De la Bioética clínica a una Bioética Institucional y Social

an attempt is made to back up the need to extend the scope of bioethics in spain and latin america, from clinical ethics to social bioethics, comprising the institutional ethical dilemmas, as well as those of public health, policies and reforms of health systems, and legislation. for this purpose, it is necessary to provide the principles of bioethics with content, and supplement it with the vision of the ethics of care, personalism and communitarism, the strictest interpretation of principialism based upon dialogic ethics. the proposal is three-fold. first, incorporate these social dimension aspects in the academic debate of bioethics. second, develop the bioethics system of principles, with supplementary principles that may be used in resolving cases and decision-making processes, so that they can also incorporate the personal, institutional and social aspects. third, use the means clearly stated in the legal regulations of many countries, which are part of the goals of promoting institutional and social ethics, proposed for the ethics assistance committees, research ethics committees, and national bioethics commissions.