Bioethics and human condition: contributions to thinking about birth

Abstract

Bioethics uses philosophy in its practice of analysis of concepts and values, problems and methodological tools in order to deal with specific problems of human life in the modern world. We propose a reconsideration of the human condition as a background from which an ethic for life is constructed – in its multiple extracts and modulations – as a philosophical perspective to the thinking about birth in Bioethics, and as broader horizon for approaching more specific bioethical problems. We highlight in this article some contributions by Hannah Arendt and Maria Zambrano, two thinkers who addressed the human condition between birth and death. The existential understanding of what it means to be born is rarely articulated dimension from a philosophical and bioethical viewpoint, whereas the existential dimension of death and dying has received better attention in these areas.

Bioethics; Bioethical issues; Live birth; Parturition; Philosophy

Resumo

A bioética recorre à filosofia ao examinar conceitos e valores, problemas e ferramentas metodológicas e ao tratar de problemas específicos da vida humana no mundo moderno. Contudo, tanto na bioética quanto na filosofia, a compreensão existencial do que significa nascer é poucas vezes articulada, enquanto a dimensão existencial da morte e do morrer tem recebido mais atenção. Neste artigo, propomos reconsiderar a condição humana como pano de fundo de uma ética para a vida em seus múltiplos extratos e modulações, e a partir da qual se pode elaborar perspectiva filosófica que pense o nascimento como horizonte mais amplo para tratar problemas bioéticos específicos. Destacamos, neste artigo, algumas contribuições de Hannah Arendt e María Zambrano, duas pensadoras que se ocuparam da condição humana, entre o nascimento e a morte.

Bioética; Temas bioéticos; Nascimento vivo; Parto; Filosofia

Resumen

La bioética recurre a la filosofía en su práctica de examen conceptual y de valores, sus problemas y herramientas metodológicas, para tratar problemas específicos de la vida humana en el mundo moderno. Proponemos una reconsideración de la condición humana, como un trasfondo a partir del cual se elabora una ética para la vida – en sus múltiples dimensiones y modulaciones – como una perspectiva filosófica para pensar el nacimiento en la bioética, y como un horizonte más amplio para el tratamiento de problemas bioéticos específicos. Destacamos, en este artículo, algunas contribuciones de Hannah Arendt y de María Zambrano, dos pensadoras que se ocuparon de la condición humana, entre nacimiento y muerte. La comprensión existencial de lo que significa nacer es una dimensión raramente articulada, en filosofía y bioética, mientras que la consideración existencial de la muerte, y del morir, han recibido mayor atención en estas áreas.

Bioética; Discusiones bioéticas; Nacimiento vivo; Parto; Filosofía

Bioethics, as ethics applied to life, increasingly assumes a public and political nature, calling the public authorities to be accountable and criticizing the current forms of administration and care for life, especially in more vulnerable contexts, such as in Latin America. This public character is reflected in documents such as the Universal Declaration on the Human Genome and Human Rights, the International Declaration on Human Genetic Data and the Universal Declaration on Bioethics and Human Rights.

Initially understood as applied ethics, as yet another way of using philosophical methodology to answer questions about the limits of life, bioethics reaches the twenty-first century with a broader view of the problems related to human life, in search of a common meaning for humanity¹. Moreover, as a multi, inter and transdisciplinary field, it begins to develop critical reflections on its epistemological foundations, language and field of investigation.

Philosophy, which is a component of the group of disciplines that has contributed to the bioethical project, has been used in applied ethics and in the conceptual examination of categories and questions related to life in general. In the same way, philosophers have also been more directly involved in bioethical questions ^2-6. Seeking to understand the political ruptures and technological transformations of the twentieth century, thinkers like Hannah Arendt and María Zambrano focused on problems related to the human condition, with special attention to phenomena such as the one that concerns us here: birth, seen by the philosophers as a worldly event that integrates the being in the course of all its existence. We will start from these analyzes, which go beyond the purely technical perspective when thinking about birth in its existential specificity, seeking to point out its relevance and ways of incorporating them into bioethical reflection.

What does the “human condition” consist of?

Existence is only possible under certain conditions. Unlike the classical philosophical conception of “human nature”, which presupposes an essence, substance or content inherent in human beings (that is, abstract, universal and homogeneous humanity), existential understanding sees the individual as conditioned or conditioning. Insoluble by science and philosophy, the problem of a universal nature that defines humanity refers to theology, which addresses questions about the “nature” of God and the “nature” of man in the context of divine revelation.

According to Hannah Arendt, it is highly unlikely that we, who can know, determine, and define the natural essences of all things surrounding us, which we are not, should ever be able to do the same for ourselves: this would be like jumping over our own shadows. Moreover, nothing entitles us to assume that man has a nature or essence in the same sense as other things ⁷ .

Human activities and capacities - to work, to create, to know, to think, to judge, to educate - are not equivalent to human nature, nor do they define or explain who we are for the simple reason that they never condition us absolutely. This has always been the opinion of philosophy, in distinction from the sciences (…) which also concern themselves with man⁸. Who we are is not something that can be determined in the same way as we stipulate the nature of the things we manufacture or perform; regarding someone, we can only suggest what we partially perceive. The question about our being, about who we are, as individuals and as subjects, differs from the question about what we are, as an object of study.

What we can know, in a more general sense, is that people are, at the same time, conditioned and conditioning beings. For, as Arendt points out, in addition to the conditions under which life is given to man on earth, and partly out of them, men constantly create their own, self-made conditions, which, their human origin and their variability not- withstanding, possess the same conditioning power as natural things⁹.

What conditions the human condition?

The known conditions do not exhaust the meaning of human existence, since new conditions, partly produced by human beings, partly imposed by nature, are continually added to it. However, if old and new conditions do not absolutely define what humanity is, nor do they answer the question of who we are as individuals, it is still possible to consider their impact on our reality.

Hannah Arendt, in her work “The Human Condition,” uses the classic term vita activa to designate the three activities she considers fundamental:

1. Labor: activity that corresponds to the biological process of the human body, its metabolism and its vital needs; the human condition of labor is life itself on earth; man, as a laborer, is defined as animal laborans;

2. The work or manufacture: activity constructing the human world, as artifice, artifact; tools that organize a cosmos that shelters and protects each individual life at its borders; the human condition of the work is worldliness; and the “doer of work” which constitutes the human world as a device like a home here on Earth, is called homo faber;

3. Action: activity that occurs directly among men on their own initiative, without being constrained by the need or the task of building or preserving the world. Through the joint action of men, the order of the world can be changed. Interpersonal coexistence, through words and deeds, corresponds to the human condition of plurality: the condition of all political life - not only as a necessary condition (sine qua non), but through which (per quam) political life occurs ¹⁰.

Moreover, these conditions (Earth, life, world, plurality) not only relate to each other, but are intimately connected with the most general condition of human existence: birth and death, natality and mortality. Labor and work, as well as action, are also rooted in natality in so far as they have the task to provide and preserve the world for, to foresee and reckon with, the constant influx of newcomers who are born into the world as strangers¹¹.

That is, the birth of “new” implies that “newcomers” come into the world as “strangers” to the older generations who have already developed some sense of familiarity and habits. In the same way, for the “new”, the world is always considered old and out of order.

Our first appearance as individuals in the world is by biological birth. In our slow growth, and through education, we develop capacities, talents, and a sense of identity. Birth, however, does not remain in the past, as a finished event. It is the condition of our own beginning, as unique individuals in the world. We become “beings of the world” by having been born in it: with word and deed that we insert ourselves into the human world, and this insertion is like a second birth, in which we take upon ourselves the naked fact of our original physical appearance¹².

Birth corresponds to the more general human condition of natality, since the new beginning that is inherent in birth can be felt in the world only because the newcomer has the capacity to begin something anew, that is, to act¹¹. Present in all activities, natality is the condition of every initiative and the possibility of new beginnings, manifesting itself especially in action among human beings. And, since action is the political activity par excellence, the author affirms that natality, and not mortality, may be the central category of the political (as opposed to metaphysical) thought¹¹.

Human beings are also “mortals”, for they do not exist only as members of a species whose immortal life is guaranteed through procreation¹³. Our mortality lies in the fact that individual life, with a recognizable life-story from birth to death, although it comes from biological life - as well as birth - is not reduced to biology. We are born into the world, we are of the world, the human space in which we exist while our life lasts. Birth is mundane, in the phenomenological sense of the appearance of one among the others, just as to die and to cease to be among men are synonyms¹⁴:

The birth and death of human beings are not simple natural occurrences, but are related to a world into which single individuals, unique, unexchangeable, and unrepeatable entities, appear and from which they depart. Without a world in which men are born and from which they leave with death, there would be only an immutable eternal return, the immortal perenniality of the human species like that of all other animal species ¹⁵.

The human life that takes place in the world between birth and death is bioi, or ways of living life; and a single human life that can be narrated, told as a biography, is bios. The story of a life, its biography, is a line that cuts off the recurring cycle of continuous “immortal” life of the species (zoe).

In Arendt, this element of spontaneous initiative, conditioned by natality, concerns the unique character of each person, in their unique existence, which transcends the life of the species. Existence is this aspect of transcendence, of externalization of self (ex-sistere), from the conditions in which life is given to us. Natality, then, is equal to the freedom that is most intensely realized in action. The fact that man is capable of action means that the unexpected can be expected from him, that he is able to perform what is infinitely improbable¹⁶.

The author emphasizes that action, the central theme of its political reflection, does not equate to “behavior” which, in its conformism, habituality and statistical predictability is the antithesis of action in its inherent unpredictability and fluctuation. Mass society, argues Arendt, where man as a social animal rules supreme and where apparently the survival of the species could be guaranteed on a world-wide scale, can at the same time threaten humanity with extinction¹⁷. This is decisive in political terms, since, according to the thinker:

If left to themselves, human affairs can only follow the law of mortality, which is the most certain and only reliable law of a life spent between birth and death. It is the faculty of action that interferes with this law because it interrupts the inexorable automatic course of daily life, which in its turn, as we saw, interrupted and interfered with the cycle of the biological life process. (…) The life span of man running toward death would inevitably carry everything human to ruin and destruction were it not for the faculty of interrupting it and beginning something new, a faculty which is inherent in action like an ever-present reminder that men, though thye must die, are not born in order to die but in order to begin ¹⁸.

“Life” is a polysemic term, and Arendt goes through the meanings that the word acquires throughout the philosophical tradition: the vita activa (or vita negociosa, actuosa) contrasts with the vita contemplativa in the language of the Romans, the most political people we know¹⁹; just as the Greeks already distinguished between bios politikos and bios theoretikos, that is, public and political life in the company of others, or the lives of contemplative thinkers.

We then considered Maria Zambrano’s reflection on human life, between birth and death, which presents phenomenological and hermeneutic aspects in common with Arendt, although the German philosopher distinguishes herself by thinking politically about human existence, while Zambrano understands it poetically²⁰. For the Spanish thinker, man has an incomplete birth, never content to live naturally, always needing something else - religion, philosophy, art or science ²¹.

From Zambrano’s perspective, we all suffer from an incomplete birth in an inadequate and hostile reality²²; hence the existential impulse for expression and creation as a challenge to complete one’s own birth, or, to be successively reborn, in this life and in this world. Only animals are born at once, while the individual, who was never totally born, has the task of begetting himself again, or expecting to be begotten²¹. We can be reborn because we are born, the birth being the condition of all human life and its realizations, where each one is distinguished, surpassing oneself in the midst of relating with others.

It is in the course of one’s life that a person can constitute their own individuality, amidst the relationships they establish with others, with the world and with themselves in their life project. Individualizing involves choice, the most decisive of all: what one makes of oneself. In this fundamental choice, human freedom, individual and collective, is realized, because it is not possible to choose oneself without choosing at the same time, the others²³.

According to Zambrano, we are beings of successive rebirths. Through the birth of what we call “real”, there is a continuous birth of ourselves and of reality, as man is a creature in a trance of continual birth²⁴. Therefore, it seems to be a condition of human life to have to be reborn, to have to die and be resurrected, without leaving this world²⁵. Hence the continuous rebirths during a life in transit, a journey between what we are not yet and what we wish to be, from the obscurity of our origin towards the light of a specific project, continuously giving birth to oneself and to reality, in which to be born and to create are equivalent to a mystical “awakening”.

The condition of birth is the impulse of transcendence and freedom that in Zambrano is translated by the impossibility of resting in the anonymous life and in the need for authenticity that moves the quest for the realization of one’s own being within the midst of culture. Birth is immanent to the human being as a living being, in its tendency to transcend itself towards its own individuality. Whoever does not die when separating from another being - since birth is always separation - will have to face extreme situations in the course of their life and must feel that they need to be born for themselves²⁶.

For Zambrano, confession is the way a living person questions the pain one suffers and questions oneself for the reasons of one’s existence, it is a method for finding this subject to whom pain occurs, and as someone who distinguishes themselves from what happens to them²⁷. Therefore, confession becomes the privileged mode of speaking, relating the vital movement in which one puts one’s existence in question, glimpsing themselves “from the outside”: a living existent, in one’s particular perception of the human condition.

While Arendt presents the biography²⁸ as the narrative of life, the story of a unique being in its existence, Zambrano defines the confession, or autobiography ²⁹, as the report of the search for self-knowledge of a human being in his/her awakening in this life in transit; by means of his/her own words, the living being accounts for his/her individuation trajectory in seeking to reconcile himself/herself with the “inadequate and hostile” reality. As a literary genre, confession is typical of moments of crisis, when human existence reveals itself to us; because it is inherent to culture, to all cultures, to conceal the naked existence of man³⁰. For Zambrano, what a crisis reveals is precisely what is hidden by culture:

The guts of human life appear, the helplessness of the man who finds himself without support, without a point of reference; of a life that does not flow to any goal and that cannot find justification. Then, amid so much misfortune, we, who live in crisis, may, perhaps, have the privilege of being able to see more clearly what is exposed by the crisis itself: human life, our life ³¹.

In Zambrano, as in Arendt, “life” is a broad concept that includes, relates to and distinguishes human life in its forms of expression and cultural creation, being, in its beginnings, already a proposal and prophecy of mediation. This life - it is not necessary to say social life, since human life is from its roots social - congenitally demands the mediation between non-living matter and living forms, even those not yet revealed - without being possible to separate thought from life , since all life is form or pursues form; all life, and all life long ³². In addition,

life needs thought, but it needs it because it cannot continue in the state in which it spontaneously takes place. Because it is not enough to be born once and to move in a world of useful instruments. Human life always asks to be transformed, for it must be continually converting itself, when it comes in contact with certain truths. For it is always necessary that this thought be assimilated and reborn, as life is reborn daily. If thought continues to live, it will have to be born and reborn as many times as the generations come at the time of history ³³.

According to Arendt and Zambrano, birth and death are not irreconcilable opposites, but conditions of human existence itself in the world and on Earth. In the words of the Spanish philosopher:

Birth and death, dawn and dusk are the most promising moments of the vital process. The limitlessness of birth, and this liberation which takes place in the instant before every death, have a great similarity; they are the moments of maximum freedom, in which this reality is manifested in a pure presence, which, while what is life itself lasts, is enclosed in a form. Birth and death consist of the destruction of a form, transitions ³⁴.

But why examine birth only, and not delivery ^35,36, since these are two perspectives of the same phenomenon, the “coming to the world”, in its transitions and forms of life in motion? Philosophical reflection on birth demands that this question be taken into account. We can respond, provisionally, that birth is a universal experience, since we are all born via delivery. But the experience of delivery, considering the different subjects involved there, is not something usually considered by traditional philosophy.

Even acknowledging the intriguing absence of a “delivery philosophy” in general philosophy and in the reflections of Arendt and Zambrano in particular - without going into the work of physician Michel Odent on the theme ^37,38 - it is important to emphasize the importance of philosophical, political and poetic reflection of birth, highlighting its symbolic strength in the philosophical tradition that gave great prominence to death and dying. The words of the Italian philosopher Adriana Cavarero point in this direction: the Arendtian category of birth - as actual rooting - and, therefore, real, to the concrete singular subject; and the reality principle that birth founds; this is the fact to which the true discourse must restore meaning³⁹.

Is birth important for philosophy and bioethics?

According to Arendt, natality must be considered a political and mundane philosophical category, not a metaphysical one. Hans Jonas, a contemporary and reader of Arendt ^4,5,40, reflects, in his posthumous tribute to the thinker:

For Hannah Arendt, mortality joins natality as the decisive category of human existence; she herself formulated the expression “Natalität”, as a concept contrary to that of “Mortalität”. This attracts our attention. In speaking of “natality”, Hannah Arendt not only shapes a new word, but introduces with it a new category in the philosophical doctrine of the human being. Mortality has always occupied our thoughts. And meditatio mortis, the meditation on death, has never been separated from the center of religious and philosophical reflection. But its counterpart, the fact that each of us is born and enters the world as a newcomer, remained surprisingly overlooked in the thinking about our being ⁴¹.

Jürgen Habermas also considers and reinterprets a number of Arendtian categories, using them to address emerging “technicization of life” topics, such as assisted human reproduction and genetic manipulation, by their impact on the philosophical understanding of “human nature”. By referring to freedom as part of something naturally unavailable, the philosopher asserts that the naturalness of birth also fulfills the conceptually necessary role of this unavailable beginning. Philosophy has rarely thematized these questions. One of the exceptions is Hannah Arendt, who presented natality within the framework of her theory of action⁴².

The passage from philosophical considerations about birth to bioethical approaches to early life and its connections with the terminality of life are still not well established. Birth and modes of birth are treated predominantly from strictly scientific and technical points of view, that is, factual and empirical, without an existential correspondent. In this sense, at least two contributions of Arendt and Zambrano are fundamental for bioethics.

The first is to take birth as a fundamental theme to reflect on the mundane beginning of the individual’s life. Of course, it is not a question of considering only certain births, marked by specific circumstances (such as poverty, disease, or assisted reproduction), but the very fact of being born, of having been born and of being natal beings, even if with a birth said to be “normal”. This philosophical contribution, to present the human birth as an underlying problem, makes the study of the human condition important for bioethics. In this way, the existential philosophy of birth or natality can support the “study of populations” or medical specialties and their casuistry, resizing them in the bioethical field in order to consider human existence from birth, without reducing it or confining it to the biological level of fertility. An interdisciplinary dialogue starts from the question: what does it mean to be born?

The second contribution of the authors is the development of a phenomenological-existential thinking - in Arendt’s case, in a critical dialogue with Martin Heidegger and Karl Jaspers; in the case of Zambrano, with Jose Ortega y Gasset and Miguel de Unamuno - who places birth in a plan not merely biological, physiological or medical, but symbolic, as a caring for oneself through existence. In Arendt, birth is politicized; in Zambrano, poetized - two ways of re-symbolizing and resizing it, generating expressions that seem at first to sound meaningless for bioethics: “second birth”, “incomplete birth”, “trans born”, “continuous rebirths”, etc. Terms that are charged with symbolic or metaphorical meaning, not “fictional” or “literary”, but which refer to the human condition itself in its structural vicissitudes.

Let us return to the Arendtian tri-partition of the vida activa between activities of labor, work, and action. Placed at each of these levels, birth will be considered in three very different ways: 1) as a biological product of the human body; 2) as a product or work of science and medical technology - for example, assisted reproduction; or 3) as a result of coexistence among humans. In general, bioethicists have great appreciation for the first dimension, but tend to reject the second - reproduction as mere production of new humans - and remain very far from the third, in which birth is seen as a symbolic interaction charged with meaning: a political action. The generic expressions “to have children” and “to procreate” conceal gigantic differences between conceiving children, producing children, and acting between generations in processes of political interaction and symbolic creation within a culture.

What we propose here, based on Arendt and Zambrano, is to reconsider the bioethical perspective on the beginning of life, taking it as the principle that characterizes human life in the world and the biographical or autobiographical trajectory of each individual. This proposal distances itself from the argument of Peter Singer, who insists on reminding us of our next genre (sentient being) and then seeks the ethics appropriate to our specific human difference (linguistic, argumentative, calculating consequences). To think of new ethical standards for “assisted procreation” through medical technology, Singer uses exemplary and unique cases, such as that of Louise Brown (1978), the first test-tube baby ⁴³, and Trisha Marshall (1993) who, despite brain death, had her pregnancy technically preserved ⁴⁴. However, these extreme cases may cover up the extraordinary that constitutes the very birth of each one of us.

The study of casuistry could benefit from a phenomenological and existential, political and poetic bias. To do so, we would have to resort to the theory of judgment, considered by Arendt the most political of mental activities⁴⁵, the human faculty of judging singular and unprecedented events. In suggesting this topic, we emphasize that the new realities, constantly incorporated into the human condition, take from us the understanding of “what we are doing”, bringing to the public dimension the debate about the meaning of new technologies and scientific developments concerning our way of life, as well as the impact of collective or governmental political decisions regarding the next generations, in relation to the life that we live or we provide to those who were born or will be born:

The conviction that everything that happens on earth must be comprehensible to man can lead to interpreting history by commonplaces. Comprehension does not mean denying the outrageous, deducing the unprecedented from precedents, or explaining phenomena by such analogies and generalities that the impact of reality and the shock of experience are no longer felt ⁴⁶.

It is not a matter of making “science of the specific”, but rather of remembering and considering that exceptions also create their own new rules - a relevant aspect for researchers involved in the debate on “procreative freedom”. For example, Maurizio Mori ⁴⁷ points out the difficulty in “limiting” birth as a phenomenon of human development through the periodization of the phenomenon in a biological or philosophical sense, opting for the first. In dealing with reproductive techniques as an extraordinary event between the freedom to procreate or not to procreate, the author seems to ignore that every birth, be it natural or technical, is extraordinary, since we can always not be born. The extraordinariness of every birth is its profound contingency: we might not have been born or might have been born dead. Once we are born alive, life involves us in the deadly game of our unique and circumstantial existence, challenging us to become someone: what will we then do, we who came into the world among others? Will we procreate or not? The answers will be part of our biography (Arendt) or autobiography (Zambrano) of existences that stand out against the backdrop of demographic studies, from which the decisions made under “population and fertility policies” are planned.

Mori, however, does not think from an existential perspective, as our authors do. Already at the beginning of the text, he sees the right not to procreate based only on factual reasons, such as the demographic situation of humanity, accepting without criticism that, in case the ecological issue and other factual issues did not exist or were overcome, birth would pose no problem. There is in Mori no appreciation of humans “being of the world” as such, but only of their social and natural circumstances. However, taking the existential bias, what matters is what humans do with their social and natural circumstances, their own responses and choices. In later stages of his text, Mori sees no meaning in the expression “the well-being of the unborn child” nor conceives how one could benefit someone through “negative freedom”. He simply does not visualize the existential elements of birth, which make it more than mere a natural event, a social or medical problem.

Human birth should be examined on the basis of the Universal Declaration on Bioethics and Human Rights (UDBHR) ⁴⁸ considering its most fundamental points, particularly Article 16 (Protecting future generations), in conjunction with the other articles dealing with human dignity and fundamental rights. In a time of worldwide devastation and the displacement of populations, UDBHR proposes a new deep-rooted ethical, judicial, political and environmental order.

What was new in the 20th century is becoming the norm in the 21st century. To think about birth, in this context and at this point, is to think about what we are doing about humanity and its future. Precisely because they think from a phenomenological-existential framework, for Arendt and Zambrano, the matter of the coming generations would not be a mere fact of physical and biological survival; to future generations we must anticipate and try to guarantee conditions for a dignified existence. Whoever is born acquires an existential identity; he/she is a being in the world, begotten, not just a citizen, worker, leader or patient, but a natal-mortal being who must establish his/her existence in the world among others.

From Zambrano’s perspective, we can speak of the poetic survival of future generations, in the sense of providing them with those elements that complete their incomplete birth, satisfactorily making the trans born through their world migration. In bioethics, even among those who oppose a purely medical or biological view of life, birth tends to be considered as mere fact, an event that has already occurred and is closed to successive symbolic elaborations such as those proposed by Zambrano. For the Spanish thinker, to be born is not only to arise in the world through childbirth, but to have opportunities to beget again in a hostile environment, to be freed for new rebirths and to be able to live not only one life, but to constitute it as an autobiography, in a personalization or appropriation of their own factual birth.

Final considerations

Habermas and Jonas have already indicated reading possibilities for Arendt’s work within philosophy and bioethics; no literature was found on the contribution of Zambrano’s thinking to bioethics. It is necessary to carefully study the texts of the two thinkers in order to delineate more clearly their presence in bioethics. We began to do this in our investigation ⁴⁹.

We understand the importance of having entries in technical dictionaries of philosophy and bioethics to mark the existential, political and poetic philosophical status of natality. In the “Dicionário Houaiss da língua portuguesa” (Houaiss Dictionary of the Portuguese Language), we find a broad lexicon in the words “nascer” (to be born), “nascente” (nascent), “nascido” (born), “nascimento” (birth), “nascituro” (unborn), “nascível” (that can be born) ⁵⁰. In “Dicionário de filosofia” (Dictionary of Philosophy) ⁵¹, there is an entry about “morte” (death); in the “Oxford Dictionary of Philosophy” ⁵² there are “death”, “death with dignity”, and “death of God”. However, in the “Vocabulário técnico e crítico da filosofia” (Technical and Critical Vocabulary of Philosophy) ⁵³, we find nothing about being born or dying, birth or death, or natality and mortality.

The scenario is similar in works from the field of bioethics, which takes up traditional references from philosophy and other natural and human sciences. In the “Encyclopaedia of bioethics” ⁵⁴ and in the Diccionario latinoamericano de bioética” (Latin-American dictionary of bioethics) ⁵ there are philosophical, medical, anthropological, sociological, psychological, and theological considerations about death and dying, and on issues related to the terminality of life, such as euthanasia, suicide, brain death, the death penalty, genocide and infanticide.

Especially in the “Diccionario latinoamericano” (Latin American Dictionary) - relevant for its attention to bioethics topics, concepts and tools, and its commitment to bringing together Latin American contributions and lines of research - we again encounter the traditional standard: there is a chapter on “Muerte y morir” (Death and Dying) ⁵⁶, but we find nothing, for example, about Nacimiento y nacer (Delivery and birth). There is a chapter on “Vida y vivir” (Life and living) ⁵⁷, which, however, generates a strange polarity between life and death rather than contributions to thinking of life, existentially considered, between birth and death.

In the voluminous Latin American bioethical reflections on human reproduction, birth and delivery, we still seek existential consideration of these topics. To the work mentioned before ^36,37, we add: that of Schramm and Braz ⁵⁸, who organized in a book significant material on public health policies for women and children, under the heading of early life bioethics; the manual of Kottow ⁵⁹, which contains a long chapter in which questions of naturaleza y generaciones futuras e dilemas en relación a la reproducción humana (nature and future generations and dilemmas in relation to human reproduction) are highlighted; and Feitosa’s master dissertation ⁶⁰, which dedicates a chapter to “insufficiency of biological birth”.

We have included the reference to Giovanni Berlinguer’s book “Everyday Bioethics” ⁶¹, for his historical and conceptual influence on Brazilian bioethics, highlighting his first chapter, “Born Today, Between Nature and Science”. However, Berlinguer’s observation is significant: a greater dedication to the fact that the born person, as they grow, finds it more difficult to build their way in life, is an issue for which, according to the author, both bioethics and politics, still “show little interest” ⁶².

In addition to new entries in technical dictionaries, it would be necessary to introduce in a more incisive way existential and vital approaches linked to the human condition in bioethical works, from dissertations and theses to articles and books. The topic of birth could be the starting point, but not the final; in fact, all bioethical problems have a double dimension, physical-biological and existential, the latter being largely neglected in literature.

Birth, as an underlying problem for bioethics and philosophy, concerns the possible political and poetic dignity of human life in its radical contingency and its links with death, as a formative part of natal beings in the drama of their human existence. It is a matter of thinking about what we are doing in this regard, and especially how birth should be considered in philosophical and bioethical training - in the transmission of a canon not always well examined in its presuppositions - in its task of educating the generations already born. Perhaps this perspective is one of the indispensable elements to reflect on the foundations of bioethics, especially in its streams that are more attentive to the human condition, in different historical, cultural and social presentations.

Referências

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Publication Dates

• Publication in this collection
  Oct-Dec 2018

History

• Received
  3 Aug 2017
• Reviewed
  24 Apr 2018
• Accepted
  26 Apr 2018