Medical ethics and bioethics in Europe
Definitions and approaches
The term “medical ethics” is often used to refer to the deontology of the medical profession covering issues such as moral rules, rules of etiquette and rules for professional conduct. The word “deontological” comes from the root “deon” which means duty or obligation in Latin. In some countries, codes or medical ethics have been supplemented by patients’ rights laws. There is a difference between the two in that the former emphasizes the obligations and duties of doctors whereas the latter usually involves some form of legal right or entitlement. Nevertheless, in some countries codes of medical ethics are enshrined in law and consequently take on a legal status (with regard to the obligations of healthcare professionals). Hoy (2004) argues that obligations which are enforced and hence not undertaken freely, are not in the realm of the ethical. For example, in countries where slavery has been abolished or certain forms of animal experimentation made illegal, such issues move from the realm of the ethical to that of the legal. On the other hand, certain practices such as abortion or euthanasia have been legalized in some countries but are not accepted some groups in society as being ethical.
The term “bioethics” was used for the first time by Potter, a biologist, in 1970 to refer to ethical problems linked to the present and the future of life in general and of human life in particular. Later, Helleger used the term to refer to a way to approach and resolve the moral conflicts raised by modern medicine (Gracia, 2001).
Bioethics is not just a series of principles but implies, in the European tradition at least, a moral obligation to act. Kant, a German philosopher from the Enlightenment period, was concerned with the motivation behind any action. He stated that action done from duty has its moral worth not in the purpose to be attained by it but in the maxim in accordance with which it is decided upon. He developed the Categorical Imperative which states, “Act only on that maxim whereby you can at the same time will that it should become a universal law or a universal law of nature” (In Kuczewski, 2004).
In Europe, bioethics is very much based on the principle of solidarity, as well as freedom, tolerance, equal opportunity, social justice and human dignity. The gradual and continued expansion of the European Union has led to new possibilities and potential problems in the health care domain. At the same time, efforts are constantly underway to harmonise health care provision, promote cooperation and find consensus on a variety of healthcare issues. In 1992, the Maastricht Treaty on the European Union made public health an object of EU policy (Ten Have, 2001).
However, long before this, the Council of Europe had decided to set up a single specialised committee to deal with bioethical issues. This committee, the Steering Committee on Bioethics, was granted permanent status in 1992. This came just one year after the Commission of the European Union set up the Group of Advisers on the Ethical Implications of Biotechnology (GAEIB).
In 1997, the Council of Europe’s Convention on Human Rights and Biomedicine was signed by 21 member states in Oviedo, Spain. Its emphasis on the principles of human dignity and solidarity can be clearly detected in some of the recitals of the preamble:
- Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being;
- Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;
- Affirming that progress in biology and medicine should be used for the benefit of present and future generations;
- Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;
- Wishing to remind all members of society of their rights and responsibilities.
Last Updated: Friday 09 October 2009