Microsoft Word - PDF 6 24 Bangladesh Journal of Bioethics 2010; 1(2):24-30 BIOETHICS: AWAKENING AND CHANGING OF HUMAN LIFE Ferdousshi Begum, PhD Professor of Philosophy, Jagannath University,Dhaka Ethics is primarily a part of the quest for truth and motive for standing . It is the desire for knowledge. In this respect it is more akin to philosophical subjects than the natural sciences where the practical applications are many and attractive.Ethics is one of the important branches of Philosophy which started from the ancient time. Ethics started through the philosophy of Sophists in ancient Greece.This culture later expanded through continuous process. The ethical culture has been expanded from Socrates, Plato, Aristotle till today. Ethics can be defined as a science that appreciates human conduct in the light of moral ideal. The English word ‘Ethics’is derived from the Greek word ‘ethica’ meaning matters pertaining to ‘ethos’ or character, that is, remarkable manners, customs and habits of men.1 There are three trend or dimension through the attentive observation of ethical history: such as traditional ethics, meta-ethics and practical-ethics. Traditional ethics deals with justice – injustice, good-bad, right-wrong of human conduct in the light of the moral ideal.2 Meta-ethics is mainly concerned with conceptual and linguistic analysis with moral language which is used in theoretical ethics. On the other hand practical ethics evaluate the social and moral problems of both individual and society regarding the logical uses and implementation of moral standard.3 Bio-ethics is a part of practical ethics. Bio-ethics is the study of moral problems in the area of life sciences and health care and insofar these problems are related with the study of social, legal and economic problem.Now a days there arises some bio-ethical problems,without relating health care and treatment. But these problems are co-related to life. The main aims and objects of treatment are to cure and strengthening of human being .Many treatments are related to lives like animal in modern age. But it is only possible for the treatment of the living being and nothing else. So it is impossible to make differences between bio-ethics and medical science. Bio-ethics is the systematic study of moral problems of human conduct in the society. Bio-ethics is the philosophical study of the ethical controversies brought about by advances in biology and medicine.Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology,medicine,politics,law,philosophy and theology.4 Bio-ethics is such type of branches of practical ethics that deals with the study of human conduct and inner-relation with each other in the light of moral values and principles. Few days ago, bio-ethics was mainly concerned with medical ethics. But now a days it is related to agricultural and environmental ethics too. From this point of view it has been discussed - the ethical problem of health care or medical ethics changing the human live,which should be acceptable and beneficiary to the whole world. 25 Bangladesh Journal of Bioethics 2010; 1(2):24-30 The term Bioethics (Greek bios, life; ethos, behavior)was coined in 1927 by Fritz Jahr, who “anticipated many of the argument and discussions now current in biological research involving animals”. In an article about the “bioethical imperative,” a he called it, regarding the scientific use of animals and plants, In 1970, the American biochemist Van Rensselaer Potter also used the term with a broader meaning including solidarity towards the biosphere, thus generating a “global ethics,” a discipline representing a link between biology, ecology, medicine and human values in order to attain the survival of both human beings and other animal species.5 Medical Ethics or Bioethics is study of moral issues in the fields of medical treatment and research. The term is also sometimes used more generally to describe ethical issues in the life science and the distribution of scarce medical resources. The professional fields that deal with ethical issues in medicine, nursing, law, sociology, philosophy and theology though today medical ethics is also recognized as its own discipline.6 Medical ethics traces it root to several early codes of ethics such as the ancient Greek Hippocratic Oath, which required physician above all to “do no harm.” Firstly ,Bioethics was learned by the side of the Epistemology, Metaphysics and Axiology as the media of learning bio-medicine. Ultimately with the gradual development of medical science and medicine-science bio-ethics reveals as the fundamental subjects. The objects of bio-ethics and medical ethics are so cordially related with one another that it is difficult to make a great differences between these two. According to Pitersinger bio-ethics is the lesson of moral problem regarding sciences. But there are some bio-centric problem which are not related to health care and medical treatment. The main aim of treatment is to care and strengthen the human body with long life. Recently many living beings including animals are treated. But there is no scope of treatment for the non-living. So there is no scope to make a difference between bio-ethics and medical-ethics. For a long time medical-ethics was the main object of bio-ethics. But there has been great changes in the educational contents of bio-ethics in last three or four decades and also expanded and extended the scope of it.7 Very recently environmental ethics and genetic engineering and applied ethics has been included in bioethics and it has been extended and expanded with the scope of new subjects. There arises the question of ethics in the agricultural field after the extension agricultural bio-ethics and food- biology. There arises some ethical problems due to the extension of bio-technology in agriculture sector. Food technology has been developed regarding the different technique of food processing ; different machineries has been used for food processing to make nutritious and quality foods . The time has come to observe deeply whether these foods are helpful for health or indulgence for human body. The question has also arisen to explain newly about the usefulness of these food. The method of hi-breeding is being examined ,which is being used for production of vegetables, corns, fishes and animals. For the double or triple production various artificial and bio-chemical manure has been used. As a result it has been dangerous for maintaining the human and animal health .The buyers and cultivators has been faced with the various moral question regarding the mechanical process of production,such as :- 26 Bangladesh Journal of Bioethics 2010; 1(2):24-30 1. whether the productive corn or food is suitable for the health care of man and animal. 2. whether it is capable for the development of health 3. whether the environment is free from danger 4. whether the role of these technologies to eradicate poverty is satisfactory 5. whether it will only help the rich o the poor will be also be benefited 6. whether it is humane and ethical regarding the animal that has been used as food or for the experiment in research centre, and if it is regarded as ethical, is there any reason for ethical purpose. Firstly agricultural and food technology has to face various ethical question, but it has been agreed regarding the usefulness of these. Considering its necessity, it has been accepted. But regarding environmental balance, economic advancement, social justice and animal rights it has given birth to a moral debate and public opinion has been formed against it. Physician and bio-scientists tried to cure various health problem with medicine. Most modern equipment is very much helpful for correct diagnosis. Most modern technological treatment regarding healthcare is very helpful for right measurement of health related area. Invention of new medicine for prevention of disease also depend on technology. For acute diagnosis to the patient, physician has to depend on pathology. And pathological research also depend on technology. But there arises some health related problems due to uses of most modern equipment in medical science. But though these problems are included in medical science ,there is a clue of ethical solving for these problems. Such problems deal with duty, good or bad – which are the object of ethics; and bio-ethics is also related to ethics. Bio-ethics make decision and judges moral standard for every issues regarding healthcare. Medical science and biological-science discuss about the difference aspects of human body; sometime there arises some problems which are responsible for moral conflicts. Regarding health, various issues are concerned with duty. So to overcome the hard problem it is very much important to explain values. So to get rid of difficult or critical problems of medical sciences it is the duty of bio-ethics to explain and to make a decision morally i.e. what is good or bad. Bio-medical ethics has been created due to ethical problem and crisis of human medical science. Modern and new technology of medical science ensure for the good human-health on the other hand there arises some problems beyond medical science. For example the most modern invented medicine is good to cure epidemic diseases; on the other hand there arises a question whether it is moral or immoral for inventing this medicine - when men are used as an experimental case. Thus bio-ethics as a part of practical science has been turned into an important subject . Medical science and bio-logical science is descriptive science of fact; ethics is a evaluative science. There are various aspects of medical science. Such as there should be: 1. an honest relation between physician and patient 2. whether there should be implementation of any technical stress upon patient for the implementation of different new technology. 27 Bangladesh Journal of Bioethics 2010; 1(2):24-30 3. whether it is ethical to use the patient as a research subject. Varieties of medical programs mainly with experimental case of patient has been faced with ethical question. There arises a conflict in the medical area regarding the responsibility and duty of physician. For example it may be mentioned about euthanasia . The term euthanasia may be defined to accept the death for relieving the severe pain. Euthanasia indeed is a kind of mercy killing or plenty of death. The question now arises whether we should accept mercy killing, the killing of disable child and incurable old people. Regarding these matter, there arises such type of conflict which can be accomplished by ethical knowledge. So bio-ethics deals with the accomplishment of different problem of medical science and biological-science. With the welfare of the patient there arises responsibility about the qualitative stage of life. Health care must be related to moral consciousness ; so that , the notion of ‘life’ and ‘death’ can be defined and analyzed to a new era. Medical science has been rapidly developed and changed at the beginning of 1970. Because from this time the knowledge of different types of medicines such as antibiotic medicine, medicine of birth control, mental health and life saving drugs and technology (i.e., machinery of artificial breathing, dialysis) replacement of kidney ,hart, cornia, fertility process i.e. test-tube-baby ,surrogative mother, genetic engineering i.e. cloning, human jenome has been developed rapidly.8 Except medical science, newly invented technology of biology added a new trend to the field of man’s will, linking, freedom and selection. So the traditional value has become weak to some extent. The new technology and use of it , has made a conflict to the old value. On the other hand the field of social justice has been extended. Women freedom is being observed due to the advantage of birth control technology. Thus different technology of medical science and biological science related to medical science has already improved our daily life; on the other hand created a new conflict. Though there arises some social problems in medical science and there arises a conflict in the field of fact and value – it would be solved in the light of ethics. The commonly accepted principles of health care ethics include: 1. the principle of respect for autonomy 2. the principle of nonmaleficence 3. the principle of beneficence 4. the principle of justice Respect for autonomy In health care decision respect for the autonomy of the patient is a very important factor. German Philosopher Emanuel Kant and British philosopher Stuart Mill highlighted the individual freedom. They have joined the individual dignity with the individual freedom. As the human posses the right to self- control, she/he has power of possessing the same right .So regarding the treatment of a patient we should consider the willingness and unwillingness of a patient. But in some stages such as the patient of C. C.U or I.C.U 28 Bangladesh Journal of Bioethics 2010; 1(2):24-30 is unable to follow the principle of autonomy. In such case when principle of autonomy become inactive , there required some side principle – such as respect for the person and informed consent. Respect for the person means to save the secrecy of the patient with dignity and sense of value.9 Principle of nonmaleficence The principle of nonmaleficence means that we should not intentionally create a needle harm or injury to the patient. It must occur either through acts of commission or omission. In case of professional model of care, one may be morally and legally blameworthy if one fails to meet the standards of due care. The legal criteria for determining negligence are as follows: 1. the professional must have a duty to the affected party 2. the professional must breach that duty 3. the affected party must experience a harm 4. the harm must be caused by the breach of duty. This principle affirms the need for medical competence. It is clear that medical mistakes occur, however, this principle articulates a fundamental commitment on the part of health care professionals to protect their patients from harm.10 Principle of Beneficence This principle is mainly based on utilitarianism of Jeremy Bentham and John Stuart Mill.There are two aspects of this principle ,one is the duty of health care with welfare benefit to the patient as well as to take positive steps to prevent and to remove harm from the patient These duties are applied both to individual patients and to the good of society as a whole. A physician has a duty to seek benefit of any or all of his/her patient.This duty becomes complex if two patients appeal for treatment at the same moment. In these case some criteria of urgency of need might be used. Or there should be some principle of first come first served, to decide who should be helpful at the moment.11 Principle of justice Justice in health care is usually defined as a form of fairness, or as Aristotle once said, "giving to each that which is his due." This implies the fair distribution of goods in society and requires that we look at the role of entitlement. It is generally held that persons who are equals should qualify for equal treatment. This is borne out in the application of Medicare, which is available to all persons over the age of 65 years. This category of persons is equal with respect to this one factor, their age, but the criteria chosen says nothing about need or other noteworthy factors about the persons in this category. In fact, our society uses a variety of factors as a criteria for distributive justice, including the following: 29 Bangladesh Journal of Bioethics 2010; 1(2):24-30 1. to each person an equal share, 2. to each person according to need, 3. to each person according to effort, 4. to each person according to contribution, 5. to each person according to merit, 6. to each person according to free-market exchanges.12 At first the decision of professional was accepted for the health care and medical treatment.But at present the importance has been given to the patient and to the freedom of patient .Such as the treatment of patient depends on the approval ,view and confession of the patient and the doctors. Principles in current usages in the health care ethics seems to be of self-evident value. Before implementing the medical care plan, it is now commonly accepted that the patient must indicate a willingness in writing to accept the proposed treatment. The physician should develop a care plan designed to provide that is most beneficial to the patient. In the history of recent period bio-ethics as a part of the practical ethics played an important role . Duty toward patient of the physician is the central point of bio-ethics. There are two aspects of duty ,one is positive dealing with direct part, other is negative dealing with indirect part. Main general and principle responsibility of the physician to the patient - is to ensure the welfare of the patient ,to respect all the patient, to restrain from deception with patient, to take proper care of the patient , to utilize health welfare incase of full cure, to give importance regarding mental and religious field, medicine should be applied skillfully with no harm etc. Adding to these they should gain skillful professional knowledge and expand the outlook through whole life learning. They should also confess and respect the others capability in case of necessity. Society for bioethics and humanities should promote multidisciplinary, interdisciplinary professional development and inter professional. The study of bioethics enhances our knowledge of the world of possibilities and thereby broaden our vision and outlook. This in turn can lead to increased tolerance that is indispensable for democracy. Bioethics can greatly enlighten us on living moral issues on gender discrimination, reverse discrimination, affirmative action, fundamental human rights, political rights , civil disobedience, environment, equality, equity, fairness, justice, war and peace. So by executing bioethics we will get a fine society ,at the same time a fine world to live in. References: 1.John S. Mackenzie,A Manual Of Ethics,University Tutorial Press Ltd, London,1964.p.1 2.William Lillie, An Introduction To Ethics, Allied Publihers Pvt.Ltd,New Delhi, 2003,p.3 3. A .S.M.Abdul Khalek, Praogic Nitibiddya, Annanya, Dhaka, p.introduction 4. Bioethics – Wickipedia, the free encyclopedia, http://en.wikipedia.org/wiki/Bioethics 5.Terminology,Wickipedia, the free encyclopedia, http://en.wikipedia.org/wiki/Bioethics 6. Arther Caplan,Glenn Mc Gee, Bioethics For Beginner, http//www.acgme.org/outcome. 30 Bangladesh Journal of Bioethics 2010; 1(2):24-30 7. A .S.M.Abdul Khalek, Praogic Nitibiddya, Annanya, Dhaka, p.introduction 8.Bioethical issue: Cloning: In the minds of many people the word cloning generally conjures up pictures of identical human beings, created without using normal reproductive processes. However cloning is more Surrogacy Surrogacy involves a woman (the surrogate mother) carrying a child for someone else, usually an infertile couple or sometimes a gay couple. Before she becomes pregnant the surrogate mother agrees to more Genetic Engineering Genetic engineering and genetic modification are terms used for genetic techniques which can be used to transfer genes from one organism to another move, delete, modify, or multiply genes within a more Euthanasia. From the Catechism of the Catholic Church Catholic teaching labels euthanasia as 'murder' while making a clear distinction between euthanasia and refusing 'overzealous' or 'extraordinary' medical more 9. Souvenir Unesco Philosophy Day, Department of philosophy, Universityof Dhak 18. November.2004 p.13 10. ibid 11 Thomas R. Mc Cormike, D Min,Principles of Bioethics.Faculty,Mdical Histor and Ethics., 12. ibid