Célébrer quarante ans de bioéthique ?

In English-speaking countries, particularly North America, the fundamentals of bioethics is becoming a sharply debated issue after more than 40 years of practice. In the present article we discuss five factors which help understand current criticisms and three perspectives which enrich and transform the field of bioethics. The five weaknesses examined are: primacy of autonomy, imperialism of principlism, narrowness of research ethics, silence on social issues and inability to recognize death as part of the life cycle. The three aspects of renewal discussed are: new ethical sensitivities, social and political dimensions of health care and presence of new disciplines allowing a richer interdisciplinarity approach to bioethics. In conclusion, in our opinion, this renewal is essential if one wants bioethics to evolve beyond the setting of private consultations onto one of a real citizen's debate about the challenges raised by biomedical and biotechnological developments.