Bioethics
Seminar 1
Bioethics
1. Understanding
bioethics: the etymology of the terminology “bioethics”
The term Bioethics (Greek bios: life; ethos:
behavior) was coined in 1926 by Fritz Jahr in an article about a
"bioethical imperative" regarding the use of animals and plants in
scientific research.
In 1970, the American biochemist Van Rensselaer
Potter used the term to describe the relationship between the biosphere and a
growing human population. Potter's work laid the foundation for global ethics,
a discipline centered around the link between biology, ecology, medicine, and
human values. Sargent Shriver, the spouse of Eunice Kennedy Shriver, claimed
that he had invented the word "bioethics" in the living room of his
home in Bethesda, Maryland in 1970. He stated that he thought of the word after
returning from a discussion earlier that evening at Georgetown University,
where he discussed with others a possible Kennedy family sponsorship of an
institute focused around the "application of moral philosophy to concrete
medical dilemmas."
Bioethics
is the study of the ethical issues emerging from advances in biology and
medicine. It is also moral discernment as it relates to medical policy and
practice. Bioethics are concerned with the ethical questions that arise in the
relationships among life sciences, biotechnology, medicine and medical ethics,
politics, law, theology and philosophy. It includes the study of values
relating to primary care and other branches of medicine ("the ethics of
the ordinary"). Ethics also relates to many other sciences outside the
realm of biological sciences.
Philosophers
today usually divide ethical theories into three general subject areas: metaethics, normative ethics, and applied
ethics.
Ethics, also
known as moral philosophy, is a branch of philosophy that involves
systematizing, defending, and recommending concepts of right and wrong conduct[1].
1. Metaethics
investigates where our ethical principles come from, and what they mean. Are
they merely social inventions? Do they involve more than expressions of our
individual emotions? Metaethical answers to these questions focus on the issues
of universal truths, the will of God, the role of reason in ethical judgments,
and the meaning of ethical terms themselves.
2. Normative ethics
takes on a more practical task, which is to arrive at moral standards that
regulate right and wrong conduct. This may involve articulating the good habits
that we should acquire, the duties that we should follow, or the consequences
of our behavior on others.
3.
Finally, applied ethics involves
examining specific controversial issues, such as abortion, infanticide, animal
rights, environmental concerns, homosexuality, capital punishment, or nuclear
war[2]
and others issues.
According
to aforesaid, Bioethics are controversial moral concepts arise in
biotechnology, Law, Medicine, Politics, Philosophy, Biology and others
sciences, because of development or advances of Biologic and Medical sciences.
As already mentioned, they concern such problems like the using or production
of GMOs, abortion, homosexuality, death penalty as capital punishment, human
cloning etc.
2. Scientific progress (biology and medicine) and
bioethics
Since the completion
of the groundbreaking Human Genome Project, massive strides have been made in our
understanding of biology, science, and bioethics, the human body. Many
developments have been made on the genetic or cellular level that could have
enormous applications for the future.
From 3D printing new organs
using stem cells to customizing drug therapies for patients to potentially
making human cells virus proof, the last decade has already born significant
fruit. As the science improves and our understanding grows, the next decade or
decades could completely change healthcare forever.
2.1. 3D Printing of Organs Could Make Organ Donation
Obsolete
One
massive development in human biology involves the use of 3D printers and human
stem cells. 3D printing is developing to such a level that it can print basic
replacement parts for human beings. Recent developments from institutions like
the University of Bristol include the use of new kind of bio-ink that might
allow the production of complex human tissues for surgical implants in the not
so distant future. The bio-ink is made from a couple of different polymer-based
ingredients. One is derived from seaweed and is, therefore, a natural polymer.
The
second and last is a sacrificial synthetic polymer. Each one of these polymers
provides a different role in the bio-ink. The synthetic component allows for
the bio-ink to solidify under the right conditions whilst the former adds extra
structural support. The idea behind this ink is to provide a means of being
able to 3D print a structure that can remain durable when immersed in nutrients
and not damage any introduced cells to the structure.
Osteoblasts
(stem cells that make bone) and chondrocytes (stem cells that help make
cartilage) can then be introduced into the 3D printed polymer structure in the
presence of nutrient-rich environment to create the final 'synthetic' new
organ/structure.
This
process once developed fully, could be used to print patients tissues using
their very own stem cells in the future.Other developments include printing
kidneys and the potential for printing skin for treating burns. Might this also
be the key to immortality?
2.2. Specific Drug Targeting Could Lead to the End of
Cancer
Many
offshoot areas of research have been made possible since the start of the human
genome over 25 years ago. One hugely important development could be the
production of genetically tailored drugs - sometimes referred to as
pharmacogenetics.
This
could potentially involve creating targeted drugs for treating cancer rather
than using the more general 'one-size-fits-all' alternatives like chemotherapy.
There are already companies, like Foundation Medicine, that provide DNA
screening for cancer cells in biopsy samples.
Their
analysis provides a report detailing the genes in the patient's DNA that are
known to be linked to cancer and provide information on "actionable"
mutations. These actionable sequences of DNA are areas where existing
anticancer drugs either exist or are undergoing testing.
Such
reports would be able to steer doctors and patients towards prescribing
specific drugs to treat the patient's particular form of cancer.
The
future efficacy of this kind of treatment could yield enormous future
discoveries into the human genome and, just perhaps, guarantee cancer treatment
success.
2.3. Scaring Could Be Prevented By Converting Cells
From One Form to Another
Early
last year it was announced that researchers may have made a huge breakthrough
in healing wounds. They may have found a way of 'hacking' tissue within the
wound to regenerate skin without leaving scar tissue.
Doctors
from the Perelman School of Medicine, University of Pennsylvania, the Plikus
Laboratory for Developmental and Regenerative Biology at the University of
California, Irvine collaborated for years and finally published their findings
in January of 2017.
They
found a method to converting myofibroblasts (a common healing cell in wounds)
to fat cells - this was once thought impossible. Whilst myofibroblasts are
essential for healing, they are also a critical element in the formation of
scar tissue.
Scars
are usually formed, in part, due to a loss of subcutaneous fat cells called
adipocytes. If then the myofibroblasts could in some way be converted into fat
cells, scaring would be less pronounced if visible at all.
George
Cotsarelis, the principal investigator of the project and chair of the
Department of Dermatology and the Milton Bixler Hartzell Professor of
Dermatology at Penn explains:- "Essentially, we can manipulate wound
healing so that it leads to skin regeneration rather than scarring."
"The
secret is to regenerate hair follicles first. After that, the fat will
regenerate in response to the signals from those follicles." - George
continued.
The
signals, they found, appeared to be a special type of protein called Bone
Morphogenetic Protein (BMP).
"Typically,
myofibroblasts were thought to be incapable of becoming a different type of
cell," Cotsarelis said. "But our work shows we have the ability to
influence these cells, and that they can be efficiently and stably converted
into adipocytes." - explained George.
This
research can have other applications for diseases as well as slowing down the
aging process - specifically preventing wrinkle formation.
2.4. Mitochondrial DNA 'Spring Cleaning' Could Prevent
Aging
Researchers
recently discovered a method to manipulate the DNA of aging cells in the human
body. The scientists from Caltech and UCLA were able to produce a technique to
tinker with the power plants of the cell - mitochondria.
Aging
in the human body is a consequence, in part, of a compilation of copying errors
in our DNA over time. This poor DNA copying leads to telomere shortening and
other mutations.
Mitochondria
are some of the worst culprits for this in the human cell - although
mitochondrial DNA (abb. mtDNA) is separate to that from the main nucleus of the
cell.
Each
cell contains hundreds of mitochondria and each mitochondrion carries their own
packet of mtDNA. mtDNA will tend to build up in the cell over time and falls
broadly into two types; normal mtDNA and mutant mtDNA.
When
the latter builds up to a certain concentration in the cell, it ceases to
function properly and dies.
"We
know that increased rates of mtDNA mutation cause premature aging,"
explained Bruce Hay, Caltech professor of biology and biological engineering.
"This, coupled with the fact that mutant mtDNA accumulates in key tissues
such as neurons and muscle that lose function as we age, suggests that if we
could reduce the amount of mutant mtDNA, we could slow or reverse important
aspects of aging."
The
team was able to find a way of removing mutated mtDNA from the mitochondria
completely, thus staving off the issues created by accumulated levels of mtDNA
in the cell.
Mutant
mtDNA has also been linked to degenerative diseases like Alzheimer's,
age-related muscle loss, and Parkinson's. Inherited mtDNA could also be a
contributing factor to the development of autism.
Source: National Human Genome Research
Institute/CCO
2.5. The Human Body's 79th Organ Was Discovered in
2017
At
the beginning of 2017, scientists officially added a new organ to Gray's
Anatomy. The organ was, literally, hidden in plain sight for centuries.
The
new organ, called the Mesentery is now officially the human body's 79th organ.
The organs name translates to “in the middle of the intestines" and is a
double fold in the peritoneum (or lining to the abdominal cavity) that attaches
the intestines to the abdominal wall.
The
Mesentery was originally thought it to be a fragmented structure which was part
of the digestive system. However, they discovered that it is one continuous
organ.
It
was first identified by J. Calvin Coffey (Professor at the University of
Limerick) who published his findings in The Lancet shortly after. As exciting
as this development is, the new organ's function is still something of a
mystery.
"When
we approach it like every other organ… we can categorize abdominal disease in
terms of this organ," explained Coffey.
“We
have established anatomy and the structure. The next step is the function,”
Coffey expanded. “If you understand the function you can identify abnormal
function, and then you have the disease. Put them all together and you have the
field of mesenteric science…the basis for a whole new area of science.”
With
it now classified as an official organ, it is up to researchers to begin to
investigate its actual role in the body. As more understanding is gained on
this, it could lead to less invasive surgeries being performed by surgeons.
This
could reduce complications, accelerate the recovery period and even reduce
costs.
2. 6. Researchers Found a New Type of Brain Cell
Earlier
this year researchers released a report in "Current Biology" that the
human medial temporal lobe (MTL) contains a new type of cell never seen before
in humans - called target cells.
The
team led by Shuo Wang, Assistant Professor of Chemical and Biomedical
Engineering at West Virginia University, discovered the new cells whilst
conducting observations on epilepsy patients. They were able to record eye
movements and single neuron activity in the MTL and medial front cortexes of
patients.
“During [a] goal-directed visual search, these
target cells signal whether the currently fixated item is the target of the
current search,” Wang explained. “This target signal was behaviorally relevant
because it predicted whether a subject detected or missed a fixated target,
i.e. failed to abort the search."
Their
findings showed that these cells 'cared' little for the content of the target.
They only seemed to 'focus' on whether they were a target to search for or not.
“This
type of response is fundamentally different from that observed in upstream
areas to the MTL, i.e. the inferior temporal cortex, where cells are visually
tuned and are only modulated by target presence or absence on top of this
visual tuning,” Wang said. “The discovery of this novel type of cell in the
MTL, in humans, shows direct evidence for a specific top-down goal-relevance
signal in the MTL.”
2.7. Complete Genomic Sequencing Could Become Routine
Routine
genomic sequencing as part of routine clinical care might become standard
practice in the not so distant future. In 2011, researchers at the Medical
College of Wisconsin had taken steps to pioneer a whole-genome sequencing
process that they hoped to make standard practice.
It
was targeted at testing children for rare inherited disorders that are very
difficult to diagnose using more traditional methods. This type of diagnostic
tool had already come a long way since the completion of the groundbreaking
human genome project.
Costs
to sequence a patient's entire genome now costs about the same as sequencing
just a few genes via commercial diagnostic testing. Back in 2011, it had
already begun to reap benefits by being able to pinpoint specific genetic
mutations underlying a set of rare and difficult to diagnose diseases.
In
some cases, it was also able to provide life-saving treatments.
Of
course, sequencing the entirety of someone's DNA is the easy part - the hard
part is figuring out what the sequence means. The team developed their own
software to trawl the sequence and flag any mutation of interest and search
genetic databases for matches.
The
team caused a stir in December of 2010 when they were able to identify the
cause of a child's poor health after 100 surgical procedures and three years of
treatment failed to. It turned out that there was a mutation on the boys X
chromosome that was linked to an interest immune disorder.
This
was so rare it is thought to have been unique and not found in any other animal
or human at that time. Armed with the information, physicians were able to
perform core-blood transplant and eight months later, the boy was out of the
hospital and thriving.
This
technique is likely to become routine in the future and will probably be
demanded by many health insurers in the not too distant future.
2.8. CRISPR-Cas9 Has Been a Game-Changer in Human
Biology Research
CRISPR
or Clustered Regularly Interspaced Short Palindromic Repeats, were first
discovered in Archaea, and later bacteria, by Fransiciso Mojica from the
University of Alicante in Spain, in 2007. Experimental observations allowed him
to note that these pieces of genetic materials formed an integral part of the
parent cells defense mechanisms to fend of invading viruses.
CRISPR
are pieces of genetic code that are interrupted by 'spacer' sequences that act
like the immuno-memory of the cell from previous 'infections'. Archaea and
bacteria use CRISPR's to detect and fight off invaders in a process called
bacteriophage in the future.
CRISPR
was catapulted into the public domain when in 2013 Zhang Lab was able to
demonstrate the first edit of a genome in mammals using CRISPR-Cas9
(CRISPR-associated protein 9).
This
successful experiment showed that CRISPR could be used to target specific parts
of an animal's genetic code and edit the DNA in situ.
CRISPR
could be incredibly important for the future of human biology through
permanently modifying genes in living cells to correct future potential
mutations and treat the causes of disease.
This
is impressive enough but CRISPR technology is constantly undergoing refinement
and improvement.
Many
industry experts believe CRISPR-Cas9 has a bright future. It will likely become
a vital diagnostic and corrective tool in the field of human biology and could
be used as a treatment for cancer and rare diseases like cystic fibrosis.
2.9. CAR T-Cell Immunotherapy Could Be The End Of The
Road For Cancer
CAR
T-Cell Immunotherapy is one potential development in research that could end
the threat of cancer for all of us.
Immunotherapy
has developed a lot over the last few years and promises to enlist and
strengthen the patient's own innate defensive systems to target and attack
tumors. This form of treatment has come to be known as the "fifth
pillar" of cancer treatment.
T-cells,
in a healthy immune system, patrol your body tirelessly looking for foreign
invaders like bacteria and viruses. Unfortunately, they tend to be ineffective
against cancer cells as they are, after all, able to 'hide' from the body's
immune system - being out of control native cells.
If
scientists could tinker with the bodies natural defensive system to identify
cancer cells as a foreign invader, it could provide a means of automatically
searching and destroying them. This is the promised 'holy grail' of T-Cell
Immunotherapy.
CAR
T-Cell therapy falls under the banner term of adoptive cell transfer (ACT)
which can be further subdivided into several types (of with CAR's are one). CAR
T-Cell therapy is, however, leagues ahead of the others in advancement to date.
Some
CAR-T Cell therapies have even been approved by the FDA in 2017. One such
example is the treatment of Acute Lymphoblastic Leukemia (ALL) using the
technique.
But
before we get carried away with its potential for the future, it is still in
its infancy.
Steven
Rosenberg, M.D., Ph.D., chief of the Surgery Branch in NCI’s Center for Cancer
Research (CCR), does have high hopes for the therapy, however.
“In
the next few years,” he said, “I think we’re going to see dramatic progress and
push the boundaries of what many people thought was possible with these
adoptive cell transfer–based treatments.”
Source: The National Institutes of
Health/Wikimedia Commons
2. 10. The Genes That Determine Nose Shape Was
Identified
Back
in 2016, researchers at the University College London were able to identify
four genes that determine the shape of human noses - for the first time. The
team focussed their research on the width and pointiness of noses which greatly
varies among people.
Conducting
research on over 6,000 people in Latin America, they were able to identify the
genes that determined nose shape and chin shape.
According
to their report:
"GLI3, DCHS2, and PAX1 are all genes
known to drive cartilage growth — GLI3 gave the strongest signal for
controlling the breadth of nostrils, DCHS2 was found to control nose pointiness
and PAX1 also influences nostril breadth. RUNX2 which drives bone growth was
seen to control nose bridge width." -Sci News
This
research may find future applications in identifying birth defects in children
and could be very useful for 'cold case' forensic studies.
11. Recent Developments in Human Biology Could Make Us
Virus Proofing
Recent
research from scientific groups like the Genome Project-write (GP-Write) is
planning to make human cells 'virus-proof'. They also plan to make cells
resistant to freezing, radiation, aging and, yes you've guessed it, cancer.
The
ultimate ambition is to make 'super-cells' that would if successful, have
enormous ramifications for human biology and society at large.
Jef
Boeke, the Director of the Institute of Systems Genetics and NYU Langone
Medical Center recently said : “There is very strong reason to believe that we
can produce cells that would be completely resistant to all known
viruses."
“It
should also be possible to engineer other traits, including resistance to
prions and cancer.” he expanded.
As
ambitious as this sounds they actually have grander plans to, hopefully, fully
synthesize the human genome in the lab one day.
Their
goals will be achieved using a process called DNA re-coding. This process will
prevent viruses from exploiting human cells being reprogrammed as virus
factories.
"The overall GP-write project is focused
on writing, editing and building large genomes. We will generate a wealth of
information connecting the sequence of nucleotide bases in DNA with their
physiological properties and functional behaviors, enabling the development of
safer, less costly and more effective therapeutics and a broad range of
applications in other areas such as energy, agriculture, healthcare, chemicals
and bio-remediation,” explained Boeke.
If
their research is successful, we could be able to tinker with and refine the
human genome at will and at a much faster rate than evolution. The
possibilities (and dangers) would be enormous for humanity.
3. Cultural and traditional approach of bioethics
In
the case of many non-Western cultures, a strict separation of religion from
philosophy does not exist.
In
many Asian cultures, for example, there is a lively discussion on bioethical
issues. Buddhist bioethics, in general, is characterised by a naturalistic
outlook that leads to a rationalistic, pragmatic approach. Buddhist
bioethicists include Damien Keown. In India, Vandana Shiva is a leading
bioethicist speaking from the Hindu tradition. In Africa, and partly also in
Latin America, the debate on bioethics frequently focuses on its practical
relevance in the context of underdevelopment and geopolitical power relations.
In
Africa, their bioethical approach is influenced by and similar to Western
bioethics. Some are calling for a change, and feel that indigenous African
philosophy should be applied. The belief is that Africans will be more likely
to accept a bioethical approach grounded in their own culture, and that it will
empower African people and give them dignity. Masahiro Morioka argues that in Japan the
bioethics movement was first launched by disability activists and feminists in
the early 1970s, while academic bioethics began in the mid-1980s. During this
period, unique philosophical discussions on brain death and disability appeared
both in the academy and journalism.
In
Chinese culture and bioethics, there is not as much of an emphasis on autonomy
as opposed to the heavy emphasis placed on autonomy in Western bioethics.
Community, social values, and family are all heavily valued in Chinese culture,
and contribute to the lack of emphasis on autonomy in Chinese bioethics. The Chinese
believe that the family, community, and individual are all interdependent of
each other, so it is common for the family unit to collectively make decisions
regarding healthcare and medical decisions for a loved one, instead of an
individual making an independent decision for his or her self.
Some
argue that spirituality and understanding one another as spiritual beings and
moral agents is an important aspect of bioethics, and that spirituality and
bioethics are heavily intertwined with one another. As a healthcare provider,
it is important to know and understand varying world views and religious
beliefs. Having this knowledge and understanding can empower healthcare
providers with the ability to better treat and serve their patients. Developing
a connection and understanding of a patient's moral agent helps enhance the
care provided to the patient. Without this connection or understanding,
patients can be at risk of becoming "faceless units of work" and
being looked at as a "set of medical conditions" as opposed to the
storied and spiritual beings that they are.
4. Religious approach of bioethics
Religion is one of the main reasons of
controversies to bioethics. Each religion has its own position to the questions
of bioethics. Religious bioethics sometimes completely opposed to the modern
secular bioethics. Let analyze the positions of some main world religions such
Christian, Islam, Judaism and Buddhism.
a) Christian Conception on Bioethics and HR
Issues
of bioethics are particularly interested scientists at the end of last century
and the contemporary time. Bioethics becomes studying object by philosophers,
health care holders, lawyers, theologians etc. Many researchers such
Nichola Capaldi, Tristram Engelhard, Megan-Jane Johnstone, Antonio Barbosa da
Silva etc. had paid many attentions to the Christian
bioethics.
The
Christian Bioethics consists on how Christians according to their faith think
about the human’s life, the sexuality, the health care, the medicine, the
suffering, the illness, the death, etc.
To
opposition, the now-dominant secular morality is framed in terms of cardinal
affirmations of liberty, equality, social justice and human dignity that
establish individual decision makers as the source of moral authority and the
moral orientation[11].
As
said, Megan-Jane Johnstone that the preoccupation of each person is the anxiety
of death[12]. n
this scope one of aims of religion is to solve this anxiety and help people to
die with dignity.
Traditional
Christian morality and its bioethics according to Tristram Engelhardt are
framed in terms of obligations to God who commands and who is the source of
moral authority and the point of moral orientation[13].
The
Christian concept of Bioethics is guided by the God’s view of the life. For the
Christian, God gives the life and all things related to it. In this way the
traditional Christian bioethics forbids human embryonic stem-cell research,
abortion, physician-assisted suicide, and euthanasia, while also rejecting any
sexual relations outside of the marriage of a man and a woman. It prohibits
surrogate motherhood, reproduction using donor gametes, and treatment of sexual
dysfunction in homosexual couples[14].
Up
to now the Christian bioethics is against the using of pills and condoms,
practicing abortions. It considers the health as a God’s gift
and the suffering, the illnesses, the disability and the death as
punishment to mankind, particularly for those who do not obey God’s principles
and sin.
In
this way the secular bioethics regards opposed to the Christian bioethics in
the contemporary world. May be it’s the time to the Christendom to review its
position about the life care because of its absurdity and archaism. Critics to
Christian bioethics now a day are very strong and treat the Christianity as one
of the main impeachments to the development. In this case, it is important to
underline that the Christianity up to now did not improve the human life by its
metaphysic and ethics concepts and continues to remain thousands of peoples in
ignorance. Therefore we thank that its time for the Christendom to accept some
secular bioethics principles in order to help many peoples to use the benefits
of the scientific progresses.
b) Islam
Conception on Bioethics and HR
Islam
conception on bioethics is one of the main religious conceptions of bioethics
based on Muslims world-views related to “three realities” namely God, Humanity
and Cosmos[15]. This
concept is one of traditional and conservative Islam principles of
the live. At this way it did not differ from Christian bioethics as it opposed
to the current secular view of bioethics.
For
Muslim only Allah (God) is able to provide life and decide about everyone, from
the life conception to the death beyond the life. For these purposes any kind
of relationship outside of the relation between men and women
is unacceptable. Any regulation of procreation is against Allah’s
worldview and must be prohibited.
There
is divine Islamic understanding of the human body, which not allowed
transplantations of the human organ tissues. As explained Abdulaziz Sachedina,
Islam human beings have responsibilities as stewards over the body, which is
understood as divine gift, not a private property. This stewardship entails
certain Islamic restrictions in the treatment of the body both during mortality
and post-mortem to avoid violating prohibitions of desecration and mutilation[16]. For this
reason, medical care leading to organs transplantation is viewed as a sin.
At
this last time, because of growing of Islamic radicalism the progress of
medicine and biology, the matters related to Islamic bioethics become more and
more strong as well as they oppose to the new secular order. Homosexuality,
abortion, euthanasia or death assisted, human stem cells researches and other
contemporary medical and biological advances are not welcomed into Islamic
world.
As conclusion Islamic bioethics oppose to
secular bioethics. This confrontation constitutes an impeachment to the
development of the society and new arisen matters related to human rights
challenges.
c) Jewish or
Judaism Conception on Bioethics and HR
Judaism
is a fundamental Jewish religious that has an important conception on
bioethics. If Christian bioethics and Islamic bioethics are radical about the
secular bioethics, particularly on understanding of the human being, the life,
the suffering, other side, the Jewish bioethics view is more controversial,
because it based on different interpretations or commentaries of the “Halachah”
made by Rabbinic.
“Halachah”
is case or rule-based law of the peoples of Israel based on precedent filtered
through Talmudic literature and its commentaries as well as
discussions of specific cases from the past, the responsa literature[17].
Different
commentaries of “Halachah” by different Rabbinic open wider worldview on the
matters related to bioethics, which can be divided in two groups. The first
group concerns are those who supports the traditional Jewish religious view.
The second group includes liberal point of view about ethics problems.
The
first group is more fundamentalist and refutes all kind of interpretations of
the “Halachah” in the favor of the secular understanding of bioethics. For
peoples who are supported such point of view, only God gives live and only he
might take it. This worldview is expressed in the Bible by the locution “God
has given, God has taken” (Jacob 2). There is not too different between their
position and those supported by Moslems as we already mentioned who think that
our body is God property and we are just the users[18].
Of
course, this position limits physician (doctors) interventions in terms of
secular understanding of medicine and rejects all kind of discourses in this
scope. This group opposes to the second one.
According
to the second group, Jewish bioethics relies on permission to heal in Talmudic
statements[19]. Even
the Talmud in some cases solves the problem of human clinic experiment by
concluding that in situation of a certain danger to life, potential relief may
be pursued, despite its own risk[20]. This
situation gives a huge possibility for physicians and autonomy of choice for
patients.
Again
we can conclude that matter of bioethics in Jewish society as previously
Christian and Islamic bioethics is subjected to discourses that are no going to
be quite soon.
d) Buddhism Bioethics and HR
The
Buddhism is nontheistic religion which differs from Judaism, Islam, and
Christendom. Buddhism can be interpreted as philosophy of harmony between human
being and his surrounding environmental life based on the conduct or behavior
of the person in the society. Buddhism principles are known as principles
of “the Dhamma” teaching. “The Dahmma teaching contains the main rules of
life according to Buddhism that must be observed everyone who believes in it.
The
aim of Buddhism as every religion is to help peoples to manage their life and
so to solve the problem of death and suffering. In this way the Buddhism play a
particular role in the life of thousands peoples.
Buddhism
bioethics so far is opposed to others religious bioethics but shares with them
many points of views as its first percept prohibits the artificial taking of
life[21]. As rule,
suicide also is not permitted[22]. These rules
are fundamental for every person, who practices Buddhism.
Yet,
according to Buddhist norms some practices are allowed in several cases. For
example, there are some cases, when taking one’s life to save the others lives
allowed. That is known as noble case[23].
Another
noble case is suicide to escape from an incurable illness that is an obstacle
“nibbana” (painful – my cursor), the final release from the wheel of life and
death. Whether there is another exception, which would allow the terminally ill
patient to refuse the extraordinary measures for preserving his life or allow a
doctor, requested by his patient, to assist the latter to end his life when there
is no hope for recovery[24].
Principles
of justice, compassion and veracity are other worth of Buddhism. The principle
of justice is based on the principle of equality between peoples as fundamental
human right that must be respected particularly by the physicians during their
work. In terms of veracity principles the doctor must tell only truth to the
patient about is disease in opposite to the Greek culture explained by Megan J.
Johnstone[25].
In
comparison to the others already mentioned religions, Buddhist bioethics is
more closer to secular bioethics based on human rights, freedoms and
self-determination of each person. There no any compelling to the metaphysic
which up to know is not able to give answers about the life, thus continues to
remain the mankind in fuzzy (vague) world. To solve these discourses between
different societies, juridical norms are setting as agreements at national as
international levels known as Law.
