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Bioethics in Serbia: Institutions in Need of Philosophical Debate

Published online by Cambridge University Press:  20 May 2011

Extract

This paper is structured in three sections. The first discusses the institutional framework pertaining to bioethics in Serbia. The functioning of this framework is critically assessed and a number of recommendations for its improvement presented. It is also emphasized that philosophers are underrepresented in public debate on bioethics in Serbia. Second, this underrepresentation will be related to two issues that figure prominently in Serbian society but are not accompanied by corresponding bioethical discourses: the first is abortion and the second is the largely unrestricted use of neuropharmacology since the 1990s, both for therapeutic and for cosmetic/recreational purposes. Finally, the perspective of bioethics in Serbia is addressed. It is asserted that this perspective can be based on the enhancement of public philosophical debate on bioethical issues, especially those with notable features in Serbian society (such as abortion and neuropharmacology). Such enhancement would also strengthen the corresponding institutional and legal frameworks.

Type
Special Section: Bioethics beyond Borders 2011
Copyright
Copyright © Cambridge University Press 2011

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References

1. The terms “cosmetic” and “recreational” are used interchangeably in the context of our argumentation.

2. The use of the term “committee” (odbor or komitet) in the Serbian bioethical context is rather specific. In the United States, for instance, the term “ethics committees” relates most often to internal hospital committees to which patients are referred. Serbian bioethics committees, on the other hand, are primarily focused on research and policy issues rather than on individual patient issues.

3. Mujović-Zornić, H.Pravni aspekti rada etičkih komiteta u medicini [Legal aspects of the work of ethics committees in medicine]. Pravni život [Legal life] 2009;56(9):253–75, at pp. 264–5.Google Scholar

4. See note 3, Mujović-Zornić 2009:265.

5. See note 3, Mujović-Zornić 2009.

6. Stefanović, V. Bioethics at medical faculties and in health institutions in Serbia. In: Marinković, D, Magić, Z, Konstantinov, K, Mladenović Drinić, S, eds. The Council of Europe’s Bioethical Instruments and Promotion of Research Ethics in Serbia. Belgrade: National Committee for Bioethics of UNESCO-Commission of Serbia, Health and Bioethics Department of CoE (Bioethics Division), Serbian Academy of Sciences and Arts, Serbian Genetics Society; 2007:31–35, at p. 31.Google Scholar See also Marinković, D. Activities of the Serbian Bioethics Committee. In: Marinković, D, Magić, Z, Konstantinov, K, Mladenović Drinić, S, eds. The Council of Europe’s Bioethical Instruments and Promotion of Research Ethics in Serbia. Belgrade: National Committee for Bioethics of UNESCO-Commission of Serbia, Health and Bioethics Department of CoE (Bioethics Division), Serbian Academy of Sciences and Arts, Serbian Genetics Society; 2007:1–3.Google Scholar

7. See note 3, Mujović-Zornić 2009:268.

8. See note 6, Stefanović 2007:35.

9. See note 6, Stefanović 2007:34.

10. Osnovano bioetičko društvo [Bioethical society founded]. B92 and Tanjug; available at www.b92.net/info/vesti/index.php?yyyy=2008&mm=07&dd=31&nav_id=310993 (last accessed 20 Oct 2010).Google Scholar

11. Home page of the Christian Cultural Centre; available at http://www.ccc.org.rs (last accessed 20 Oct 2010).Google Scholar

12. Mujović-Zornić, H. Review of main legal and bioethical questions according to the state of Serbian legislation. In: Marinković, D, Magić, Z, Konstantinov, K, Mladenović Drinić, S, eds. The Council of Europe’s Bioethical Instruments and Promotion of Research Ethics in Serbia. Belgrade: National Committee for Bioethics of UNESCO-Commission of Serbia, Health and Bioethics Department of CoE (Bioethics Division), Serbian Academy of Sciences and Arts, Serbian Genetics Society; 2007:37–46, at p. 43.Google Scholar

13. The Constitution of the Republic of Serbia. 2006: art. 24 (our emphasis).

14. Francis Fukuyama of course emphasizes the embryo’s destruction in both therapeutic cloning and embryonic stem cell research; Fukuyama, F.Our Posthuman Future: Consequences of the Biotechnology Revolution. New York: Farrar, Strauss and Giroux; 2002:174.Google Scholar He also discards reproductive cloning as leading to the establishment of an asymmetrical relationship of the clone with his or her parents, that is, to a situation Fukuyama describes as one in which the clone, who is both the child and twin of one of his or her parents, although genetically unrelated to his or her other parent, becomes at some point in his or her sexual maturity a version of the person with whom his or her nongenetic parent has probably once fallen in love. Consequently, Fukuyama considers cloning as “a highly unnatural form of reproduction”; Fukuyama 2002:207. Many other authors favor therapeutic cloning and embryonic stem cell research for medical purposes, but also reproductive cloning for a variety of social reasons; see Pence, GE.Classical Cases in Medical Ethics: Accounts of Cases That Have Shaped Medical Ethics, With Philosophical, Legal, and Historical Backgrounds. New York: McGraw-Hill; 2004.Google Scholar The Serbian Constitution, however, simply states that the “cloning of human beings is prohibited,” failing to give us any further hint of the legislators’ intentions and rationale.

15. Further in the text we denote the concept of induced abortion by using the unqualified term “abortion.”

16. Popis 2002: 95 odsto gradjana vernici, 0, 5 odsto ateisti [2002 Census: 95% of citizen believers, 0.5% atheists]. B92; available at www.b92.net/info/komentari.php?nav_id=113071 (last accessed 20 Oct 2010). For useful analyses of the rise of religiosity in Serbia during previous decades, see Blagojević, M.Religijska situacija u SR Jugoslaviji od kraja 80-ih do početka novog veka. [The religious situation in the Federal Republic of Yugoslavia from the end of the 1980s until the beginning of the new century]. Teme [Themes] 2003;27(3):411–36Google Scholar; Blagojević, M.Religijska situacija u SR Jugoslaviji od kraja 80-ih do početka novog veka. Teme 2003;27(4):525–52.Google Scholar Of interest also is Radisavljević-Ćiparizović, D. Vezanost ljudi za religiju i crkvu u Srbiji krajem devedesetih [The affiliation of people to religion and the Church in Serbia during the end of the 1980s]. In: Djordjević, DB, Todorović, D, Živković, J, eds. Vera manjina i manjinske vere [The confession of minorities and minority beliefs]. Niš: JUNIR, Zograf; 2001:98–107.Google Scholar

17. Our focus here is on Orthodox Christianity, the prevailing faith in Serbia.

18. On the assumption, of course, that the (approximately) 150,000 abortions per year was the average number over the last 20 years or so. According to available estimates, this assumption appears to be warranted. It ought to be emphasized, however, that the data we use here are not official figures. Because abortions are usually not reported (in particular those that are performed in private clinics), official records are highly unreliable. Hence, we ought to use other data. Reliable sources agree, however, that the above-mentioned estimate of 150,000 is reasonably accurate. A useful piece on the “endemy of abortions in Serbia” is Rašević, M, Sedlecki, K.Endemija abortusa u Srbiji. Naše teme 2006;1:69–73.Google Scholar

19. Srbija prva u Evropi po broju abortusa [Serbia the first in Europe in number of abortions]. Politika 2009 Mar 25.

20. See note 19, Srbija prva u Evropi po broju abortusa 2009.

21. The lax restrictions on abortion in Communist Yugoslavia are beyond the scope of this paper. They do, however, provide us with a tentative explanation for the relative popularity of abortion even before the wars of the 1990s.

22. According to reliable surveys, Serbia occupies the first place in South-Eastern Europe where the use of tranquillizers is concerned; Srbija je zemlja sedativa [Serbia is the country of tranquilizers]. Monitor 2008 Jun 3. In 2005, more than 43 million boxes of tranquillizers were distributed in Serbia, that is, around seven boxes per capita; Velika potražnja za sedativima [High demand for tranquilizers]. B92; available at www.b92.net/info/vesti/index.php?yyyy=2008&mm=06&dd=02&nav_category=12&nav_id=301519 (last accessed 20 Oct 2010).Google Scholar The recreational use of tranquillizers is also popular among Serbian youngsters, surpassing even the use of marijuana. According to a 2008 survey, 7.6% of ninth graders have used tranquillizers without prescription; Marihuana i sedativi najčešće droge iz klupe [Marijuana and tranquilizers the most common classroom drugs]. Danas 2009 Jul 2.

23. Breast and lip implants are considered as “conventional” cosmetic surgery. The subjection of Serbian young women to this type of intervention is so common that a street in Belgrade (one that is famous for its nightlife) has acquired the public sobriquet “Silicone Valley” (“Silikonska dolina”).

24. Serbian laws are not only unsatisfactory where bioethics is concerned. The scope of their imperfections cannot, of course, be explained by the same arguments as the ones we propose in this article, that is, by a deliberation of the role of philosophy in public debate in the specific realm of bioethics. The somewhat cumbersome legal system in Serbia ought to be addressed from a range of other perspectives. These perspectives are obviously not within the scope of this article.