Legal and bioethical principles. Separation, connection, integrationThis work is intended to establish relationships between legal and bioethical principles especially when bioethical principles complement and enrich legal ones in order to solve a specific case. Prior author’s contributions on bioethical principles as legal topics and legal bioethics creation in terms of a branch of bioethics which studies legal regulations as well as legal implementation and scope of bioethical problems are referred, making a critical reflection on growing and fruitful relationships between bioethics and law. An Interdisciplinary integration proposed in order to realize cooperation between both fields rejecting a separation or mere connection is suggested: «hetero integration», an integrating system produced by development of common and related principles. The article concludes stating that law structure is a «textual» subject not just involve on the writing of the law but capable to be analyzed from a social sense point of view, conferred to different manifestation of this discipline together with several social practices; a path warning by the need to broad theoretical-practical frameworks in order to move towards the interdisciplinarity taking into account bioethics from its foundations. / El objetivo de este trabajo es examinar la relación que existe entre los principios jurídicos y los principios bioéticos, en particular cuando los principios bioéticos enriquecen y complementan los principios jurídicos en la solución del caso concreto. Se acude a aportes anteriores del autor sobre los principios bioéticos como tópicos jurídicos y la creación de la bioética jurídica como rama de la bioética que estudia la regulación jurídica y las proyecciones y aplicaciones jurídicas de la problemática bioética y permite, como se procura aquí, una reflexión crítica sobre las crecientes y fecundas relaciones entre bioética y derecho. Desechada la separación y aun la mera vinculación, se propone una integración interdisciplinaria tendiente a instrumentar la cooperación entre ambos campos: heterointegración, producida por desarrollo de principios comunes y afines. Se concluye que el derecho constituye una materia textual, susceptible de ser analizada desde una perspectiva que no se agota en la mera escritura de la ley, sino que intenta captar la producción de sentido social que se inviste en las diversas manifestaciones de esta disciplina y que abarca distintas prácticas sociales, senda por la que se advierte la necesidad de ampliar los marcos teórico-prácticos para poder transitar la interdisciplinariedad y en la que no debe faltar la bioética desde sus principios

Body Integrity Dysphoria (BID) is a rare condition where a person has a desire to become disabled. This desire creates distress so intense that some request, and in a few cases have received, disabling surgery. The condition has raised debate, both concerning the BID suffers autonomy and whether the disabling surgeries conflict with the medical profession's obligations to respect patients’ autonomy, promote well-being and not do harm. In this paper, I argue that some BID sufferers plausibly possess the abilities required for medical decisionmaking, which means that they could be sufficiently autonomous to make a decision about disabling surgery. Further, I argue that if a BID sufferer is decision-making competent, and if disabling surgery is expected to have therapeutic benefits that outweigh the expected harms, and if no other treatments have proven effective for them, then it seems morally permissible for the medical profession to offer them disabling surgery as an experimental treatment.

The object of this thesis is the foundation of ethics. The question is whether there exists a universal core to ethics consisting of a fundamental ethical principle across cultures. This principle could for example be the so-called Golden Rule, which goes as follows: ‘You should do to others what you want them to do to you’. The Golden Rule is to be found in many of the world’s religions and is also reflected in secular society. The rule can for example be found in a political version in legal declarations e.g. the Humans Rights Declaration of 1948. There are philosophersand scientists who interpret the Golden Rule secularly. If one looks at the Golden Rule from a non-religious point of view, it can be understood for instance in the following ways: 1) As a rule which is followed to fulfil self-interest and 2) As a rule concerning role reversal. In this thesis we will go into detail on these two interpretations of the Golden Rule, because as we will see, they can be seen as two very different views of human nature. We will discuss which of the two interpretations of the Golden Rule is most adequate in connection with the description of human beings as moral agents having reason, motives, freedom and responsibility. Furthermore we will focus on the Golden Rule in a Nordic context, in this connection we will look at whether the Golden Rule corresponds to the four bioethical principles presented by the two American philosophers Tom L. Beauchamp and James F. Childress. These principles are the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence and the principle of justice. According to the Danish physician Henrik R. Wulff one cannot use Beauchamp and Childress’ bioethical principles as a tool for solving ethical problems in the North, because they do not correspond to the Golden Rule. Wulff argues that the Golden Rule is a moral ideal within the health services in the Nordic countries. The purpose of the thesis is, among others, to analyse and discuss whether the four bioethical principles are implicitly contained within the Golden Rule and whether Beauchamp and Childress’ method can be used to analyse bioethical problems in a Nordic context. Finally, we will set forth an ethical assessment of a treatment within biomedicine. As an example of the application of the four bioethical principles, we will look at whether human somatic gene therapy is an ethical acceptable treatment. Thus my thesis is that the Golden Rule can be viewed as a fundamental ethical principle across cultures and that Beauchamp and Childress’ four bioethical principles correspond to the Golden Rule. That is, I think there is a reason to maintain, that the bioethical principles can be of use for solving bioethical problems across cultures.

<p>The object of this thesis is the foundation of ethics. The question is whether there exists a universal core to ethics consisting of a fundamental ethical principle across cultures. This principle could for example be the so-called Golden Rule, which goes as follows: ‘You should do to others what you want them to do to you’. The Golden Rule is to be found in many of the world’s religions and is also reflected in secular society. The rule can for example be found in a political version in legal declarations e.g. the Humans Rights Declaration of 1948. There are philosophersand scientists who interpret the Golden Rule secularly. If one looks at the Golden Rule from a non-religious point of view, it can be understood for instance in the following ways: 1) As a rule which is followed to fulfil self-interest and 2) As a rule concerning role reversal. In this thesis we will go into detail on these two interpretations of the Golden Rule, because as we will see, they can be seen as two very different views of human nature. We will discuss which of the two interpretations of the Golden Rule is most adequate in connection with the description of human beings as moral agents having reason, motives, freedom and responsibility. Furthermore we will focus on the Golden Rule in a Nordic context, in this connection we will look at whether the Golden Rule corresponds to the four bioethical principles presented by the two American philosophers Tom L. Beauchamp and James F. Childress. These principles are the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence and the principle of justice. According to the Danish physician Henrik R. Wulff one cannot use Beauchamp and Childress’ bioethical principles as a tool for solving ethical problems in the North, because they do not correspond to the Golden Rule. Wulff argues that the Golden Rule is a moral ideal within the health services in the Nordic countries. The purpose of the thesis is, among others, to analyse and discuss whether the four bioethical principles are implicitly contained within the Golden Rule and whether Beauchamp and Childress’ method can be used to analyse bioethical problems in a Nordic context. Finally, we will set forth an ethical assessment of a treatment within biomedicine. As an example of the application of the four bioethical principles, we will look at whether human somatic gene therapy is an ethical acceptable treatment. Thus my thesis is that the Golden Rule can be viewed as a fundamental ethical principle across cultures and that Beauchamp and Childress’ four bioethical principles correspond to the Golden Rule. That is, I think there is a reason to maintain, that the bioethical principles can be of use for solving bioethical problems across cultures.</p>

A biotecnologia trouxe grandes transformações para a saúde, a doença e a morte e sua influência modificou conceitos e o meio ambiente cultural. Os ritos de morte do passado, que aconteciam na família e na comunidade mudaram para os hospitais e para as unidades de tratamento intensivo, de modo que a morte ficou invertida ou medicalizada. A tecnologia permitiu um afastamento da morte e um prolongamento da vida, especialmente, na moderna técnica de transplantes de órgãos. Assunto polêmico mundialmente, o momento do morrer tem significância ímpar para a sociedade, visto tratar-se de um processo incerto e complexo que tem necessidade de determinantes legislativas. Pontuar uma reflexão na esfera ética, jurídica e biológica sobre a morte, tem grande atualidade e significado para a comunidade em geral e para aquela que espera pela doação de órgãos a fim de ter recuperada a saúde e a vida. O tema deste estudo focaliza a compreensão do conceito de saúde e as representações sociais da morte e como elas exercem influências no momento da morte encefálica, indispensável para que se realize a remoção dos órgãos vitais para transplantes. O estudo, atento aos princípios da justiça, autonomia e beneficência, princípios bioéticos relacionados aos princípios constitucionais e refletidos sob a luz da Constituição Federal 1988, da Declaração Universal de Bioética e da legislação específica para transplantes aponta para uma possibilidade integradora com o direito à informação, na tentativa de refletir-se sobre um novo conceito de cidadania. O fulcro do estudo é a presença do princípio da dignidade humana, como formatador do novo conceito de cidadania em relação à saúde, doença e morte em tempos de pós-modernidade. Tem relevância para a sociedade que vivencia estes conflitos e incertezas, quanto às possibilidades do acesso aos órgãos necessários para a cura de doenças graves e fatais. Analisa-se a responsabilidade da assistência à saúde como dever do Estado e ônus da sociedade, concluindo com algumas soluções para o ambiente da saúde e de vida com qualidade tanto para os que estão no final da vida como para os receptores em espera por mais vida; todos sujeitos de direitos fundamentais protegidos pela Constituição Federal. / Submitted by Marcelo Teixeira (mvteixeira@ucs.br) on 2014-05-20T16:08:46Z No. of bitstreams: 1 Dissertacao Marcia Lionco.pdf: 761597 bytes, checksum: 8ba7ff98ff08eb745c9ded210f8bfaee (MD5) / Made available in DSpace on 2014-05-20T16:08:46Z (GMT). No. of bitstreams: 1 Dissertacao Marcia Lionco.pdf: 761597 bytes, checksum: 8ba7ff98ff08eb745c9ded210f8bfaee (MD5) / Biotechnology has brought about great transformations in health, disease, and death, and its influence has modified concepts and the cultural environment. The rites of death from the past, which took place in the family and the community, have shifted to hospitals and intensive care units, so that death has become inverted, or medicalized. Technology has allowed a step to be taken back from death, and the prolonging of life, especially in the modern organ transplant techniques. Controversial all over the world, the moment of death has unparalleled significance for society, as it is an uncertain and complex process that requires legislative determinants. Reflection in the ethical, legal, and biological sphere on death is of great current significance for the community in general and for those waiting for organ donation to recover their health and life. This study focuses on comprehension of the concept of health and social representations of death, and how they excise influence at the encephalitic moment of death, which is essential to the removal of vital organs for transplant. The study, respecting the principles of justice, autonomy, and beneficence, bioethical concepts regarding constitutional principles and reflected on in the light of the Brazilian Federal Constitution 1988, the Universal Declaration of Bioethics, and specific legislation for transplants, indicates the possibility of integration with the right to information, in an attempt to reflect on a new concept of citizenship. The fulcrum of the study is the principle of human dignity, as the formatter of a new concept of citizenship in regard to health, disease and death in post-modern times. It is of relevance to society living through conflict and uncertainty over the possibility of access to organs needed to cure serious and fatal diseases. Finally, it analyses the responsibility held by health assistance as a duty of the State and its onus on society, concluding with some solutions for the health environment and for a life of quality both for those who are at the end of their lives and those receptors in waiting; all people with fundamental rights protected by the Brazilian Federal Constitution.

A biotecnologia trouxe grandes transformações para a saúde, a doença e a morte e sua influência modificou conceitos e o meio ambiente cultural. Os ritos de morte do passado, que aconteciam na família e na comunidade mudaram para os hospitais e para as unidades de tratamento intensivo, de modo que a morte ficou invertida ou medicalizada. A tecnologia permitiu um afastamento da morte e um prolongamento da vida, especialmente, na moderna técnica de transplantes de órgãos. Assunto polêmico mundialmente, o momento do morrer tem significância ímpar para a sociedade, visto tratar-se de um processo incerto e complexo que tem necessidade de determinantes legislativas. Pontuar uma reflexão na esfera ética, jurídica e biológica sobre a morte, tem grande atualidade e significado para a comunidade em geral e para aquela que espera pela doação de órgãos a fim de ter recuperada a saúde e a vida. O tema deste estudo focaliza a compreensão do conceito de saúde e as representações sociais da morte e como elas exercem influências no momento da morte encefálica, indispensável para que se realize a remoção dos órgãos vitais para transplantes. O estudo, atento aos princípios da justiça, autonomia e beneficência, princípios bioéticos relacionados aos princípios constitucionais e refletidos sob a luz da Constituição Federal 1988, da Declaração Universal de Bioética e da legislação específica para transplantes aponta para uma possibilidade integradora com o direito à informação, na tentativa de refletir-se sobre um novo conceito de cidadania. O fulcro do estudo é a presença do princípio da dignidade humana, como formatador do novo conceito de cidadania em relação à saúde, doença e morte em tempos de pós-modernidade. Tem relevância para a sociedade que vivencia estes conflitos e incertezas, quanto às possibilidades do acesso aos órgãos necessários para a cura de doenças graves e fatais. Analisa-se a responsabilidade da assistência à saúde como dever do Estado e ônus da sociedade, concluindo com algumas soluções para o ambiente da saúde e de vida com qualidade tanto para os que estão no final da vida como para os receptores em espera por mais vida; todos sujeitos de direitos fundamentais protegidos pela Constituição Federal. / Biotechnology has brought about great transformations in health, disease, and death, and its influence has modified concepts and the cultural environment. The rites of death from the past, which took place in the family and the community, have shifted to hospitals and intensive care units, so that death has become inverted, or medicalized. Technology has allowed a step to be taken back from death, and the prolonging of life, especially in the modern organ transplant techniques. Controversial all over the world, the moment of death has unparalleled significance for society, as it is an uncertain and complex process that requires legislative determinants. Reflection in the ethical, legal, and biological sphere on death is of great current significance for the community in general and for those waiting for organ donation to recover their health and life. This study focuses on comprehension of the concept of health and social representations of death, and how they excise influence at the encephalitic moment of death, which is essential to the removal of vital organs for transplant. The study, respecting the principles of justice, autonomy, and beneficence, bioethical concepts regarding constitutional principles and reflected on in the light of the Brazilian Federal Constitution 1988, the Universal Declaration of Bioethics, and specific legislation for transplants, indicates the possibility of integration with the right to information, in an attempt to reflect on a new concept of citizenship. The fulcrum of the study is the principle of human dignity, as the formatter of a new concept of citizenship in regard to health, disease and death in post-modern times. It is of relevance to society living through conflict and uncertainty over the possibility of access to organs needed to cure serious and fatal diseases. Finally, it analyses the responsibility held by health assistance as a duty of the State and its onus on society, concluding with some solutions for the health environment and for a life of quality both for those who are at the end of their lives and those receptors in waiting; all people with fundamental rights protected by the Brazilian Federal Constitution.

Trata a presente tese de uma pesquisa vinculada à linha de pesquisa de Políticas Públicas do Centro Universitário de Brasília – UniCEUB, que tem como propósito atestar a possibilidade de se aperfeiçoar a Política Nacional de Biossegurança com vistas à devida segurança alimentar de organismos transgênicos, em observância aos princípios bioéticos da autonomia, beneficência, não-maleficência e justiça; e da precaução, juntamente. Estabeleceu-se um fio condutor lógico, perpassando por conceitos operacionais fundamentais, análise de doutrina, julgados, pareceres conclusivos para liberação comercial de organismos transgênicos para consumo humano, e entrevistas realizadas com ex-membros da Comissão Técnica Nacional de Biossegurança - CTNBio. O estudo, para tanto, foi delineado em quatro eixos: conceitual operacional, político normativo, analítico e propositivo. Partiu-se de correlações entre os princípios bioéticos e da precaução, responsabilidade ética e equidade intergeracional, tendo como ponto convergente a segurança alimentar frente os organismos transgênicos. Foi realizada, em seguida, problematização quanto a relação entre transgênicos, bioética e meio ambiente equilibrado, por meio de análise crítica da atual legislação. Posteriormente foi realizado o estudo de Pareceres Técnico Conclusivos de liberação comercial de organismos transgênicos, emitidos pela CTNBio. Por fim, analisou-se um conjunto de políticas conectadas com segurança alimentar, bioética e transgênicos e entrevistou-se ex-membros da Comissão supracitada, no intuito de confirmação de dados colhidos via legislação, doutrina e pareceres. A realização da pesquisa possibilitou concluir que os princípios bioéticos não são utilizados quando dos estudos para a liberação comercial de transgênicos, muito menos quando da construção da Política de Biossegurança atual. Sugere-se que tais princípios são condição sine qua non para toda a lisura do processo, e que a adoção dos mesmos possibilitaria o fortalecimento do princípio da precaução. Garantir-se-ia, inclusive, a devida participação social e científica interessada, cumprindo o solicitado pelo Estado de Direito Ambiental, frente ao solicitado pelo meio ambiente equilibrado. / This present thesis is linked to the public policies research of Centro Universitário de Brasília - UniCEUB with the purpose to attest the possibility to develop a National Policy of Bio-security with the proper of transgenic organisms observing the principles of bio-ethic autonomy, beneficence, not-maleficence, justice and precaution. It was established a logical thinking through fundamental operational concepts, doctrine analysis, decisions, conclusive legal advices to the commercial releasing of transgenic organisms to human consumption and interviews with ex members of Comissão Técnica Nacional de Biossegurança - CTNBio. This research was developed in four parts: Conception, operational, normative political and analytical and propositional. It was started with the relations among the principles of bio-ethicals and precaution, ethical responsibility, inter-management of equity as convergent point the food security to transgenic organisms. It was done following this the problematisation with the relation among the transgenic, bio-ethic and proper environment through a critical analysis of legislation in force. Lately it was done a study of conclusive technical advices of transgenic organisms commercial releasing emitted by CTNBio. Finally it was analyzed the group of connected policies related to food security, bio-ethic and transgenic organisms and interviews of ex members of CTNBio to confirm the collected data through legislation, doctrine and advices. It was possible to conclude with this research the the bio-ethical principles are not used with the commercial releasing and also the building of Bio-security Policy in force. It is suggested that this principles are a condition sine qua non to the whole process smoothness and the adoption of these principles would reinforce the principle of precaution. It would be also ensured the right social and scientific participation in accordance what is asked by environmental law and environment.