Cultural history represented by a number of different theories about the nature of moral obligation and moral values. Such diversity is associated with a choice of different starting bases in explaining the essence, nature and functions of morality and moral relations. The very same difference between the original reason boils down to its logical limit to two types of ethical theories.

The first type of ethical theory relates solution ethical problems with the Divine Revelation. The second type is characterized by the denial of this connection and the desire to avoid the principle of effectiveness and usefulness. The logical confrontation between the two types of ethical theories in the history of culture has taken different forms, and the theories themselves were called differently. The first type of ethical theories received the name «authoritarian», «religious», «deontological» ethics.

The second was associated with the ethics of «naturalistic», «pragmatic». Naturalistic and pragmatic type of ethical theories presented in the cultural history of the Taoist tradition in the East, Cynic hedonism in antiquity, the ideology of «naturalness» of human nature, law, morality in modern times, pragmatism, utilitarianism, in contemporary culture. Positive content of any of these concepts in the framework of this type is located between two positions.

The original, as a rule, is the recognition of the «primary» natural reality needs or the needs, interests of social rights, which are the «basis» for a series of successive values and ideals. End position at a given source inevitably becomes nihilism, t. E. The denial of the reality of the ideal measure of human relations.

The value of «mercy», «love», «caring», «compassion» deprived of self-sufficiency and are regarded as more or less successfully used means to achieve the goals and the interests of rival «wills.» «Good» and «good» are the criteria of moral behavior and action, and the «good» is treated as a benefit for the largest possible number of people. It is obvious that the use is different. The list of possible «benefit», again under this type of ethical teachings, takes the leading place economic benefits.

Simple economic calculations lead to the conclusion that «the patient — a parasite of society.» It is this judgment is the source and determined in that new «morality for physicians,» which suggests Nietzsche. In his philosophy of logic and pragmatic naturalistic ethics represented most consistently. In the 36th fragment «Twilight idols» Nietzsche writes: «Morality for physicians. The patient — a parasite of society.

In a state of indecent continue to live. Vegetating in cowardly dependence on physicians and artificial measures after the lost meaning of life, the right to life must be causing deep contempt of society. Clinicians should be mediators in this contempt — not recipes, and every day a new dose of aversion to his patient …

Create a new responsibility, responsibility of a doctor, in all cases where a higher interest in life, the ascending life, demands ruthless suppression and elimination degenerate life — for example, to the right of birth, the right to be born, the right to live … not in our hands to prevent our birth: but this mistake — because sometimes it’s a mistake — we can fix it. If destroys itself, then things are worthy of the greatest respect for the matter: it is almost deserve to live …. Society, what I say — life itself is a great benefit from it than from any «life» in renunciation, greensickness and other virtues. … «14

Basic settings naturalistic and pragmatic ethics are principles of justification of moral and ethical «lawfulness» of euthanasia, economic and demographic expediency «predictive» control of medical genetics for «public health», the legitimacy of the destruction of life on the embryonic level, rendering the «price» extension and end of life criteria for «brain death» and so on. n.

In the second half of the twentieth century formed the first block of the «new ethical standards.» These include: «moral murder,» «morality off life-sustaining equipment» — these concepts are working at the level of the header of articles fixed the scientific conferences; «To live with dignity, die with dignity» — the slogan of supporters of euthanasia; «Brain death» — not only medical but also ethical sanction for the exploration and use of human biological material (European culture is familiar with the situation when the anatomical and physiological concepts simultaneously filled and ethical meaning, such as «heart» of Christian morality in person); «Organ donation» — «cultural space» of the former USSR, the most prepared for the adoption of this standard through the archetype of Gorky’s «hero Danko» who saves his people to pull away, pounding, «hot» heart; «Procreation» — one of the names of the new type of business, today prosperous due to the «pregnant» income; «Rational family planning», «genetic policy», «genetic approach» for hereditary diseases in order to «correct natural selection» as a means of prenatal diagnosis «of artificial selection» and so on. D., And so on. N. These «ethical standards» are the building blocks of liberal forms of bioethics.

Naturalistic ethics and pragmatic liberal ideology share a common source base, which is the dominance of natural law and the innate human needs. At the same time it is important that the natural needs themselves, elevated to the rank of supreme values, become the basis of the exit from the natural naturalness. This is what happens in the liberal bioethics, to defend the right to have children, even when it does not give the right to nature, to continue to live, even when it takes the right nature, die «easy», in spite of the natural processes that change their sex, contrary to nature, destroy life, when it is bestowed by nature.

Communication liberal bioethics and naturalistic and pragmatic consciousness principle. Naturalistic and pragmatic consciousness by chance got a solid grounding in the philosophy of Nietzsche and features — immorality indicating primarily about their opposition to the traditional moral and ethical consciousness. The traditional moral and ethical consciousness represents the type of ethical teachings to which the ethical doctrine of Judaism, Confucianism, ethical views of Heraclitus, Socrates, Plato.

All these concepts completely original, individual, internal consistency, moreover, with each other are difficult to reconcile. But they can be combined logically represented as a kind of (in the second our classification) typological unit. For this type of ethical theories support and base solutions moral problems is an ideal self-contained reality, not reducible neither to human nature, nor practical calculations, nor to economic benefits, nor to social desirability, but giving the direction and meaning moral not only behavior but also the whole human existence.

The difference in the understanding of this reality leads to the fact that this type of ethical teachings can be called idealistic, or deontological or religious. In the books of the Old Testament ethics sacred. It is understood as «the law of our God» (Isa. 1:10) and a set of laws and moral and ethical postulates coming from God and turned to the man. In Confucianism ethics «metaphysical» and very authoritarian. «Lee» — a ritual consciously set of necessary and socially sanctioned rules of conduct. «You can not look at that contradict, you can not listen to what is contrary to see, we can not say that contradict» — Confucius demanded 15. The Code of regulations «if» did not allow a situation or some creativity. Allowed only one thing — their careful study and observance. To characterize the ancient ethics often use the saying of Heraclitus, according to which, since man is a man, he lives close to God. This «abode» («ethos») and is ethics, which in its origin deep ontological, or, as Heidegger says, fundamentally ontological 16. A special place among the religious teachings type takes Christian ethics.

European culture in general, and for the Russian, in particular, the Christian moral doctrine is crucial. It existed and exists as a centuries-old tradition of religious and ethical interpretation of Revelation, beginning with the works of the Fathers of the Church, including the theology of the Middle Ages, modern times, until modern religious ethical consciousness. «Key» to Christian ethics can be considered the words with which St. Augustine begins his «Confessions»: «… I do not know the rest our hearts, until they rest in Thee.» 17 In Christian ethics «measure» of morality is given or open to every person in biblical revelation and in the «moral law within.» For Kant, for example, that domestic law, ie. E. The highest moral value, is duty, obedience and which is itself a moral act. Due to Kant, the word deontology («Deon» — debt, «logos» — the law, the doctrine) becomes synonymous with moral philosophy.

The influence of Kant in modern religious Catholic and Protestant ethic — great. «The moral law within us» becomes the determining the basis for the modern conservative Christian bioethics. For Protestantism it is primarily «ethic of responsibility» physicians, researchers and front man for man and is understood as the defining landmark in professional activities. For the Catholic Christian bioethics is also characterized by basis.

Christian Bioethics is understood as «anthropology of human dignity» as a philosophical tracking, penetration and evaluation of all cases, incidents, and their destinies klassifikatsiya18. Orthodoxy, being historically and logically the first Christian creed, the established tradition of ontological understanding of morality .

The deep involvement of morality in a unified and coherent «dispensation of the world.» That is why the Orthodox moral philosophy moral values and the first of them — the love of God and neighbor — not only desirable norm of behavior. This is — the norm or principle of being, or the law of «the dispensation of the world,» without observing that breaks the «connection time» and meanings, one of the links which is the meaning of human life.

The meaning of human life in Christian ethics is directly related to the service of our neighbor and «doing good.» In connection with this healing, in fact — one of the unique human occupations, the meaning and purpose of which coincides with the maximum «doing good», c Christian values of charity, philanthropy, and save lives. No coincidence that the first model of social Institutes of Health as active manifestations of charity and humanity has been realized in Christian monasteries. Deeply symbolic red godmother symbolism of an international organization of care and compassion, which rely today in every disadvantaged area of the world that once again confirms the words of St. John Chrysostom: «Such is the power of charity: it is immortal, incorruptible and can never die.» 19 Typological proximity of religious and medical deontological and professional ethics is obvious. What are the demographic and social impacts of medical prediction.

Answers to these questions are directly related to the choice of moral values. Typological characteristics and coexisting fundamentally different ethical traditions provides the necessary guidance for the selection of rules and values, which should make every modern doctor. One reason for this choice is the reliance on history and logic of the development of professional medical ethics.