THE HISTORY OF BIOETHICS

Healthcare dates back to the periods in which healing was seen as a divine act and essentially,
physicians were priests. Following this period, a Greek by name Hippocrates (5th century
B.C.) was of the view that, healing should be regarded as a scientific activity, based upon
observation. Thus, he sought that medicine be separated from religion but not from moral
roots, since Hippocrates epitomized a love for mankind. Medical associations from the
Middle Ages to the first part of the 20th Century, therefore, preserved images of a
trustworthy, dignified and respectable doctor. Medical ethics upheld during this time was
stable and unaffected by social and cultural trends.

Bioethics was more or less a reactive response to biomedicines technological advancements

in the 20th Century. These advancements sprung from numerous experiments which were
conducted on humans but were usually illegal or performed without the informed consent of
the test subjects. For instance, the CIA in America sprayed whooping cough virus on Tampa
Bay killing twelve people, mustard gas was tested on soldiers via involuntary gas chambers,
the US infected Guatemalans with syphilis and did not give them penicillin, and many others.
Surgical experiments, such as that conducted by J. Marion Sims, the father of gynaecology,
throughout the 1840s, were performed on African slave women without anaesthesia. Pre-
dating these events, Thomas Percival, an English physician and author, is known for crafting
the first modern code of medical ethics. He drew up a pamphlet with the code in 1794 and
wrote an expanded version in 1803, Medical Ethics, or a Code of Institutes and Precepts,
Adapted to the Professional Conduct of Physicians and Surgeons, in which he coined the
term medical ethics.

Also medical ethics had to be reviewed since the ethical code which traditionally supported
the medical profession was confronted with new questions. For instance, what were the
implications for interventions on new-born life and on the human genome? What were the
consequences of organ transplants? What were the limits for the use of resuscitation and for
sustaining life? To answer these questions, governments had to institute commissions to
elaborate and recommend guidelines and tribunals began to hear and formulate ethical
arguments in line with their sentences, encouraging legislators to approve laws regarding
these matters.

The bioethical movement brought about drastic and profound revision of the centuries-old
professional ethics that had once governed the behaviour of doctors and their relationships to
patients. The cradle of this movement was the United States of America. Discoveries in the
field of genetic engineering produced a frightening possibility to create biological weapons
and to alter the same statute of the diverse forms of life, of species and individuals. For this
reason, a Dutch oncologist, Van Rensselaer Potter, coined the term bioethics in an article
published in 1970, in which he foresaw the urgency for a new knowledge that not only
finalized the ability to understand natural phenomena and to explain them, but also a much
tighter way to discover them and to use wisely the scientific-technical knowledge that favours
the survival of the human race and to improve the quality of life of future generations.

Two notable personalities, V.R. Potter and Andre E. Hellegers have been instrumental in the
development of bioethics. The term bioethics, from the viewpoint of Hellegers, was
introduced in a definitive way by the powerful Encyclopaedia of Bioethics (New York 1978)
in which it became defined as the systematic study of human conduct in the area of life
sciences and healthcare, insofar as this conduct is examined in the light of moral values and
principles.

A number of code of ethics have been established which regulate the discipline of healthcare
and examples include:

Beaumonts Code (United States 1833), which encourages experimental treatments when
all fails, but with the patients receiving informed consent. The patient also has the right to
request the experiment be stopped.

Walter Reed (United States 1898), which introduced the use of written consent contracts,
the use of healthy human subjects in medical experiments

Reich Circular (Germany 1932), which is concerned with the consent and wellbeing of the
subjects.

Others include the Declaration of Geneva, Declaration of Helsinki, Belmont Report,

American Medical Association Code of Medical Ethics.