Возвращение к философским основам биоэтики (Рецензия на монографию Б.А.Навроцкого и М.В.Реймер «Философская антропология как методология «культурологического поворота» в биоэтике»)

Полный текст

Originally bioethics was the attempt of normative regulations for scientific researches in medicine involving human subjects [2]. Then its research field began to expand rapidly. The natural scientific paradigm remained, but there was the necessity of a) ethical reflection on practical medicine which was associated with professional medical ethics before and b) formulation of bioethical principles as personal maxims for every person, not only for health care professionals as the subject of bioethics according to V.R. Potter is the moral attitude of man toward live objects [3]. The founder of bioethics himself considered the science as the unity of scientific and human values. Consequently, it would be reasonable to pursue such unity in philosophy [4]. As ‘the youth’ of bioethics was at the time of post-modern expansion into philosophical world, it is easy to understand what methodological basis of bioethics was actively discussed by scientists [5]. But this discussion lead to the considerable disappointment, and new searches for methodology of bioethics were not so active as before. Increasingly, bioethics played the role of the normative regulation to the detriment of theoretical search for meaning of life. Only the social expansion of new biotechnologies, in particular “human enhancement technologies”, revived the interest in philosophical fundamentals of bioethics [6]. And in this sense, the presented monograph is unique as it proposes the new -culturological - paradigm which differs from modern western “culturological turn”. Such approach has been already presented in the first chapter - “Russia and the West: the peculiarities of “culturological turn”. Here the authors review the history of bioethics in Russia in natural science, normative and culturological variants and prove the actualization of the transition to culturological interpretation in Western philosophy. They tried to find positive aspects in the postmodern impact on the development of bioethics and they found them: “Modern medical philosophy ceases to be the branch of philosophy of science and become the branch of philosophy of culture. We think that such intellectual trend occurred due to post-modernism and the critical analysis of its experience. This analysis has shown that medicine is fundamentally embedded into culture and cannot be considered beyond culture” [1, 39]. The authors believe, therefore, that bioethics ceases to be the description of the formation of cultural identity in compliance with various 61 kinds of cultural patterns, but effectively prevents the cultural destruction of man and society. In the second Chapter - “Necessary and sufficient conditions of “culturological turn” (deliberative approach to bioethics)” the authors prove the central idea of the monograph - philosophical anthropology constitutes the methodology of “culturological turn”. M.V. Reymer has already floated this ides in one of her papers [7] but without extensive grounding. This grounding is presented in the monograph. Also the axiology of communitarism and individualism has been considered in details. The authors come to the conclusion that “the interpretation of man in philosophical anthropology allows to explicate the culturological sense of bioethics avoiding, on one hand, the technicist model of medicine and post-modern model of uncertainty of individual existing, on the other hand” [1, 72]. Criticizing the communitarian approach for the lack of attention to person, rejection of the creativity of personal ethical judgments, they admit that the mechanism of integration of person into culture has been developed in this approach. The individualistic approach emphasizes the value of personal ethical judgments, though largely ignores the cultural impact on person. Consequently, the optimal variant is the integration of these two approaches, but only in the context of intersubjective model of deliberative bioethics. It calls for much speculation as the variants of integration can be various and readers should make the choice themselves. The title of the third chapter is symbolic: “Culturological turn’ in bioethics has occurred: what is next?’. Perhaps nobody has the unambiguous answer to this question. That is why the position of the authors, who propose to reflect on the most significant features of new status of bioethics, seems true. This section of the book is especially pleasant to read because issues for discussion have deep personal sense for every of us. The comparison between literary bioethics and narrative bioethics draws to the conclusion which is indisputable for Russian scientists because it is understood for them. “Narrative approach is not typical for national bioethics, literary approach has been represented very well but it is not systematic. The modern understanding of moral problems in Russia is impossible without the interpretation of the moral foundation which was laid at the turn of the last century. Moreover, the birth of bioethics in literary works initiated the program of its development for the next period until enshrined values and developed norms became required for the science” [1, 134]. “Culturological turn” in bioethics can’t be definitely connected with the narrative pattern though it is extremely common in the West. The unique literary tradition in Russia and the invaluable experience of classic literature prove the advantages of literarily bioethics over narrative bioethics. And we fully agree with this statement [8]. It is literarily bioethics, not narrative one, is able to overcome the crisis of post-modernism. However, the authors consider that the real way out is phronesis. Phronesis underlies bioethical choice and unites cultural and moral values of an individual and a society. In conclusion, the authors contribute the idea of good as the backbone factor of “culturological turn” in bioethics with the full description of its benefit. This idea is not original and the authors admit it. The idea of good was suggested by E. Pellegrino [9], and the authors invite to use it precisely in Pellegrino’s interpretation. However, the proposed idea is related to the questioning of its application: “Modern utilitarianism of clinical bioethics related with medical commercialization will avoid realization of this concept” [1, 135]. That is why the task of culture experts is the active support and promotion of this concept. It is true, but this task is not only for culture experts, but for every specialist in the field of bioethics and philosophy. We hope very much that this interesting and original monograph will contribute to increasing the number of supporters of the idea of good as the fundamental one in modern bioethics, and create the impetus for developing philosophical problems in bioethics.

Об авторах

Н. Н Седова

ГБУ «Волгоградский медицинский научный центр»; ФГБОУВПО «Волгоградский государственный медицинский университет»

Email: nns18@yandex.ru
доктор философских наук, доктор юридических наук, профессор, заведующий Отделом этической, правовой и социологической экспертизы, заведующий кафедрой философии, биоэтики и права г.Волгоград

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