Bioethics and Medicine: More questions than answers
The principle of "do no harm" is not enough for medicine
Irina Timofeeva, STRF.ruWhy was the term "bioethics" introduced?
Is the "do no harm" principle proven for centuries not enough for world medicine? These and other issues were the focus of the Russian-French round table "Medical Ethics and Bioethics: Between Science and Morality" on April 22.
Jacques Testard, Honored Professor of Medicine at Paris Descartes University, Didier Sicard, Honorary Director for Scientific Work of the National Institute of Health and Medical Research, Alexander Chuchalin, one of the founders of Russian pulmonology, full member of the Russian Academy of Medical Sciences, Corresponding Member of the Russian Academy of Sciences, Professor Boris Yudin, gathered to participate in it.
Numerous achievements of modern science open up new opportunities for mankind to influence living matter. These are organ transplants, artificial insemination, genetic engineering, human cloning, the use of embryos, stem cell treatment and much more. But is everything that is possible in medicine acceptable from the standpoint of bioethics?
"Bioethics is the ability to influence the human body by changing it," Jacques Testard reflected. It is not comprehensive. We need to learn how to separate innovations before they are translated into practical medicine. Ask scientists and philosophers the question: is it necessary? Is this not related to the violation of human rights? New technologies can lead to the loss of human lives. How can people save themselves? Probably by developing a genetic norm."
The outstanding Russian pulmonologist Alexander Chuchalin believes that bioethics is determined by three fundamental human rights. The first and most important thing is the right to compassion. This distinguishes medical ethics from other fields. The second is the patient's right to demand a high level of competence from doctors. The third is the right to transfer knowledge. It primarily concerns doctors. Professor Chuchalin especially stressed that France is a pioneer in the development of the Code of Physicians.
Professor Didier Sicard is sure that the questions posed by bioethics concern the whole society, not just doctors. They are connected with existential problems. Bioethics as a set of rules governing the attitude to a living being appeared in the 70s of the XX century in the USA. And medical ethics is two thousand years old. She has already adapted to regulate the relationship between doctors and patients. But these two concepts are often intertwined in modern life. What should I do in this case? We need to look for new answers to new questions, said Didier Sicard.
Corresponding Member of the Russian Academy of Sciences Boris Yudin clarified that the concept of "good" today comes from the patient. And this is the fundamental difference between bioethics and traditional ethics. After all, since the time of Hippocrates, the doctor himself decided what would benefit the patient and help in his cure.
Professor Yudin believes that bioethics primarily protects human rights today. It provides all layers of society, members of various faiths with a field for dialogue. Bioethics is not limited to the medical corporation. The scientist is sure that the ethics of care should be in the first place in the community of doctors today, although, in general, it is not the main one for humanity.
In this regard, Alexander Chuchalin recalled how, before his first transplant operation, he came to Optina Pustyn, a monastery associated with the history of Russia. There he took the blessing for the operation from the venerated elder and informed his patient and colleagues about it. In his opinion, this act gave him the moral right to surgical intervention.
Alexander Chuchalin also told about a significant case from the practice of French colleagues. One day, in the early 2000s, a young man crashed in a car accident in Marseille. His brain was destroyed. Doctors appealed to the boy's mother with a request to allow the transplantation of his heart to a 70-year-old pastor suffering from pathology. "I am glad that my son's heart will continue to beat in the chest of another person," the wise woman responded.
Professor Didier Sicard noted that bioethics is being shaped by all of humanity today. After all, various approaches are applicable to this issue. The countries of the world solve the problems of medicine in different ways. But a person who is waiting for an organ transplant should be protected by bioethics. This requires a universal approach. We need to ask society questions – why use human organs? What will this give us in the future? And all together to look for answers to them.
Professor Jacques Testard believes that bioethics has the right to prohibit certain medical technologies. For example, the use of stem cells in therapy should first be tested on animals, to understand whether their treatment does harm. Only then can we confidently say that this method is harmless to humans.
Many outstanding doctors of Russia and France were also present in the hall. So, the children's doctor Leonid Roshal also intervened in the heated discussion, who said that the Moscow Institute of Emergency Pediatric Surgery and Traumatology performs operations on children with traumatic brain injuries. Their results are not always positive. Therefore, Dr. Roshal and his colleagues are conducting experiments using stem cells. As soon as doctors have confidence in the safety of the method, they will transfer the new technology to the operating rooms.
Concluding the discussion, Boris Yudin, representing Russia in the Steering Committee of the Council of Europe on Bioethics (CDBI), noted that there are still more questions than answers in this area, but discussions need to continue, there is no other "recipe" today.
It is worth noting that this open dialogue between French and Russian scientists took place within the framework of the year "Russia-France 2010". This meeting is a "fragment" from the cycle of round tables "What will science give to society in the XXI century?", which is organized by the Department of Science, Technology and Space of the Embassy of France with the support of the Dmitry Zimin Dynasty Foundation, the French National Center for the Development of Culture, Science and Technology and RIA Novosti.
Portal "Eternal youth" http://vechnayamolodost.ru28.04.2010