Bioethics: Life, Death, and the Boundary of Intervention

Medicine as an Ethical Space

Medicine has always been an ethical space — but the twentieth century created fundamentally new dilemmas. Life-support machines made death controllable. Transplantology — the body as a source of resources. Genetics — traits as mutable. Reproductive technologies — birth as planned and constructed.

Bioethics as a discipline took shape in the 1960–70s: Van Potter introduced the term, Georgetown University developed the principles. Four principles (Beauchamp and Childress): autonomy (the patient’s right to make decisions concerning their own body), non-maleficence (primum non nocere), beneficence (acting in the patient’s interests), justice (fair distribution of resources and access to assistance).

Euthanasia and the Autonomy of the Dying

Euthanasia — the deliberate ending of a person’s life to ease suffering — is one of the most ethically charged topics. Distinguish: passive (cessation of treatment), active (administration of a lethal substance), voluntary (at the patient’s request), involuntary (without consent).

Arguments for: autonomy — a fundamental principle, the person has the right to die with dignity; suffering that cannot be relieved itself violates the principle of non-maleficence. Arguments against: risk of the “slippery slope” (weakening protection for the vulnerable); pressure on the elderly and sick “not to be a burden”; alternatives (palliative care) insufficiently developed.

The Netherlands, Belgium, Canada, a number of U.S. states have legalized euthanasia or assisted dying with strict procedural requirements. Monitoring results show: abuses are rare, but the discussion continues.

Human Genetic Engineering: Where is the Limit?

CRISPR-Cas9 enables precise genome editing with unprecedented accuracy. Where is the ethical boundary? Treating monogenic diseases (Huntington’s, cystic fibrosis) — almost consensually permissible. Enhancing intelligence or physical attributes of future children — “designer babies” — most bioethicists consider unacceptable.

The principle of “open future” (Joel Feinberg): children have the right to an indeterminate future. The designer child is deprived of this right: their characteristics are predetermined before their consent. This is a preventive violation of autonomy.

Question for reflection: If you could edit the genome of your future child — eliminate the risk of Alzheimer’s disease — would you do it? And if you could increase their IQ by 20 points? Where is your personal boundary?