Bioethical reflections on sexuality and human reproduction

AutorJosé Eduardo de Siqueira
CargoProfesor of Medicine and Bioethics at State University of Londrina; President of Brazilian Society of Bioethics (2005-2007). Board Member of International Association of Bioethics (IAB).
Páginas18-23

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Moral codes and ethical decisions

When dealing with the ethical issue, sexuality and human reproduction, it is essential to clearly elucidate what we understand about ethics and morals, once this is the route we are going to take. We agree with Segre and Cohen who perceive morals as a set of rules which are elaborated by different segments of society aiming to facilitate sociability amongst its members. It therefore obeys the vertical and asymmetrical direction in its dynamics, which implies the imposition of values in the society as a whole to be obeyed by all integrating individuals. The disobedience of rules implies the application of sanctions, penalties and, eventually, the deprivation of freedom. (SEGRE and COHEN,1985).

Emblematic examples are what we find in the codes which inspect the practice in different professions, which is inappropriately denominated as code of ethics. After graduating, every Brazilian doctor receives a small abridgement containing 145 commandments in order to be obeyed throughout their professional practice. Disobedience of any commandment could result in different levels of punishment, leading to a provisional or definite suspension of the right to practice. Most chapters are presented with the expressive statement: " it is forbidden to the doctor...". Out of 145 commandments, only 9 refer to rights, the remaining 136 are rules of duty imposed on professionals. The newly-graduate is not offered the possibility of issuing any judgment over the rules expressed in the code, it only imposes unrestricted obedience. Interchangeably, morals are applied to different human groupings at specific moments in their histories being, however, transmitted, modified and enriched through time, which means that they represent

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only an individual’s provisionary agreement with society. The exercise of changes which implies acknowledgement of conflicts as well as the search for the reconstruction of new moral values ( the word moral derives from the latin "morale", meaning custom) is performed by every individual who, acting autonomously within their community, proposes the elaboration of new sociability rules more compatible with the historical realities which incessantly emerge.

This exercise of transformation of moral rules, or the custom of a people, is denominated as ethics. Thus, the Brazilian Medical Ethics Code of 1965 reflected the conditions of the then professional practice, guided by a liberal model in Medicine, strongly corporative, which privileged the doctor-doctor relation to the detriment of the doctor-patient one, and for that, many authors regard as an example of a professional etiquette code. The code, which has been in force in Brazil since 1988, was elaborated after a long dictatorial regime and privileges the respect for the patient’s autonomy and contains chapters which are dedicated to human rights, donation and organ transplants, as well as medical research.

Although advanced, we perceive it as incomplete, for new scientific progress emerged such as the knowledge of human genome, different perceptions of the interruption of pregnancy and the appliance of vital support methods to terminal patients. The dominion over this new knowledge makes ethical reflections obligatory, which will result in proposals for modifications of the existing moral rules. In summary, ethics transforms morals or, if preferred, ethical reflection is an instrument for the improvement of moral rules. The Greek culture valued natural as "good", and the anti-natural as "bad". That teleological reasoning acknowledged an intrinsic purpose in every manifest of nature. Therefore, the exercise of human sexuality would only be "good" if aimed at the reproduction and perpetuation of the species, which would make masturbation morally unacceptable, as it would characterize a bad, anti-natural attitude, once it would disrespect the natural purpose of the sexual organs. When considering the issue of a sinless human sexuality exercise, expressed by Saint Thomas Aquinus: "Sin is present in human acts when performed against the reasoning order (...) The same way, the preservation of a man’s life demands the use of food, preservation of all human kinds also imposes the use of sexuality (...) August’s book "De Bono Conjugali" teaches that the food for a man’s health is the same for the health of human kind. Therefore, the same way food can be used without sin, the use of sexuality can also be performed without it, if performed accordingly and appropriately, in agreement with whatever suits human procreation." ( GRACIA, 1988 )

We can read in the Epistle of Paul to the Romans (1:24-27 ) that all human actions must express the presence of God. If done otherwise, men become subject to God’s wrath: "Wherefore God also gave them up to uncleanness thought the lusts of their own hearts, to dishonour their own bodies between themselves (...). For this cause God gave them up unto vile affections: for even their women did change the natural use into that which is against nature: And likewise also the men, leaving the natural use of the woman, burned in their lust one toward another; men with men working that which is unseemingly, and receiving in themselves that recompense of their error which was meet." (JERUSALEM BIBLE, 1973)

The updated reading of the apostle’s words performed by some believers, made it possible to identify, in homosexual relations, the cause for the dissemination of the Acquired Immune Deficiency Syndrome (AIDS) and led to the reinforcement of the...

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