Bioethics
Bioethics is a part of ethics that has emerged as a "field" or "discipline" news, in the course of the 1960s and questions about the development of biomedicine and technoscience , History and development of bioethics The 1960s saw the emergence in industrialized countries a number of claims based on individual rights and the autonomy of the person, leading to significant social changes (decriminalization of suicide , the abortion , the homosexuality , liberation sexual , the legalization of divorce , the birth , etc.).. Some thinkers (including theologians Joseph Fletcher (in) and Paul Ramsey ) have criticized the paternalism of physicians Areas of Bioethics Bioethics has become a hot topic, following manipulation genetic conducted on food plants at cloning and the use of embryonic humans. Historically, it appeared when the power supplied by the medicine has become more important (fertility control by women using the contraceptive pill, onset of critical care services with the possibility, hitherto unknown, of 'aggressive treatment and there was unprecedented difficulty in making the decision to stop treatment became futile). Similarly, the changing attitude towards science was that she no longer enjoyed an aura consistently positive (atomic bomb experiments by Nazi doctors). Finally, Harry Beecher, an article which is a milestone in the history of bioethics, had criticized medical experiments morally unacceptable. Among issues of concern to ethicists for their new challenges in this area, non-exhaustive, include: If the transgenesis is the problem of bioethics, the most common reactions against the genetic engineering are largely a function of the ultimate goal, more than the agency, at least when that body is not of human origin. In 1975 , the Asilomar Conference had declared a moratorium on such research, time for reflection, which was subsequently lifted. Thus, genetic engineering with medicine and pharmaceuticals (production of vaccines , gene therapy , prenatal diagnosis ) is it better seen as manipulations with food or recreational purposes (GMOs, cloning of pets), which raises far more problems. Human manipulation (genetic profile, reproductive cloning , improvement) are increasingly debated in the scientific community. The issue of patenting of life is whether a gene sequence is patentable and whether the applications of his discovery, drugs , tests, etc.., are too. It is a key issue for companies that have invested considerable sums of money in decoding the genome human, but also for any advances in knowledge brought about by the discovery of these genes. In addition, the issue of patents of drugs poses the problem of access to care for the poorest. Inappropriate legislation could lead to biopiracy. According to a statement of the UNESCO on 11 November 1997, the human genome is the heritage of humanity and can not be marketed. The decoding of the genome can be patented, but from this decoding, the therapeutic applications can be. In addition to problems relating to the patenting of genes, many other cases have been raised before the judges ( Moore v. Regents of The University of California (in) in 1990, the California Supreme Court has admitted the possibility for doctors to patent a cell line , similar to the HeLa cell line , created from cells of a patient without his consent. In France the National Consultative Ethics Committee (CCNE) has examined this issue in its Opinion No. 98 (2006) on the "commercialization of stem cells and other human cell lines " . The concept of nature has been used by some, sometimes arbitrarily, as a criterion of good. Today, man has acquired the power to create new technical in nature and in humans. It must however qualify this position since the selection by man of genetic traits that suited him on the plants and animals date back several thousand years (grafted plants, animal breeds creation ...). This direct power of individuals on the genome , to satisfy their interests, makes us take a fresh look at the evolution of life as we know it ( Theory of evolution ). The issue of benefits and risks involved arises. Many people fear an appropriation of nature by man and call the (re) definition of moral norms present. The vision remains the most traditionalist rather anthropocentric and establishes the requirement of minimizing the human impact on the environment, so as to keep intact and fit for human life (life of future generations). This vision is widely followed in France. A different approach seeks to place the man in the biosphere. It is based on the concept of deep ecology , and argues that man has no greater rights than other living species and must respect nature, it was at his expense. It should be noted however, that the activities of living contribute to modify its environment, as did, for example, the first plants that colonized the planet, changing the composition of the atmosphere by their release of oxygen and of carbon dioxide. The current utilitarian Anglo-Saxon, mostly developed by the English Jeremy Bentham and John Stuart Mill , who are redefining the subject of bioethics is the definition actualist people. For them, only those persons who have certain characteristics, especially self-awareness, communication skills, owning interests, projects, a rationality ... Humans who does not would update these conditions are not considered persons, for example, embryos, newborns, the demented, the comatose etc. Conversely, there are people who are not human beings, as some higher animals (great apes ...), which some attribute precisely the characteristics of person not yet use this term. In philosophy of mind, HG Frankfurt defines precisely what constitutes a person . Following this position, a type of entity can be considered a person if it has volitions of the second degree. In other words, if the entity wishes to desire to do X and if his desire to "want to do X" as his will, then it is a person. The issue of bioethics is no longer either obligations or duties, or values in itself, but the satisfaction of the interests of different people, human or animal. It is the "ethical interests." All interests are equal and should be considered on an equal basis, they are not considered in themselves. The guiding principle of this ethic is thus the principle of distributive justice: it must meet the highest possible interest the greatest number of people, whoever they are. The two main interests are the pursuit of happiness and avoid suffering, the morality of an action is a reality that can be demonstrated and measured, from the basic motivations of sentient beings. For this purpose, bioethics Utilitarian introduced the concept of balance ethics. Thus, life can be saved at the expense of another if the quality of life saved is larger than life sacrificed. For example, a pig (a species biologically very close to man and of similar size, thus potentially useful for organ transplants) is generally considered to have a less rich, less fulfilled, and therefore of lower quality than that of a human. The sacrifice of pigs to save humans would be morally defensible. However, utilitarians also indicate that some human lives can be so degraded (those "vegetables" irreversible coma deep, people whose suffering is extreme and incurable) that their quality is inferior to the quality of life of some animals. Thus, to be consistent, should not only allow the use of xenografts, but also not a priori reject the use of certain human organs bedridden. The utilitarian approach is that a rational approach is to weigh the positive and negative action in relation to its overall impact. In other words, an action is morally acceptable from the point where it is considered more useful than harmful, not only from the point of view of the person who acts but from the perspective of the common good of all people that this action affects. All ethical questions then lies in assessing the balance of action, and many debates and controversies arise from the difficulty of this evaluation. However, this current is the subject of much criticism, especially because it opens the door to many abuses. Thus, some assessments Law and Bioethics The Nuremberg Code (1947) is a code of ethics consists of ten rules on human experimentation. The first of these rules is the consent of individuals; experimentation should be necessary, we must evaluate the proportionality between the risks for the patient and the benefit to science, the purpose of testing must be scientific. It is for this reason that the Nazi doctors were convicted, the court holding that under the dignity of the human person , the principle of non- retroactivity of the law did not apply. The meeting of the World Medical Association in Helsinki in 1964 , then the international conference in Manila in 1981, drawing on the work of Nuremberg, have issued statements on international experimentation. Following Nuremberg and Manila, the country will gradually regulate the experiments. In France , it was not until the Act of December 20, 1988 to be regulated as human experimentation, which is limited to that performed on willing. The Act establishes the general principle of non-compensation experiments. Subsequently, the law of 29 July 1994 on the human body, the donation and use of components and products of the human body, has laid the foundations of the current law on bioethics, in particular the principle of unavailability of the body human , which bans such as the sale of organs , allowing the donation. With the Act of 6 August 2004 amending the 1994, the term "bioethics" will appear for the first time in positive law French. They deal with two major themes: the question of cloning of embryo and organ harvesting. One can not address the philosophical question of respect for the living without invoking the Kantian categorical imperative: "Act in such a way that you treat humanity, whether in your person than any other, always at the same time as the end , never merely as means ". This maxim would be for some, the very foundation of bioethics: the principle of respect for human dignity as "the principle matrix" of bioethics. Kant develops the principle of dignity as "absolute inner value " which expresses a requirement for non-instrumentalization of human beings (in terms of biomedical experimentation or transplantation of organs for example). One can nevertheless question the relevance of the application of this quasi-systematic reference to all questions relating to bioethics. On the one hand the principle of human dignity conceals the philosophical question on other living beings. Moreover, this principle erected in absolute risk of conflict with other principles such as freedom for example. Living beings are, in common parlance, both humans, animals and plants. The excesses of the "industrial society" led in the second half of the twentieth century to a realization of the benefits of a less anthropocentric world, taking into account the entire living world. "The environmental charter " inserted since 2005 in the preamble to the French Constitution, and the "Universal Declaration on Bioethics and Human Rights " adopted the same year by UNESCO, are Relevant examples of this "refocusing" of bioethics and texts in which it is expressed. In terms of value conflicts that can lead to unilateral promotion of the principle of human dignity, one can cite, for example, the current debate on euthanasia between those who claim its legalization in the name of right to die dignity and those who argue against this practice in the name of this same principle interpreted differently. On the one hand, the dignity of the human person is understood as the duty to respect the human right to choose death and not to "lose" her dignity in illness, on the other, that dignity is a value absolute on which the individual man has no power because it belongs to all humanity and respect for this dignity is understood as accompanying the patient to his death without any form of assistance which directly deprivation of life. If the reference to Kant's philosophy is used to support thinking on bioethics, we can nevertheless point out that with the biotechnology revolution, philosophy, traditional morality is no longer sufficient to meet all new ethical questions. Since the Enlightenment, the philosophical reflection had instead focused on the human as a citizen, individual freedom, rational and reasonable. This thinking was reflected in practice through the promotion of human rights during the French Revolution. Now the challenge posed by the current progress of science and technology in contemporary philosophy is to reflect the values of humanity and its relationship to the body, or even life in general (animals, environment). For some, the bioethical debate would create a new generation of Human Rights (after the civil rights and political, economic and social class) or even be at odds with the traditional conception of Human Rights. "Human Rights and revisited not only do they lose their essence, in fact liberal policy to establish moral values and compelling science? . The debate between the primacy of human dignity versus liberty is again highlighted within the text of bioethics. Indeed, most of these conventions refer to a new value system. Promoting the principle of "human dignity" differs considerably from that of freedom and independence proclaimed by the philosophy of Human Rights. The moral choice, legal or policy of giving primacy to the dignity at the expense of freedom in some contexts (as in end of life or assisted reproduction, for example) is indicative of a renewed conception of society. This change in reference values follows the awareness of the disproportionate power that modern science offers to the man on his own destiny. Finally, the contemporary philosophical reflections on the biotechnology revolution are mainly between two extremes: the "technophobia", represented by Hans Jonas and heuristics of fear and "techie" represented by Engelhardt. But most philosophers propose a middle ground between these two extremes is not to reject the scientific progress by indulging in doom ambient while regulating the practice and setting values for society. The primacy of human dignity in some cases would then not be contrary to freedom but would set limits to ensure the necessary social cohesion and survival of the human species. Kant, The Metaphysics of Morals, Paris, Flammarion, 1994 Nolle Lenoir and Mathieu Bertrand, International standards of bioethics, Paris, PUF, 2004 Kant, ibid. charter promulgated on 1 March 2005 (link on the website of the Ministry of Ecology) Universal Declaration on Bioethics and Human Rights, UNESCO, 2005 C. Byk, "Scientific Progress and Human Rights: a break? " including the ECHR and the Universal Declaration on Bioethics and Human Rights adopted by UNESCO in October 2005 H. Jonas, Le principe responsabilit, Paris, Flammarion, 1999 HT Engelhardt, The Foundations of Bioethics, Oxford University Press, 1996 Gilbert Hottois , Technoscience: between technophobia and technophiles, where the author stresses the importance of the first approach among contemporary philosophers Bioethics, born of ethical questions raised by the use of "new" medical technologies and issues of power they put forward is, in this light, a relatively new area of thinking that lies at the intersection of three disciplines old and entrenched in society that are the moral ( philosophical or religious ), the science and policy. Nevertheless, if politics, morality and science among others gather to talk in the institutions of national and international bioethics, their major differences of view are often a hindrance to decision making. The world of bioethics is essentially a discursive world, debates, so that politics and science are more at the level of action. But this emphasis on dialogue is not it also reveals a new mode of government that seeks to engage, engage, rather than monitor and punish? Moreover, unlike morality regarded as rather static and dogmatic, the ethic is more dynamic, reflexive and flexible and thus better fits the demands of politics and science. Indeed, the progress of science requires a responsive, flexible thinking and even proactive. Is it not the role of politics also react quickly and anticipate changes in society to avoid the crisis and maintain social cohesion ? It is no accident that in recent years, the neologism "biopolitics" and "biopower" invented by Michel Foucault to describe this new form of power that focuses on intimate subjects in their bodies , were formed on same basis as that of "bioethics". So what is "organic" is at the heart of our modern society? This is captured by the living science with revolutions in human reproduction , the end of life , of genetics , etc? Is this the humanities and social sciences who seek to understand life ? Is it the policy that have a grip on the body? Current developments in bioethics and the ever more important that this reflection takes in the worlds of politics, media and society shows that the stakes are high and that questions of bioethics seeks to answer are essential for the future of our societies. These responses made by public actors are founders of social choice in the sense that they relate to the values that society gives to work and aims at the creation of social norms. "Since the policy research and public health are becoming a key issue for the social bond , we are inevitably led to questions about the ability of our political institutions to enable us to maintain control and to draw up prospects for their development. " We are witnessing a proliferation of instances of bioethics. In France , the National Ethics Advisory Committee was established in 1983. Its mission is to give opinions on ethical problems posed by advances in science and technology Cu (3). For the first time, a multidisciplinary body was entrusted with the role to lead a public debate on the issues raised by developments in science and technology. But this body, as its name implies, is only advisory, and leaves it to the competent authorities to set the rules. Is this difficulty to combine together ethics and law that led, after 25 years of operation, a reflection, or political will to change the organization of the committee? It is true now exists in the normative landscape of bioethics a Biomedicine Agency whose duties also extend to normative ethical reflection. At the international level, the Steering Committee on Bioethics (CDBI) of the Council of Europe or international committees and the Intergovernmental Bioethics of UNESCO have a major activity and influence on the great themes of bioethics. Meanwhile, the "bio-law" develops and legislative activity is dynamic with the adoption in France since 1994 of bioethics laws (revised for the first time in 2004, a second revision to be implemented from 2009). Finally, the expressed will of the President of the Republic suggests that the principles and values from the bioethical considerations may soon be included in the preamble of the Constitution of the Fifth Republic , proof that bioethics, already present in the Charter of Fundamental Rights of the European Union , is a political issue. D Memmi and D. Fassin (eds), Government bodies, ed EHESS, 2004 Article Christian Byk, "Bioethics" in Dictionnaire Permanent Bioethics and Biotechnology, Ed legislative Montroge, updated 2005 see website CCNE whose missions have been revised in the Act of August 6, 2004 According Trudo Lemmens, a bioethicist at the Joint Centre for Bioethics at the University of Toronto, a conflict of interest occurs when the professional judgments regarding a primary interest, such as research or patient care may be unduly influenced by an interest secondary, such as financial gain or personal prestige. Strategies to cope with these situations include the disclosure of the conflict, establishing a system of review and authorization, and prohibition of activities that lead to conflict. This issue of conflict of interest points that bioethics is foremost a branch of ethics. Two recent cases reflect the fact that this is not necessarily so, at least in the minds of political leaders: In the famous case of Hwang Woo-suk , an official Korean Bioethics was co-author of one of the items whose data had been falsified. She told the journal Nature that it had not contributed to experimental work and that its role was merely to give notice of bioethics. While accepting the idea that she could not suspect fraud, it is clear that the notion of conflict of interest as an ethical problem had eluded him. Mention may also Axel Kahn (who was a member of the National Ethics Advisory Committee ) as Chairman of the Commission of Biomolecular Engineering , he had issued an opinion favorable to the cultivation of genetically modified organisms in France (and the cons Notice of thirteen of the environment ministers of the European Community ). Having received in 1997 that the authorization to import GMOs but not to cultivate, he left the Commission. A few months later, however, he was employed by Rhone-Poulenc , even though the company was interested in his opinion in favor of GMOs, since she was involved in creating GM for ten years (it was subsequently condemned the United States to withdraw from sale its transgenic corn herbicide pollution ). Biotechnology applied to humans
Human Reproduction
Genetic engineering
Patenting Life
spoke on the human body
Experimentation
Interventions beings and nonhuman environments
Bioethics & Nature
Criticism of anthropocentrism by bioethics Utilitarian
Article 40 of the Act provided for a revision in 2009. She has been postponed until 2010, and must rely on a report , which contains 95 proposals (including maintaining the ban on surrogacy, embryo research, unless waived (limited to 5 years as c is already the case). The report also proposes to maintain the ban on embryo transfer post-mortem, except for women involved in a parental project initiated and interrupted by the death of a spouse. A notion of cross donation (exchange anonymous matching organ from 2 families) is proposed. The conditions of aid to procreation could be eased (it was 2 years of cohabitation for people linked by a PACS and it was to be a man and a woman), with priority to those with medical problems. The trisomy could be systematically sought in the preimplantation diagnosis as requested by the CCNE October 2009 . The report includes a review of the implementation of three laws of July 29, 1994 and Act of 6 August 2004 , defines the ethical and legal issues raised by scientific developments, to inform discussions preparatory to the new bioethics law (2011). The key issues listed by the report in the hearings are medically assisted procreation, prenatal diagnosis, human rights, genetic features, the donation and use of components and products or by-products of the human body, research on embryos, Stem cells, therapeutic cloning and emerging issues raised by neuroscience and nanobiotechnology. European Law
Morality in Science
The philosophical question of respect for the living
The moral and political stake
Conflict of Interest
References
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