Bioethics and Law: Navigating Ethical and Legal Boundaries in Healthcare
The Relationship Between Bioethics and Law
Bioethics assumes the coexistence of values and principles that underpin any democratic society. As a new and pluralistic discipline, it arises in a context of uncertainty, bringing together knowledge of the biological world with the formation of policies to achieve social good. This young discipline faces much ambivalence.
Bioethics is a moral and political issue since governments make decisions in this area. However, prior to decision-making, various issues must be considered with transparency and debate. Bioethics represents the bond of humanity with science and the ethical and moral reflection of advanced technologies.
Arguably, the term “bioethics” has several problems, not only regarding its breadth but also encompassing political and legal ethics.
Regulatory Framework
Bioethical reflection calls upon political, moral, and legal considerations.
In a modern state, law is understood as the set of binding rules of conduct established or authorized by the State and supported by its power. The state determines legal norms (compulsory rules of conduct), even though the law also comprises different kinds of corrective rules, such as social or ethical ones. It establishes guidelines, determines what citizens believe to be lawful or unlawful, has many functions (such as education), and regulates and resolves conflicts.
However, the law alone is not enough because technology (science) and society are moving much faster than the ethical committees that create these laws. These and other figures in the Spanish legal landscape exemplify the relationship between ethics and law and contribute to social debate and the union of civil society.
The law sets a minimum standard for coexistence based on respect for human rights. The Council of Europe (specifically responsible for ensuring these rights’ effective recognition and protection) tries to establish a “common law” and harmonize international laws on bioethics.
The close relationship between bioethics and law becomes apparent in decision-making procedures. When all stakeholders cannot reach an agreement, the law sets the allowable limits.
The main problem is that ethics and moral discourse have not yet built answers to bioethical problems. On the contrary, dogmatic theology offers answers that lead to human rights, making the use of legal norms a valuable resource and starting point. Therefore, uniting the notions of bioethics and law is useful.
The feature that best identifies bioethics as a multidisciplinary field is that it affects the entire community and cannot be approached from the traditional separation into branches of knowledge. By introducing the law, human rights become both the legal basis and the indispensable ethical minimum upon which democratic societies are built.
Deontology and Privacy Code
The code of ethics concerns professional ethical duties of respect for citizens’ rights. It determines the highest ethical conduct.
Confidentiality can be understood as a right, and the right to privacy as a set of ethical rules reflected in the ethics code, providing a pattern of conduct to follow.
The right to confidentiality or privacy is the right to preserve our personal privacy because each person has the power to establish the extent to which others can enter their intimate territory. Thus, we understand privacy as the field of each individual’s mental contents, among other things.
Intimacy is linked to our dignity and liberty. Preserving privacy is a sign of respect towards people and enables social interaction between a plurality of individuals with personality.
In healthcare relationships, privacy must be protected because it is a commitment to confidentiality that allows individuals to explain intimate aspects. If confidentiality is not respected, it can hinder proper healthcare. This is what we call confidentiality.
Sometimes, maintaining absolute intimacy is incompatible with current healthcare practices (e.g., drafting clinical histories, testing, diagnostics). Therefore, breaching a person’s intimate territory is sometimes inevitable. The basic rule would be that if you invade a person’s intimacy, it must be objectively justified by healthcare needs and the value of intimacy should be respected at all times.
It also corresponds to the patient’s personal privacy to make decisions about their health and the healthcare they receive or do not receive. This is called informed consent or advance directives.