Protective Bioethics

Abstract

The ethics of protection sets the theoretical basis for an applied form of protective bioethics, which develops as an adjunct to the interpersonal realm of clinical ethics, concentrating on the values involved in the collective agenda of public health and ecology. The duality of proposing an ethical framework for both individual and collective actions is of special interest since traditional population-based public health has given way to prevention in the singular clinical encounter currently emphasizing personal health care responsibility.

At the individual level, protection is a voluntary, irreversible, continuous and open-ended commitment, to be served as long as the ward lacks autonomy and empowerment to obtain personal care. Protecting the disempowered must be restricted to areas where autonomous decision-making and empowerment are lacking, and reduce its intervention whenever and wherever protégés gain the capabilities of caring for themselves. At the collective level where public health operates, protection is required to engage in specific problems that require urgent attendance, presenting technically effective, sustainable and fairly distributed remedial solutions. Risk of unwanted side-effects should not burden specific groups or individuals, but be randomly distributed. By fulfilling these conditions, public health gains legitimacy to impose disciplined participation and reject individual claims for exemption.