The Impetus of the Encyclical "Laudato Si'"
Imagine for a moment an extraordinarily competent physician who masters every clinical procedure, knows all medications and their dosages, but treats patients in a room with polluted air, offers them contaminated water, and gives them food poisoned with pesticides. Could we consider their practice ethical?
Focuses on individual patient-doctor relationships, informed consent, and clinical ethics within healthcare settings.
Recognizes that human health cannot be separated from the environment that sustains it, embracing ecological concerns.
This apparent paradox reflects the fundamental transformation that bioethics is undergoing in the 21st century: the understanding that human health cannot be separated from the environment that sustains it.
In this revolutionary context, the encyclical "Laudato Si'" by Pope Francis, published in 2015, has emerged as an intellectual and moral beacon that has radically redefined our understanding of the relationship between medical ethics, social justice, and ecology 5 . What began as a religious document on caring for creation has revealed itself as a visionary manifesto that pushes bioethics beyond the traditional confines of hospitals and laboratories toward an integral vision that connects patient rights with planetary rights.
Bioethics officially began with an understandably anthropocentric and clinical focus, centered on the doctor-patient relationship, informed consent, confidentiality, and fair distribution of scarce healthcare resources.
The founder of bioethics already visualized it as a "science of survival" that should encompass broader concerns 4 .
Over time, bioethics began to experience what some experts have called an expansive "identity crisis" 2 . Bioethicists gradually realized that the social, political, cultural, and commercial determinants of health required a broader perspective.
| Traditional Approach (20th Century) | Expanded Vision (21st Century) |
|---|---|
| Doctor-patient relationship | Environmental determinants of health |
| Informed consent | Climate justice as a health requirement |
| Clinical research ethics | Ethics of genetic engineering and synthetic biology |
| Distribution of healthcare resources | Equity in access to healthy environments |
| Dilemmas at beginning/end of life | Protection of intergenerational health |
This expansion has not been without tensions. Some wonder if we are asking bioethics to "be something it is not," while others argue that this evolution is natural and necessary for the discipline to maintain its relevance in today's world 2 . The fundamental question is: if the ethics of life ("bio-ethics") does not address all the conditions that sustain or threaten life, who will?
"Everything is connected."
The publication of "Laudato Si'" in 2015 marked a crucial turning point in this debate, providing a solid conceptual framework for understanding the deep connections between medical ethics, social justice, and ecological sustainability 1 . Pope Francis structured his argument around several innovative concepts that have proven to have significant relevance for contemporary bioethical thinking.
The central concept of "integral ecology" presented in "Laudato Si'" acts as a conceptual bridge between traditional bioethical concerns and environmental challenges.
This vision finds a surprising echo in contemporary systems thinking. As scientist Fritjof Capra notes in his analysis of the encyclical, Francis demonstrates a remarkable understanding that the world must be understood as a network of interconnected relationships, not as a collection of isolated objects 6 .
One of the most significant contributions of "Laudato Si'" to expanded bioethics is its explicit linking between environmental degradation and social injustice.
Francis writes: "A true ecological approach always becomes a social approach; it must integrate questions of justice in debates on the environment, to hear both the cry of the earth and the cry of the poor" 6 .
This connection provides bioethics with an ethical language to address what we now recognize as environmental injustice: the disproportionate distribution of environmental burdens on impoverished and marginalized communities 9 . From this perspective, bioethics cannot remain indifferent to the fact that low-income communities and ethnic minorities suffer higher exposures to pollutants, have less access to green spaces, and experience the health impacts of climate change more intensely.
To address these expanded challenges, 21st-century bioethics is developing a broader set of principles that complements the traditional framework of autonomy, non-maleficence, beneficence, and justice that has dominated medical ethics for decades.
| Principle | Traditional Application | Expanded Application (Post-Laudato Si') |
|---|---|---|
| Non-maleficence | "First, do no harm" to the individual patient | Limit harmful effects of environmental degradation on community health |
| Justice | Equitable distribution of healthcare resources | Environmental and climate justice between generations and communities |
| Autonomy | Informed consent for treatments | Right to participate in decisions about environmental policies that affect health |
| Sustainability | Maintaining treatments long-term | Ensuring that health and life systems do not compromise future generations |
Traditionally focused on the well-being of individual human patients with a relatively immediate time horizon.
Privileged a broader perspective, concerned with entire species, ecosystems, and future generations.
"Laudato Si'" helps bridge these perspectives by reminding us that, ultimately, human well-being and planetary well-being are intertwined. As an analysis published in the National Center for Biotechnology Information notes, although these two ethical traditions have different approaches and concerns, "they can find common cause" when they recognize their fundamental interdependence 4 .
Climate change represents perhaps the clearest challenge where the expanded vision of bioethics is essential. The World Health Organization estimates that between 2030 and 2050, climate change will cause approximately 250,000 additional annual deaths from malnutrition, malaria, diarrhea, and heat stress 9 .
From the perspective of "Laudato Si'," addressing climate change is not just an environmental or technical issue, but a bioethical imperative of the first order, directly connecting with the principles of non-maleficence (reducing avoidable harm) and justice (protecting the most vulnerable).
Consider the problem of per- and polyfluoroalkyl substances (PFAS) - persistent industrial chemicals that contaminate drinking water and are associated with increased risk of cancer, diabetes, liver damage, and developmental disorders 9 .
PFAS pose a multidimensional ethical conflict: on one hand, they are used in critical applications such as extinguishing aircraft fuel fires, where they save lives; on the other, their environmental persistence and toxicity pose long-term threats to public health.
| Environmental Problem | Impact on Human Health | Related Bioethical Issues |
|---|---|---|
| Air pollution | 4.2 million annual deaths from outdoor pollution; 3.8 million from indoor pollution 9 | Justice in differential exposure; right to breathe clean air |
| Agricultural pesticides | Increased risk of cancer, birth defects, neurological diseases 9 | Balance between food security and health protection; informed consent about residues in food |
| Unsafe housing conditions | Higher risk of death from accidents, fires, floods 9 | Social determinants of health; right to adequate housing as a health right |
| Digital spaces | Anxiety, depression, exposure to harmful content among children and adolescents 8 | Autonomy and protection of vulnerable populations in new environments |
The social vision of bioethics driven by "Laudato Si'" continues to evolve to encompass emerging challenges. UNESCO has recently highlighted areas such as synthetic biology, quantum computing, space exploration, and the impact of digital technologies on the mental health of children and adolescents as critical frontiers for contemporary bioethical reflection 8 .
Ethical considerations in designing and creating new biological systems and organisms.
Ethical implications of AI in healthcare, data privacy, and digital determinants of health.
Bioethical considerations for human expansion into space and planetary protection.
These developments confirm that the expansion of bioethics' scope is not a passing trend, but a necessary adaptation to a world where technological advances and environmental crises constantly create new ethical dilemmas at the intersection of natural and human systems. The proposal of "Laudato Si'" for an "ecological citizenship" that assumes responsibility for the planetary common good offers a solid ethical foundation for navigating this complex territory.
"The cry of the earth is joined to the cry of the abandoned of the world."
The encyclical "Laudato Si'" has provided a transformative impetus to the project of developing a social vision of bioethics for the 21st century. By insisting on the deep connections between caring for people and caring for the planet, between social justice and ecological sustainability, between present and future well-being, it has helped catalyze a necessary expansion in bioethical thinking.
This expanded bioethics does not replace the traditional concerns of the discipline, but complements and enriches them, recognizing that human health flourishes best on a healthy planet, and that justice among humans inevitably requires justice toward the natural systems that sustain our existence.
21st-century bioethics, driven by this understanding, is developing the conceptual tools and ethical principles necessary to respond to this double cry in an integrated, creative, and compassionate way, thus honoring the original vision of bioethics as an authentic "science of survival" in an interconnected world.
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