The Concept of Human Person at the Heart of Brazilian Bioethics
Bioethics is not just an academic discipline - it's a mirror that reflects our greatest dilemmas about life, death, and what it means to be human. In Brazil, where cultural diversity and social inequalities shape medical practice, the concept of "human person" has become an axis of heated debates. From the beginning of life to palliative care, this notion defines who deserves protection, who has autonomy, and how we balance science with human values 1 .
Bioethics officially arrived in Brazil in 1995, with the foundation of the Brazilian Society of Bioethics (SBB) and the publication of Resolution 196/96, which regulated research with human beings. Its emergence responded to an urgent need: to create bridges between scientific advances (such as in vitro fertilization and genetics) and ethical values in a country marked by profound social disparities 1 2 .
Different philosophical currents compete in the definition of "human person". While utilitarians focus on autonomy and quality of life, the Ontologically Founded Personalism, led by the Italian Elio Sgreccia, dominates a significant part of the Brazilian debate. This view sees the person as a "unitotality" - an inseparable integration of five dimensions:
Body and health
Emotions and mind
Community relationships
Freedom and conscience
Existential meaning
"For personalism, human life begins at fertilization and ends only with natural death. Dignity is inherent to every human being, regardless of their cognitive or social capacity" 1 .
In 2009, researcher Maria Carolina Lucato conducted a pioneering study at USP. Her goal was to audit the concept of "person" implicit in Brazilian bioethics. Using Gadamer's philosophical hermeneutics, she analyzed 63 scientific articles cataloged in BIREME, classifying them into five thematic categories 1 :
| Category | Number of Articles | Main Debates |
|---|---|---|
| Beginning of Life | 18 | Abortion, embryo as person, fertilization |
| End of Life | 15 | Euthanasia, dysthanasia, palliative care |
| Clinical Practice | 12 | Patient autonomy, doctor-patient relationship |
| Public Health | 10 | Health access, distributive justice |
| Various Themes | 8 | Eugenics, transgenics, animal rights |
Table 1: Distribution of Studies by Thematic Category
The analysis revealed deep tensions:
| Question | Dominant Position | Personalist Counterpoint |
|---|---|---|
| When does life begin? | At a moment post-fertilization (72%) | At fertilization (100%) |
| When does life end? | Autonomy over death (50%) vs. natural death (50%) | Only natural death (100%) |
| Criterion for decisions | Autonomy and quality of life | Intrinsic dignity and unitotality |
Table 2: Views on Beginning and End of Life in Brazil
[Interactive chart showing the distribution of views would appear here]
Brazilian bioethicists combine qualitative and quantitative methods. In Lucato's research, the following stood out:
| Tool | Function | Practical Example |
|---|---|---|
| Philosophical hermeneutics | Interpret texts in historical context | Analyze "autonomy" in advance directives |
| Systematic review | Map consensuses and dissents in literature | Group articles by position on abortion |
| Elementary experience | Validate concepts by concrete reality | Test "dignity" in palliative care |
| Prima facie principles | Hierarchize conflicting values | Balance autonomy and non-maleficence |
Table 3: Essential Resources for Bioethical Research
Highlight: The "elementary experience" - central idea of the study - proposes that abstract concepts (like dignity) are only valid when anchored in lived reality. Example: What "dying with dignity" means for a terminal cancer patient versus a young quadriplegic? 1 .
The concept of human dignity remains the most controversial. How to apply an "inherent" principle to all if there are irreconcilable views? Four approaches attempt to answer:
Human rights are what ground dignity - not the opposite. If a right is violated (e.g., access to health), dignity is denied .
Being "worthy" is maintaining standards of self-respect even in illness - like an elderly person who demands to be heard .
Dignity is the basis of rights. An embryo has dignity, therefore has right to life, even without "consciousness" .
Focus on sub-concepts like "non-instrumentalization" (e.g., prohibit organ commercialization) .
In public health, the principle of distributive justice tensions personalism. While the latter prioritizes the individual person, the SUS (Brazil's public health system) needs to allocate scarce resources - how to define who receives a ventilator in a pandemic? The solution, suggests the study, lies in subsidiarity: collective policies that do not annul singularity 1 2 .
Lucato's research reveals that Brazil still doesn't have a unified concept of "human person". But this diversity can be a strength. By adopting the "elementary experience", we can build a bioethics that:
The future demands that we overcome polarizations. After all, as Lucato reminds us: "Decisions about life and death are not abstract problems - they are stories of real people, in a real country" 1 .