Key Considerations in Bioethics from a Cultural Perspective

Abstract

This article critically examines the conceptual, historical, and epistemological foundations of bioethics as a transdisciplinary field that emerged in response to the ethical tensions produced by technoscientific development. Through an analytical and interpretative approach, the paper revisits the historical events that shaped modern bioethics and the contemporary challenges that arise from the expansion of biomedical and technological interventions. The analysis highlights persistent dilemmas involving autonomy, paternalism, vulnerability, and intercultural asymmetries, as well as the ethical impact of technoscience on the reconfiguration of life, death, and human nature. The article argues for a pluralistic and adaptive bioethics capable of sustaining epistemic vigilance and guiding decision-making processes in diverse and complex sociocultural contexts.

1. Introduction: A Conceptual Approach to Bioethics

The main historical events that led to the emergence of bioethics are related to the atrocities committed during World War II and the genocide perpetrated by the Nazi regime, where the relationship between health professionals and people subjected to experimentation reached extreme levels of abuse, dehumanization, and organized violence. In this sense, the rights and integrity of communities considered “expendable” under pseudoscientific racial ideologies that legitimized coercive experimental practices were systematically violated [1]. Likewise, the devastating impact of the atomic bombs dropped on Hiroshima and Nagasaki constitutes another decisive reference point for the configuration of bioethics [2], given their long-term consequences on civilian populations that historically did not participate in the decision-making processes that affected them. Another critical episode was the syphilis study conducted in Tuskegee, Alabama, between 1932 and 1972, where impoverished men of African descent with limited access to formal education were deceived and deliberately deprived of available treatments, demonstrating how structural inequalities can be exploited in the name of scientific research [1]. Within this framework, the article advances the central thesis that contemporary bioethics must be reconfigured as a pluralistic and intercultural field, capable of sustaining continuous epistemic vigilance regarding technoscientific developments and of guiding ethical decision-making in diverse and complex sociocultural contexts. This reconfiguration constitutes a necessary condition for critically addressing the tensions between life, technology, and human dignity in the contemporary world.

Methodologically, the article adopts an analytical–interpretative approach aimed at examining bioethics as a situated field of reflection. The selection of sources follows three criteria: their relevance in shaping the historical development of contemporary bioethics, their contribution to debates on technoscience and life, and their capacity to problematize the cultural, epistemic, and material asymmetries that shape bioethical debates across diverse global contexts. On this basis, the argument moves from a conceptual review of bioethics toward a critical reading of its limits when confronted with issues of accessibility, inequality, and intercultural deliberation.

Although bioethics has its origins in diverse philosophical traditions, over time it has become established through dialog with multiple fields of knowledge and has developed its own practice oriented toward reflection and ethical decision-making. An influential figure in this consolidation was Van Rensselaer Potter, an American oncology researcher whose book Bioethics: A Bridge to the Future, published in 1971, is recognized as a milestone in formulating contemporary bioethics [3]. Alongside Potter, Daniel Callahan, Edmund Pellegrino, Albert Jonsen, Tom Beauchamp, James Childress, and David Thomasma are often mentioned as central figures in institutionalizing bioethics in the United States, especially for their interest in structuring a secular bioethics focused on the dilemmas generated by biomedical developments in the 1970s [4]. However, references to these authors should be understood as part of a situated genealogy and not as the only legitimate source of bioethical thought.

This genealogy requires expansion when viewed from Latin America, where bioethics developed not only as a response to individual clinical dilemmas but also as a reflection linked to social inequality, public health, vulnerability, health justice, and human rights. In the region, bioethical debates have been shaped by historical conditions marked by exclusion, technological dependence, fragmented health systems, and unequal access to the benefits of scientific research. Therefore, the history of contemporary bioethics cannot be exhaustively covered by European and North American milestones, since it must also consider how Latin America has produced its own responses to the tensions between technoscience, dignified life, and social justice.

Bioethics cannot be understood as a product exclusive to the American academic tradition. As early as 1927, German theologian Fritz Jahr used the term bioethics in his article “A View of the Ethical Relations between Human Beings, Animals, and Plants,” published in the journal Kosmos [5]. His reflections, influenced by Kantian ethical imperatives, emphasized the formulation of a principle aimed at regulating human behavior towards other forms of life, both human and non-human [6]. This proposal anticipates contemporary debates by rethinking moral obligations within an interdependent ecosystem. This expansion of the moral community makes it possible to establish a bridge with Latin American perspectives that have insisted on understanding life through concrete social, ecological, and territorial relations. In these approaches, the bioethical question of life extends beyond the biomedical sphere and becomes linked to the historical conditions that make dignified living possible in contexts marked by inequality, environmental degradation, and technoscientific dependence.

Both ethics and bioethics seek to discern the value of good and evil in human actions. As with ethics, bioethics studies and systematizes concepts that enable us to understand good and evil, and guides reflection on how to act in different situations. Both are based on a theory of action, founded on principles of virtue or obligation, and outline guidelines for human behavior that seek to maintain consistency with cultural diversity.

Traditional ethics has lagged behind various contemporary issues, in which technoscience provides answers and simultaneously raises questions that were previously addressed within mythical–religious frameworks [7]. Scientific advances, mediated by technologies that intervene in decision-making and personal autonomy, generate tensions with central ethical assumptions, especially around notions of life and humanity. In this context, classical ethical approaches show limitations in guiding reflection or action in the face of current transformations.

Paradigmatic ruptures in the social sciences and humanities, particularly within critical theory, have revealed that traditional ethics retains underlying assumptions that continue to shape its reflections, reproducing anthropocentric, monocultural, and paternalistic frameworks despite ongoing revisions. In this regard, authors such as Dussel [8], Haraway [9], and Santos [10] have shown how these perspectives tend to position the Western subject as a privileged reference point in the understanding of the human [8]. Although presented as beneficial to humanity, this perspective carries a problematic Eurocentric burden by reproducing models of coexistence that are unfavorable to the environment and other species. Together, these conceptions have contributed to placing humanity in a critical position regarding its relationship with the planet and its status as just another species.

Today, the human being is understood as part of a whole, embedded in a world that affects them but that they can also transform. From this perspective, bioethical values and principles seek to promote forms of coexistence that guarantee respect for life, dignity, and autonomy. In this vein, bioethics adopts a systemic posture and horizontal coexistence with other species, refining the vestiges of traditional ethics and drawing on various disciplines that have reflected on the value of life from multiple perspectives. This openness has made it possible to understand more broadly the repercussions of techno-scientific advances on the planet and on humanity, whose bodies and minds are also transformed by these developments.

This critical horizon makes ethical reflection more complex, as it invites us to understand humanity with greater humility and to work toward an ecosystemic balance that recognizes other species and other possibilities of the world [9]. From its theoretical corpus, bioethics shapes its identity by integrating diverse perspectives on life, death, and the human condition. Its principles promote pluralistic deliberations that include as many points of view as possible and guide situated decisions. This is especially relevant in light of the challenges posed by technoscience, which demands ethical responses aligned with the transformations inherent in new scenarios.

Technoscience has transformed the world and, in the process, has also transformed us, destabilizing paradigms that used to guide our experience. These changes are not limited to material: they affect our relationships, forms of coexistence, and ways of understanding ourselves as social, human, living, and finite beings. Such transformations invite us to reconsider our position within systems that transcend us and in which we do not occupy a central place. Thus, bioethics promotes an attitude of respect for biological and cultural diversity.

Unlike classical ethics, which maintains the trans-subjective existence of normativity and a presumed moral objectivity, bioethics grants greater relevance to the subjective elements from which consensual norms are constructed. It is based on a framework of reflection that allows for the examination of technological progress and its social impact, and employs an analytical method for decision-making based on a normative, pragmatic, and diversified search whose purpose is to reach minimum agreements acceptable to most people [7].

Although it is related to medical ethics, bioethics has a much broader scope, as it is not limited to clinical practice. It can be defined as a branch of ethics with a practical character that, from a macrosocial perspective, addresses issues derived from the impact of technoscience on the different manifestations of life, human and non-human. From a microsocial perspective, it operates in practice through the analysis of specific cases that affect individuals and groups, especially in biomedical and environmental fields. Bioethics seeks to build elements that contribute to the discernment of ethicality through reflections and deliberations guided by a negotiated “ought to be” based on moral principles. It seeks to guide human behavior in the application of life sciences, guaranteeing respect for the values and principles that guide ethical action. Based on this, principlism, as one of the bioethical models, focuses on the principles of autonomy, non-maleficence, beneficence, and justice [10].

Bioethics seeks to articulate technological and scientific advances, which allow humans to intervene in different manifestations of life, with the value of responsibility, creating bridges between the experimental sciences and the humanities, as proposed by Potter [3]. This definition gradually expands to encompass life in the biological sense, together with the social conditions that shape the possibility of a dignified life. The analytical tools of bioethics allow us to respond and act in accordance with moral principles aimed at protecting life in a scenario of rapid technological and scientific developments. They also enrich our reflection on our responsibilities as creators of technology, seeking to maximize the benefits of scientific advances and reduce the risks associated with their use. Their contribution is fundamental to promoting ethical consensus in the face of controversies associated with technological implementation in a globalized and culturally diverse world.

The contemporary crisis of values also favored the emergence of bioethics, which has expanded its field of action to address structural issues such as inequality and systemic injustice in access to health services, phenomena that affect the validity of human rights and are subject to conflicts of interest. In this context, it is necessary to analyze the role of bioethics in the face of conditions of inequality and exclusion linked to the distribution of wealth and other forms of injustice present at different social levels [11].

From an intercultural perspective, bioethics requires the recognition of cultural diversity and the protection of populations exposed to the risks generated by technoscientific developments, particularly in the biomedical field. In this sense, it has been argued that bioethics must be conceived from difference, acknowledging the validity of multiple value systems beyond the Western tradition [12]. Accordingly, it is not enough to incorporate inclusion from already established hegemonic guidelines; it is necessary to articulate the worldviews of ethnic minorities in the very formulation of the epistemological foundations of bioethics. Only in this way can a binding intercultural conception be configured, capable of developing principles consistent with the endogenous perspectives of non-Western minority peoples [13].

Bioethics thus consolidates its importance as a transdiscipline devoted to the broad study of moral dilemmas and constitutes a tool for promoting a more equitable world, where cultural differences are recognized as opportunities to value diversity while upholding respect for principles without undermining human dignity. In doing so, it fosters the construction of negotiated decisions oriented toward truly inclusive social justice.

From this perspective, bioethics requires expanding its frameworks of understanding beyond inherited normative traditions and engaging in an intercultural dialog that incorporates diverse ways of understanding life, death, and dignity. Only in this way can it be consolidated as a truly plural field, capable of responding to the ethical challenges of technoscience in a deeply unequal and culturally diverse world.

In this article, pluralistic and intercultural bioethics is understood as a deliberative framework grounded in four guiding criteria: recognition of cultural diversity, justice in accessing benefits of technoscience, participation of affected communities in decision-making processes, and critical vigilance toward epistemic asymmetries that privilege certain forms of knowledge over others. These criteria make it possible to move the bioethical discussion from an exclusively normative formulation toward a situated reflection on the concrete conditions in which decisions about life, health, and dignity are made.

2. Bioethics, Technoscience, and Epistemological Vigilance

Within this landscape, technoscience is widely legitimized as a means of improving the quality of life and sustaining certain ideals of social well-being, expressed through the development of innovative products, services, and processes. Its expansion, however, calls for closer examination of the ethical implications that arise when such advances impact fundamental notions such as life, death, and human nature.

Despite the widely recognized benefits of technoscience, its scale of impact demands careful consideration of the consequences of its application. The risks associated with inappropriate scientific practices can generate profoundly deleterious effects, reinforcing the necessity of conceptualizing bioethics not as an ancillary or external element, but as a constitutive component of research and scientific practice. The history of science itself reveals that many currently accepted bioethical principles emerged from crucibles of controversy, most notably in the wake of the Nuremberg trials.

For extended periods, scientific practice operated in the absence of bioethical frameworks to protect research subjects, permitting experimentation on human beings without the recognition of their fundamental rights. These practices reached a critical zenith in the experiments conducted by the Nazi regime, whose condemnation at the Nuremberg trials precipitated the formulation of explicit ethical principles that now serve as normative benchmarks, synthesized in the Nuremberg Code [14].

Science as a discourse is grounded in principles oriented toward the production and socialization of knowledge across cultural and geographic boundaries, aiming to disseminate explanations of nature and the cosmos through a collective, trans-border effort. Nevertheless, as an institution comprising human actors, it is not immune to errors, economic pressures, or conflicts of interest that may compromise the integrity of research and the processes of scientific validation.

Even when scientific investigations are motivated by ostensibly legitimate intentions, the absence of robust bioethical protocols can inflict significant harm upon participating subjects. Studies such as those conducted by Stanley Milgram [15] demonstrate how, even within controlled experimental frameworks, the erosion of clear ethical criteria can lead to grave violations. Such instances subsequently catalyzed the institutionalization of protective mechanisms, including interdisciplinary bioethics committees and informed consent protocols.

Despite everything, there is currently still no consensus regarding how to address problems of scientific integrity and ethics in research, as in many cases, sanctions have not yielded the most ideal outcomes [16]; therefore, there is a need to understand how scientists may commit these violations to prevent them and strengthen integrity [17]. This should be treated as a substantial part of scientific research, and not as a mere bureaucratic procedure or paperwork that delays scientific procedures. Therefore, it should be linked from the outset as part of the practice itself. As a result, beyond any aversion that may exist towards science, these fears stem from malpractice and ethical lapses. Thus, trust between science and individuals is undermined as a human construct, which is why research needs an ethical approach by the actors who constitute it and those who benefit from it [18].

This issue becomes particularly visible in Global South contexts, where asymmetries in access to healthcare, medicines, diagnostic technologies, and the benefits of scientific research reveal structural bioethical tensions. Accessibility cannot be understood solely as an administrative or economic problem, since it directly involves the principles of justice, equity, dignity, and the protection of vulnerable populations. Kurihara et al. [19] argue that the social value of health research requires effective mechanisms for the equitable distribution of benefits and post-trial access to research-derived interventions, especially when vulnerable communities or populations in low-resource settings are involved.

In Latin America, for example, the unequal distribution of medical technologies, high-cost treatments, vaccines, diagnostic tests, and specialized services shows that the benefits of technoscience are not incorporated homogeneously across all territories. Progress toward universal health coverage still coexists with high levels of out-of-pocket expenditure, persistent inequalities between urban and rural areas, socioeconomic disparities in effective access to care, and increasing judicial pressure to obtain high-cost technologies. This gap between formal coverage, technological availability, and material access calls for bioethics to be understood in terms of the concrete conditions that make a dignified life possible, especially when biomedical innovation advances faster than institutional capacities to assess its value, define priorities, and ensure its equitable incorporation into health systems [20].

A particularly illustrative example is the judicialization of access to high-cost medicines and health technologies in several Latin American countries. This phenomenon shows that individual appeals to the right to health can become a legitimate pathway for claiming otherwise denied or inaccessible treatments, while also revealing deep tensions between individual justice, collective sustainability, health prioritization, and the State’s regulatory capacity. From a situated and intercultural bioethical perspective, these cases show that the question of access involves much more than the technical availability of an innovation: it entails criteria of equity, resource distribution, institutional legitimacy, and the protection of historically excluded populations.

A vigilant stance toward technoscience must be sustained, safeguarding the space between the freedom of scientific practice and the boundaries of a plural bioethics that protects scientific principles from potential negligence, omissions, or fraud, thereby preventing the reproduction of biases in the treatment of bioethical issues. Within this framework, the role of interdisciplinary bioethics committees becomes particularly significant in ensuring responsible scientific development, securing the application of principles such as communality, universality, organized skepticism, and impartiality as ethical minimums guiding the relationship between scientists and their practice in pursuit of social benefit.

From this perspective, the need for continuous epistemic vigilance underscores that bioethics must be configured as a plural and intercultural field capable of critically accompanying technoscientific development across diverse contexts.

3. Tensions with Autonomy

Building on these transformations, technoscience, while offering responses to concrete problems, simultaneously generates new scenarios that demand renewed ethical reflection. These dynamics give rise to novel controversies that, over time, may become integrated into the common sense of a given era, much like principles that are now taken for granted were once considered disruptive. Within this process, the notion of autonomy becomes particularly challenged, as scientific developments reshape how individuals understand and exercise their capacity for decision-making over their own lives.

In this context, the existence of multilateral pacts and adherence to international declarations, such as that of Helsinki, have been fundamental, allowing for the creation of bioethics committees in disciplines with direct intervention in human beings [21]. These normative frameworks establish criteria to evaluate the risks associated with scientific research to determine its ethical acceptability, especially when human health is compromised, guaranteeing that decisions are based on clear information and respect for the autonomy of the participants.

At this point, moral autonomy acquires a central role by allowing free decision-making oriented toward the good, without transgressing the principle of non-maleficence. Recognizing individuals as agents capable of consenting implies guaranteeing clear and understandable information processes [22]. Nevertheless, this autonomy enters tension when, under paternalistic logics, the decision-making capacity of patients is restricted under the argument of protecting them, especially when technical knowledge is presented as a barrier that legitimizes the substitution of their will. This tension acquires particular nuances in non-Western cultural contexts, where autonomy is not always conceived as a strictly individual attribute. In various Asian traditions, for example, health-related decisions are often mediated by family or community, which challenges bioethical models centered exclusively on individual autonomy and calls for more flexible and intercultural frameworks of ethical deliberation. In Latin America, this discussion also becomes relevant in Indigenous, rural, and community-based contexts, where decisions about health, care, territory, and collective life may be mediated by community authorities, family ties, traditional knowledge, and historical experiences of institutional exclusion. In these scenarios, respecting autonomy requires more than obtaining individual consent: it calls for conditions of understanding, trust, participation, and cultural recognition that make situated ethical deliberation possible.

Reflection on paternalism considers scientists as authorities, thereby configuring asymmetric relationships based on trust and access to sensitive information [23]. This condition demands additional precautions when working with vulnerable populations, to balance the inequalities that Rawls calls the “natural lottery” [24]. In these cases, respect for autonomy requires accompaniment processes that ensure conscious, informed, and protected participation, especially in research involving children or other vulnerable groups.

While scientific practice continues to learn and adapt, it is essential to minimize situations that compromise human well-being. It is not ethically acceptable for bioethical advances to emerge only in response to harm after it has occurred. Hence, an adaptive and pluralistic vigilance is needed to anticipate possible violations of autonomy, constantly accompany technoscientific processes, and guide ethical decisions in emerging controversies.

Technological advances materialize in artifacts that sustain increasingly accelerated creative processes, while bioethical reflections, depending on human experience and deliberation, seem to advance at a different pace. This asymmetry is problematic, since, while technoscience produces devices of increasing scope, many of the principles guiding its ethical evaluation remain anchored in millennial philosophical traditions. While still valid, these principles are frequently unknown, neglected, or insufficiently applied, which directly affects the subjects’ capacity to exercise an informed autonomy.

This vigilance must recognize that bioethical principles emerge from a situated Western episteme historically grounded in the primacy of reason. Consequently, it becomes necessary to continuously reopen and update discussions regarding what should be carried out in contemporary scientific practice, preventing the consolidation of highly technified practices detached from ethical criteria and moral sensitivity. Otherwise, instrumental reason may enable advanced scientific knowledge into tools of domination and as reproductions of necropolitical logics [25]. These tensions reveal the limitations of rigid universal approaches to understanding autonomy and reinforce the need for a pluralistic and intercultural bioethics that considers the situated conditions in which individuals exercise decision-making.

4. About Life and Death

These discussions lead to a broader reflection on life and death as categories whose meanings vary across cultural and epistemological frameworks. Life, as a human experience, has been the subject of multiple interpretations and hypotheses regarding its origin, transformation, and purpose. Different schools of thought and situated epistemologies have offered explanations of its beginning, meaning, and ultimate purpose.

From biology, philosophy, and theology, situated discourses have been constructed to explain the phenomenon of life within specific epistemic frameworks. In modern science, life is usually understood from a predominantly material perspective, heir to a reductionist approach based on reason as the axis of Western thought [26]. In this horizon, life is explained as a metabolic and biochemical process that produces micro-organic interactions, from which intangible experiences emerge [27]. Nonetheless, this approach tends to omit holistic dimensions that exceed physiological criteria by establishing presumably universal rules to describe the vital phenomenon.

Theology conceives life as a phenomenon that transcends the strictly biological. Although it acknowledges a material origin, it also allows for symbolic and intangible possibilities that cannot be explained through biological materialism [28]. This perspective recognizes a relationship between the material and the metaphysical, admitting a certain degree of autonomy between both dimensions and legitimizing an epistemic dualism in which materiality, even as a support for the spiritual, acquires independence from its own complexity.

Philosophy does not establish absolute truths about the origin of life. While its explanations were linked to supernatural forces in antiquity, philosophical reflection has been oriented toward questioning the sense and purpose of existence beyond the biological and theological designs, with a critical responsibility toward life itself [29]. Similarly, various Indigenous worldviews in Latin America conceive life as a network of relationships between human beings, nature, and spirituality. These perspectives challenge dominant anthropocentric approaches and contribute essential elements to developing an intercultural bioethics that recognizes alternative ways of understanding life, death, and dignity.

Regardless, life is traversed by the experience of birth. Beyond a biological process culminating in gestation, birth inaugurates the experience of living as an event that escapes individual will [30]. The cutting of the umbilical cord marks the closure of the initial biological link and gives way to a psychological experience mediated by the senses and their interpretation. In this scenario, autonomy emerges as a possibility for decision and the exercise of freedom. As Sartre proposes, human beings are born into a world in which they must define themselves through their choices, making life a space where existence precedes essence, and where initial nothingness is filled with meaning through freedom [31].

Death, as the culmination of the vital process, just as occurs with life, acquires different meanings according to the epistemic framework from which it is approached. In biology, it is defined as the irreversible interruption of metabolic and brain functions. In theology, it is interpreted as a transition toward a transcendent existence that does not constitute a definitive end [32]. Philosophy, in turn, conceives death as a constitutive condition of human existence, from which meaning is given to life through freedom, dignity, and self-realization. In this sense, the human being is understood as “Dasein”, a “being-towards-death” thrown into the world, whose existence is signified by its decisions while trying to understand life [33].

The experience of dying is configured differently by the sociocultural context in which it occurs. In the West, death has been progressively medicalized until becoming a taboo, displaced to hidden spaces of existence, as described by Ariès [34]. Parallelly, it has been spectacularized, commercialized, and depersonalized. This distanced relationship, traversed by a social thanatophobia, is expressed through the use of euphemisms that technologize the understanding of dying [35], moving it away from its human and ritual dimension [36].

Although a biological infrastructure exists that enables human action, the capacity to grant meaning to life evidences the transition from the tangible to the intangible. As Csordas [37] points out, embodiment is simultaneously material and significant. We live and feel the world through the body, which allows both the interpretation of reality and its transformation; in this process, the human being models the world and, in turn, is modeled by it.

From this perspective, the brain is configured by actions, attitudes, and interactions with the environment, and is molded by significations and emotional experiences. This is evident, for example, in social constructions of gender and sexuality, understood as symbolic processes in interaction with biological factors [38]. In this way, life manifests as a multidimensional, holistic, and systemic phenomenon that overflows the dualisms between the symbolic and the biological.

This scenario becomes more complex as human beings acquire the capacity to structurally modify life, blurring the traditional boundaries between the natural and the artificial. Within this framework, classical ontological distinctions lose stability and give rise to emerging configurations of life [39]. The consequences of human action are amplified, requiring ethical frameworks capable of responding to transformations that affect the understanding of life and the human condition, opening the debate on new rights and responsibilities [40]. Under these conditions, understanding life and death in their complexity requires recognizing the need for a plural and intercultural bioethics that integrates diverse epistemologies and guides ethical decision-making in culturally diverse scenarios.

5. Bioethics and Contemporary Controversies

This horizon of transformation becomes particularly visible in contemporary bioethical controversies. The drive to address fundamental questions about life and understand ourselves as a species has led to significant scientific discoveries. Numerous advances have challenged paradigms long considered immutable, enabling the explanation of phenomena once interpreted as miraculous [41]. However, this progress has also positioned science at the center of contemporary well-being, understood as situated knowledge shaped by the limits, risks, and uncertainties of technological modernity [42].

The development of the sciences, particularly biomedical sciences, has intensified interest in directly intervening in the phenomena of life. This tendency has favored the search for tangible explanations for dimensions traditionally understood from symbolic registers, leading to biological reductionist approaches that reduce emotions and feelings to biochemical processes. From this perspective, the human tends to be fragmented into components analyzable in isolation, reinforcing an instrumentalization of life that empties the experience of living of its metaphysical dimension [43].

Under this instrumental approach, the boundaries that protect human dignity and life are diluted in the name of scientific progress, to the extent that the human is reduced to a technically available and manipulable object [44]. Against this, those intangible dimensions that grant meaning to life and sustain relational dispositions such as empathy and compassion become relevant, as they are indispensable for understanding the human beyond explanations anchored exclusively in biological determinisms [45].

It is necessary to situate scientific interventions within contextualized deliberation processes that allow for the problematization of their consequences on the conceptions of humanity that legitimize them, questioning notions such as dignity, solidarity, and spirituality. In this framework, constant bioethical vigilance becomes essential to guide scientific practices as open processes in permanent revision, avoiding the reproduction of dogmatisms, monisms, or dualisms inherited from Western thought.

Under these conditions, the human condition must be understood as a multifactorial phenomenon, shaped by cultural and sociohistorical dimensions, within a horizon where the boundaries between the natural and the artificial become increasingly blurred [46]. It is important to recall that biologism has historically been used to establish hierarchies among human beings, legitimizing asymmetric power relations and domination processes over dehumanized communities, which underscores the need for a critical bioethical reflection on these legacies. These dynamics reinforce the need for a pluralistic and intercultural bioethics that, through sustained critical vigilance, enables questioning the assumptions guiding technoscientific interventions on life.

6. Bioethical Dilemmas

Building on these transformations, bioethical dilemmas emerge as concrete expressions of moral tensions that challenge traditional ways of understanding and acting in relation to life. These dilemmas are shaped by historically situated principles, values, and norms that structure how individuals organize their symbolic universe and orient their conduct within specific sociocultural contexts. Within this framework, bioethical moral questioning challenges assumptions that have guided human action, particularly when scientific advances destabilize previously naturalized normative frameworks.

From this perspective, a moral dilemma is presented when ethical principles that have traditionally guided action come into conflict and demand a deliberation without automatic solutions. In medical practice, such tension manifests when professionals must weigh conflicting principles—such as autonomy, beneficence, or non-maleficence—to make decisions that consider the patient’s singularity, even when their own moral values do not fully coincide with those of the patient [47]. The complexity of the dilemma resides precisely in the impossibility of simultaneously satisfying all the principles involved without generating some type of ethical affectation.

However, it is necessary to distinguish these situations from those in which, despite the appearance of conflict, equally defensible alternatives allow for a reasonable balance between the principles involved. In these cases, one would not be facing a moral dilemma in the strict sense, but rather a so-called false dilemma, where ethical deliberation enables a resolution that does not substantively violate any of the principles involved [48]. This distinction helps to avoid over-dramatizing circumstances that can be resolved through adequate contextual weighing.

In contrast, an ethical problem is configured when the action considered correct ceases to be evident and requires a reflexive exercise guided by principles, values, and norms to determine the most appropriate response. This condition demands a rational analysis that, far from relying on absolute certainties, resorts to contextual common sense and prudent deliberation to guide the decision [49]. In this framework, bioethical dilemmas are presented when a situation linked to any manifestation of life requires a critical examination of the conflicting values, with the aim of guiding the action toward the greatest possible benefit for the people involved [50].

In such scenarios, bioethics does not operate as a closed normative system, but as a space for deliberation that seeks to reach a situated ought to be, guided by moral principles and norms of conduct that regulate action in specific contexts [51]. A bioethical problem arises when a decision carries transcendental consequences for those involved and engages responsibility toward life, dignity, and autonomy, making evident the need for an ethical reflection that recognizes the complexity of contemporary contexts. Within this framework, bioethical dilemmas highlight the need for a plural, intercultural bioethics that, beyond universal solutions, enables the construction of situated responses through contextual deliberation.

7. Conclusions

Bioethics plays a central role by problematizing conceptions of humanity and promoting practices oriented toward avoiding the instrumentalization of the human. Within this framework, principles are brought into play that recognize human beings as entities constituted beyond their biological dimension, integrating symbolic and relational elements. Through the dialog between the disciplines that converge in bioethics, it is possible to deliberate on the human as a condition neither closed nor immutable, whose configuration depends on the historical, cultural, and technoscientific contexts in which it is inscribed.

In this sense, what has been understood as human in the West can be approached as a dynamic condition in permanent transformation, open to adaptive processes driven by technoscience and by the encounter—often conflictive—between different cosmogonies. These perspectives, from their singularities, contribute to enriching the understanding of humanity as a situated notion whose historical origin does not exhaust its possibilities for resignification.

Just as technoscience, through developments such as nanotechnology and bioscience, questions Western notions of the human, ancestral thoughts have long proposed diverse understandings of the human condition. These views highlight the risk of a homogenizing pretension implicit in certain conceptions of human nature [52]. This underscores the relevance of bioethical vigilance that accompanies technoscientific applications, avoiding rights violations and guaranteeing respect for autonomy and freedom.

Controversies currently arise from unprecedented situations that question the fundamental assumptions of traditional ethics, revealing its insufficiency in resolving problems related mainly to the characteristics of life and its newly conceived forms. Many enduring principles and assumptions were built on regimes of truth [53] different from those that live today; therefore, these new contexts construct new subjectivities that open the debate on what makes us human, and what constitutes us as individuals and social subjects. Unlike in the past, many elements of today’s technology are beginning to receive scrutiny and prompting re-evaluation of the concept of humanity, while questioning the extent to which life can be understood solely as metabolism. Thus, the original contribution of this article lies in articulating pluralistic and intercultural bioethics with the problem of accessibility in the Global South, showing that bioethical deliberation cannot be confined to formulating abstract principles when the material conditions of access to healthcare, technology, and research are substantially unequal. From this perspective, bioethical justice requires attention both to cultural frameworks of interpretation and to the concrete conditions that enable or prevent participation in the benefits of technoscience.

In this context, the consolidation of a pluralistic and intercultural bioethics emerges as a practical necessity in response to contemporary technoscientific challenges. This orientation involves strengthening ethical deliberation frameworks capable of recognizing cultural diversity, incorporating multiple value systems into decision-making processes, and designing public policies responsive to the social and territorial conditions of populations. It also entails developing educational processes that foster a critical understanding of the relationship between science, technology, and society, along with the recognition of situated knowledge that broadens how life, death, and dignity are understood. From this perspective, bioethics gains the capacity to intervene in concrete contexts, guiding situated decisions and contributing to the construction of more just, equitable, and culturally inclusive scenarios.