Become the universal moral consciousness of our society.
The essence of bioethics
Bioethics originated in the United States in the 1960s. In just over 40 years, it has gone through an extraordinary road from concrete to abstract, from ethical concept to practical operation. At this moment, we can and need to refine the fundamental purpose of this young discipline, which will help us to understand bioethics and its influence on our times more deeply.
Bioethics originates from the solution of moral problems such as human experiment, euthanasia, organ transplantation, assisted reproduction, birth control and genetic eugenics, that is, it starts from problems. For example, can experiments be conducted on people without the knowledge of patients or subjects? Is it against medical purpose to turn off the ventilator of brain-dead patients? In the case of a serious shortage of organs, can the sale of organs be allowed? Will a large amount of money invested in the research and development of artificial organs cause unfair distribution of social resources? Can a fetus with genetic defects prevent birth? How to determine the parents of IVF? These problems brought by the new biomedical technology are unprecedented, and the interests involved are complicated. Although traditional ethics (theoretical ethics) is also used in the research, on the whole, theory can not meet the needs of reality. Therefore, bioethics seems to have achieved early results with the research paradigm of "taking things as they are", such as demonstrating and establishing medical ethics and biological research norms such as safety first, informed consent, patient autonomy, prohibition of organ trading and protection of patient privacy. These achievements not only answered practical questions and met scientific and technological challenges, but also activated or saved the ancient and boring theoretical ethics, and even helped practice, which induced the patient rights protection movement in many countries.
Even though the initial stage of bioethics is problem-based research, it has laid the most basic foundation for the development of the discipline. At the end of 1970s, bioethics began to enter the stage of theoretical construction. On the one hand, the territory of "solving difficult problems" is constantly expanded, and new problems such as genetic engineering, public health ethics, gene therapy, behavior control of mental patients and genetic counseling are brought into view; On the other hand, it tries to summarize and extract the basic principles of bioethics from specific norms. The representative results are as follows: 1978, the State Committee for the Protection of Human Biomedical and Behavioral Research Objects published the Vermont Report, which put forward three principles of respect, benefit and justice, and believed that it could be widely used in medical and health services. 1979, Biot Chip and Chadriss published Fundamentals of Bioethics, which put forward four principles of independence, benefit, harmlessness and impartiality, which are the famous "four basic principles" in international medical ethics and bioethics. Although the four principles have also been criticized, they have been widely recognized. Scholars all over the world use it as a theoretical tool to analyze and solve new ethical problems such as transgenic technology, human genome research, cloning technology, stem cell research, regenerative medicine, AIDS and so on. In the activity of "solving problems", the four principles have been enriched, expanded and concretized; In order to solve the contradiction between the principles, this paper shows many auxiliary assumptions and explanations. What is more gratifying is that in recent years, some achievements have been made in the exploration of bioethics methodology. As a result, the basic theory and method system of bioethics with the four principles as the core is gradually enriched.
The four principles are the four basic values of bioethics and the four basic standards of bioethics evaluation. What are the ultimate values and higher standards that run through the four principles? It is the principle of respecting life. Autonomy, advantage, harmlessness and justice all point to human life. All theories and practices of bioethics are demonstrating, advocating, implementing and promoting the moral concept of respecting life. Respect for life is the fundamental purpose or theme of bioethics.
Establish the principle of respecting life
Respect for life includes respect for human life and a certain degree of respect for non-human life. After the birth of environmental ethics (eco-ethics), it undertook the task of showing and publicizing respect for non-human life and inanimate nature. Therefore, in the context of bioethics, respecting life means respecting human life forms, mainly respecting the biological existence and health interests of each individual.
Respect for life, as a simple moral concept, has a long history. In primitive religions, three major religions, tribal customs and traditional morality, there are moral contents or admonitions to respect, love and fear life. Why should we respect life? In these early moral consciousness, the answers are mainly in two ways: divinity and intuition. Because man was created by the supreme God, he was painted with divine light. To respect God, one must love others and respect human life. Religion has never been the leading force of our national spirit, and Confucianism explained why we should respect life in an intuitive way. "Don't do to others what you don't want them to do to you." If you don't want to hurt your own life, you can't hurt others' lives; Everyone has compassion, and instinctively feels pain when others are sick, bleeding and their lives are destroyed. So the heart of sympathy, the virtue of good life is produced. Since the thinkers represented by Kant put forward that morality should be based on pure rationality and become practical rationality, ethics began to look for the basis of respecting life from rationality. There are three main reasons for summing up modern ethical thoughts and respecting life.
First, it is proposed that man is an end, not a means, so life must be respected. This is the basic idea of deontology. All human thoughts and actions are for the pursuit of human happiness, and human beings are an end in themselves. The material wealth, art, science and technology, education and even the country and government created by human beings are ultimately the means to serve people. Buying and selling human organs, buying and selling blood, and surrogacy fees. It is unfair to take the noble life or part of life as an end and a means of profit. Criminals regard the life of miners, the life and health interests of abducted women and children and food consumers as a means of profiteering, which is a blatant provocation to respect the principle of life. "Man is a respectable object, which means that we can't treat him casually ... He is an objective purpose and a person who exists as a purpose. We can't just change his position as a means to achieve a certain goal. " (Kant: Fundamentals of Moral Metaphysics, quoted from Zhou Fucheng: Selected Works of Western Ethics, p. 37 1 p.)
Second, it is pointed out that man is the highest value, so life must be respected. This is the theoretical basis of utilitarianism. There are thousands of values in the world. When different values conflict and different people's interests contradict each other, utilitarianism advocates that by calculating values and weighing interests, the choice that can make the most people get the greatest happiness is oriented. Because human life is the first prerequisite to realize happiness and all other values, for an individual, losing life means losing the whole world, and once lost, life can't be recovered. Therefore, utilitarianism undoubtedly gives life the highest value in value comparison. Since human life is the highest value, there is no equivalent, so we say that life is priceless. Why does our government resolutely oppose reproductive cloning while approving and supporting therapeutic cloning? It is precisely because we believe that the latter won the treatment to save the lives of countless patients at the expense of early human embryos (cell mass 14 days ago). Gains and losses are relative rights, which can better reflect the respect for human life.
Third, it is believed that respect for life has the greatest universality, so life must be respected. This is based on the feasibility of ethical principles. The values of different cultural groups are different, but as long as they are not anti-human cultures (such as cults), I am afraid they will all agree with cherishing and caring for life. Because everyone wants his life not to be harmed, and everyone wants others to respect his life and health. How is this environment possible? Only when everyone respects the lives of others can it be established. Respect for the universality of life has another meaning. We can't expect everyone to be selfish and dedicated to others. This is a high-level and high-level moral requirement. But we can ask everyone to respect others' lives, and we must never hurt others' lives without justifiable reasons. This is the bottom line morality and the most common morality.
The above three reasons complement each other and constitute a strong argument for respecting the principle of life, making it an irrefutable and unquestionable "absolute order". The key to the rapid development of bioethics into a dynamic "universal ethics" lies in its simple, solid and modern ethical spirit of respecting life.
The mission of bioethics
The future direction of bioethics is: first, to inherit the tradition of research on problems and develop in the direction of institutionalization and mechanism, that is, to infiltrate the results of case studies into the legal rights system through academic research → ethics Committee → decision-making or legislation or formulation of management measures, and give full play to the guiding and normative role of ethics in practice; The second is to deepen theoretical understanding and build a theoretical platform for exchanges and dialogues between different cultural groups. Looking back at history, it seems to give people an impression that bioethics was born to solve moral problems in medical biotechnology; In order to continue to solve such problems. There is nothing wrong with looking directly at the problem. However, looking back, we feel more and more that bioethics has its social and cultural background. Especially in contemporary China, its rapid spread echoes the needs of social and cultural progress, and its development has historical significance beyond the boundaries of science and technology.
Over the past 20 years of reform and opening up, China has made remarkable achievements in economic development and improvement of people's living standards. However, in recent years, people's lives and health have been illegally violated. Major accidents or cases in food safety, production safety, traffic safety and law enforcement infringement have been frequently exposed and severely investigated, but the problems are still one after another. There is a question of understanding and attitude towards life.
It is a long way to go to establish and improve our nation's life values and bioethics. The direct task of bioethics is to solve the development direction and behavioral norms of biomedical technology, but its ultimate value and mission is to carry forward the ethical spirit of respecting life. The research and education of bioethics is to solve the conflict between the development of science and technology and the dignity of life from a special perspective, and repeatedly emphasize and show people and society that human life has lofty value, so that everyone can enjoy a special dignity and majesty as a human being, that is, human dignity. Human dignity makes it different from things and other non-human life forms, and it must be respected to the highest degree. In the historical process of implementing people-oriented Scientific Outlook on Development and building a harmonious socialist society, China's bioethics shoulders the sacred mission of popularizing and respecting life as the bottom line ethics in the whole society.