. This situation often gives rise to a conflict of interest between doctors, on the one hand, and patients or their relatives, on the other. In some cases, patient representatives may insist on continuing life-sustaining treatment, which, according to doctors, is useless; in other cases, on the contrary, patients (their representatives) demand the cessation of medical manipulations, which they consider degrading the dignity of the dying person. This raised the question of modifying the previously accepted criteria that should guide the determination of the moment of death. In addition to the traditional criteria - irreversible cessation of breathing or circulation (which can now be maintained artificially) - the criterion of brain death began to be applied.

The severity of this problem has intensified with the success of transplantation: transplantation of organs such as the heart, liver, lungs, involves their removal from a donor who has been declared brain dead; at the same time, the probability of successful transplantation is the higher, the less time has passed since the moment of death. Concerns began to arise in society that the extension of the recipient's life could be ensured at the cost of accelerating (or hasty ascertaining) the death of the donor. As a response to these fears, the norm was adopted, according to which brain death should be ascertained by a team of doctors, independent of those involved in the harvesting and transplantation of organs.

Another source of difficult moral dilemmas has been the development since ser. 1970s technology of artificial human reproduction. These technologies, on the one hand, cause difficulties in establishing family relationships - to the point that one child can have five parents, and the woman who carried him (“surrogate mother”) can be his grandmother at the same time, if the child was conceived with her daughter's egg. On the other hand, artificial insemination technologies often include manipulations with human embryos, up to the so-called embryo reduction, when part of the developing (and viable) embryos have to be killed in a test tube or even in the womb. As a result, the problem of establishing criteria for accurately determining the moment of the beginning of human life becomes relevant, which imposes certain moral obligations on others.

The main area of ​​interest of bioethics is the moral content of the relationship between the doctor and the patient or, in the context of biomedical research conducted on humans, between the researcher and the subject. At the same time, it is recognized that the interests (and in a modern pluralistic society - and values) of the parties do not always and not always coincide in everything. Moreover, this discrepancy is not necessarily determined by the evil will of the participants in the interaction. Thus, the conflict of interests between the researcher and the subject is of an institutional nature: for the first, it is important, first of all, to obtain new scientific knowledge, while for the second, it is important to improve or maintain one's own health. At the same time, the relations of the parties are significantly asymmetrical: the doctor or researcher has special knowledge and skills that the patient (subject) usually does not have; at the same time, it is precisely the latter that bears the risk with which any (and especially experimental) medical intervention is inevitably associated.

The rapid development and unprecedented power of biomedical technologies in recent decades have led to the fact that the natural life process of an individual from birth (and even from conception) until death becomes more and more mediated and controlled, i.e. organized and managed socially and technologically. At the same time, in relation to the patient (subject), medical interventions are becoming more and more invasive, deep, and often aggressive, and their cost, as well as the total costs of the individual and society for maintaining and improving health, are steadily increasing. Under these conditions, the task of bioethics is to protect life, health, bodily and personal integrity, rights and dignity of the patient (subject). In other words, the entire field of medical practice and biomedical research is considered in bioethics as one of the areas in which vital human rights are realized (or violated) in the literal sense of the word - up to the right, which causes especially heated discussions, to independently make a decision to die when the disease is incurable and is associated with severe physical and mental suffering (see. Euthanasia ).

The most developed mechanism for protecting the rights and dignity of the patient is the concept of informed consent, according to which any medical intervention should be carried out only on the basis of the competent, voluntary, informed and explicit consent of the patient (subject); the latter should be provided with all the necessary information about the objectives of the intervention, the risk associated with it and possible alternatives, in a form that is understandable to him. Initially, the norm of informed consent was applied in the practice of biomedical experiment; At present, in most countries, including Russia, this norm is institutionalized, i.e. is anchored not only ethically but also legally for both research and therapeutic interventions. All deviations from this norm (the consent of not the patient himself, but his representatives when the patient is incompetent; intervention without consent in an emergency, etc.) are also legally fixed.

Another institutional mechanism, developed and justified within the framework of bioethics, is designed to protect subjects - participants in biomedical research. Its essence lies in the mandatory ethical review of each application for biomedical research involving experiments on humans. Such an examination is carried out by an ethical committee, the status of which should guarantee its independence from the administration of the laboratory in which the study will be carried out, from the researchers themselves and from those who finance the research project. Conducting a study without the approval of the ethical committee is not allowed; complementary to this mechanism is the policy of most leading biomedical journals not accepting articles on research that has not passed ethical review. Characteristically, during the examination, not only the actual ethical side of the project is assessed (for example, the proportionality of the risk to which the subjects are exposed to the expected benefits for them), but also its scientific validity - since it is considered unacceptable to expose the subjects to any risk, as long as the implementation of the project will not give a significant scientific result. It is also worth noting that the US ethical review system applies not only to biomedical research, but also to any research (sociological, anthropological, psychological, etc.) involving a person.

In general, bioethics currently exists and functions more as a constantly expanding and more complex field of problems that have both cognitive and technical, as well as ethical and value content, and therefore, as a rule, do not have simple and unambiguous solutions than as a scientific discipline. with a strict and generally accepted conceptual apparatus. There are many versions of bioethics, fundamentally different from each other in the most essential points. In this sense, bioethics is similar to a number of other modern fields of knowledge, for which interest in a rigorous theoretical substantiation and formalization of the array of knowledge produced and used within their framework is not paramount. Of the theoretical concepts of bioethics, the scheme proposed by the American philosophers T. Beechamp and J. Childress received the greatest popularity (and, at the same time, the sharpest criticism). It includes four principles and a number of rules based on the principles. Rules, in turn, serve to provide moral justification for decisions and actions in specific situations. The main principles of bioethics, according to Beechamp and Childress, are the principle of respect for the autonomy of the patient, which justifies, in particular, the concept of informed consent; the principle of “do no harm” dating back to Hippocrates, which requires minimizing the damage caused to the patient during medical intervention; the principle of "benefit" emphasizing the doctor's duty to take positive steps to improve the patient's condition; finally, the principle of equity, which emphasizes the need for both fair and equal treatment of patients and a fair distribution of resources (which are always limited) in the provision of medical care.

When justifying a moral choice in specific situations, the requirements arising from these principles may come into conflict with each other. Thus, the principle of respect for autonomy requires truthful informing of the patient about the diagnosis and prognosis of the disease, even if this prognosis is extremely unfavorable. However, the communication of such information to him can lead to severe psychological stress, undermine the body's resistance to the disease, which will be a violation of the "do no harm" principle. In such cases, one has to go to the violation of one of the principles; therefore it is said that principles are effective not in an absolute sense, but only prima facie: one has to deviate from them in specific situations, realizing, however, the moral inferiority of such an act; in other words, a departure from principle leaves a moral imprint.

The subject of heated debate in bioethics is the question of which of the ethical theories is the most appropriate in the search for answers to the moral dilemmas that arise in modern biomedicine. In traditional medical ethics, the importance of the individual moral qualities of a doctor (the so-called ethics of virtue) has invariably been emphasized. The ethic of principles opposes it to a certain extent.

With the globalization of bioethics, the universality of the emphasis on autonomy and self-determination of the individual, which is characteristic of bioethics in Western countries, especially in the United States, begins to be questioned. It is argued that it reflects those traditions of individualism that are inherent in the culture of these countries, and does not pay enough attention to the values ​​of living together, the principles of solidarity. Emphasizing precisely these values ​​is especially characteristic of bioethics, which is developing in the countries of the East.

Literature:

1. Bioethics: problems and prospects. M., 1992;

2. Bioethics: principles, rules, problems. M., 1998;

3. Introduction to bioethics. M., 1998;

4. Konovalova L.V. Applied Ethics (Based on Western Literature). Issue. 1: Bioethics and Ecoethics. M., 1998;

5. Beauchamp T.L., Childress J.F. Principles of Biomedical Etics. N.Y., 1994;

6. The Birth of Bioethics. – Hastings Center Report, Special Supplement, 1993, v. 23, no. 6;

7. Callahan D. Bioethics as a Discipline. – Hastings Center Studies, v. 1, no. 1, p. 66–73;

8. Idem. bioethics. – The Encyclopedia of Bioethics, v. 1. N. Y., 1995, p. 247–256;

9. Danner Closer K. bioethics. – The Encyclopedia of Bioethics, v. 1, 1978, p. 115–127;

10. Encyclopedia of Bioethics, f. Revised edition, 5v. N.Y., 1995;

11. Tristram E.H. Jr. The Foundations of Bioethics. Oxf., 1986;

12. Potter Van. Rensselaer Bioethics: Bridge to the Future. Englwood Cliffs - N.J., 1971;

13. Rothman D.J. Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making. N.Y., 1991.

B.H. Ignatiev, B.G.Yudin

Each area of ​​human professional activity has its own types of professional ethics. However, they all have certain specific features.

Ethics is a discipline that considers the moral aspects of human behavior. Its study introduces us to the whole variety of norms and relations between people. All types of professional ethics are certain rules. They consider the order and patterns of human internal regulation. Ethical ideals are taken as the basis for this. One type of this discipline concerns the medical field.

medical ethics

This teaching acquaints us with the high moral character that a person must possess in whose hands the life of his patients is in his hands. To date, all the basic rules of this discipline are contained in a document called the Code of Ethics of the Russian Doctor. It was accepted in 1994. The traditional ethics of the doctor is designed to address issues of personal qualities and relationships between the doctor and the patient.

Bioethics

Life does not stand still. At the present stage of development of society, it became necessary to create a certain form of professional medical ethics. This teaching is intended to outline the permissible boundaries within which the manipulation of human life and death is permitted. All these actions must necessarily observe the morality and health of the patient. And here bioethics comes to the defense of human life.

History of development

Bioethics is a complex phenomenon that takes place in modern culture. It originated in the United States in the 60s-70s of the last century. The term "bioethics" was proposed by the American oncologist Potter in 1970. It was he who called on doctors and biologists to join their efforts to ensure decent living conditions for people. According to Potter, bioethics is not just a science of survival. This is a new wisdom that combines the knowledge of the biological industry and existing universal values.

As for the very term "bioethics", the concept, more precisely, its content, after some time has changed significantly. In the first place came interdisciplinary moral research, and the emergence of which contributed to the latest reproductive genetic and transplant biomedical technologies.

In the seventies of the last century, the first educational and research centers were established in America, where bioethics was studied. This drew attention to the problems studied by this discipline of religious figures, journalists, and politicians. Some questions were also of interest to the general public.

The development of bioethics in the next decade allowed it to gain recognition in the countries of Western Europe. In the nineties, much attention was paid to the study of this discipline in Eastern Europe (including Russia), as well as in Asia (primarily in China and Japan).

The main task

Bioethics is a doctrine designed to reveal the difference in positions regarding the most complex moral problems that arise in connection with the development of the progress of biomedical practice and science. This course is designed to answer the following questions:

Is it possible to clone a human?
- Is it possible to create by genetic methods a special "breed" of a person with high intellectual and physical qualities?
- Is the consent of relatives necessary if it is planned to take organs from the deceased for transplantation to seriously ill people?
- Do I need to tell the patient that he is terminally ill? Etc.

The task of bioethics is to find socially acceptable and morally justified solutions to such issues. Of course, a legitimate doubt arises as to whether medical bioethics is needed at all? There is the Hippocratic Oath. She has been giving moral lessons to doctors for many centuries. Many leading physicists also play an active role in preserving life on our planet. They organize a movement calling for a ban on nuclear weapons testing. Moral lessons are taught to mankind by biologists, fighting for the protection of our environment.
However, Hippocratic ethics and bioethics have certain differences. The first of these two teachings is purely corporate in nature. For many centuries, it has considered the doctor as a moral subject, called upon to fulfill his duty to the patient. The patient is considered to be a suffering individual. He is passive and does not participate in making an important decision for his life. The subject of bioethics is the patient as an active moral subject. At the same time, he is able to enter into dialogic or even competitive relations with scientists and doctors.

Peculiarities

The new discipline does not abolish traditional values, including mercy and charity, the moral responsibility of doctors and the principle of not harming the patient. Only in today's cultural and social situation do all these moments acquire a new sound and meaning.

The subject of bioethics is the originality and uniqueness of the personality of each individual. This discipline recognizes the right of every person to independently make the most important decisions that concern his life.

It is worth noting that biologists or doctors as experts have knowledge about the method of human cloning. However, they cannot allow such actions. This is beyond their professional competence. That is why one of the features of bioethics is its development with the participation of specialists from various disciplines. This list includes biologists and psychologists, doctors and philosophers, politicians and lawyers, etc. And it is not surprising, because the problems that arise in connection with the development of medicine and biology are so diverse and complex that their solution is possible only with the joint efforts of people with certain knowledge and experience.

Bioethics has another important feature: it has long been proven by history that imposing one system of national, ideological and other values ​​on society is a very dangerous act. That is why bioethics does not just study the moral problems that arise during the development of society. With its participation, various institutions characteristic of pluralistic societies are being created. An example of this is the ethical committees working at hospitals, research centers.

What is the focus of bioethics?

Morality and health - this is the basis that serves to develop appropriate recommendations by the modern science of moral relations. She addresses the following key issues:

Euthanasia;
- suicide;
- transplantology;
- determination of the fact of death;
- conducting experiments on humans and animals;
- relationship between doctor and patient;
- organization of hospices;
- attitude towards people who are mentally handicapped;
- childbearing (surrogate motherhood, genetic engineering, etc.).

Bioethical issues concern the ethical side of such actions as sterilization and contraception, as well as artificial termination of pregnancy. All of them are modern forms of medical intervention in the reproductive function.

Consider, for example, abortion. Does it violate the basic principle of the Hippocratic Oath, which says: "Do no harm"? Can it be done ethically? If so, always or only in certain cases? The answers to these questions depend on the moral principles and professional training of the doctor.

Problems of bioethics also concern artificial insemination. On the one hand, the latest reproductive technologies affect the nature of marriage itself, which is the most important human value. On the other hand, for some spouses this is the only opportunity to have a child. Bioethics in this case calls to adhere to the line when artificial insemination helps a desperate woman, without turning this manipulation into a kind of a certain experiment.

A controversial issue considered by bioethics is surrogate motherhood. With this method, a fertilized egg from biological parents is introduced into the uterus of a completely different woman. This is necessary for bearing a child. After giving birth, she gives the baby to the biological parents. On the one hand, these are manipulations performed on the bodily nature of the child, on the other hand, the only chance for some couples to create a full-fledged family.

Fierce debate continues around such a problem as human cloning, possible using the latest developments in genetic engineering. Biologists and doctors, politicians and philosophers take part in the discussion of the moral side of this issue. The clergy do not bypass this problem either. At present, there are two completely opposite points of view. One of them proceeds from the fact that cloning is quite ethical and safe for humans and society. Proponents of this view believe that cloning is the path to immortality and the elimination of disease. But there is also an opposite opinion. Its supporters believe that such manipulation is immoral. In addition, it carries a potential danger, since science cannot yet predict all the possible consequences of this experiment.

Very complex legal and ethical problems are generated by transplantology. Today, heart and liver, lung and bone marrow, etc. are being transplanted. Problems in this area relate to the obligations and rights of the donor, as well as his relatives, medical workers, ascertaining the fact of irreversible death.

One of the most hotly debated ethical issues today concerns euthanasia. This is a deliberate acceleration of the death of a patient considered incurable. Euthanasia is designed to end the patient's suffering. This action is contrary to the views of all religious denominations, as well as the Hippocratic Oath. But at the same time, this issue is not considered definitively resolved.

Basic principles of discipline

There are basic concepts in bioethics. Science relies on them in solving urgent problems of our time. Basic principles of bioethics:

Respect for human dignity;
- non-infliction of evil and creation of good;
- autonomy of the individual;
- observance of justice.

Science adheres to four rules. These are confidentiality and truthfulness, informed voluntary consent and privacy. The principles of bioethics in conjunction with the rules form a kind of ethical coordinates that characterize the attitude towards the patient as a person.

Development of bioethics in Russia

The prerequisites for the development of the discipline under consideration appeared in our country in the early nineties. However, this does not mean that bioethics in Russia emerged only at the end of the last century. On the contrary, most biomedical technologies were first created in our country. An example of this is an apparatus that allows artificial circulation of blood. It was created by S.S. Bryukhonenko back in 1926. In the same year, the world's first Institute of Blood Transfusion was opened. In addition, in 1931 Yu.Yu. Ravens underwent kidney allotransplantation in clinical conditions. 1937 was also noteworthy. Then the world's first operation to implant an artificial heart muscle was performed. This experiment was supervised by V.P. Demikhov, and he had Christian Bernard as an intern.

It was in Russia for the first time in the world in 1920 that all restrictions on legislative acts on artificial termination of pregnancy were lifted. In the twenties of the last century, Russian scientists of the school of A.S. Serebrovsky, a number of fundamental studies were carried out, as a result of which it was possible to prove the complex structure of the gene.

A wide range of work in various areas of medical technology in the USSR was carried out constantly and very successfully. However, the ethics of scientific research in Russia during the years of Soviet power simply could not be formed. One of the reasons for this was the ideology of the state. Science in the USSR was considered not only the productive force of society, but also the highest human-forming value of culture.

However, despite this, bioethics in Russia gradually began to gain its positions. So, IT Frolov raised the question of the value of scientific achievements from the point of view of human welfare. In 1995, M.K. Perov's manuscripts were published for the first time. Back in the 1960s, this Russian methodologist formulated the idea that science is blind to everything human.

A new stage in the development of bioethics

At the end of the last century, Russia took the path of democratization of society. This became the main prerequisite for the intensive development of bioethics. The concept of this discipline was constantly fixed not only at the research, but also at the publishing, theoretical and educational levels.

In the organizational system of scientific institutes in Russia, there are currently special structural units. These include the sector of bioethics, which operates at the Institute of Man of the Russian Academy of Sciences, the laboratory of the Institute of Philosophy of the Russian Academy of Sciences "Axiology of Knowledge and Ethics of Science" and many others.

In 2000, the state educational standard was adopted in Russia. According to this document, the discipline "Bioethics" has become mandatory in the training of specialists in medical universities of the country. This approach was approved by the Educational and Methodological Conference in 1995, which considered issues in higher pharmaceutical and medical educational institutions of the Russian Federation. Introduction to Bioethics was recommended as a separate course for undergraduate students.

In 1995, a special program saw the light. It was created at the Institute for Retraining and Advanced Training of Teachers of Social Sciences and Humanities at Moscow State University. Lomonosov. This program was intended for teaching staff teaching students in the specialty "Biomedical Ethics".

Currently, you can get acquainted with the problems of modern ethical issues in medicine in the special literature. Very popular in this area are the magazines "Chelovek" (editor-in-chief - B.G. Yudin), as well as "Medical Law and Ethics" (editor-in-chief - Mylnikov I.S.). For students of medical universities, literature is also published that deals with bioethics. Yudin and Tishchenko, Ignatiev, Ivanyushkin, Siluyanova, Korotkikh are the authors of some works on this topic.

Philosophical aspects

Currently, the discipline that studies the moral side of the relationship between modern medicine and man covers numerous problems. Thanks to bioethics, the understanding of the individual in his ethical and natural-biological aspects is deepened and radically expanded. The questions considered by this doctrine are on the verge of two sciences. and biology. The key point of this science is the moments of the search for the true essence of man.

Recently, the process of formation of the bioethical worldview of society has been more and more active. There are two reasons for this - global and local. The first of them is connected with the probability of dangerous consequences of scientific and technological progress in medicine and biology, which are accompanied by the constant emergence of new problematic situations of a moral and ethical nature. This situation affects the interests of the entire human society to a certain extent. The dynamics of this process is constantly increasing. This is happening in connection with the growing democratization of social relations. At the same time, one of the fundamental human rights is considered to be the right to life, health, death and to receive information.

The second reason for the development of bioethics, local, is determined by the specific nature of the development of this science. Here, the humanization of the life of the whole society and the individual, a process that causes the transformation of medical and traditional ethics, the technologization of medicine, etc., exerts its influence. All these factors influence the development of bioethics both positively and negatively.

Today in our country there is no unequivocal attitude to the actualization of this discipline. However, even those who are aware of the humanistic significance of bioethical problems recognize the process of formation of the corresponding worldview that has begun. Sometimes this is perceived as a way of life imposed on us by the West. At the same time, it is believed that this process is capable of undermining the traditions and foundations of our society.

There is a completely opposite opinion. Some believe that bioethics simply will not take root in Russia, and a worldview corresponding to this doctrine is unlikely to form. Everything is explained by the fact that in our country there are different cultural, religious and social traditions, a different mentality and psychology.

However, the process of forming a bioethical worldview is underway. It requires a philosophical understanding of some traditional problems. Among them are the definition of the essence of a person, his life and death, treatment and recovery, illness and health, etc.

Biomedicine is currently developing at an incredibly rapid pace. Its controversial success in many ways makes some people want to somehow streamline the achievements of medicine and biology, arranging them according to the degree of risk. This will allow society to be as prepared as possible for all possible consequences for it.

What is bioethics?

At the end of the XX century. a new, original direction in ethics has arisen, related to medicine, but having a much broader ideological significance (influencing ideas about life and death) and changing the relationship between doctor and patient - bioethics.

This direction required the creation of new ethical principles, since it was associated with major discoveries in biology, leading to a revolution in the entire system of values, to a revolution in morality and culture. The revolution in biology has brought with it problems that humanity has never faced before. This revolution also touches upon the most fundamental issues of human existence, which occupied an important place in traditional culture and represented the greatest mystery, including: the issue of a moral attitude to the birth of a new life, the concept of erotic love and childbearing, the problem of attitude to death and understanding of life itself, etc.

Bioethics is a field that considers moral issues in the newest areas of medicine related to decision-making regarding health and the continuation of life. Every stage of human life - conception, childbirth, birth and death - today is subject to change at the will of the patient, his relatives and doctors. Humanity is now ready to bring the living forces of nature under its control. This technological progress goes beyond traditional moral values. Therefore, such a direction as bioethics arose, the task of which is to determine the boundaries of the use of new tools of life and death.

The main directions of research of the biological nature of man:

Behavior modification with "shock therapy"

Genetic Engineering,

Surrogacy,

Cloning,

ethics of abortion

organ transplant,

Sale of children

sex change,

Artificial life extension, euthanasia.

When did bioethics originate?

In 1965, the "Institute for the Study of Social Ethics and Life Sciences in Hastington (Hastington Center) was opened in the USA, where active research related to the problems of life and death began. Since these studies have touched on many ethical issues that need special considered, this moment can be considered the moment of the emergence of bioethics.

What is behavior modification?

One of the first areas that identified a new problem - behavior modification ("Behavior Modification"), known in the United States as "brainwashing" (and in our country as "zombie"). The first experiments were carried out in the USA - electrodes were sewn into the subject's brain and an electric current was passed at the right time in order to influence the change in the subject's behavior in the right direction. Thus, along with other values, the moral autonomy of the individual disappears, the very concept of the individual as an autonomous subject, as a free individual, changes. These programs can be effective in the treatment of mental disorders, help the weak-minded in the implementation of seemingly rational actions that do not involve independent thinking.

In our time, the most widely used method of changing behavior with the help of "shock therapy" carried out by the media, including advertising. "Shock therapy" today has a powerful psychological effect that causes stress, doubts about generally recognized cultural values, and frustration.