Semantic algorithms of bioethics

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Abstract


In the article the authors study moral and legal algorithms of bioethics as universal methods of solution of topical problems in the health care system which reflect a wish of citizens to live and act healthily. Specificity of bioethical ideology in the modern health care system consists in the demand to follow the algorithms of preserving life in general, protection of a man and protection of his health from different negative circumstances and deliberate or occasional technological influence. In order to bring to light the ideals and principles of biomedical ethics the authors pay special attention to natural (biological) origin of a man. It is stated that co-evolutional imperative of bioethics is to push scientists-medicals and clinicians to overcoming of social, economic and political conflicts. The article is presented in English that is topical in the context of growing popularity of the Russian higher education among foreign students, as well as the lack of educational literature in foreign languages. The material of the article can be used in designing work programs, lecture and practical courses of «Bioethics».

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Algorithms of bioethics are the system of principles and rules of behaviour of medical specialists and scientists for effective solutions of life tasks of and health preservation. Today moral-rectitude and state-legal algorithms as general methods of solvation of topical problems in health care system reflect a natural wish of citizens to live and act in a healthy state. They are fixed in constitutions and laws being a humane pivot of philosophy of health care. This philosophy demonstrates growing interest to their rights and responsibilities expressed in the algorithms of bioethics. A specific character of this science as the philosophy of health protection aims at their protection from risky scientific and biomedical experiments. Bioethics, 2 (24) 2019 ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ addressing conscience of scientists and medical specialists, awakes in their consciousness the feeling of personal responsibility of their patients’ treatment and experiments on animals and people. Bioethics whose nucleus has become ethical-legal algorithms in medicine and society in general, defines problems which are connected with finding out specificity of new universal intellectual-moral values and humane principles in scientific and clinical activity, that allows to solve the matter about a man’s right for life and death effectively. Bioethics forms a new weltanschauung and way of thinking in medicals’ activity. Fundamental concepts of traditional ethics fulfil the task to use philosophical-methodological principles for bioethics. It concerns proper application of those universal moral-ethical values that are essential for modern scientists and medicals’ orientation in their professional activity. In the conceptual structure of bioethics traditional ethics occupies a special place. Being an independent field, it highlights the idea of reverence for life in general and human life in particular. Bioethics deals with systemic research of a human consciousness and behaviour from the point of view of moral values and principles within the frames of sciences about life and health preservation. Its object is a humane attitude of the society and medicals to wildlife and especially to a man, his life, death and health. Ethical dilemmas of medicine are not something absolutely new. They were revealed when a small group of doctors headed by Hippocrates in the 4th century B.C. signed a moral code of medical practitioners which is an oath for modern doctors up to nowadays. But unlike those days when doctors had limited possibilities to influence a clinical course, ethical canons are absolutely different nowadays. Modern doctors can interfere into fundamental processes of life and death. Moreover, bioethical problems of medicine are not considered as the exclusive prerogative of professionals only. If traditional ethics was and is the branch of humane philosophy, bioethics includes legal problems as well, which are used in medical and scientific practice. All kinds of bioethics can be called as applied or professional ones because bioethics is based on the idea that some solutions of scientific and applied problems demand more delicate moral actions than others and these actions can influence making personal professional decisions. Bioethics approximated comprehension of aggravation of moral problems in the present day development of the mankind and comprehension of personal responsibility of medical specialists and scientists for their activity. In modern health care system in the result of rapid development of science and technologies and implementation of the discoveries into medicine there have appeared difficult moral-legal problems. These problems have reflected unusual situations in medicine connected with genetic interference into a man’s life and with interference into the processes of reproduction. We can suppose that evolution of scientific-technical development in this connection will follow the way of global problems of preserving life and health solution. While comprehending some key problems of bioethics as new moral-legal teaching in health care system, we shouldn’t lose sight its main priorities in medicine, biomedicine and applied medicine, that is intellectual-moral potentials, moral-legal norms, socio-cultural values and humane demands, weltanschauung and methodological attitudes of modern philosophy. Specificity of bioethical ideology in modern health care system is in the demand to keep algorithms of life preserving, consolidation of a man’s health. The achieved possibilities of modern medicine and medical-experimental science in particular put burning issues for the society and specialists. So in resuscitation science which gives to seriously ill people some hope for an adequate life, there was the need to appeal for public opinion if such interference into a natural course of life is morally and legally justified. Does the patient want to return to life? Advancement of genetic engineering, organs transplantation, biotechnologies which have changed a usual way of life, demands a different definition of constitutional human rights in the spirit of bioethics as new ideology of health care. In health care there appear new problems which are to be solved right now. Such issues as euthanasia, cloning, transplantation, artificial intellect creation need to be philosophically comprehended. It concerns not a technological aspect of the matter. It’s important to clarify the essence of bioethical innovations and possible consequences of interrelations between renewed medicine and traditional humanistic values which constitute the base of human culture, that is civilization of a society and personality. In the conditions of changing natural and social reality, manipulation with mass and individual consciousness, transition from uninterested personal relations to rationally-market ones there is a need to organize and educate specialists ethically in a new way. In the modern anthropogenic epoch of scientific-technical achievements scientists and medicals got into a difficult moral-legal situation. They are creating the things that have never existed before. But such a creation of scientists plays an ambiguous role in people’s life. Of course, many things are directed to the good, but not fewer are directed to the evil. Physicists and chemists have given a lot to people in the technical aspect but they have also created thermonuclear weapon, poisoning substances. So microbiologists try to protect people from harmful microorganisms but at the same time they make dangerous bacteriological weapon. A scientific-creative activity 7 8 ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ 2 (24) 2019 of scientists, technicians and technologists can’t be stopped but can be humanized. That’s why the public appeals to the mind and conscience of specialists and try to awake the sense of responsibility for the results of their activity. Appearing of bioethics in a health care system witnesses an absolutely new approach to the human personality, respect of his rights and dignity in the face of death. The nucleus of bioethics has become working out of new principles regarding life and death. Life is understood as the highest selfvalue. It’s the matter of common knowledge that biomedical ethics as a moral-legal science about preserving life and health in the sphere of scientific researches in clinical sphere was formed in the 60s of the 20th century. For the recent years a philosophic-ethical paradigm has become an algorithm of «reverence for life». At the first stages of development of medicine the same question concerning the essence of life and the way to make a man happier was put. But there hasn’t been such keen moral attitude to life. To consider life in a new sense nowadays we need some particular combination of its value characteristics in regard to which people are equal to each other on legal and moral levels. Doctors must be characterized through conscience because the result of their activity and professional competence will determine destiny of other people either patients or their relatives. Any medical specialist must do his best at his work but treat his patient carefully not as an object but as a subject of health improving process. He must be able to explain to the patient what is happening to him and the ways of treatment. In Russian medical practice a philosophical-psychological approach to patients has been existing for many years. In modern natural-scientific and humanitarian education as well as in philosophical-ethical education of doctors such topics as the necessity to keep to new strict moral demands are of major importance. It’s not by chance that countries-members of the EU and some other countries supporting the Universal Declaration of Human Rights of 1948, Convention for the Protection of Human Rights and Fundamental Freedoms of 1950, signed in 2005 the Convention for Biomedicine and human rights. In these documents a qualitative distinction of biomedical ethics from bioethics is underlined. The first mentioned one has a purely corporative character, it considers moral-legal relations existing between medicals and between medicals and patients. Meanwhile humane principles of medical ethics which have been forming for centuries such as mercy, charity, responsibility of medics are not cancelled. Dialectical unity of biology and bioethics is deduced to evaluating of the innovative character of their manifestation in the health care system. It’s necessary to comprehend a socio-humanitarian role of biology in scientific cognition of formation and selfdevelopment of life from the philosophical point of view. Understanding of life and prospective of its development depends a lot on interpreting a subjective-gnoseological status of biology. Since the end of the 20th century scientific discoveries and generalization have led to the fact that biology became a thick base of modern scientific natural science. In this respect the 50s of the 20th century have become bordering ones. Celebration of the anniversary of Ch. Darwin’s book «Origin of Species» showed that uniting of Darwin’s idea of natural selection with genetics has led to creation of theoretical foundation for the classical biology and underlined its role and importance in the sphere of innovative movement in medicine. To comprehend the ideals and principles of bioethics deeper we should pay attention to the biological origin of a man. In ancient times philosophers paid special attention to comprehension of a role and importance of natural origin of a man in his spiritual and socio-cultural life. Epicurus wrote that despite being mortal originally, a man became immortal through consideration of the nature. Such contemplation of the nature liberates a man from fears of gods, destiny and death. Cicero also said that contemplation of your nature is a natural food for souls and minds. People become wiser and their world outlook is wider when they contemplate the supreme. Modern scientists-biologists always pay their attention to the biological evolution of the mankind. But if for all animals natural selection stands to be the main factor of their evolution, for a man his role is to preserve genepool and to change mutations that do harm to a human health. The result of people’s natural selection can be seen on the level of embryo cells. This process was grounded in the scientific decoding by Watson and Creek of the DNA molecular structure and comprehension of its role and importance in transmission of the hereditary biological information. This revolutionary discovery allowed to re-estimate all the material of classical biology. The task of modern biology concludes complete and detailed description, systematization and classification of structure, organization and behavior structure speaking of all groups of living organisms on the Earth. Researches showed that processes of metabolism in a human body depends not only on hormones but also on nutrition, outer biological environment and geographical conditions. A scientific-theoretical explanation of the structure, organization and behavioral peculiarities of all living systems on the Earth will let biology go behind the limits of a human biology into the sphere of his socio-cultural life. That’s why in creative construction of different forms and kinds of socio-cultural life and activity of people we can’t ignore people’s natural component - a biological sphere. 2 (24) 2019 ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ Among biological and socio-cultural concepts of a man, dealing with moral aspects we should mention a concept of biocentrism by M. V. Gusev. This teaching is closely connected with the ideas of modern natural philosophy considering the nature in its integrity. Professor Gusev deprecated division of the nature into 2 parts - a man and his environment, he opposed discrimination of bios against anthropocentrism. One of the most important ideas of biocentrism is the fact that human needs must be satisfied only up to provision of the very dynamic balance of biosphere that a man is genetically adapted to. It’s not by chance that nowadays there is an active struggle for preservation of all biological forms and kinds of life especially of a human life. According to philosophers and scientists it’s the highest task of the mankind. Its basic principles are not to contrast all values in a human life to biology. People have always been and are a part of the nature and they can’t live and develop without plants and animals. So biomedical ethics, admitting the necessity to cognize the biological nature of a man in order to comprehend its role and meanings in diagnostic, prophylactic and medical actions, puts a task of philosophical-ethical comprehension of biology itself. According to its definition biology is a science which studies living forms and kinds of self-development of substance, their composition, ways of activity, natural communities, their origin and distribution, interconnection with each other and inanimate nature. If we express the main intention of scientific researches of the role and meaning of modern biology in formation and development of the mankind as well as preserving his health, the most appropriate word combination would be «searching for its originality». This problem is both the most difficult and the most debatable philosophical problem in biology. But one thing is undoubtable - biology is a science about life, its essence and regularities of life phenomena. Biology deals with description and systematization of scientific facts, relating to life. A biologist deals only with phenomena happening in integral living organisms and a human organism. Great achievements in modern biology and medicine, qualitative changes in clinical activity put a number of new moral-legal demands to different kinds and forms of medical activity in the face of the world public. In resuscitation science gravely ill people can be returned to life and moreover, even people who have survived after clinical death go on living. That’s why there has appeared a need to work out strict requirements fixing moral legality of all their practice. Due to wide proliferation of biotechnologies that have changed a habitual way of life of practical medicine there is a need of a stricter observance of all constitutional rights of a man as a patient in the spirit of modern bioethics as a new ideology of all the health care system. Bioethical ethics balances ethical and legal demands to scientific researches, prophylactic and medical acts in different spheres of biological life of people. Biomedical ethics is a combination of philosophical and moral-legal measures in the field of medicine influencing medicals’ consciousness in order to provide control over innovative scientific-creative actions for the sake of life and health preservation. A society in the technotronical epoch tries to create a system of ideas, principles and mechanisms of a moral-legal character in order to preserve life processes, influencing health of people. Socio-philosophical interpretation of a notion «biomedical ethics» lets us understand and estimate a multiaspect life potential of a present day biology. It shows to health care system specialists and scientists important aspects of modern sciences about living beings and problems of people’s health preservation. It is interesting for philosophers, sociologists and lawyers who reflect on professional and moral-legal interrelation of scientists and doctors with patients. Naturalism emphasizes a man’s connection with the nature. It influences consciousness, needs and interests of medicals in their scientific, practical and cultural sphere. And as bioethics is based upon biology, naturalism is apparently of a biocentrical character. It means that biomedical ethics explains to the mankind an absolute value of all kinds and forms of life on the Earth. Beside social philosophers, psychologists, lawyers and medicals dealing with life preservation problems, the problems of biomedical ethics are the matter of interest in biology as well. One of the key notions of biomedical ethics is the notion of biosocial systems. These systems can be defined as the integration of species of any biological kinds characterized by organization, orderliness and integrity, communication, affiliation between individuals and groups. The notion «biosocial systems» points out likeness, relationship, comparability of human social life and biosociality of other social forms and kinds. So biomedical ethics must contribute to formation of a new view to biological objects with the non-traditional for modern science and medicine sociohumanitarian point of view. The most important ideas, principles of modern biomedical ethics have turned out to be weltanschauung, axiological, traditionally ethical, legal and political ones. The matter is that biomedical ethics proceeds from the interpretation of a man as a part of single planet biological variety, a product of biological evolution. In the base of biomedical ethics there are ideas of natural philosophy. Biomedical ethics considers variety of life on the Earth to be a single object. This metaphoric wording emphasizes interconnection of people in the society and the society with powerful biological environment, allows understanding of the resistance to the tendency of atomization of a society in the present day world, when some connections disintegrate and turn into some kinds of isolated atoms that are inclined to competence but not to cooperation. 9 ФЕДЕРАЛЬНЫЙ НАУЧНО-ПРАКТИЧЕСКИЙ ЖУРНАЛ 2 (24) 2019 10 In the conclusion we would like to say that bioethics stands for stimulation of coevolution - a balanced cooperative development of systems including individuals and different ethnic, social, cultural and other groups of the society. A co-evolutional imperative of bioethics must evoke specialists to ty to overcome social, economic and political conflicts. The task is to harmonize the society. In a democratic society which is being built in Russia by the progressive part of the society, we shouldn’t lay too many hopes on central bodies of power. Any innovations can effectively develop from ordinary people. In moral-legal social structure and health preserving the key role belongs to bioethics. It’s proved by history, searching for the answer to fundamental issues of health protection. Only bioethics can work out qualities which in their total would determine intellectual outlook, civil responsibility of people, degree of moral attitude to yourself and professional service.

About the authors

N. A. Ageeva

Rostov-on-Don State Medical University

Email: nataliya.ageeva@mail.ru

Candidate of Philosophical Sciences, associate professor ofphilosophy department

N. L. Wiegel

Rostov-on-Don State Medical University

Email: 22nara@mail.ru

Doctor of Philosophical Sciences, professor ofphilosophy department

G. N. Shapoval

Rostov-on-Don State Medical University

Email: sgalinka@rambler.ru

Candidate of Philosophical Sciences, associate professor of philosophy department

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