Interests, Rights and Standards of Care in the Context of Globalized Medicine

Historically speaking, medical ethics responded to the ideological misuse of scientific (or pseudo- scientific) research and gave priority to the individual patient’s right to be respected in any medical intervention. This right has been confirmed in several guidelines, from the Helsinki Declaration to the European Oviedo Convention of Human Rights in Biomedicine and many professional ethics codices. For most works on medical ethics, the right of the patients is spelled out as respect for their interests, justified by freedom as basis of autonomy, moral agency, and a modern understanding of the individuals’ right to decide on questions of their (good) lives. Physicians’ duties, then, are constrained by the freedom rights, and they are to justify any intervention in light of the patients’ own understanding and concept of the good life. Successful communication (or doctor-patient- relationship) will result in the free and informed consent to a medical intervention – without it, the intervention would be considered morally wrong. Over the last few decades, informed consent formulas have become a kind of magic formula to guarantee patients’ rights. However, given the bureaucratic environment of modern medicine, it was not long that lack of time to engage in a long communication turned the thoroughly reflected ‘free and informed consent’ into a very matter-of- fact standardized form – merely to be signed by the patient in order to make the operational sequences of medical action as effective as possible

Ethical aspects of prenatal genetic diagnostics

Starting with some basic distinctions, i.e. the distinction between an ethics of human self-fulfilment ,of individual and social values and of virtues on one hand, and an ethics of individual rights, of obligation and of social justice on the other, this paper explores the manifold scenario of the problems of prenatal diagnosis with respect to these different aspects of ethical analysis. This is followed by a normative evaluation of the status of the human embryo, and by an elaboration of different adressees of responsibility in the field of biomedicine and, especially, of prenatal genetic diagnosis. The author comes to the conclusion that a narrow-minded vision of person and personhood ignores the necessary connection of biological identity and biographical continuity as well as the necessity of social recognition as one of the moral roots of personhood. Thus, the author argues that, for ethical reasons, in general the protection of embryo and of fetus must be demanded. However, in situations of conflict (and prenatal diagnosis can certainly be regarded as such) the search of a balance between well-being and rights is an adequate response to the situation. With respect to this conflict of rights, the author explores the different adressees and the different levels of responsibility and shows that the responsibility of a pregnant women or of a couple must be supported by medical and political measures. These measures primarily concern access to adequate medical and psychological counselling as well as financial and social support for families, especially those who live with handicapped children