Bioethics comes from the Greek words bios, which means “life”, and ethos, which originally means “custom”. On the one hand, ethics is a branch of philosophy that studies the rightness or wrongness of human actions. On the other hand, bioethics is the application of the principles of ethics to the field of medicine and healthcare. Broadly construed, bioethics, as applied ethics, is defined as the ethics of life.
In particular, bioethics is concerned with the ethical issues that arise from the emergence and development in the life sciences, such as biotechnology and medicine. Some of these ethical issues include euthanasia, abortion, suicide, human cloning, allocation of healthcare resources, genetic engineering, artificial insemination, contraception, and organ donation and transplantation. As we can see, bioethicists address the morality of these ethical issues using appropriate ethical theories, such as utilitarian ethics, Kantian ethics, Christian ethics, and Pragmatic ethics. For example, a bioethicist may argue that abortion is immoral because, using Kantian ethics, it treats the human person as a means rather than as an end.
Core Bioethical Principles
As an applied ethics, bioethics applies the principles of ethics to the field of medicine and healthcare. Some of these principles are stewardship, totality, solidarity, respect for persons, non-maleficence, beneficence, justice, and autonomy.
Stewardship is a principle in Christian ethics that suggests that human life comes from God, and no individual is the master of her own body. Humans are only viewed as stewards or caretakers, having the responsibility of protecting and cultivating spiritual and bodily functions. Thus, as stewards, humans should not harm but rather improve and care for their bodies.
Totality refers to the whole body. This means that every person has the duty to develop, use, care for, and preserve all her bodily parts. However, this ethical principle suggests that an individual has the right to cut off or mutilate any defective or worn out parts of the body.
Solidarity suggests being one with the other. In the healthcare profession, healthcare professionals should be one with their patients or clients. As we can see, the principle of solidarity is very important in dealing with the poor, the uneducated, the disadvantaged, and the marginalized.
Respect for persons means that every person has the responsibility to treat persons always as an end and never as a means. Respect for persons, therefore, is the recognition of the equality possessed by every human being as a unique, worthy, rational, self-determining creature, and having the capacity to decide what is best for him. Respect for persons is best practiced in the principle of free and informed consent.
Non-maleficence is the non-infliction of evil, harm, or injury to others and, of course, to one’s self.
Beneficence is the practice of doing acts of goodness, kindness, and charity.
Justice is the act of giving one what she deserves or what is due to her. For example, X has a right to his due. Hence, Y has the obligation not to deprive X of his due.
Autonomy is the right of every person to have control over their lives and decisions regarding their care. This principle has become the basis of informed consent which has become a core concept in modern medical practice.
Personhood and Bioethics
As a healthcare professional, one must care for human persons in a scientific way. But for one to be able to practicably do this, one must understand the meaning of personhood.
In essence, every human person has an inner worth and inherent dignity. Every person possesses these characteristics not because of what she has or does but because of what she is: a human person. As a human person, she must, therefore, be respected regardless of the nature of her health problem, social status, competence, a past action, and the like. For this reason, decisions about health must aim at the maximum integrated satisfaction of one’s needs biologically, psychologically, socially, and spiritually.
The Calling of the Healthcare Profession
The healthcare profession is a special calling, a service characterized by a trusting and caring relationship that cannot be measured in monetary terms. Thus, in bioethics, providing healthcare is not a career, like accountancy or engineering, but a vocation more like a healing ministry. For this reason, the relationship between a healthcare provider and a patient is not a contract likened to a seller and a buyer of goods. It is, therefore, a covenant – a trusted caring service between a healthcare giver who offers help and a dependent patient who needs and receives it. The patient trusts that the healthcare provider will be his advocate and will always have the patient’s best interest as his first priority. Furthermore, this trust is characterized by mutual honesty, openness, and understanding, and information that is freely given and exchanged.
The healthcare profession, therefore, is a caring relationship wherein the healthcare provider and the receiver have a sense of oneness, fulfillment, and growth, assisting each other’s importance, uniqueness, complexity, feelings, and needs. Each one helps the other find a voice and be heard so that both may be enriched.
The Patient
As the principle of stewardship suggests, every person has the obligation to care for her own health. Thus, she has the right to seek and receive healthcare. It must be noted, however, that a sick individual becomes a patient only if:
1) she admits that she is sick,
2) she can no longer take care of herself, and
3) so, she asks for help.
Because she is sick and unable to heal herself, a patient is vulnerable. Also, she is often unable to judge or choose the quality of healthcare she needs or receives. Hence, she must be protected against harm and exploitation.
As a patient in need of healthcare, she must be given the best possible care and taught to care for herself. Also, as a patient asking for healthcare she must accept responsibility for her care, cooperate with her healthcare giver by telling the truth and doing her best to follow instructions. She must also give respect, gratitude, and compensation to her healthcare provider.
In all these, the patient always remains a person with dignity and must be treated with respect. Her privacy and autonomy must not be violated.
The Healthcare Provider
When a person chooses to be a healthcare provider, she becomes one committed to healthcare, invested with authority but with corresponding responsibilities to her patients, her profession, and the society. She must, therefore, be a patient advocate, keep the patient’s best interest as her first priority, and be competent both in scientific and interpersonal skills. It is imperative that she appreciates the facts gathered from the history, physical examination and laboratory results as well as the patient’s values regarding what is acceptable to her and how she feels. She must guard against being arrogant and must recognize her limitations and ask for help when and if needed.
As an authority in her profession, she must contribute to knowledge, conduct herself in an ethical professional way and be worthy of being a role model to her younger colleagues. She must maintain and upgrade the standards of her profession.
She must also manifest a social conscience, stand for justice for the poor, make health care available at a reasonable cost, avoid the temptation to exploit or take advantage of the patient, and always care about human values. A good healthcare provider, therefore, needs to be competent in mind and hand, and compassionate in heart, that is, one needs the triumvirate of knowledge, skills, and interpersonal relations.