Revista Bioética: influencing ethical and bioethical thought in Brazil for 25 years

Revista Bioética (Bioethics Magazine) is celebrating 25 years of existence. Published by the Conselho Federal de Medicina – CFM (the Federal Council of Medicine) since 1993 ¹, the publication offers the opportunity to discuss various aspects of medical ethics and bioethics, and has contributed to the development of these areas of knowledge, medicine and society, as well as those who work directly or indirectly in health in Brazil and around the world. During this period, 56 issues, 55 editorials, 14 presentations and 873 articles have been published. Revista Bioética is the only Brazilian journal specializing in bioethics indexed in international databases.

Revista Bioética mobilizes more than three hundred Brazilian collaborators and two dozen foreigner contributors in every issue to enable readers to reflect on the soul of medicine and its simple and complex, harmonious and contradictory, sad and joyful, humane and supportive aspects. It serves as fuel for the search of the best road to follow, so that one can act in the best possible way in the application of this science and art. It extends the discussions of its issues to the social determinants of the health-disease process in line with the determinations of the Universal Declaration on Bioethics and Human Rights ².

It is quite possible that ethics was the first concern to motivate reflection, from the beginnings of Western culture, says Franklin Leopoldo e Silva ³, in the first article of the first issue of Revista Bioética, “A Brief Historical Background of Ethics”. We can safely say that bioethics has evolved around the world, especially in Brazil, gaining importance and credibility, increasing the list of topics discussed, growing in interest and in the number of specialists, postgraduate students, researchers, courses and publications. There is also growing interest in universities with increasing numbers of students, teachers and researchers becoming involved. Commissions are being created in hospitals and medical councils, with support and encouragement from the CFM.

There is also the Sociedade Brasileira de Bioética (the Brazilian Society of Bioethics), founded in 1995, which has contributed to the dissemination of bioethics in Brazil, organizing conferences, producing and disseminating articles and books, and supporting professionals and institutions in various related activities⁴. It can often be seen how the three powers use the experience and knowledge acquired by those who study and discuss bioethics on a daily basis in the creation of laws, government programs, and the regulation of norms, such as assisted reproduction ⁵.

The first issue of the magazine was based on the issues that arose from the AIDS virus. At the time we were walking on little known, almost unmarked terrain. Today, despite all the progress made, society retains a certain prejudice due to a lack of knowledge about the disease. From a bioethical point of view, however, there is more agreement than disagreement on the subject. Regarding research or access to treatment, the position of Brazilian bioethics is firm and consensual in defense of the vulnerable.

The environment and the imminent risk of the death of the Earth were, at that time, a reason for concern among Brazilian society. As many national and international leaders, scientists and scholars have argued, many of the evils that are devastating the planet are irreversible, and the recovery of what can be saved would take centuries. This disregard for health and life is the result of ignorance and the excessive incentivizing of consumption, which has been considered all around the world as the sole and primary factor for the achievement of individual and social happiness. The stimulus of profit from this craving is fueled by the precarious information available to society and the time lost by all, including science, as well as omission and neglect, as in the case of the underwhelming and insufficient mobilization of many governments, culminating in the ludicrous and irresponsible abandonment of the Paris Agreement ⁷by the United States ⁶.

The climate studies that led to the drafting of the recommendations of that agreement have shown that if we do not radically change our behavior, in a few decades we will have irremediably lost the Earth, our home, the substratum of our life, which gives us security, comfort, energy and indispensable nutrients. The Earth will not disappear as a planet in its solar orbit, but will no longer keep us alive and healthy. Our insanity has also affected other forms of life, making vegetables and animals extinct, creating deserts, consolidating the scene of devastation.

Lovelock does not entirely blame science for having been, to a point, slow to support the pioneer bravery of those who alerted us to the problem, for it itself has been damaged in the last two centuries by its division into many different disciplines, each limited to seeing only one tiny facet of the planet without a cohesive view of the Earth ⁸. He states that the Earth was only recognized as a self-regulating entity in 2001.

Modern medicine, divided into specialties, has fragmented the study and care of the human body by scrutinizing it as isolated parts, not as a self-regulated whole. Today we have a shortage of physicians who attend their patients as whole beings, physically and mentally, integrated within the family, the environment in which they live, the world of work and involved in dilemmas and difficulties. We are, then, at a crucial moment in relation to what it is necessary and possible to do with the natural and social environments and with our lives. What each of us must do, with our lives, to act consciously and responsibly for the good of all.

It is no different from what is happening with the country’s health system. Incompetence; corruption; disinterest; vested interests (personal, political and business); poor decision making; an excess of medical schools with poor quality teaching; cultural changes and other developments; pressure from industry and entrepreneurs in health intermediation; the impoverishment of the population, among other problems, have all led us to this situation. The health system is in an extremely grave state and, like with regard to the environment issue, we are facing an emergency. If there is no effective and rapid universal decision, the situation will be irreversible and we will all die early, in one form or another, figuratively or real, accompanying our brothers and sisters, who by the thousands are obliged to surrender their health and their lives to this corrupted, poorly cared for, misunderstood and neglected system.

It is not only a problem for the health system user, the government, the manager, the doctor or the nurse; the social worker or the general services employee; the student, his or her parents or the dean; the supplier or the police. It is a social problem that concerns everyone: the child and the adult, the worker and the businessman, the fan and the artist, the woman and the man, the atheist and the believer, the sick and the sane. It belongs to everyone, without exception. As does the environmental problem.

It is impossible, therefore, to fail to realize that we are facing issues that are bigger than each one of us. Dilemmas that compel us to look around and try to act in consonance with others for the collective good, for life and the planet. Faced with a serious problem, various motivated groups without ideals or with different ideals, or even a large single group, without an ideal or motivation, will be unable to make a difference ⁹. We are experiencing an unprecedented ethical and bioethical crisis in all sectors and at all levels. Dilemmas come one after the other, contrast and overlap. But it is not the end. On the contrary, it seems to be the beginning of a new era that will bring us, if we survive, new concepts and paradigms.

Never has so much been discussed and published in this area of knowledge. In all sectors, new horizons are opening up and giving rise to awareness and understanding of what needs to realized and done, so that strategies can be organized to tackle the problem, which include systematic study, collaboration, research, discussion and consensus whenever possible. Publicity via all types of media, taking advantage of all the opportunities available to promote debate and learning will also plays a key role at this time. The challenge is transformation.

We live in a distressing moment, fraught with risks and doubts, but which offers us an unparalleled opportunity to formulate a new science that is contemporary and indispensable, analytical yet formulating, and complex, as it has been since its origin, accessible and indispensable, recognized and respected. We believe in the recovery of the Earth, in the preservation of the health and life of our brothers and sisters, and in the birth of a new, scientific, era, based on an overall, rather than a narrow vision, philosophical, technological, supportive, humane and merciful.

The Editors

Referências

• ¹
  Bioética. [Internet]. 1993 [acesso 13 jun 2017]. 1(1). Disponível: http://bit.ly/2tpzqnO
  » http://bit.ly/2tpzqnO
• ²
  Organização das Nações Unidas para Educação, Ciência e a Cultura. Declaração universal sobre bioética e direitos humanos. [Internet]. Paris; 2015 [acesso 14 jun 2017]. Disponível: http://bit.ly/1TRJFa9
  » http://bit.ly/1TRJFa9
• ³
  Leopoldo e Silva F. Breve panorama histórico da ética. Bioética. 1993;1(1):7-11.
• ⁴
  Ortoga C. Nosso histórico. Sociedade Brasileira de Bioética [Internet]. 2016 [acesso 6 jun 2017]. Disponível: http://bit.ly/2sxIg2P
  » http://bit.ly/2sxIg2P
• ⁵
  Conselho Federal de Medicina. Resolução CFM nº 2.121, de 16 de junho de 2015. Adota as normas éticas para a utilização das técnicas de reprodução assistida – sempre em defesa do aperfeiçoamento das práticas e da observância aos princípios éticos e bioéticos que ajudarão a trazer maior segurança e eficácia a tratamentos e procedimentos médicos – tornando-se o dispositivo deontológico a ser seguido pelos médicos brasileiros e revogando a Resolução CFM nº 2.013/13. [Internet]. Diário Oficial da União. Brasília; p. 117, 24 set 2015 [acesso 5 jun 2017]. Seção 1. Disponível: http://bit.ly/2sQfLR6
  » http://bit.ly/2sQfLR6
• ⁶
  Batista HG. Donald Trump retira EUA do acordo de Paris sobre o clima: presidente diz que vai começar novas negociações que sejam mais justas para o país. O Globo. [Internet]. 1º jun 2016 [acesso 14 jun 2017]. Disponível: https://glo.bo/2sxlAQe
  » https://glo.bo/2sxlAQe
• ⁷
  Naciones Unidas. Acuerdo de París. Paris: ONU; 2015 [acesso 14 jun 2017]. Disponível: http://bit.ly/299LLa4
  » http://bit.ly/299LLa4
• ⁸
  Lovelock J. A vingança de Gaia. Rio de Janeiro: Intrínseca; 2006.
• ⁹
  Boff L. Ética e moral: a busca dos fundamentos. 9ª ed. Petrópolis: Vozes; 2014.

Publication Dates

• Publication in this collection
  May-Aug 2017