Medical Ethics

The prevention and treatment of illnesses is conditioned not only by our biological knowledge but also by the effective integration that we have of other sciences and our control of the physical environment. Medicine is obviously linked to the rest of human knowledge but, being the science of human life, is also determined by the particular social forms in which our life develops, by the economical conditionings in which health and sickness find an additional restriction. In this sense, medicine is a social science and a social action, not a mere biological knowledge of the physiological functions of the human body.

The social action of medicine, the self-care and self-preservation performed by human societies, is not the result of the efforts and ideas of a single generation but a vast cultural endeavor. For that reason, it cannot come as a surprise that beyond the evident success of our survival as species, the accomplishments and failures of the medical practice have not been measured with an identical rod, and the very same biological actions of life and death have been ethically valuated differently according to diverse axiological systems. Medical actions have not a simple biological valuation but a symbolically complexified domain which gives them a particular axiological tension. Such encounter of disparate forces –common to other life sciences- demands from medicine a continuous critical thinking in which theoretical reflections cannot lose sight of its everyday praxis, the resolution –urgent most of the times- of cases in which a concrete human being fights with death in unbearable pain. Medical ethics is the result of this critical thinking, covering a wide domain of problems, from the moral decisions of the clinical practice to the questioning of concepts like health, sickness, person, life and death, providing philosophical frames for their definitions. On the other hand, medical ethics examines critically the cutting edge research of the biological sciences, taking care that the main international political and ethical agreements are honored, and that the human being is treated within the ideals of respect, equality and dignity.

Medical ethics, like any other ethical action, is a ground for continuous disagreements and conflict at the individual and collective level. The differences of ethical codes are founded on different metaphysical values linked to ways of life, leaving little room for philosophical argumentation. Today, human ethical valuations range from those of the Anima Mundi groups and nations, to mixtures of different kind of universalisms of the laws and gods, passing through the materialistic valuations of modern science. In this global milieu, if there is going to be any general reference frame for ethics it has to be the consensual international conventions and declarations where the social person of the human being is put, at least ideally, at the center of any medical action. The Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948, the Conventionfor the Protection of Human Rights and Fundamental Freedoms of 4 November 1950, the Conventionon the Rights of the Child of 20 November 1989, are today the pillars for any medical ethics, not as a final charts, but as starting points for further development.

When we talk about medical ethics we are therefore talking about a praxiological action (ethical and political) with epistemological consequences. The definitions of life, death, person, human being, sickness, health, pain, individual consciousness, etc., -according to our present knowledge of the universe- determine intellectual frames of reference that will produce new emotional and cognitive horizons. Such an expansion is not ethically easy. Medical ethics needs to be expressed through non-contradictory critical argumentations and not simply by sterile appeals to religious or political authority. To this methodological axiom, I would add the inspiring role of two ethical values which underlie not only the Hippocratic Oath, but also Aristotle’s works on ethics: love for life and valor.