When we consider such topics as abortion vs. euthanasia, it is necessary to look into the concept of bioethics – a complex cultural phenomenon that has arisen as a response to the threat of moral and physical well-being of a person arising from the rapid progress in biomedical science and practice. The term was proposed in 1970 by an American oncologist Van Rensselaer Potter. He called for uniting representatives of the humanities and natural scientists (especially biologists and physicians) to provide decent living conditions for people. According to Potter, science of survival should not be just a science, but rather new wisdom, which would unite the two most important and critical elements – the biological knowledge and human values.
Significance and importance of the existence of bioethics as a social institution can be demonstrated by referring to the so-called Christian Barnard incident. On December 3, 1967, South African surgeon Christian Barnard was the first in the world to perform heart transplanted from one person to another. He saved the life of a terminally ill person, taking a beating heart out of a woman, whose brain was irreversibly damaged by a car accident.
Public reaction to this revolutionary event proved to be extremely controversial. Some praised Barnard as a hero who created the method that could save hundreds of thousands of terminally ill people. Others, however, accused him of the murder: he removed the still-beating heart. Interrupted one life to save another! Did he have the right? Or it was not killing in fact if the person’s brain was already dead? Admissibility of this kind of medical procedures from ethical, moral, religious point of view is the subject of bioethics.
Logical question is why it was necessary to create and develop such a social, scientific and philosophical institution as bioethics, as for centuries medicine and science alone solved similar problems? In fact, well-known, for example, is the Hippocratic Oath, which for many centuries served as a foundation for professional ethics of physicians, and the role of leading physicists in the movement to ban nuclear weapons testing and the position of biologists in the fight for the environment is difficult to overestimate.
The main difference of bioethics from traditional, Hippocratic, ethics, is that the latter has merely a corporate nature. It considers doctor as the sole moral subject performing a duty to the patient, which is passive and does not participate in the development of a vital decision for him, as is in the role of the suffering individual. Bioethics is based on the idea of active patient who as a moral entity enters into complex dialogical (and sometimes competitive) relations with other subjects – doctors and scientists.
Traditional values of mercy, charity, not causing harm to the patient, the moral responsibility of physicians does not detract. Just in the current social and cultural situations, they get a new meaning and a new sound. Much more attention is given to the society moral worth of the individual as unique and inimitable personality. In the center of the moral consciousness there is the idea of human autonomy, its inalienable right, documented by international and national law, to independently make the most important decisions about his own life.
Among the major problems in bioethics, there are euthanasia (passive or active, voluntary or forced) and abortion. A clear definition of a unified international euthanasia still does not exist. The volume of the concepts covered by this term is not the same, and the interpretation given by various authors are often incomplete and inconsistent. This term is used in a variety of phrases and has a different meaning, which causes confusion.
The term "euthanasia" was introduced in the XVII century by English philosopher Francis Bacon for light painless death, that is peaceful death without pain and suffering. Euthanasia is also defined as compliance with a request to accelerate the patient's death or the actions of agents, including the termination of artificial life-support measures. It is also deliberate acceleration of death of terminally ill to end their suffering.
These lexical interpretations certainly give some idea of what is euthanasia, but do not make clear in the question of what the scope of the possible use of the term is, since none of them can be considered exhaustive, including all the features and covering all possible situations.
For many years, the topic of euthanasia in society is a mixed reaction. Attention to the issue of euthanasia has increased with the development of social progress, and in particular - the technology of life support in critical care. Relevance of this topic is difficult to overestimate, first, because it is associated with the most expensive thing a person has - with his life, and secondly - because of poor knowledge of the problem, its lack of lighting in the writings of scholars lawyers and almost complete absence of relevant legal acts in the laws of many countries.
Numerous debates on this issue have been constantly erupting among doctors, lawyers, psychologists, politicians, religious figures. However, a clear answer to the question of the justification of the practice of euthanasia we cannot hear. In early 2005, the United States witnessed heated debate around the death of American Terri Schiavo, who for 15 years was in a coma, induced by clinical death and subsequent irreversible changes in the brain. By decision of the Court of the State of Florida, received by the suit of Michael Schiavo, Terry’s husband, she was disconnected from the artificial feeding, which meant a fortnight delayed death of the patient. Following this court decision, all of America actually split into two camps.
This example reflects the real attitude towards euthanasia in the world community, split into its intransigent supporters and opponents (Houghton 48). Both camps had fairly strong arguments that did not allow to reach any particular compromise. Numerous historical examples cited by opponents of euthanasia and supporting arguments "against", highlight the danger posed by the insufficient knowledge of the phenomenon. The very possibility of fixing euthanasia in law raises many questions and contradictions. This is confirmed by the experience of some foreign countries.
In particular, in one of the states of Australia – Northern Territory – the Act of May 25, 1995, allows active euthanasia under strict control and under certain prerequisites. Northern Territory occupies about one-sixth part of Australia, but its population is only 168,000 people. The bill was proposed by a member of parliament as the "Bill of Rights of the terminally ill in 1995." The project idea contradicts the position of the Australian Medical Association and community groups that protect the right to life. Voting took place not consolidated, each member of parliament expressed their opinion, regardless of the party's position on the issue. However, on March 25, 1997 the above-mentioned law of the Northern Territory was canceled (by 38 votes to 33). Such a position is contrary to the public opinion of lawmakers. According to the survey, for the possibility of euthanasia spoke 81% of the adult population of Australia. Also interesting is the Canadian experience: there are several lawsuits involving terminally ill people who are defending their right to commit suicide with a doctor's assistance. Senate Commission examined these cases, and in 1995 the Minister of Justice said that the legalization of euthanasia cannot be considered. At the same time, non-governmental organizations that defend and promote the right to a dignified death, a number of actions in support of the legal recognition of euthanasia were held.
In the Netherlands, euthanasia has until recently been theoretically banned. Nevertheless, in 1993 a law was passed that protects doctors from prosecution for euthanasia under certain conditions. On July 12, 1999, the Government presented a bill to legalize medical assistance in suicide. The bill was passed by the lower house of Parliament on November 28, 2000, and the Netherlands became the first country with a law on euthanasia and physician assisted suicide. Moreover, since March 1, 2012 in the Netherlands there began to operate special medical mobile teams to help seriously ill people to voluntarily withdraw from life.
In addition to national regulation on the permissibility of euthanasia, there exist international legal documents in this highly controversial area. In particular, under the provisions of the Declaration on Euthanasia (adopted by the 39th World Medical Assembly in Madrid, October 1987), euthanasia as an act of deliberate deprivation of life of the patient, even at the request of the patient or at the request of his family, is not ethical (Singh, Singh and Singh 110). This does not preclude the need to respect the doctor to the patient's request not to impede the flow of the natural process of dying in the terminal phase of the disease.
Another interesting document that reflects the attitude of the Catholic Church to the possibility of intentional deprivation of life of the patient at his request, is a declaration of the Congregation for Doctrine of the Faith, adopted in 1980 in Rome. Its position suggests that it is absolutely necessary to declare emphatically that nothing and no one can decide on the murder of an innocent human being, whether the embryo or fetus, or a child or an adult, or elderly, terminally ill or dying. Moreover, no one can claim to commit such a murder against himself or against anyone else, under its responsibility, also cannot agree to this, neither directly nor indirectly.
It should be noted that the Orthodox Church has a similar judgment. For example, based on public statements of Church Council on biomedical ethics "On current trends in the legalization of euthanasia" from August 1, 1999, signed by three co-chairs of the Council, upon recognizing the value of every human life, his freedom and dignity as the unique properties of the individual created in the image and likeness of God, Orthodox priests, scientists, doctors consider unacceptable any attempts of implementation of euthanasia as a deliberate action to killing terminally ill people, considering euthanasia as a special form of murder (on doctors' decision or agreement of relatives) or suicide (at the request of the patient) or as a combination of both. Council opposes euthanasia in any form, because its use will inevitably lead to the criminalization of social medicine and loss of confidence in the Institute of Public Health, to the desecration of the priceless gift of human life: to diminish the dignity of the doctor and the perversion of the meaning of his professional duty, to reduce the rate of development of medical knowledge, particular developments resuscitation methods, painkillers, for the treatment of incurable diseases, the spread in society of the principles of cynicism, nihilism and moral degradation in general, which is inevitable in case of refusal to comply with the commandment "Thou shalt not kill."
Thus, the position of some countries, international organizations and representatives of different religions against euthanasia vary widely. Another urgent bioethical issue is the admissibility of abortion. The history of social movements and organizations fighting against the possibility of artificial interruption of embryonic life, has been known in the XVI century. However, on a more global scale, it appeared in the second half of XIX century, when the U.S. emerged nationwide movement to ban abortion. Leading role in it was played by an authoritative guide to the American Medical Association. Based on embryological discoveries, doctors argued that the fetus is a living being from the moment of conception, and not from the time the mother is feeling the movements of his body. Therefore, doctors insisted that abortion, even very early in pregnancy, is murder. As a result, by 1880 abortions in the U.S., if it was not about saving the life of women, were banned. Adopted laws then basically maintained until the 60s of the XX century.
Also in this aspect is very significant legal experience of European countries. In 1869, the British Parliament passed the "Act of crimes against the person", according to which abortion from the moment of conception, has been considered a felony. Abortion produced by the woman was punished much more severely if it occurred after the fetal movements. In Germany in 1874, abortion was considered for the money as an aggravating circumstance. In France there was legitimized serious punishment against doctors for committing or facilitating abortion, while at the same time (1791 to 1810), the woman was freed from the punishment at all.
In the professional medical environment moral evaluation of abortion does not coincide entirely with legal qualifications. In the XX century in the debate about the permissibility of abortion feminist movements became particularly active. Supporters protest against feminism traditional position of women in society and touched her sexual role, then it is certainly affected and questions of sexual morality.
In the 50s of the XIX century, one of the first American feminists, S. Grimke, in the essay "Marriage" wrote about a woman's right to decide when she would be the mother, how often and under what circumstances. At the beginning of the XX century, American feminist M. Sanger coined the term "birth control", which at first made sense to promote the use of contraceptives, and later came to be seen also in the context of eugenic ideas.
At the moment, as in the case of euthanasia, the opinions of various states in relation to this issue are ambiguous. In some countries, such as Angola, Egypt and Indonesia, abortion is categorically unacceptable. In others, including Morocco, Saudi Arabia and South Korea, abortion is permissible only when leaving the fetus threatens the life and health of the mother or incorrigible were found abnormal development of the embryo, it could lead to long-term illness or death. In the third group of countries, abortion is allowed at the request of women (Russia, Romania, France).
Thus, there is nothing surprising in the fact that in Egypt, Indonesia and Angola doctors take a risk and an operation is performed on the artificial termination of fetal life. Naturally, such actions are considered by the authorities of the countries concerned, largely built on rigid religious dogma, not only as a crime, but as a flagrant violation of the rules of ethics and morality.
Motivated more by increasing contradictions assessment admissibility of euthanasia and abortion, as well as other medical procedures that constitute the major issues in bioethics, the international community in the face of UNESCO has planned a number of international forums and conferences on these issues. In particular, on 2-5 September 2012 in the city of Tiberias (Israel), the 8th International Conference on Education in bioethics: the content, methods, trends was held. At the conference there were discussed the legal problems of protecting the rights of patients and assist dying patients (hospices and palliative care). Interest in the legal issues of bioethics will further have progressive development of the law of many states in the field of biomedicine.
Houghton, Adrian M. "Abortion reform’s lessons for assisted dying." BMJ: British Medical Journal 345 (2012).
Singh, A. K., S. Singh, and M. P. Singh. "Bioethics A new frontier of biological Science." Cell. Mol. Biol 58.1 (2012): 110-114.