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Ukrainian-American Birth Defects Program
Abstracts of the Reports of the UABDP Participants
of the 2-nd National Bioethics Congress
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Bioethics as a word was first used less than 60 years ago. Ethics is far older and dates formally from the Greek philosophers. But ethics in some form had to come into being with the evolution of man into a thoughtful human being living in families and larger human communities. Rules to live by, limits to acceptable behavior, are necessary for any community to exist. An example of such a collection of rules are the Ten Commandments. These like all early sets of rules had certain presuppositions. Usually the existence of God or gods as powers which were in some way above the rules and yet demanded that the rules be kept by man. Thou shalt not kill is God's command to the Israelites and historically soon after giving the rule, God literally leads the Jews in conquering Palestine and slaughtering the legitimate occupiers of the land.
Presuppositions to ethical systems continue to exist in the minds and hearts of all who accept religious belief as part of their reality and I believe that these presuppositions are important in ethical decision making. However, ethical theories arising during the Enlightenment attempted to derive ethics and ethical behavior from reasoning alone. Thus Ethics became a philosophic discipline rather than a form of moral theology.
Bioethics arose in the United States with the recognition of ethical lapses in major research passed through peer review and published in prestigious journals. The Nuremberg Laws were not being applied by the medical profession. An answer to the question of how to pre-approve research and protect the patient-volunteer was drawn up in the Belmont Report and subsequently by other instruments, most importantly by the Helsinki Accords.
The Belmont Report proposed a method of judging research and patient care based on principles. These principles are not an ethical theory but were a way of proceeding which individuals who embrace specific theories of ethics and/or have suppositions can meet and discuss individual protocols and patient care plans based on the principles of Respect for Autonomy, Nonmaleficence, Beneficence, and Justice. These principles allow ethics committees of various types made up of representatives from a very pluralistic society to function well and reach acceptable decisions for proposed cases, protocols, and even policies.
Institutions and governing bodies must be able to come to ethical solutions to a growing number of problems as molecular biology goes from the laboratory to the bedside and clinical trials.
What is ethical and acceptable in a pluralistic society may not be morally acceptable to a person committed to a faith perspective. Moral decision making for the individual is not the same as what may be allowed in a liberal society. Advances in reproductive biology especially bring about personal decisions which are difficult and the effects of such decisions can deeply affect the lives of individuals long after the decided upon action is taken.
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17/November/2004 sl