The right to die with dignity

This is a natural right of every human being, just as the right to live with dignity, because death is the other side of human life. The right to die with dignity expresses the generic human condition, the natural desire for pleasure and the avoidance of suffering, both physical and spiritual. The right to die with dignity captures the moral dimensions of dignity that harmonize the life of the individual and society as a whole. Not only the withdrawal from life for personal reasons, when one prefers a dignified death to an undignified life, but also the non-standard situations generated by scientific and technological progress in medical practice (organ transplants, the maintenance of an unconscious “vegetative” state, new approaches to the definition of death criteria, etc.) compel society to reconsider and deepen its attitude toward right to die with dignity. This right presupposes moral concern for the autonomy and dignity of the dying person, primarily on the part of medical professionals, who must give the patient truthful information about the diagnosis of his disease, about treatment procedures and the arguments for and against them, so that the patient can make his own choice. Right to die with dignity includes the concept of dying with dignity.

Praxiology

(from Greek praktikos - active, active) This is a concept describing the mechanisms of effective organization of human practical activity. It was formed at the beginning of the ХХth century in the context of searching for universal principles of universal organizational science - technology, forms of rational activity - the most general norms of maximum expediency of actions; the system of general technical recommendations and warnings applied to professional activity. At the present time, an instrumented understanding of practice is being formed and developed, which is expressed, on the one hand, in philosophical reflection on its foundations, and on the other, in its technologization. In the case of biomedical practice, it is a search for operational mechanisms of organization of professional activity; techno-analytical development of principles, levels, components and mechanisms of professional activity. In bioethics, the ideas and generalizations of praxiology are very important for the analysis of decision-making mechanisms in biomedical research, the moral choice of medical scientists, their behavior in extreme situations, regulation of the relationship between the individual and society in the process of applying new biomedical technologies, and the normative-value aspects of doctor-patient cooperation and interaction, etc.

Predestination

This is a concept within the framework of the religious worldview that stems from the determinism of human ethical behavior and its “salvation” (“judgment”) by the will of God. Having developed within religious systems and being their specific product, the concept of fatal predestination in modern bioethics serves as a kind of philosophical-logical model of actualization of such its most important problems as free will, moral responsibility, moral choice, moral duty “to cure to the end”, the problem of euthanasia, etc.

Prenatal diagnostics

This is determining the sex of the child, identifying hereditary diseases, and other manipulations during the fetus’ intrauterine development. Moral legitimacy of the procedure is determined, first, by the goals of diagnosis:

1. determination of the gender of the fetus or detection of its hereditary pathology;
2. and second, by the consequences of diagnosis: whether it will result in a selective termination of pregnancy depending on the results. Ethical examination of this technique requires taking into consideration the following circumstances: the degree of voluntariness of Prenatal diagnostics of the population with the purpose of detecting carriers of hereditary diseases (especially when one of the parents of the future child is a carrier of a defective gene);
3. justification of moral desire of parents-carriers of hereditary diseases to have offspring;
4. making decision on what hereditary diseases detection allows (or directly obligates) parents to have an abortion;
5. is abortion permitted in cases when the only ground for abortion is a hereditary disease? Opponents of the Prenatal diagnostics accuse it primarily of serving as a basis for abortions. However, Prenatal diagnostics’s ability to detect various chromosomal diseases, sex-related diseases, birth defects, etc., requires a doctor to take an ethically neutral stance in genetic counseling: patients themselves should decide on the issues they are interested in. The moral justification for Prenatal diagnostics is that it saves more lives than it takes, allowing “doubting” parents to be sure that their child is healthy. At the same time, many ethical issues of Prenatal diagnostics remain unresolved, particularly the issue of selective abortion in the case of a fetus with a disease that is amenable to drug therapy or will not necessarily adversely affect the health of the child.