Prof. dr. sc. Tonči Matulić

Katolički bogoslovni fakultet Sveučilišta u Zagrebu  

Znanstveni članak

Sažetak

Nema nikakve sumnje da je tzv. nova genetika predstavljala važnu pokretačku snagu u nastajanju bioetike. Sintagma nova genetika pretpostavlja postojanje stare genetike. Datum koji lomi genetiku na staru i novu je 1953. godina. Spuštanje bioloških istraživanja na molekularnu razinu organizma nagovijestilo je stvaranje jedne nove prirodoznanstvene i humanističke epohe. Brzi razvoj molekularne biologije je zamijenio staru eugeniku novom eugenikom. Stara je pročišćena od znanstveno neutemeljenih rasističkih predrasuda. Zatim je oplemenjena novim - sofisticiranim genetičko-inženjerskim metodama i tehnikama. Odrekla se također ideologizirane prošlosti. No, njezini ciljevi su ostali isti - selekcija ljudskih bića prema nasljednim karakteristikama u skladu s jednostranom matematičkom definicijom kvalitete života. Primjena klasične ili stare medicinske etike je u kliničkoj praksi počela nailaziti na poteškoće. Kliničko okruženje se sve više otkrivalo kao visoko tehnologizirano a istom nisko personalizirano. Takvo je stanje bilo neposrednim uzrokom nastanka bioetike. Bioetika kao nova medicinska etika je pokušala i još uvijek pokušava sačuvati vezu, tamo gdje je ostala, i uspostaviti, tamo gdje je pokidana, između medicinsko-etičkih načela i kliničke liječničke praske u izrazito tehnologiziranim i sofisticiranim kliničkim okolnostima. Međutim, medicinska znanost se pod utjecajem novih (bio)tehnologija raspada na mnoge discipline i specijalizacije što ima za posljedicu raspadanje same vizije o čovjeku kao pacijentu na njegove organske sastavnice bez sustavnog uvažavanja cjeline, tj. čovjeka kao osobe. Javljaju se tzv. jatrogene bolesti, tj. bolesti koje uzrokuje sama medicinska praksa. Ukratko, to je kritička definicija društvenog i medicinskog konteksta unutar kojega i o kojemu se danas vode korisne filozofske, teološke, etičke, socijalne, pravne i, dakako, medicinske rasprave o različitim hereditarnim bolestima te o mogućnostima njihove prevencije, dijagnoze i terapije pod vidom bezuvjetnog etičkog zahtjeva za poštivanjem dostojanstva svakog ljudskog bića neovisno o njegovim biološkim i genetičkim kvalitetama.

Ključne riječi: kultura, medicina, biologija, genetika, eugenika, jatrogena bolest, bioetika

Summary

Bioethics and Genetics: Medical Practice Between Eugenics and Iatrogenic Disease

There is no doubt that a new eugenics represented an important driving force in originating bioethics as a new discipline. The notion of new genetics presupposes the existence of an old genetics. The breaking date between the new and old genetics was 1953. Descending of biological research on molecular level announced creation of a new epoch of natural scientific and humanistic activities. But it must be noted that fast development of molecular biology created also conditions for the change of the old eugenics with new one. Firstly, the old one was purged from unscientific and racist prejudices. Secondly, it was enriched with new - sophisticated methods and techniques of genetic engineering. Thirdly, it renounced also of the proper ideological past. But still its goals remained the same - artificial selection of human beings according to their hereditary characteristics and in keeping conformity with one-sidedly mathematical definition of the notion of quality of life. Furthermore, the application of classical or old medical ethics in clinical practice began to deal more and more with unsolvable difficulties. The clinical surrounding was unveiling more technologized but less personalized. Such condition has been immediate cause of the appearance of bioethics. Bioethics as new medical ethics tried and is still trying to protect the line, there where it remained, and to sew up, there where it was broken, between the principles of medical ethics and the physician practice in very technological and sophisticated clinical circumstances. Medical science under the influence of new technologies was disintegrated in many disciplines and specializations. This fact directly caused the disintegration of man as patient on his/her organic components with consequent losing of the vision of man as a whole, e.g. man as person. In these circumstances appeared the so-called iatrogenic diseases. This is a kind of diseases caused by medicine itself. In brief, these few remarks on present conditions in he field of biological and medical activities represent a general framework of the historical context in which are being conducted various medical, ethical, social and legal discussions about different hereditary diseases, among them also Down Syndrome, with regard to the possibilities of their prevention, diagnosis and therapy. This article brings forth some important historical, social and ethical changes in the field of medical ethics and bioethics.

Key Words: Culture, Medicine, Biology, Genetics, Eugenics, Iatrogenic Disease, Bioethics

Cijeli rad možete pogledati u PDF formatu ovdje.