Bioethics is ethics applied (which has rules) which settles disputes between ethical axioms (which we have concreated in deontology) and ontology (part of metaphysics that is the be general and transcendental properties). It is therefore an attempt to resolve conflicts from an abstract level (abstraction of circumstance).

This attempt can be undertaken in three main ways: from utilitarianism, from principlism and from personalism.

If we turn to utilitarianism, the current maximum exponent is Peter Singer. This moral theory is both consequentialist (vision of a SINGLE act so it is derived) and hedonistic (considered good the concience pleasurables states and bad the painful one’s). His biggest challenge judges that an act may have good consequences, but be inherently unfair.

If we position ourselves in principlism of Tom Beauchamp and James Childress, will be four starting points for resolving bioethical discussions (autonomy, beneficence, non-maleficence and distributive justice). Principialist Bioethics is the UNDERPIPING MAIN HOW TO ACT IN HEALTH, it determines law and which brings us to construct actual institutional. However, he faced with something that his detractors is an arbitrarily eclectic system: there is no rational way to decide between the principles at stake.

If we take the third option personalist moral reflection, it is based on the Aristotelian tradition, the ethics of Thomas Aquinas and John Finnis update. This moral judgment is summarized in something that sounds, and much, in its opposite version Machiavellian: THE END NOT JUSTIFIES THE MEANS, and to consider the removal of pain (from all sources) is not reachable at any price. In this conceptualization, goods (values) that support human health action are life and health, so if they are deliberately targeted, it is an act maleficent and therefore bioethically incorrect. This allows the rational application of the principles underlying our profession. But … .ante debate pro and anti (abortion, capital punishment, euthanasia, genetic manipulation, etc) does not foresee a clear reconciliation.

I finish.

If we consider human identity, nonmaleficence is not to kill, and its opposite, the bioethical incorrect. When in Paris or Kabul human beings are murdered by other human beings identical in their identities, what it is happens ?, that what it is? I think ALL leads us to look where it hurts us to answer.

Thank you.

Félix José Martín Gallardo (
Intensive Care physician.
Critical Care and Emergency Management Unit

Hospital de la Serranía en Ronda, Málaga.