BIOETHICS: THE FIELD & ITS CHALLENGES IN RELEVANCE WITH CONTEMPORARY INNOVATIVE TECH RESEARCH

Introducing Bioethics

Medical ethics has traditionally focused on the moral principles, code of conduct and relevant guidelines for healthcare professionals and their interactions with patients. Examples of these issues are informed consent, confidentiality, managing conflicts of interest, and end-of-life decisions. However, as medical technology and research advanced rapidly, such as in the case of reproductive medicine, the field of medical ethics has expanded to include a wider range of issues related to the intersection of biotechnology and ethics and transformed into a complex multidisciplinary study.

As a result, the discipline of bioethics emerged in the 1960s, not only focusing on the rather “new” ethical considerations that accompanied genetics, biotechnology, and other modern areas of the life sciences, but also “revisiting” traditional ones through its novel multidisciplinary and diverse methodological approaches for conducting applied ethics, as emerged within the development of its intense discourse. Within the years, bioethics came to include more diverse topics for ethical scrutiny and evaluation. From pivoting on the implications of technological advancements and innovative research that would not directly involve only human subjects, the interest expanded also to animals or mere tech research, as is the case with artificial intelligence. In this respect, it is notable that, recently, the term “bioethics” has often been coupled with that of “technoethics'' to describe this inclusion of topics of interest that do not involve applications to humans per se and to draw  a distinction between the -long established- field of  Technology Ethics and  that of “applied ethics in technology”. For example, in 2021 the Greek National Bioethics Commission was renamed as “The National Bioethics and Technoethics Commission”.

Bioethics can be defined as an interdisciplinary discourse on applied ethics that addresses controversial questions of moral significance arising from the integration of rapidly advancing technological achievements into clinical practice and beyond. Various famous definitions and theories have shaped the field, emphasizing the need for ethical reflection and the development of normative frameworks and novel tools for examining ethical cases [Beauchamp and Rauprich, 2022]. Amongst the first to introduce the term, Van Rensselaer Potter characterized it as "a new discipline that combines biological knowledge with a knowledge of human value systems in an open-ended biocybernetic system of self-assessment." Potter's definition highlights the fusion of biological understanding with an awareness of human values, recognizing bioethics as a self-reflective and self-assessing field that continually adapts to evolving scientific advancements and ethical considerations. As with many other fields, the dynamic that constantly shapes bioethics, and the various branches it opens up to, is driven by a profound awareness of the immense impact of technology on human beings and reflection over relevant ethical issues “related to life, to life in its entirety and each part of this entirety, to life in all its forms, stages, phases, and manifestations." [Jurić, 2017] Over the years, regulatory and ethical principles have been established through academic discussion, guidelines, court cases, and unfortunate instances of unethical research. These efforts have contributed to a consolidated normative framework and the recognition of the moral responsibility of scientists towards society. One of the most famous frameworks, namely principlism, approaches ethical dilemmas based on four principles, the respect to autonomy, non malefiscence, benefiscence and justice [Beauchamp and Rauprich, 2016].

Challenges

Despite the rich history and continuity of the field of Bioethics the last five decades, its context, methodological approaches and even relevance, are still subjects of inquiry. They are also often contested [Scher and Kozlowska, 2018]. A rather significant question posed in this context is that of whether or up to what point its core characteristic, that of integrating interdisciplinary approaches into applied ethics, can really be achieved. Apart from collaborative academic work or the efforts to construct multidisciplinary academic programmes, this question is of high relevance within the place where technological advancements and their application is actually happening; “in the field”, so to say.

Rapid technological advancements often outpace the development of ethical frameworks to regulate their use. For example, the application of artificial intelligence in clinical decision making or various diagnostic tools has opened ethical challenges and implications to ensure responsible development and deployment. These ethical dilemmas are quite complex and hard to navigate, since many procedures are not clear  from the technical perspective as yet. To provide a few paradigms on this, the algorithmic bias of machine learning algorithms, the risks to data protection and privacy and the social inequalities that can result in biased data and hence, biased outcomes are some common cases that challenge their handling, since our technical knowledge is still incomplete. This requires a collaboration and a bridge  between various disciplines, such as computer science, philosophy, law, biology and medicine that can lead to “lost in translation” results, due to different vocabularies and regulatory frameworks. The globalisation of our world imposes more obstacles, as social diversity needs to be taken into account. Developing ethical guidelines and policies that are globally applicable while respecting cultural diversity is a significant challenge.

While bioethics play a vital role in guiding ethical decision-making, several controversies surround its field and application. Ethical considerations range from assessing simple risks that can be mitigated through rules of conduct to evaluating the social impact of research within a pluralistic society. In practice, addressing ethical issues in research is sometimes reduced to mere legal compliance or conformity with bureaucratic or formal requirements. There are also grey areas where politics, policies, and bioethics intersect, raising questions about the role of philosophy in guiding ethical discourse. Additionally, interdisciplinary communication and the integration of ethics are sometimes undervalued, leading to misunderstandings and a lack of interest in ethical considerations. Furthermore, the economic impact of embedding ethics in the final products of research is often overlooked. 

The Requirement to Integrate Applied Ethics in Research: The Horizon Framework Paradigm

The Horizon 2020 and HORIZON Europe framework, which guide research and innovation activities in the European Union, have recognized the importance of embedding ethical reflection and addressing ethical concerns within emerging tech research. The ethics assessment processes implemented within Horizon, such as the Ethics Appraisal Procedure, highlight the value of ethical reflection in such research that raises old and new ethical and legal concerns. It emphasizes the moral responsibility of scientists towards society and the need for the social acceptance of research results. Moreover, it underlies that integrating ethics throughout the entire research process, starting from the conceptual stage of a research proposal, is critical for the development and establishment of frameworks that safeguard the fundamental ethical values of our society in the face of ongoing technological advancements.  

Another notable recognition of the importance of integrating ethical principles and safeguards directly into the technology itself rather than addressing ethical concerns as an afterthought or relying solely on reactive measures comes from the recent efforts within the EU in establishing a normative framework for Trustworthy AI. In this context, the ethics-by-design principle was introduced, pointing to the proactive integration of ethical considerations and values into the design, development, and deployment of artificial intelligence (AI) systems. It emphasizes the need to embed ethical principles and safeguards directly into the technology itself rather than addressing ethical concerns as an afterthought or relying solely on reactive measures [European Commission] .

Concluding remark

Despite the controversies, it is crucial to recognize the importance of bioethics, especially in the context of innovative technologies such as AI and biotechnological solutions that leverage the potentialities of exploiting big data, IoT systems, and other further advances coming from the computer science sector. Such areas of research and their applications often bring about social disruption and face unexplored questions of moral significance. Addressing the associated ethical challenges requires a robust societal perspective that the tradition of integrated and interdisciplinary bioethics brings. Accordingly, to ensure ethical practices within and beyond research, as well as to foresee policies on good governance of marketed tech, it is essential to formalise public engagement efforts around bioethics.  It is important to involve stakeholders from academia, industry, policy-making bodies, and civil society to collectively navigate the ethical implications of emerging technologies. The essential engagement of the various affected stakeholders is crucial for promoting transparency, inclusion, and the alignment of technological advancements with societal values. Strengthening interdisciplinary communication and recognizing the economic impact of embedding ethics in research can further enhance the field's relevance and effectiveness.