Bioethics

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Bioethics describes the ethical reflection of all human interaction with the living environment, in particular the human interaction with life (other people), animals, nature and with medical and biotechnical applications. One of the goals is to find social consensus on these questions and discussions in order to create a ( moral ) basis for the establishment of normative rules ( laws , conventions , decision-making bases for ethics committees) for a responsible approach to life. Bioethics is a branch of ethics .

Definition of terms and area of ​​responsibility

The German term bioethics covers a wide range of subjects. This ranges from ethical problems in dealing with the living environment, starting with the responsible use of our biological resources (e.g. protection of the rainforests ) through the implementation of comprehensive species protection (see extinction of species ) to dealing with livestock and experimental animals in the Food industry and research ( animal ethics ). With increasing importance, bioethics finally deals with the effects of biotechnical and medical developments on the individual and on the human community. It also includes all areas of medical and human-ecological ethics. The word bioethics comes from Anglo-American and was coined there in the early 1970s in view of the rapid biomedical development. In contrast to the English term bioethics , which in the Anglo-American area can be largely equated with medical ethics , the term in German has been expanded to include all of the above-mentioned areas.

The main bioethical problem areas in public are: Genetic engineering - roughly divided into the two areas of red genetic engineering and green genetic engineering and assessed very differently. In addition, the problem area of reproductive medicine (which originally had nothing to do with genetic engineering, but has now developed more and more points of contact with it) has gained in importance in recent years (keywords: reproductive cloning or pre-implantation and prenatal diagnosis of certain hereditary diseases , chromosome peculiarities and physical malformations ). Almost all countries in the world have now set up advisory bodies on these topics. B. for Austria the Austrian Bioethics Commission and for Germany the German Ethics Council .

Mainstreams of bioethical approaches (moral theories)

Kant's ethics / deontological ethics

The moral quality of a decision and thus also of an action do not depend primarily or exclusively on the foreseeable and probable consequences of the same, but primarily on the moral quality of the personal intention and the maxim (subjective rule of action) that determines the decision. The categorical imperative is used to assess the moral quality of a maxim, which demands the generalizability of the maxim into an objective norm or a generally applicable rule of action.

From Kant's ethics, however, no generally binding moral or legal norm for the appropriate moral handling of human embryos follows. However, a certain version of the categorical imperative (purpose-in-itself formula), which prohibits the intentional and exclusive instrumentalization of other subjects or persons, is also applied to human embryos by some (Kantian) ethicists. However, this is also problematic from a Kantian point of view, because human embryos, at least at an early stage of development, are not yet fully-fledged subjects or persons with practical reason. It is disputed among medical ethicists whether human geneticists and medical researchers are allowed to “produce” and “consume” human embryos for research purposes with long-term therapeutic goals that are still vague.

In particular, it is disputed whether human embryos can and should normatively be assigned the moral and legal status of full protection of life and human dignity as soon as the cell nuclei have merged. This is supported by the potentiality argument that human embryos have the genetic potential for independent development as soon as the cell nucleus fuses. Against this is the fact that the final number of human individuals is not genetically determined from the start. In addition, the complicated process of the complete embryonic development of one or more children can only take place under the favorable real conditions of successful implantation of the fertilized cell nucleus in the uterus of a certain woman. Commercially available contraceptives such. B. Condoms, the "pill", the "coil" or the "morning after pill" prevent either the formation of a fertilized cell nucleus or the implantation or further development of the cell nucleus. However, every woman of legal age - at least in the modern constitutional state - also has a civil right to personal self-determination, to dispose of her own body and thus also to allow, execute or terminate her own pregnancy. The right to abortion and artificial insemination is governed by national legislation.

Utilitarianism (consequence-based theory)

In this moral theory, do's and don'ts are judged based on their consequences. One goal is to achieve the greatest possible benefit for the greatest possible number of people. From a scientific point of view, statements such as the following thesis can only be described as polemics: “In its classic, pure form, this theory is practically not applicable to bioethics, since in principle it should allow a person to be killed for the purpose of organ removal and transplantation. The benefit for all the organ recipients would be greater than the harm for one person ”. In order to make utilitarianism fruitful for bioethics, one must introduce generally applicable, non-negotiable principles (e.g. right to life), which it recognizes at least for people. However, who and from when these legal ethical criteria are met for the fundamentally different ideological concepts of people remains the contentious question. Less drastic questions can then be decided after weighing the harm and the benefit. The question of whether it should be allowed to release surplus embryos for stem cell production can be answered in the affirmative with a view to the benefits for potentially sick stem cell recipients.

The utilitarian approach is particularly represented in Anglo-American bioethics. The theses of the Australian utilitarian Peter Singer and the German legal philosopher Norbert Hoerster (whereby Hoerster is to be assigned to “contractualism” in legal theory) were controversial and are considered controversial.

Liberal individualism (rights-based theory)

Bioethical issues are negotiated between the (moral and legal) positive and negative rights of the individual affected individuals. The stronger law applies in each case. In the case of embryos, one could theoretically establish a positive protection for life, which prohibits any use as stem cells . Whereby no representative from the tradition of a non-religious, i.e. secular, argumentation model has been found. One could, however, understand the deliberate pressure of the pharmaceutical industry as a logical support for this theory.

Communitarianism (community-based theory)

This moral concept is directed in particular against liberal individualism and in its bioethical decisions emphasizes the effect on the community rather than on the individual. Proponents of this theory could make arguments in favor of using embryos as well as against using them. This is supported by the potential benefits for the medical care of people who can subsequently be further integrated into the work process (contributors) and require fewer resources for their care. On the other hand you could z. B. the potential exploitation of women (unpleasant egg donation).

Reception of bioethical issues in public

Bioethical issues sometimes meet with great public interest. However, the level of knowledge about the sometimes complex scientific fundamentals has remained constant over the last eight years and not too high. When asked whether tomatoes that have not been genetically modified either contain genes, only around 35% correctly answered yes. Around 50% wrongly believe that eating genetically modified foods can change one's own genes. There is a clear north-south divide in Europe in terms of knowledge of the scientific basis. In Sweden, out of 9 questions, 6.35 are answered correctly, in Portugal only 3.93. Germany and Austria are in the middle (~ 4.79). Nevertheless, the question of whether biotechnology will bring benefits for their lives is answered in a undecided manner by 25% of the European population (EU). Of Europeans who have an opinion, 44% are optimistic and 17% are pessimistic. In the general mood towards biotechnology, one can see a clear turn around 1999. From 1991 to 1999 approval fell rapidly, from 1999 it increased again and has now almost reached the level of 1991 again. The reason could lie in the largely positive topic of the complete sequencing of the human genome and the supposed benefit for medicine.

A clear difference in the approval rate can be observed across the various areas.

Red genetic engineering

The Red genetic engineering encompasses all areas which are associated with medical devices in conjunction, such as recombinant production of medicaments, gene therapy , stem cell research , basic research and genetic engineering methods and genetic testing. The assessment of genetic testing e.g. B. has been consistently high over the past 8 years, but is falling slightly (from 94% (1996) to 91% (2002), half full agreement and half risk-dependent agreement).

In Switzerland, on November 28, 2004, the first binding vote in a democratic country was carried out on a law on the use of surplus embryos (from in vitro fertilization experiments) for stem cell research. Almost two thirds of the population (66.4%) and all cantons voted yes.

Reproductive medicine

The discussion about reproductive medicine encompasses many different problem areas such as abortion , in vitro fertilization, egg donation and late motherhood, and last but not least (reproductive) cloning . 32% of Europeans fully support the endeavors to clone (regardless of whether they are reproductive or therapeutic), 50% are risk-dependent and 17% do not at all.

Green genetic engineering

The green genetic engineering involves the application of genetic engineering in plant breeding. This is where the attitude of rejection is highest. Approximately one third of the population fully support, risk-dependent or reject this area. The rejection is even stronger when it comes to food, here around 50% show a strict rejection.

Other problem areas

The problems of animal ethics or human ecology interest a somewhat smaller area of ​​the public. Especially in animal welfare there is a z. Sometimes very strong resistance that vehemently fights both animal breeding for the food and clothing industry and animal experiments.

Legal

Biomedical Convention (Council of Europe)

abstract

  • Chapter I General Provisions
    • Article 1 Object and Purpose
The Contracting Parties to this Convention protect the dignity and identity of all human beings and guarantee everyone, without discrimination, the respect for his or her integrity and other fundamental rights and freedoms with regard to the use of biology and medicine.
Each Contracting Party shall take the necessary measures in its internal law to make this Convention effective.
    • Article 2 primacy of human beings
The interest and welfare of human beings take precedence over the mere interest of society or science.
    • Article 3 Equal access to health care
The Contracting Parties shall take appropriate measures, taking into account health needs and the resources available, to ensure equal access to health care of adequate quality in their areas of responsibility.
    • Article 4 Professional duties and rules of conduct
All health interventions, including research, must be conducted in accordance with relevant legislation, professional obligations and codes of conduct.

Declaration on the human genome and human rights (UNESCO)

In 1997, the UNESCO Universal Declaration on the Human Genome and Human Rights was adopted. Art. 11 of this declaration contains the following provision:

  • “Practices that run counter to human dignity, such as reproductive cloning of human beings, should not be allowed. The states and the competent international organizations are invited to cooperate in order to identify such practices and to take measures at national and international level which guarantee that the principles set out in this declaration are respected. "

"Reproductive" cloning is given as an example only. Other biotechnology practices that violate human dignity are not mentioned. To what extent this declaration influences further international and national regulations is difficult to assess. In any case, hardly all countries feel compelled to immediately implement such vaguely worded provisions.

No worldwide cloning ban (UN)

In November 2004, after months of negotiation, around 60 countries (including the USA) could not prevail in the UN General Assembly with their demand for a total ban on cloning human cells . On March 8, 2005, a non-binding declaration was drawn up which forbids reproductive cloning, but leaves the dispute over therapeutic cloning pending. However, this declaration does not have the status of a generally binding convention.

Selected problem areas

Bioethics for all living things

Bioethics in relation to humans

Definition of the beginning of life

One of the particularly controversial topics in bioethics is the question of when human life should be granted full, unrestricted human dignity and thus full protection of life. The answers can be roughly divided into two groups:

  1. The normative claim under z. (Incl. Full protection of life) as relying on the dignity of man starts from the merger of seeds - and the Eizellkerne (or - less frequently represented - from the fusion of sperm and egg) as they fertilized egg already the unrestricted Has the potential to create a person ( totipotency ). This view is espoused by Christian ethicists and by many deontological bioethicists and prohibits any manipulation of the embryo after the fusion of the cell nuclei , such as pre- implantation diagnostics , therapeutic and reproductive cloning , and in some cases also abortion (on this, however, the opinion is divided, see Discussion on termination of pregnancy on this page). This view is essentially also represented in the German and Austrian Embryo Protection Act.
  2. The normative claim under z. B. Appeal to human dignity begins at some point thereafter, either gradually or the legal setting of a socially pragmatic criterion such as birth. Substantial time points that are called for (a) the implantation ( nidation ) of the fertilized egg in the uterus , (b) the origin of the central nervous system , (c) the appearance of the first sensations, (d) the birth and (e) the time of the appearance of the personality ( person ). In general, this view is often held by utilitarians but also by ethicists of liberal individualism . The controversy on this subject in the bioethical debate increases the later full human dignity is granted to the beginning of life. In particular, the views of the Australian philosopher Peter Singer and, in a weakened form, of the German legal philosopher Norbert Hoerster , that human dignity is directly linked to personal status (which is essentially also linked to self-confidence and therefore only occurs in childhood ), are sometimes heavily criticized . In the debate about stem cell research , doctors , biologists and ethicists often regard the time of implantation as the decisive factor, not least to justify embryonic stem cell production through therapeutic cloning . Some abortion advocates believe that the formation of the central nervous system ( CNS ) and the appearance of the first sensations are crucial.

How to deal with surplus fertilized embryos - these are essentially embryos not implanted during in vitro fertilization - is directly related to this question of the occurrence of human dignity , but also to the principle of dealing with human life. Either one takes the view that any instrumentalization of life is absolutely forbidden (some proponents of ethical Kantianism ), or one allows the balancing of the life protection of embryos with the use of stem cells developed from them for potential patients or research ( utilitarianism ) or one considers embryos (outside the womb) not at all as (potential) people with rights.

Definition of death

Reproductive medicine

Medical ethics

Human genetics

research

literature

  • Günter Altner : Forget about nature. Basics of a comprehensive bioethics. WBG, Darmstadt 1991 ISBN 3-534-80043-5
  • Kurt Bayertz : GenEthics. Problems of the mechanization of human reproduction. Rowohlt, Reinbek near Hamburg 1987 ISBN 3-499-55450-X
  • Kathrin Braun: Human dignity and biomedicine. On the philosophical discourse of bioethics. Campus, Frankfurt am Main / New York 2000 ISBN 3-593-36503-0
  • Wolf-Michael Catenhusen , Hanna Neumeister (Hrsg.): Opportunities and risks of genetic engineering. Documentation of the report to the German Bundestag. Enquête Commission . 2nd edition, Campus, Frankfurt am Main / New York 1990 ISBN 3-593-34228-6
  • Peter Dabrock, Lars Klinnert, Stefanie Schardien: Human dignity and protection of life. Challenges of theological bioethics . Gütersloher Verlagshaus, Gütersloh 2004 ISBN 3-579-05417-1
  • Ole Döring: Understanding China's bioethics. Abera, Hamburg 2004 ISBN 978-3-934376-58-8
  • Marcus Düwell, Dietmar Mieth (ed.): Ethics in human genetics. 2nd edition, Francke, Marburg 2000 ISBN 978-3-7720-2620-1
  • Thomas Eich: Islam and bioethics. A critical analysis of the modern discussion in Islamic law . Reichert, Wiesbaden 2005 ISBN 3-89500-566-5
  • Thomas Eich (ed.): Modern medicine and Islamic ethics. Life Sciences in Muslim Legal Tradition. Herder, Freiburg im Breisgau 2008, ISBN 978-3-451-29739-7
  • Eve-Marie Engels , Th. Junker, Michael Weingarten (Hrsg.): Ethics of the life sciences - history and theory. Science and Education, 1998
  • Ole Großjohann: Churches as friends of life. The ecumenical development of bioethics , Edition Ethik Volume 17, Göttingen: Edition Ruprecht 2015, ISBN 978-3-8469-0228-8
  • Jürgen Hampel, Ortwin Renn (ed.): Genetic engineering in public. Perception and evaluation of a controversial technology. Campus, Frankfurt am Main / New York 1999 ISBN 3-593-36348-8
  • Torsten Hartleb: Basic rights repercussions in the bioethical debate - alternative guarantee dimensions of Art. 2 II 1 GG and Art. 1 I GG. In: Deutsches Verwaltungsblatt 11/2006, pp. 672–680.
  • Lars Klinnert: The dispute over the European bioethics convention. On the ecclesiastical and social debate about humane biomedicine , Edition Ethik Volume 4, Göttingen: Edition Ruprecht 2009, ISBN 978-3-7675-7124-2
  • N. Knoepffler, D. Schipanski, SL Sorgner (eds.): Humanbiotechnology as Social Challenge. An Interdisciplinary Introduction to Bioethics . Ashgate 2007.
  • Wilhelm Korff , Lutwin Beck , Paul Mikat (eds.): Lexicon of Bioethics . 3 vol., Edited on behalf of the Görres Society . Gütersloher Verlagshaus, Gütersloh 1998 ISBN 3-579-00234-1
  • Roland K. Kobald: Preludes of Bioethics . In: Critica - Journal for Philosophy and Art Theory . No. 3 , 2011, p. 15-40 ( ssoar.info ).
  • Peter Kunzmann, Sabine Odparlik (Ed.): A dignity for all living beings? Utz, Munich 2007 ISBN 978-3-8316-0741-9
  • Bernhard Mann : Bioethical questions from the point of view of the World Health Organization (WHO) and international commissions and conventions. In: Prevention. The trade journal for health promotion. 4/2008.
  • Elmar Mayer: Preimplantation Genetic Diagnosis. Critical consideration of the influence of modern medical-genetic technology on early human beings and our society . Tectum, Marburg 2006, ISBN 978-3-8288-9147-0
  • Regina Oehler, Petra Gehring , Volker Mosbrugger (eds.): Biology and Ethics: Life as a Project. E. Schweizerbart'sche Verlagsbuchhandlung, Stuttgart 2017, ISBN 978-3-510-61409-7 ; Series: Senckenberg Books, No. 78.
  • Jobst Paul: In the network of bioethics . Duisburg, ISBN 3-927388-43-2
  • Silke Schicktanz: Humanities and biosciences - interdisciplinary transgressions using the example of bioethics . In: Florian Keisinger et al. (Ed.): Why do humanities? Controversial arguments for an overdue debate . Frankfurt am Main / New York 2003, ISBN 3-593-37336-X
  • Thomas Schramme: Bioethics , Campus, Frankfurt am Main 2002, ISBN 3-593-37138-3
  • Peter Singer : Practical Ethics , German: Praktische Ethik , 2nd edition, Reclam, Stuttgart 1993, ISBN 3-15-008033-9
  • Ralph Weimann , Bioethics in a Secularized Society. Ethical problems of PGD , Paderborn 2015, ISBN 978-3-506-78274-8 .

See also

Web links

Wiktionary: Bioethics  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ^ Austrian Bioethics Commission ( Memento of April 4, 2005 in the Internet Archive )
  2. ↑ Europeans and Biotechnology in 2002 Eurobarometer 58.0A report to the EC Directorate General for Research from the project 'LifeSciences in European Society' QLG7-CT-1999-00286
  3. ↑ Convention for the Protection of Human Rights and Human Dignity with a View to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine . Council of Europe. April 4, 1997. Retrieved January 28, 2019.
  4. ↑ Universal Declaration on the Human Genome and Human Rights ( English ) UNESCO. November 11, 1997. Retrieved January 28, 2019.