Historical Development and Basic Principle of Bioethics in the Field of Health Research
There are some conflicting answers to the following questions in our daily lives such as; you have to pass the exam successfully. To achieve your goal, shall you cheat on the exam or rather study hard? Patient X needs kidney transplantation, another patient is dying due to a car accident that has a normal kidney. Shall the doctor allow let the critical patient to die fast and transplant the kidney to the other patient? Two competitive companies prepared a new brand of COVID-19 vaccine. You are assigned as a researcher to verify the effectiveness of this vaccine. Finally, you concluded that the two vaccines were not effective as initially claimed. However, one of the companies has paid you much more money than the other with an added bonus to receive after the final report submission. What would be your decision? Here, you might be stranded and be in dilemma between conflicting ideas, values, goals, and responsibilities either to decide the right or wrong option. Therefore, ethics is all about making decisions between compelling alternatives. Ethics (moral) is usually choosing the right things against the wrong ones.
Moral or ethics is one of the oldest philosophical fields of study. The word moral derived from most in Latin means nature or character, whereas ethics comes from the word ethos in Greek which means practice. Therefore, ethics is the study of what is right and wrong. The choices or decisions are reached based on certain principles, guides, standards, rules, values, convictions, beliefs, and codes of practice. So the term ethics means rightness or wrongness of the human act. Generally, it is concerned with what is good for the given society at the national or global level.
Moral norms are a specific system of individual values with a validity of genesis, development, and adoption to it. On the other hand, religious norms are associated with the concept of sanctity which means holiness of life and character. They are absolute in nature. Breaking or violating religious norms means committing a sin against his moral dignity which is prohibited by the scriptures.
Traditionally, the field of ethics is arranged as meta-ethics (nature of right or good), normative ethics (governing standards, rules, principles), and applied ethics which is characterized by the actual practice of ethical rules, principles, laws, standards, norms, and values. Ethics is led by moral principles that govern human actions with other persons in a given society. Hence, morality is what people believed to be right and good, while ethics is a critical expression of morality. Therefore, grounds of ethical justification come from standards, norms, principles, values and etc. to support or object to certain ideas or issues.
The concept of bioethics traced back its origins to Egypt and Mesopotamia. It was assumed that the first regulations related to medicine were detected. Furthermore, bioethics has also some association with Hippocrates (Greece, 460-370 BC) and who was awarded the Hippocratic Oath, a mandatory principle that guides doctors in the field of clinical practice.
On the other hand, scholasticism (the system of philosophical and theological teaching predominant during the medieval period, based on the authority of the church fathers and of Aristotle and his commentators) advanced in the field of moral theology which addresses the questions of natural laws and preservation of life. In addition to this, from the 17th century onwards, books and texts began to prepare that dealt with the fields of moral values and medicine. These ideas, soon after, progressed into the secular world, and later are considered the origins of Medical Deontology. Beyond these origins, in which the word bioethics as such did not exist. Generally, history of the bioethics is divided into two main stages; these are classified as before Potter and after Potter (oncological physician van Reseller Potter at the University of Wisconsin, an American Biochemist who named the term bioethics for the first time).
The Before Potter stage includes the two phenomena mentioned above: Firstly, the Hippocratic Oath and Medical Deontology. The second stage called after Potter extends from the Nuremberg Code to the first heart transplant (carried out by the South African Christian Barnard at Groote Schuur hospital, in Cape Town on the .3rd of December 1967).
Medical ethics have some similarities with bioethics (biomedical ethics), but both are not identical. Medical ethics is concerned mainly with issues of medical practice, whereas bioethics is a broad subject area primarily focused on moral values in practicing biological sciences. Bioethics does not require an acceptance of traditional values which are basic practices and fundamental in medical ethics. The birth of modern research ethics began with a desire to protect human subjects from intentional illicit acts that get involved in the research process.
Hence, bioethics is a branch of applied ethics that studies philosophical, social, and legal matters arising in health and other life sciences. It is mainly concerned with human well-being, although sometimes addresses ethical issues related to nonhuman and another biological environments. As mentioned earlier, the concept was coined in Potter`s Bioethics, the Science of Survival (1970) which describes bioethics as a global movement. On the other hand, Callahan further noted Bioethics as a Discipline (1973), he further argued for the establishment of a new academic discipline; he also stressed that bioethics is a creation of a new organization in which researchers could examine and analyze their medical dilemmas. German theologian Fritz Jahr published several articles during the years 1927, 1928, and 1934 using the German term called ‘Bio-Ethik’ which translated as ‘Bio-Ethics’ and further argued to emphasize more on a more civilized, ethical approach to events related to human beings and the biological environment. His bio-ethical perspective further elaborated as; Respect every living thing, in principle, as an end not as a means in itself and treat it accordingly wherever it is possible.
Bioethics addresses the following types of issues such as; it decides what researchers should perform (what decisions or choices are morally right or acceptable to do), it explains why researchers should do something,4 and how they justify their choices or decisions using moral appropriate terms. Bioethics also describes how researchers could do something with a method or in a manner of their response when someone acts on their decision.
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