Contemporary Bioethics is experiencing a “qualitative leap” driven by technological trends such as transhumanism, posthumanism, Artificial Intelligence, and Neuroethics, all of which have in common that none of them address or take into account the spiritual dimension of the person. This new direction is no longer merely secular, but secularist, in that it “sidelines, if not eliminates, the spiritual and transcendent dimension of the person,” resulting in the technification of care and the consequent loss of human warmth and humanity in healthcare. Faced with this bioethical gap, which suggests the loss of humanization and comprehensive patient care, and which only finds explicit coverage in Palliative Care, the urgent response lies in dialogue with the Pastoral Theology of Health, given that this discipline considers the spiritual care of suffering to be an absolutely central element.

In Bioethics, great importance has been given, as could not be otherwise, to patient rights and, at this time, to transhumanism, posthumanism, Artificial Intelligence and Neuroethics.

It seems that, on the one hand, Bioethics is moving beyond the limits of patient care, and, on the other hand, care is beginning to become more technical (through new technologies and Artificial Intelligence), losing the human warmth and, therefore, the humanity that is inherent to the merited care of a person experiencing illness and suffering.

Transhumanism  ,  posthumanism , new technologies and  Artificial Intelligence  have in common that none of them addresses or takes into account the spiritual dimension of the person.

This latter aspect raises the following research questions: Has the loss of the spiritual dimension in patient care, including in bioethics research and application, resulted in a loss of humanization in patient care? Have we lost, or are we losing, comprehensive patient care? And finally: How can we best fill this bioethical gap?

The answer to these research questions lies in the Pastoral Theology of Health.

Indeed, given that this gap is beginning to emerge in Bioethics, except in  Palliative Care , while in Pastoral Theology of Health the spiritual care of the suffering of the person suffering from an illness is absolutely central, there should be a dialogue between both disciplines.

Perhaps we must agree with Keenan (2025, p. 290), for whom “(…) now more than ever, specialists in theological ethics direct their gaze almost exclusively in response to human suffering.”

This is what we are trying to investigate in this scientific article.

The two directions in the history of Bioethics

In the history of bioethics, two directions can be observed: 1) The shift from medical paternalism to patient autonomy. 2) The shift from theological bioethics to secular bioethics.

The first direction, resulting from the principle of autonomy and patient rights, is obvious. The second, which consists of marginalizing religion to the private and intimate sphere, requires further verification, especially considering the aforementioned object of research.

For this reason, we verified this second direction by referring to the contributions of several renowned bioethicists:

“It is undeniable that theologians played a leading role in the early days of bioethics [Fletcher, McCormick, Ramsey, Curran, among others, are mentioned later]. (…). However, the marginalization of religion and religious language in bioethics is an undeniable fact.” (Ferrer & Álvarez, 2003, p. 80)

“As a final piece of information on the birth and early development of bioethics, it is necessary to note the leading role played, among others, by philosophers and theologians, both Catholic and Protestant [he cites the same authors as the previous authors].” (Ciccone, 2006, p. 18)

“(…) in the last 30 years there has been a process of secularization that affects many areas of Western society and that also has repercussions in the field of Medical Ethics. (…). D. Callahan (…) has written that the most striking change of the past two decades has been the secularization of Bioethics.” (Gafo, 2003, pp. 30-75)

A new direction in the present and future of the history of Bioethics

On the other hand, we have considered the two directions that have guided the history of Bioethics. However, when the question of which direction it will follow arises, it seems that a qualitative leap is beginning to take place.

We are talking specifically about transhumanism and posthumanism ^[1]:

1) It is no longer secular, it is secularist: it marginalizes, if not eliminates, the spiritual and transcendent dimension of the person.

2) Human beings will become progressively less human.

In fact, regarding the secular character, for Pouliquen (2018), “transhumanists are generally atheists, gnostics and materialists. (…). For them, there is no relationship between the body and the soul, since the latter does not exist. Transhumanism is essentially atheistic. The horizon of a transcendence greater than man and a benevolent origin of his existence is for them an illusion of the spirit.” (p. 144)

While, with regard to the second character, the progressive loss of the human in the human being, in the words of Barona (2022, p. 29, “(…) the transhumanists [and, above all, the posthumanists, we would add on our part] (…) foresee the disappearance of the human being and advocate the overcoming of the human creature by the Cyborg (hybrid).”

Thus, it seems that as the spiritual dimension is lost on our horizon, human beings are losing their own humanity.

Consequences of that direction

We have all accepted without any problem that Bioethics is secular, but while this secularism has positive aspects, especially in relation to dialogue between different paradigms, it also has serious drawbacks.

These problems are caused, as we have anticipated, by the technological development of healthcare, by the excessive workload of doctors and nurses who, while praising their professionalism and not being responsible for this situation, prevent more continuous treatment of the patient, and by the consequences of transhumanism and posthumanism: the latter attempt to resolve with NBIC convergence what, in reality, cannot be resolved by that path, with the serious risk of dehumanizing the human.

It is therefore imperative to address the spiritual care of patients, which is tantamount to appealing to the humanity and warmth of healthcare. In short, it is about how to deal with illness, suffering, and death.

Let us remember that attention must be comprehensive.

And on this issue, Pastoral Theology of Health has been ahead of Bioethics.

As Callahan (1990, in Gafo, 2003, p. 76) said, “we have also lost something of great value: the faith, the vision, the intuitions and the experience of entire peoples and traditions that, no less than those of non-believers, struggled to make sense of things.”

But it should be noted from now on that spirituality is not the same as religion: the spiritual is a fundamental dimension of the person, while faith is a gift: we are referring to the former, although it has an obvious relationship with the latter.

The contribution of Pastoral Theology of Health

With Alarcos (2002, p. 187), we could define the Pastoral Care of Health by stating that “it is the presence and action, in the name of the Lord Jesus, the Savior, of a specific ministry of helping relationship, (…) carrying out its mission in the encounter with the sick, their family, with health professionals, with health structures and with the healthy to promote a culture more sensitive to pain, suffering, disability, agony, death, mourning and the defense of life.”

We should, therefore, accompany people who suffer to convey to them that such suffering can be “integrated into human experience; that it can have meaning in the whole of life; (…)” (Alarcos, p. 198)

The difficulty of such accompaniment is evident, and it requires specialized training in Pastoral Care, since it requires certain skills and attitudes that do not come naturally, but rather must be acquired through systematic study, practice, and the necessary reflective and critical interrelationship between the two.

Such attitudes, following Brusco & Pintor (2001, pp. 185-245), based on the Gospel and missionality, go along the following paths:

1) Inculturation: is a process that goes through three stages: welcome (which requires understanding the world of each patient), positive consideration (unconditional acceptance, respect, appreciation, trust, human warmth…) and authenticity (the ability to be ourselves in the patient-companion relationship).

2) The relationship: building lasting and trusting interpersonal relationships, knowing how to use counseling as a tool, among others. In short, knowing how to walk together.

3) Humanization: giving and creating warmth and love where there is none, respecting and promoting, above all, the dignity of the person who is experiencing illness and suffering.

4) Service and solidarity: none of the above makes sense if it does not lead to dedication, service and action. ^[2]

All of this is achieved by creating a network of contacts with healthcare professionals and hospital chaplains (perhaps the most overlooked in healthcare bioethics research): the relationship and care with the patient must be multidisciplinary and interdisciplinary. We all care for the patient, but since the type of care is not the same for each healthcare professional, each chaplain, and each family member or volunteer, a harmonious relationship must be achieved among all.

And this is so because, as Pangrazzi (2013, p. 24) says, “a challenge for everyone is to heal the wounds,” but healing is global, integral, since each one and the sum of all the health agents (those previously mentioned) accompany and heal the patient from different, but related, perspectives.

Now, pastoral health workers must acquire the fundamental virtue of communicating with the sick if they wish to provide effective and useful support through the three communication skills: knowing how to observe, knowing how to listen, knowing how to respond. (Pangrazzi, pp. 79-90)

It is true that, as Bermejo (2021, pp. 8-9) says, “for some people, religion is a source of social support, help, strength and hope in the midst of situations of illness.”

But it is no less true that, as the same author continues (p. 7), for all people, whether believers or not, being a fundamental dimension of the human being, “(…) a comprehensive, multidimensional view is necessary, where the spiritual occupies its corresponding place to humanize the view. (…).”

Conclusions

Two of the trends in the history of bioethics are the importance of patients’ rights and the long-standing trend toward secular bioethics.

Today, new directions are moving, among other things, toward transhumanism and posthumanism, thus going beyond the fundamental patient care of Bioethics.

Added to this is the fact that this type of care is becoming increasingly technological, especially through new technologies and the application of Artificial Intelligence.

A possible risk of all this could be the loss of humanity in patient care, given that the spiritual dimension is increasingly being sidelined: it is not found in new technologies, transhumanism, or posthumanism.

That is why this scientific article emphasizes the cordial relationship between healthcare bioethics and the pastoral theology of health.

In this way, patient care acquires a holistic approach that must not be lost. Not surprisingly, the aforementioned theological specialty focuses on spiritual care, placing humanity at the center of healthcare.

But this requires training in knowing how to accompany the sick, progressively acquiring attitudes of inculturation, relationship, humanization, service, and solidarity.

To do this, it is necessary to train in counseling, while also acquiring the difficult skills of observing, listening, and responding.

Spiritual care, therefore, must be given its proper place if comprehensive patient care is to be achieved, which is achieved through Bioethics and Pastoral Care, whose relationship, as we have argued, becomes necessary.

David Guillem-Tatay. Bioethics Observatory of the UCV. Institute of Life Sciences

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Literature

Alarcos, FJ (2002).  Bioethics and Pastoral Care of Health : San Pablo Publishing House: Madrid.

Barona, S. (2022).  Algorithmic Justice and Neurolaw. A Multidisciplinary Perspective . Tirant lo Blanch Publishing House: Valencia

Bermejo, J.C. (2021).  Spirituality and Health. Diagnosis and Spiritual Care . Sal Terrae Publishing House: Maliaño (Cantabria).

Brusco, A. & Pintor, S. (2001).  In the Footsteps of Christ the Physician. Handbook of Pastoral Theology in Healthcare . Sal Terrae Publishing: Maliaño (Cantabria).

Ciccone, L. (2006).  Bioethics. History. Principles. Issues . Palabra Editions: Madrid.

Ferrer, J. J. & Álvarez, J. C. (2003).  Foundations of Bioethics. Theories and Theoretical Paradigms in Contemporary Bioethics . Comillas Pontifical University and Descleé de Brouwer: Madrid.

Gafo, J. (2003).  Theological Bioethics . Desclée de Brouwer and Comillas Pontifical University: Madrid.

Keenan, J.F. (2025).  A History of Catholic Theological Ethics . Sal Terrae Publishing House: Maliaño (Cantabria).

Pangrazzi, A. (2013).  The Pastoral Care of Health. Global Healing . Sal Terrae Publishing: Maliaño (Cantabria)

Pouliquen, T.M. (2018).  Transhumanism and the Fascination with New Technologies . RIALP Publishing: Madrid.

[1]  These are not the only directions, but we expressly include them here because they affect our objectives and, above all, the research questions.

[2]  It is necessary, in addition to acquiring these attitudes, that the health worker does not stop living the triad Prayer-Sacraments-Service.