Keywords

During the last 30 years medical science has progressed by leaps and bounds, but oddly enough, never before has human life been threatened so much and so directly from this progress. It is the first time that scientists have not realized so tragically their responsibilities arisen from a thoughtless disperse of medical methods, which could eventually put the subsistence of the human beings itself into jeopardy. Both in an international level and a national one, medical unions, states and governments seek for a code of ethics in medical behavior which is generally accepted, avoiding any kind of dogmatism that would immerge from ideological, philosophical, political, or religious thoughts on behalf of the doctors, as well as their consequent parameters which is propaganda, fanaticism, and enforcement.

In other words there is a demand for an ethical direction in science with the best possible minimalism, so that its directions do not insist on minor problems of inferior or disputable correctness but focus major and more serious problems that common conscience of obligation leads every person to enlisting for a common target.

Modern achievements of Medicine are spectacular, like those of biotechnology and genetic engineering. Unfortunately, not only in personal but also in societal level, modern ethics is in a state of crisis. The apparent progress in the sector of medicine has already created the frame of new perspectives in fields like life expectancy, dealing or totally eradicating diseases that would be incurable during past centuries as well as the potential through medical research to provide with revolutionary solutions in matters like reproduction, study, analysis even interventions, or alternations in human genome, in other words DNA.

However, at the same time it is obvious that through all this progress that there are some ethical dilemmas arising according to which society is wondering if and to which level it is legal and feasible medical research to cross some boundaries. These boundaries have been obviously set based on some commonly used ideas and worldviews which inmost till today, in the technological and scientific progress era, seem to imbue the common subconscious with a nexus of traditional ethic codes. For instance religious codes, however, regressive they may appear nowadays.

In this case, there is an obvious effort on behalf of nations nowadays to set a total code of rules according to which the deontology issue in case of medical research can be adjusted. Today, we examine this very thinking, which is the need for medical deontology to exist. “What is medically amazing doesn’t necessarily mean it is ethically accepted” (Alachiotis 2004).

Medical Deontology Code

First of all, it should be noted that The Medical Deontology Code was published on November 28, 2005, while the first one can be located in the work of Hippocrates (Jones 1868). Specifically in Unit 7 titled “Scientific Research” and in articles 24–27 there is a reference on the preconditions for medical research in humans, for clinical research in new medicines or modern curing and diagnostic methods, for non-remedial biomedical research and finally for the publicity of the discoveries.

The research that has human beings as its objective (experimental subject) should have its dominant aim the prevention of diseases, the preservation and the furtherance of health and generally the amelioration of human life and the society (Politis 2006).

Ethics should rely on three basic principles:

  • respect for human personality

  • science propulsion with legitimate means

  • avoidance of desiring reckless profit and any kind of human being exploitation

According to these principles, human being focused research should be driven by respect for genetic identity of a human being, the right of explicit consent and confidentiality of personal data, the exclusion of any kind of human body exploitation even it means organs or cell genome, either for financial reasons or patent actualization purposes. Researchers should pay respect and protect human rights as well as citizen rights and therefore neither taking part in illegitimate inequitable and segregative practices deliberately, nor convincing at them.

From the previous it is obvious that some dilemmas arising directly as far as the medical research ethics is concerned, as well as to “when it can be moral or not.”

For instance, in the case of stem cells research (actually they are fetal cells at their primary phase of their development, 4–5 days); there were plenty of controversies from the beginning, especially in the USA, with the mindset that the dominant, but not the unique, source of stem cells are embryos coming either from vitro insemination (Vidalis 2013) or abortions. At the heart of these dilemmas, there are some perceptions on human life protection, therefore fetus’ life. Some points of view with metaphysical background have been supported, according to which “human life is absolutely protected by the time of its first existence.”

Through several perceptions with metaphysical essence, there is a basic skepticism accruing on the possibility of usage for medical research: can we destroy several types of life (human) even if we have to do with the simplest of these lives like, for example, in the case of a fertilized ovum?

In case of cloning there is undoubtedly the relevant legislative adjustment both abroad and Greece according to which human cloning is forbidden. In our opinion, correctly enough, the idea lies to the fact that there is a danger of some conditions and eugenic genetics to accrue, in terms of personal and ideological targets and resultants. The last one has been connected with some relevant researches that several German scientists have conducted during the Nazi dominant period in Germany. Those researches, abiding to the ideological tenacities of the Nazi theories, were related with the effort to produce human beings by order through genetics, which would eventually meet the Nazis’ evolutionary supermen expectations.

Surely, the thought and the potential of having a baby by order which could very well carry genetic elements that you would prefer personally (for instance hair color or eye, body construction characteristics or physical power, etc.), can be undoubtedly very attractive for a lot of people. Nevertheless, it is a case that “surpasses the limits of right to reproduction, aiming at replica production of those who has it, in order either to satisfy his narcistic tendencies or the absolute control of the clones’ life”: in the name of a misinterpreted right, the human dignity is being underestimated by the time the “clone” is being used as a simple “medium” for other purposes.

At the same time cloning puts a limit on the genetic variety of the human species. By this way, if it spreads it is quite possible that human will be deprivated of his capability of adjusting to the process of evolution, and consequently this will lead to his biological degeneration step by step. Cloning, by means of sex and other features consists a eugenic method, which will lead to illegitimate social discriminations in a society of equality.

The knowledge of predetermination of features encumbers the “clone’s” personality crucially and continuously. On the one hand he is an equal subject of the human value—so he is independent “by nature”—on the other hand he carries the burden to prove in his whole life the difference from the “prototype”. In other words this method fillips every single person’s “uniqueness”, which is the necessary precondition of his practical enjoyment of his autonomy.

As far as the deontology in other sectors of medical research is concerned, like in several pharmaceutical products, it is obvious that in case that they are about to be tested on human beings, there is a necessity for the consent on behalf of the person who is about to be used as a guinea pig actually. Apart from consent, doctor has the obligation to indicate any possible side effects of the tested medicine (Vidalis 2013).

Conclusions

Recent progress in field of medical research (with prevailing fields like this of genetics) leaves us speechless by all means but at the same time it creates a series of speculation even objections on how they can be held and where they can aim sometimes.

Clinical research conduction in humans—either it concerns medicine or other therapeutic means—and biomedical research that includes edition of biological specimens of people or editing biological personal data, requires today the austere compliance of certain ethical standards, for the protection of anyone who participates. From the guarantees for the compliance to these standards, the funding by public carriers depends (ex. EU) but also the wide publication of the results of a research (something that concerns any research that is privately funded). So ethics in a research has an impact on the scientific reliability itself. The control of the deontology should be efficient: to guarantee the protection of the participating persons’ rights, offering suitable solutions so as the research to carry on integrally.

Based on the Christian ethics (Pellegrino and Gray 1994), a person’s internal value is considered to be valuable and non-negotiable as an ambiguous, unrepeatable, priceless and unique species on earth. The recognition of this fundamental principle unstrainly equals to every human’s right to enjoy respect and honor for his life and his human dignity. This right is absolute and is a safe guide to every initiative that has human and his health as its main topic. Consequently, human life is an inviolable and totally respected good, that is why the right to life always precedes to the physical integrity, which should be observed especially in cases like transplants, which criteria must be objective and absolutely clear. Otherwise there is a danger to abuse the living donor, if he is a defenseless person. Acceleration of this death or misleading certificate must be avoided.

Of course the general direction here is that through revolutionary medical researches humanity has got the capability to cope up with disease that would remain incurable during the past and that generally there is a chance given to the human life expectancy and to forward some programs that would be of benefit to the population’s health.

In some cases these medical researches can be the springboard for the planning and interests promotion, with personal, political, ideological or simply financial aspect, which will eventually lead to human beings and societies to suffer damages in the long run. The suggested solutions to bioethical problems are related to everybody’s metaphysical beliefs (Koumantos 2003).

Medical research is neither unlimited nor uncontrolled. It is true that medicine progress has been based upon research that has to do with human experimentation. But this research either for curing the particular disease or for aiming to the advance of science has to take into account the ethic and spiritual principles as they were experienced and are experienced today in the European space, and especially humans’ respect to the human person and his dignity. Bioethics is not coming to put a halt on progress; on the contrary it is coming to prove those safeguards that will ensure the respect for human dignity, autonomy, and meritocratic living (Dragona 1989).

Bioethics purpose is not to put limits on science but show new roads. These roads define, not restrict. Its purpose is not to issue consensus or prohibitive prescriptions for every serious problem, but notify about the basic bioethical principles, inform for any consequences that human consent may have in a new technology, making then human responsible for his decisions toward new generations.

That is the reason why it is necessary for a deontology frame to exist, by which some limits and inviolable rules would be set; the spirit of the rules will be dripped in every stakeholders (doctors, researchers, studiers, genetic material donor, etc.) In this point the legal frame contribution could be considered as extremely important, as well as the corresponding state intervention, so that this deontology to be officially grounded but protected too.

We should remember that it is not enough for someone to be a good doctor, but a nice colleague instead.

The protection of human life, health, and dignity precedes the interests of science or society.