This year’s fourth issue presents two basic subject matters: One of them is about social bioethics, which is captured in articles about violence. The other subject matter deals with ethical decision making, and its anthropologic basis, which is exemplified in various topics of medical practice.

Regarding violence, five articles are published:

«A philosophical thought about violence and bioethics» of José Enrique Gómez Álvarez; «Power ethics as a trust basis in medical care relationships» of Paola Premoli de Marchi; «Impact of family violence in criminal behavior» of Patricia Martínez Lanz «Medical violence and the most vulnerable» of Martha Tarasco Michel, and lastly, Julia Lozano, Marcelino Pérez y Justo Aznar performed a «Study and assessment of sexual and reproductive health in women in Spanish penitentiary institutions».

José Enrique Gómez Álvarez offers us a reading in which he will develop the meaning of violence from the philosophical point of view. We shall understand how violence corrupts a person, and also all of who surround him. It will be discussed, the epistemology of violence, and we shall see why it is antithetical to men.

In the paper by Dr. Paola Premoli de Marchi, the subject of power and ethics will be addressed, and we will be able to identify the correct and incorrect forms of using power and leadership within the health teams. We shall understand why trust is important within the health teams. In the end, we will understand the morally correct form of using power. Precisely, in the bioethics based on utilitarianism, a negative ethics of power is given, because this thinking model looks for the greatest wellbeing for the majority, but there remains a minority, which does not get such benefit. Precisely, a power, which is not of leadership, creates a personal and social resentment, which usually ends up in violence.

Dr. Patricia Martínez Lanz, does a review of the relationship that there is between family violence and the development of criminal behavior. In her experience as a researcher in several Mexican penitentiaries, the author has published multiple papers about the delinquent behavior. Thus, the great value that this paper has. She points out an etiologic factor, which unfortunately doesn’t get any treatment whatsoever regarding the deprivation of freedom. Perhaps, even it gets worse; because those are much distorted family constellations, the ones who are the source of the problem. No doubt it is a very complex problem, which requires interdisciplinary measures, and therefore bioethics has a lot to provide. It results, in a subject matter seldom addressed in academic publications of this area.

As a matter of principle, medicine’s objective is to help a patient into clinical improvement of their illnesses. Nevertheless, even though it has existed in every season and time period, today it has become a habit, that the law does not penalizes any more, and that the public social security covers with our taxes, to admit eliminating the life of vulnerable patients. In Dr. Tarasco’s paper, the violence towards the embryo topic is specially analyzed, because it belongs to that social group that cannot have his rights enforced. This violence is exerted through abortion, in the assisted reproductive techniques, and in the freezing and thawing of embryos; but besides, the violence against the patient is given at an obstetric level, in patients with a mental or intellectual disability, in the elderly people that do not receive all the necessary care, or a dying person with euthanasia. The paper is focused on the most vulnerable person, which is the embryo, but there is no doubt that its arguments can be applied to any of the other above mentioned cases.

The so called «Sexual Health», is a confusing term, because even if it is true that there are illnesses that impact the sexual functions, it is not common to use the term for it. Julia Lozano, Marcelino Pérez and Justo Aznar members of the Bioethics Observatory of the University of Valencia, perform a study about knowledge and the use of different methods for family planning and for abortion, in women in different penitentiary centers of Spain. Comparatively with Mexico, there are discrepancies related to the degree of knowledge of the contraceptive methods, and above all about the day after pill, due to the fact that the younger Mexican women, do not use it in a sporadically manner, but almost customarily. On the other hand, abortion in Mexico, is beginning to be used just as another method of family planning. While as noted earlier in the article, there is no reference to other papers about abortion in Spanish jails, and furthermore there is much to be discussed about the findings encountered by the authors; there is an absence of, and it could be brought in, the ethical thinking about the findings. Nevertheless it is still a violent action against these women, who have lost their freedom, but have also lost the reproductive function in their bodies.

Regarding the other three papers, that while they are addressing very different subject matters, have in common the problem of philosophical anthropology, as a basis for the ethical decision. The first paper is, from the author that founded the personalistic Bioethics with Ontological basis in Italy, and which nowadays continues being the head of such school of thinking in Europe, and in many other places in the world: Elio Sgreccia who publishes about Charly Gard’s case. A case well known but nevertheless underlies the question about the human nature: What is it, and when does it stop being it? Because in other cases, such as the one of this baby have been happening in the United Kingdom, and surely without publicity, in other countries. Of course, it is violence against the child, and against his parents, but also against the human family and its paternity links. But Sgreccia speaks about the person of this child, and of his permanence as such, even though he will never acquire all the functions which, for the materialism, and for the reductionism he qualifies as a person. In this lecture it will be discussed the principles that want to take care and protect the dignity of every human being.

Besides, we have the papers about the Genetic editing of a research group from the Istituto di Bioética dell’Universita Cattolica del Sacro Cuore; the authors Pietro Refolo, Vincenzo L. Pascali and Antonio G. Spagnolo, describe the different techniques of Genetic Editing, and place on the table a rarely treated problem, about it, and which is related with the biologic identity of these organisms, because specially with the technique CISPR-CAS9, the organisms genetically modified cannot be differentiated, from the natural ones, stating the dilemma between what is artificial and what is natural. Furthermore, they point out many medical and ethical consequences, especially when the human embryo is edited.

In the last paper of this group, «Bodies and reasons. Nietzsche and the human complexity» from Paolo Scolari, we find a thorough analysis of what the human body was for the philosopher. Nietzsche speaks of the body as a duality between suffering and power, criticizes science for being reductionist and to Christianism for interpreting that it despises the body. Finally ends with a dualism in which body and soul disappear as a duality, and only the body stays which is the one that creates thinking. But although the article is an excellent summary of Nietzsche’s thinking about corporeality, above all it is of great importance for understanding many of the ideologies which have been established nowadays, with radical bioethical consequences at a social level, as it can be the denial of biological facts by the gay ideology, or the transhumanism. In both cases, they seem to be opposed to Nietzsche’s idea, but in reality are an accurate expression and supplement of it.