The refusal of medical treatment is a recurrent topic in bioethical debates and Jehovah's Witnesses often constitute an exemplary case in this regard. The refusal of a potentially life-saving blood transfusion is a controversial choice that challenges the basic medical principle of acting in patients' best interests and often leads physicians to adopt paternalistic attitudes toward patients who refuse transfusion. However, neither existing bioethical nor historical and social sciences scholarship sufficiently addresses experiences of rank-and-file Witnesses in their dealings with the health care system. This article draws on results of a nine-month (2010, 2011-2012) ethnographic research on the relationship between religious, legal, ethical, and emotional issues emerging from the refusal of blood transfusions by Jehovah's Witnesses in Germany (mainly in Berlin). It shows how bioethical challenges are solved in practice by some German physicians and what they perceive to be the main goal of biomedicine: promoting the health or broadly understood well-being of patients. I argue that two different understandings of the concept of autonomy are at work here: autonomy based on reason and autonomy based on choice. The first is privileged by German physicians in line with a Kantian philosophical tradition and constitutional law; the second, paradoxically, is utilized by Jehovah's Witnesses in their version of the Anglo-Saxon Millian approach. Copyright © 2013 Elsevier Ltd. All rights reserved.
Araújo, Joana; Gomes, Carlos Costa; Jácomo, António; Pereira, Sandra Martins
Objective: The Bioethics Teaching in Secondary Education (Project BEST) aims to promote the teaching of bioethics in secondary schools. This paper describes the development and implementation of the programme in Portugal. Design: Programme development involved two main tasks: (1) using the learning tools previously developed by the US Northwest…
The author offers a commentary on the question, "Are there Hindu bioethics?" After deconstructing the term "Hindu," the author shows that there are indeed no Hindu bioethics. He shows that from a classical and Brahminical perspective, medicine is an inappropriate and impure profession.
The concept of dignity is pervasive in bioethics. However, some bioethicists have argued that it is useless on three grounds: that it is indeterminate; that it is reactionary; and that it is redundant. In response, a number of defences of dignity have recently emerged. All of these defences claim that when dignity is suitably clarified, it can be of great use in helping us tackle bioethical controversies. This paper rejects such defences of dignity. It outlines the four most plausible conceptions of dignity: dignity as virtuous behaviour; dignity as inherent moral worth; Kantian dignity; and dignity as species integrity. It argues that while each conception is coherent, each is also fundamentally flawed. As such, the paper argues for a bioethics without dignity: an 'undignified bioethics.'
Russo, Michael T.; Sunal, Cynthia Szymanski; Sunal, Dennis W.
All citizens will make bioethics decisions as a result of today's biotechnology revolution. The decisions made require citizens to find possible acceptable solutions to dilemmas that have become public issues. In this activity, students practice making decisions in ethical dilemmas after evaluating the influences of their own ethical beliefs and…
Ortiz Llueca, Eduardo
This paper shows the insufficiency of a bioethics which would intend to derive its proposals from Utilitarianism, identifying some inadequacies in the ethics of John Stuart Mill, e.g., the difficulties of the utilitarian commitment with instrumentalism, the deficiency of an utilitarian moral psychology and the naiveté of the forensic dimension of the utilitarian submission.
McCullough, Laurence B
Bioethics has a founding story in which medical paternalism, the interference with the autonomy of patients for their own clinical benefit, was an accepted ethical norm in the history of Western medical ethics and was widespread in clinical practice until bioethics changed the ethical norms and practice of medicine. In this paper I show that the founding story of bioethics misreads major texts in the history of Western medical ethics. I also show that a major source for empirical claims about the widespread practice of medical paternalism has been misread. I then show that that bioethics based on its founding story deprofessionalizes medical ethics. The result leaves the sick exposed to the predatory power of medical practitioners and healthcare organizations with only their autonomy-based rights to non-interference, expressed in contracts, to protect them. The sick are stripped of the protection afforded by a professional, fiduciary relationship of physicians to their patients. Bioethics based on its founding story reverts to the older model of a contractual relationship between the sick and medical practitioners not worthy of intellectual or moral trust (because such trust cannot be generated by what I call 'deprofessionalizing bioethics'). On closer examination, bioethics based on its founding story, ironically, eliminates paternalism as a moral category in bioethics, thus causing bioethics to collapse on itself because it denies one of the necessary conditions for medical paternalism. Bioethics based on its founding story should be abandoned. © 2010 Blackwell Publishing Ltd.
Making difficult healthcare decisions is often helped by consultation with a bioethics committee. This article reviews the main bioethics principles, when it is appropriate and how to call a bioethics consult, ethical concerns, and members of the consult team. Bioethics resources are included.
Chattopadhyay, Subrata; De Vries, Raymond
Modern bioethics was born in the West and thus reflects, not surprisingly, the traditions of Western moral philosophy and political and social theory. When the work of bioethics was confined to the West, this background of socio-political theory and moral tradition posed few problems, but as bioethics has moved into other cultures - inside and outside of the Western world - it has become an agent of moral imperialism. We describe the moral imperialism of bioethics, discuss its dangers, and suggest that global bioethics will succeed only to the extent that it is local. PMID:19593391
The paper is about the links between ethics and science, at a time (1974-2014) when the life sciences expanded rapidly. First (1974-1994), the development of a principlist ethics, set out by philosophers, sustained the research, and the scientists, expected to behave responsibly, felt like they could easily converge towards impeccable and consensual solutions to any problem arising from scientific innovations. Later on (1994-2014), however, while yielding ground to social sciences and ground work, bioethics took an empirical turn; then it became clear that behaving responsibly was compatible with a plurality of divergent normative convictions. Ethics crumbled. Local or national policies restored order, so-called bioethical laws short-circuited ethical reflection. And far from being respected as the wise men, apt to recommend the very best solutions to problems raised by new scientific advances, researchers happened to be deemed irresponsible, as some of them were suspected of lacking intellectual integrity. Copyright © 2015 Académie des sciences. Published by Elsevier SAS. All rights reserved.
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Rendtorff, Jacob Dahl
This paper presents an update of the research on European bioethics undertaken by the author together with Professor Peter Kemp since the 1990s, on Basic ethical principles in European bioethics and biolaw. In this European approach to basic ethical principles in bioethics and biolaw......, the principles of autonomy, dignity, integrity and vulnerability are proposed as the most important ethical principles for respect for the human person in biomedical and biotechnological development. This approach to bioethics and biolaw is presented here in a short updated version that integrates the earlier...... research in a presentation of the present understanding of the basic ethical principles in bioethics and biolaw....
The global spread of bioethics from its North-American and European provenance to non-Western societies is currently raising some concerns. Part of the concern has to do with whether or not the exportation of bioethics in its full Western sense to developing non-Western states is an instance of ethical imperialism or bioethical neocolonialism. This paper attempts an exploration of this debate in the context of bioethics in sub-Saharan Africa. Rather than conceding that bioethics has a colonial agenda in Africa, this paper defends the position that the current bioethics trend in sub-Saharan Africa is an unintended imperialistic project. It argues that its colonizing character is not entirely a product of the Western programmed goals of training and institution building; rather, it is a structural consequence of many receptive African minds and institutions. Though bioethics in Africa is turning out as a colonizing project, one serious implication of such trend, if unchecked urgently, is that bioethics’ invaluable relevance to Africa is being incapacitated. This paper, therefore, attempts a decolonizing trajectory of bioethics in Africa. Contrary to the pretense of ‘African bioethics,’ which some African scholars are now defending, this paper through the logic of decolonization makes case for ‘bioethics in Africa’. In such logic, the principle of existential needs is prioritized over the principle of identity and authenticity that define African voice in bioethics. PMID:28344985
Albrizio, M A; Ozuna, J; Mattheis, R; Saunders, J
In 1985 the Seattle Veterans' Administration Medical Center nursing service implemented a nursing program for bioethics with three goals: (1) to expand the nurse's knowledge of bioethical principles, (2) to develop the nurse's ability and confidence in analyzing bioethical dilemmas, and (3) to increase bioethical application at the bedside. Two psychosocial clinical nurse specialists (CNSs) led this highly successful nursing program that prepared nurses to more actively and responsibly participate in bioethical decision making within the medical center. The program offers an annual workshop for new members, holds a monthly discussion group, conducts a yearly enrichment program, and completes an annual evaluation report. This article describes nursing service bioethics program from planning through evaluation and the role of the CNS as program coordinator, facilitator, and educator in the expanding field of bioethics.
Nunes, Rui; Duarte, Ivone; Santos, Cristina; Rego, Guilhermina
"Education for Values and Bioethics" is a project which aims to help the student to build his/her personal ethics. It was addressed to ninth grade students (mean age 14) who frequented public education in all schools of the City of Porto, Portugal-EU in 2010-2013 (N-1164). This research and action project intended to promote the acquisition of knowledge in the following areas: interpersonal relationships, human rights, responsible sexuality, health, environment and sustainable development, preservation of public property, culture, financial education, social innovation and ethical education for work. The students were asked to answer to a knowledge questionnaire on bioethics. To assess the values it was used Leonard Gordon's Survey of Personal Values and Survey of Interpersonal Values. The results of this study show that the project contributes to an increase of knowledge in the area of bioethics. Also the students enrolled in the program showed a development with regards the acquisition of the basic values of pluralistic societies. It is also suggested that this general knowledge on bioethics could be especially helpful to students that want a career in health sciences.
Ruiz de Chávez-Guerrero, Manuel Hugo
Bioethics in Mexico has a history that reveals the vision and ethical commitment of iconic characters in the fields of health sciences and humanities, leading to the creation of the National Bioethics Commission responsible for promoting a bioethics culture in Mexico. Its development and consolidation from the higher perspective of humanism had the aim to preserve health, life and its environment, while at the same time the bases of ethics and professional practice from different perspectives have been the building blocks of medical practice.
Daar, Abdallah S.; Khitamy, A.
ISLAMIC BIOETHICS DERIVES FROM A COMBINATION OF PRINCIPLES, duties and rights, and, to a certain extent, a call to virtue. In Islam, bioethical decision-making is carried out within a framework of values derived from revelation and tradition. It is intimately linked to the broad ethical teachings of the Qur'an and the tradition of the Prophet Muhammad, and thus to the interpretation of Islamic law. In this way, Islam has the flexibility to respond to new biomedical technologies. Islamic bioethics emphasizes prevention and teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account. Because Islam shares many foundational values with Judaism and Christianity, the informed Canadian physician will find Islamic bioethics quite familiar. Canadian Muslims come from varied backgrounds and have varying degrees of religious observance. Physicians need to recognize this diversity and avoid a stereotypical approach to Muslim patients. PMID:11202669
Historically, the preconditions for the emergence of bioethics in China. were political reforms and their applications. The Hanzhong Euthanasia Case and the publication of Qiu Ren-zong's academic work Bioethics played a significant role in the development of bioethics in China. Other contributory factors include the establishment of the Chinese Society of Medical Ethics/Chinese Medical Association (C.M.A), the publication of the Journal of Chinese Medical Ethics, and the teaching and education of bioethics in China. Major achievements of bioethics in China include the establishment of ethics committee and ethics review system, active international communication and cooperation among the academic circles, and the successful management of the 8th World Congress of Bioethics in Beijing in 2006. Chinese bioethics focus on native Chinese realities and conditions, absorb the international research achievements in relevant fields, and combine international ideas with traditional Chinese doctrines. Admittedly, there are still some aspects to be improved, yet bioethics has attracted a lot of attention from the core leadership in China and has gained sound financial support, which augers well for its further development. This article also briefly introduces the development of bioethics in Hong Kong and Taiwan, China.
Both object of science and conscience, bioethics is concerned about the impact of biomedical research and its applications for the human person. Object of pluralistic and multidisciplinary thought and proposal, bioethics seeks to reconcile respect for fundamental values and progress in life sciences. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Ivani Nadir Carlotto
Full Text Available Data de Submissão: 1-11-2017 Data de Aceitação 20-12-2017A abordagem denominada Health Promoting Universities (HPU ou Universidades Promotoras da Saúde (UPS – Organização Mundial da Saúde (OMS considera que as Instituições de Ensino Superior (IES possuem um papel preponderante na preservação da saúde e bem-estar da comunidade acadêmica. As IES são, sob este paradigma, conduzidas pelos marcos conceituais da promoção da saúde (PS, e por valores interdisciplinares como inclusão, equidade, justiça social e sustentabilidade. A Bioética, em conjunto com as UPS e a PS, apresenta-se como uma ferramenta reflexiva, mutuamente compartilhada e interdisciplinar que objetiva a adequação das ações que compreendem a vida e a cidadania, em seu caráter equitativo e inclusivo, no contexto da Educação Superior. Neste texto a Bioética busca refletir sobre a PS docente nas IES, contribuindo para a construção de processos qualificados de ações em saúde docente.Bioethics and promotion of teacher health in higher education: an interface requiredThe Health Promoting Universities (HPU - World Health Organization (WHO approach considers that Higher Education Institutions (HEI play a preponderant role in preserving the health and well-being of the academic community. HEIs under this paradigm are driven by conceptual frameworks of health promotion (HP, and by interdisciplinary values such as inclusion, equity, social justice and sustainability. Bioethics, together with HPU and HP, presents itself as a reflexive, mutually shared and interdisciplinary tool that aims at the adequacy of actions that comprise life and citizenship, in its equitable and inclusive character, in the context of Higher Education. In this text Bioethics seeks to reflect on the teaching HP in HEI, contributing to the construction of qualified processes of actions in teacher’s health.Keywords: Bioethics; Higher Education; Teachers; Health Promotion
This article deals with the question as to what makes bioethics a critical discipline. It considers different senses of criticism and evaluates their strengths and weaknesses. A primary method in bioethics as a philosophical discipline is critical thinking, which implies critical evaluation of concepts, positions, and arguments. It is argued that the type of analytical criticism that restricts its critical role to critical thinking of this type often suffers from other intellectual flaws. Three examples are taken to demonstrate this: premature criticism, uncritical self-understanding of theoretical assumptions, and narrow framing of bioethical issues. Such flaws can lead both to unfair treatment of authors and to uncritical discussion of topics. In this context, the article makes use of Häyry's analysis of different rationalities in bioethical approaches and argues for the need to recognize the importance of communicative rationality for critical bioethics. A radically different critical approach in bioethics, rooted in social theory, focuses on analyses of power relations neglected in mainstream critical thinking. It is argued that, although this kind of criticism provides an important alternative in bioethics, it suffers from other shortcomings that are rooted in a lack of normative dimensions. In order to complement these approaches and counter their shortcomings, there is a need for a bioethics enlightened by critical hermeneutics. Such hermeneutic bioethics is aware of its own assumptions, places the issues in a wide context, and reflects critically on the power relations that stand in the way of understanding them. Moreover, such an approach is dialogical, which provides both a critical exercise of speech and a normative dimension implied in the free exchange of reasons and arguments. This discussion is framed by Hedgecoe's argument that critical bioethics needs four elements: to be empirically rooted, theory challenging, reflexive, and politely skeptical.
The biocultural ethic recovers an understanding of the vital links between the life habits of the coinhabitants (humans and other-than-human) that share a habitat. The ″3Hs″ formal framework of the biocultural ethics provides a conceptual and methodological tool to understand and to better manage complex eco-social or biocultural systems in heterogeneous regions of the planet. From the global bioethics originally proposed by V.R. Potter, the integration of theory and praxis promoted by Alfredo Pradenas in the Bioethics Society of Chile, and the conceptual framework of biocultural ethics (including traditions of philosophical thought, scientific and Amerindians), I develop a comparative analysis of: 1. an ecosystemic and intercultural concept of the human body, 2. an intercultural understanding of health with complementary Western and Native American medicinal practices, and 3. an appreciation and respect for the fundamental links among the life habits, the habitats where they take place, and the well-being and identity of the communities of cohabitants. Implicit links in the ″3Hs″ biocultural ethics are present in the archaic meanings of the term ethos. This understanding retrieves a primordial root in the genesis of Western ethics, which did not start bounded to how to inhabit or dwell, but also considered where to inhabit and with whom to co-inhabit. I propose to restore the complexity and breadth of the concept of ethics originated in Ancient Greece, to reaffirm the common roots of bioethics and environmental ethics contained in Potter's global bioethics, and to incorporate the systemic and contextual perspective of the biocultural ethic that values biological and cultural diversity (and their interrelationships), to sustain a conception of human health interconnected with the sustainability of the biosphere.
Goldsand, Gary; Rosenberg, Zahava R.S.; Gordon, Michael
Jewish bioethics in the contemporary era emerges from the traditional practice of applying principles of Jewish law (Halacha) to ethical dilemmas. The Bible (written law) and the Talmud (oral law) are the foundational texts on which such deliberations are based. Interpretation of passages in these texts attempts to identify the duties of physicians, patients and families faced with difficult health care decisions. Although Jewish law is an integral consideration of religiously observant Jews, secularized Jewish patients often welcome the wisdom of their tradition when considering treatment options. Jewish bioethics exemplifies how an ethical system based on duties may differ from the secular rights-based model prevalent in North American society. PMID:11332319
Pauls, Merril; Hutchinson, Roger C.
“PROTESTANT” IS A TERM APPLIED TO MANY DIFFERENT Christian denominations, with a wide range of beliefs, who trace their common origin to the Reformation of the 16th century. Protestant ideas have profoundly influenced modern bioethics, and most Protestants would see mainstream bioethics as compatible with their personal beliefs. This makes it difficult to define a uniquely Protestant approach to bioethics. In this article we provide an overview of common Protestant beliefs and highlight concepts that have emerged from Protestant denominations that are particularly relevant to bioethics. These include the sovereignty of God, the value of autonomy and the idea of medicine as a calling as well as a profession. Most Canadian physicians will find that they share certain values and beliefs with the majority of their Protestant patients. Physicians should be particularly sensitive to their Protestant patients' beliefs when dealing with end-of-life issues, concerns about consent and refusal of care, and beginning-of-life issues such as abortion, genetic testing and the use of assisted reproductive technologies. Physicians should also recognize that members of certain Protestant groups and denominations may have unique wishes concerning treatment. Understanding how to elicit these wishes and respond appropriately will allow physicians to enhance patient care and minimize conflict. PMID:11868645
Pauls, Merril; Hutchinson, Roger C
"Protestant" is a term applied to many different Christian denominations, with a wide range of beliefs, who trace their common origin to the Reformation of the 16th century. Protestant ideas have profoundly influenced modern bioethics, and most Protestants would see mainstream bioethics as compatible with their personal beliefs. This makes it difficult to define a uniquely Protestant approach to bioethics. In this article we provide an overview of common Protestant beliefs and highlight concepts that have emerged from Protestant denominations that are particularly relevant to bioethics. These include the sovereignty of God, the value of autonomy and the idea of medicine as a calling as well as a profession. Most Canadian physicians will find that they share certain values and beliefs with the majority of their Protestant patients. Physicians should be particularly sensitive to their Protestant patients' beliefs when dealing with end-of-life issues, concerns about consent and refusal of care, and beginning-of-life issues such as abortion, genetic testing and the use of assisted reproductive technologies. Physicians should also recognize that members of certain Protestant groups and denominations may have unique wishes concerning treatment. Understanding how to elicit these wishes and respond appropriately will allow physicians to enhance patient care and minimize conflict.
Hoskins, Betty B.; Shannon, Thomas A.
Discusses the importance of developing bioethics programs for undergraduate students. Two aspects are considered: (1) current areas of concern and sources of bibliographic information; and (2) problems encountered in undergraduate projects. A list of references is provided. (HM)
Nielsen, Morten Ebbe Juul; Andersen, Martin Marchman
This article examines two current debates in Denmark-assisted suicide and the prioritization of health resources-and proposes that such controversial bioethical issues call for distinct philosophical analyses: first-order examinations, or an applied philosophy approach, and second-order examinati......This article examines two current debates in Denmark-assisted suicide and the prioritization of health resources-and proposes that such controversial bioethical issues call for distinct philosophical analyses: first-order examinations, or an applied philosophy approach, and second......-order examinations, what might be called a political philosophical approach. The authors argue that although first-order examination plays an important role in teasing out different moral points of view, in contemporary democratic societies, few, if any, bioethical questions can be resolved satisfactorily by means...... of first-order analyses alone, and that bioethics needs to engage more closely with second-order enquiries and the question of legitimacy in general....
Explores a hermeneutical perspective of modern medicine. The author suggests that good medical decision making requires interpretation, and bioethics will be well served by incorporating this interpretive element. (LZ)
There have been considerable disputes the positioning of neuroethics as a new field since its emergence in 2002. It is the novelty of the neuroethical issues and the necessity for updated moral approaches to them that leading exponents of neuroethics have emphasized; advances in neurosciences have created an entirely new field of moral inquiries that the conventional bioethics had never noticed. Futher, as neuroethics embraces the subdivision of ethics in neuroscience, it should take precedence over bioethics, which depends on the fundamental moral concepts without questioning their bases. Many bioethicists have squarely opposed these insistences and thereby detected the claim of neuroethics exceptionalism: the asserted newness of issues comes mainly from the ignorance of exponents of this new field regarding accumulated bioethical inquiries, so that the overlapping concerns between bioethics and neuroethics are passed on to the future by them. Moreover, bioethicists point out that the recent tendency of Balkanization in the field of bioethics could endanger the integrity of moral investigations. Subfields of bioethics, such as geneethics, neuroethics, nanoethics and so on, originate consecutively, entail wastage of valuable time and money, and increase the risk of fragmentizing moral considerations in an inconsistent way. By reviewing this controversy between neuroethics and bioethics, I argue that the relevant scientific investigations and technologies, which have appeared to promote the proliferation of bioethical sub-disciplines to date, are beginning to converge into 1 complex that demands not the division into subspecialities but the novel integration of bioethical inquiries: it is time to attempt the unification of bioethical applied ethics for moral considerations regarding nano-bio-info-cogno convergent technologies.
Markwell, Hazel J.; Brown, Barry F.
THERE IS A LONG TRADITION OF BIOETHICAL REASONING within the Roman Catholic faith, a tradition expressed in scripture, the writings of the Doctors of the Church, papal encyclical documents and reflections by contemporary Catholic theologians. Catholic bioethics is concerned with a broad range of issues, including social justice and the right to health care, the duty to preserve life and the limits of that duty, the ethics of human reproduction and end-of-life decisions. Fundamental to Catholic bioethics is a belief in the sanctity of life and a metaphysical conception of the person as a composite of body and soul. Although there is considerable consensus among Catholic thinkers, differences in philosophical approach have given rise to some diversity of opinion with respect to specific issues. Given the influential history of Catholic reflection on ethical matters, the number of people in Canada who profess to be Catholic, and the continuing presence of Catholic health care institutions, it is helpful for clinicians to be familiar with the central tenets of this tradition while respecting the differing perspectives of patients who identify themselves as Catholic. PMID:11501460
The Universal Declaration on Bioethics and Human Rights has made clear its aims to provide a universal framework of principles and procedures to guide States in the formulation of their legislation, policies or other instruments in the field ofbioethics and also to guide the actions of individuals, groups, communities, institutions and corporations so as to promote appreciation for human dignity and to protect human rights. It also sets up 15 principles to be applied. One of the principles in the Declaration is about the recognition of cultural diversity as an important element of bioethics. Thus it is clear that bioethics has its relativeness and is susceptible to different cultures. However, in order not to have the bioethics principles being defeated because of the cultural factor, the Declaration set forth conditions to limit the application of the cultural diversity element. This approach is called "qualified absoluteness" by the author. The paper discusses these conditions and the problems arising from their applications. Basically, there is a clear line drawn to limit the application of cultural diversity in setting up and in applying bioethical rules. The line drawn is based on the concept of human rights, the principles and concepts of which have not only been set forth in the Human Rights Convention, but have also been prescribed in other provisions in the Declaration. From conceptual viewpoint, the Declaration has listed a number of soft-law rules, which in turn also provide authorization for the government or private or public groups to take cultural diversity into account. Although the rules set forth in most of the parts in the Declaration are of soft but absolute mandates in nature, the requirement of paying due regard to cultural diversity is in fact providing governments as well as groups a possibility to enact or apply their bioethical rules to reflect their cultural uniqueness. The term "qualified absoluteness" is used in this paper to reflect
Shapiro, Robyn S.; Layde, Peter M.
Abstract Recent initiatives to improve human health emphasize the need to effectively and appropriately translate new knowledge gleaned from basic biomedical and behavioral research to clinical and community application. To maximize the beneficial impact of scientific advances in clinical practice and community health, and to guard against potential deleterious medical and societal consequences of such advances, incorporation of bioethics at each stage of clinical and translational science research is essential. At the earliest stage, bioethics input is critical to address issues such as whether to limit certain areas of scientific inquiry. Subsequently, bioethics input is important to assure not only that human subjects trials are conducted and reported responsibly, but also that results are incorporated into clinical and community practices in a way that promotes and protects bioethical principles. At the final stage of clinical and translational science research, bioethics helps to identify the need and approach for refining clinical practices when safety or other concerns arise. The framework we present depicts how bioethics interfaces with each stage of clinical and translational science research, and suggests an important research agenda for systematically and comprehensively assuring bioethics input into clinical and translational science initiatives. PMID:20443821
Griniezakis, Makarios; Symeonides, Nathanael
The authors of this essay suggest that the field of bioethics and Christian theology have a great deal to offer each other. The authors first argue that representatives from both fields must first make sure that they fully and correctly represent their respective position. In other words, scientists, ethicists, and theologians alike must make sure that they present their fields and not use their knowledge merely for personal gain at the stake of misguiding people. Once this is established, the authors then proceed to show the intimate relationship between Christianity and medicine that has existed throughout the ages. It is a call for a continuation of such a relationship that the authors suggest between bioethics and theology. Through an integration of bioethics and Christian theology, both scientists/physicians and theologians are able to gain greater insight into the human person--a focus in both fields.
Pérez-Soba Díez del Corral, Juan José
Bioethics emerges about the tecnological problems of acting in human life. Emerges also the problem of the moral limits determination, because they seem exterior of this practice. The Bioethics of Principles, take his rationality of the teleological thinking, and the autonomism. These divergence manifest the epistemological fragility and the great difficulty of hmoralñ thinking. This is evident in the determination of autonomy's principle, it has not the ethical content of Kant's propose. We need a new ethic rationality with a new refelxion of new Principles whose emerges of the basic ethic experiences.
Hellsten, Sirkku K
This article discusses what 'global bioethics' means today and what features make bioethical research 'global'. The article provides a historical view of the development of the field of 'bioethics', from medical ethics to the wider study of bioethics in a global context. It critically examines the particular problems that 'global bioethics' research faces across cultural and political borders and suggests some solutions on how to move towards a more balanced and culturally less biased dialogue in the issues of bioethics. The main thesis is that we need to bring global and local aspects closer together when looking for international guidelines, by paying more attention to particular cultures and local economic and social circumstances in reaching a shared understanding of the main values and principles of bioethics, and in building 'biodemocracy'.
Dupras, Charles; Ravitsky, Vardit; Williams-Jones, Bryn
A rich literature in public health has demonstrated that health is strongly influenced by a host of environmental factors that can vary according to social, economic, geographic, cultural or physical contexts. Bioethicists should, we argue, recognize this and--where appropriate--work to integrate environmental concerns into their field of study and their ethical deliberations. In this article, we present an argument grounded in scientific research at the molecular level that will be familiar to--and so hopefully more persuasive for--the biomedically-inclined in the bioethics community. Specifically, we argue that the relatively new field of molecular epigenetics provides novel information that should serve as additional justification for expanding the scope of bioethics to include environmental and public health concerns. We begin by presenting two distinct visions of bioethics: the individualistic and rights-oriented and the communitarian and responsibility-oriented. We follow with a description of biochemical characteristics distinguishing epigenetics from genetics, in order to emphasize the very close relationship that exists between the environment and gene expression. This then leads to a discussion of the importance of the environment in determining individual and population health, which, we argue, should shift bioethics towards a Potterian view that promotes a communitarian-based sense of responsibility for the environment, in order to fully account for justice considerations and improve public health. © 2012 John Wiley & Sons Ltd.
Luka Tomašević, PhD, ScD
Full Text Available Every creature is good and subject to the principle of solidarity that everyone has been blessed and gifted with life by God. Therefore, we cannot have one without the other, and no man exists without an animal.Over the last several decades, our world has been confronted with many ethical problems and ethics is being more and more sought after in spheres of human conduct and profession. Man has acquired enormous power over the world and over life itself, but he has also, willingly or not, become more responsible for 'the threats' against his very life, as well as against the life of other creatures. Within this context a discussion on biocentrism has ensued, which should replace Christian biblical anthropocentrism. At any rate, man has encountered a challenge to expand his moral sphere because nature needs his protection, whereas he no longer needs to protect himself from nature. It is exactly this point that poses a paradox: only man can give protection to nature and the whole of life within it. Having crossed all limits, he has to establish them yet again. Once again, he has to search for these limits within himself, which is exactly what original Christianity demands: to act according to one's pure belief (St. Peter. The aim of this work lies in trying to answer the questions of how to preserve life and healthy environment, how to achieve harmony between the development and modern ideas and trends as well as to establish the right relationship between man and his environment. The author primarily points out to the rising of pastoral medicine in Catholic theology, whose emergence was caused by the development of medical science and which gradually transforms into today's bioethics that is acknowledged by the theology. He then proceeds to discuss the disharmony between man and nature, about the rising of the 'animal rights' movement, and finally, about the beginnings of scientific and global bioethics which has developed in USA and which has
Although bioethics societies are developing standards for clinical ethicists and a code of ethics, they have been castigated in this journal as "a moral, if not an ethics, disaster" for not having completed this task. Compared with the development of codes of ethics and educational standards in law and medicine, however, the pace of professionalization in bioethics appears appropriate. Assessed by this metric, none of the charges leveled against bioethics are justified. The specific charges leveled against the American Society for Bioethics and Humanities (ASBH) and its Core Competencies report are analyzed and rejected as artifacts of an ahistoric conception of the stages by which organizations professionalize. For example, the charge that the ASBH should provide definitive criteria for what counts as "medical ethics consultation" antecedent to further progress towards professionalization is assessed by comparing it with the American Medical Association's decades-long struggle to define who can legitimately claim the title "medical doctor." Historically, clarity about who is legitimately a doctor, a lawyer - or a "clinical ethicist"- is a byproduct of, and never antecedent to, the decades-long process by which a field professionalizes. The charges leveled against ASBH thus appear to be a function of impatient, ahistoric perfectionism.
Kieffer, George H.
Examined is the issue concerning teaching bioethics. Differing points of view are discussed. The author concludes that moral and ethical reasoning should be incorporated into the public school curriculum, using morally laden issues that have grown out of advances in biological knowledge and biomedical technology. (CS)
Kedraka, Katerina; Kourkoutas, Yiannis
In this small scale study in higher education, a good educational practice on the teaching of Bioethics based on transformative learning and accomplished by debates is presented. The research was carried out in June 2016 at the Department of Molecular Biology and Genetics, Democritus University of Thrace, Greece and it includes the assessment of…
Full Text Available The purpose of this presentation is to discuss some concepts related to bioethics and ageing, specifically with regard to health and disease. Considerations on medical practice are made by referring to Kant and Heidelberg school of thought. Perception of time in the elderly and issues such as euthanasia and death are mentioned.
Full Text Available The article explores two questions: what is feminist bioethics, and how different it is from standard bioethics. Development of feminist bioethics, it is argued, began as a response to standard bioethics, challenging its background values, and philosophical perspectives. The most important contribution of feminist bioethics has been its re-examination of the basic conceptual underpinnings of mainstream bioethics, including the concepts of “universality”, “autonomy”, and “trust”. Particularly important for feminists has been the concept of autonomy. They challenge the old liberal notion of autonomy that treats individuals as separate social units and argue that autonomy is established through relations. Relational autonomy assumes that identities and values are developed through relationships with others and that the choices one makes are shaped by specific social and historical contexts. Neither relational autonomy, nor feminist bioethics, however, represents a single, unified perspective. There are, actually, as many feminist bioethics as there are feminisms-liberal, cultural, radical, postmodern etc. Their different ontological, epistemological and political underpinnings shape their respective approaches to bioethical issues at hand. Still what they all have in common is interest in social justice-feminists explore mainstream bioethics and reproductive technologies in order to establish whether they support or impede gender and overall social justice and equality. Feminist bioethics thus brings a significant improvement to standard bioethics. [Projekat Ministarstva nauke Republike Srbije, br. 41004: Bioethical Aspects: Morally Acceptable Within the Biotechnologically and Socially Possible i br. 43007: Studying climate change and its influence on the environment: impacts, adaptation and mitigation
McKneally, Martin F.; Singer, Peter A.
BIOETHICS IS NOW TAUGHT IN EVERY CANADIAN MEDICAL SCHOOL. Canada needs a cadre of teachers who can help clinicians learn bioethics. Our purpose is to encourage clinician teachers to accept this important responsibility and to provide practical advice about teaching bioethics to clinicians as an integral part of good clinical medicine. We use 5 questions to focus the discussion: Why should I teach? What should I teach? How should I teach? How should I evaluate? How should I learn? PMID:11338804
Tan Kiak Min, Mark
Despite flourishing as a multidisciplinary subject, the predominant view in bioethics today is based on Anglo-American thought. This has serious implications for a global bioethics that needs to be contextualized to local cultures and circumstances in order to be relevant. Being the largest continent on the earth, Asia is home to a variety of cultures, religions and countries of different economic statuses. While the practice of medicine in the East and West may be similar, its ethical practices do differ. Thus, the Western understanding of autonomy may not be wholly applicable in the Asian setting, especially in the setting of breaking bad news, giving consent, determining best interests and deciding on end-of-life care. This article explores these topics in depth, attempting to find shared integrating factors, but at the same time arguing for a modified ethical application of autonomy, based on Asian beliefs.
Sodeke, Stephen Olufemi
The Tuskegee University National Center for Bioethics in Research and Health Care was established in 1999 in partial response to the Presidential Apology for the United States Public Health Service's Study of Untreated Syphilis in the Negro Male conducted in Macon County, Alabama, from 1932 to 1972. The Center's mission of promoting equity and justice in health and health care for African Americans and other underserved populations employs an integrative bioethics approach informed by moral vision. Etymological and historical analyses are used to delineate the meaning and evolution of bioethics and to provide a basis for Tuskegee's integrative bioethics niche. Unlike mainstream bioethics, integrative bioethics practice is holistic in orientation, and more robust for understanding the epistemic realities of minority life, health disparities, and population health. The conclusion is that integrative bioethics is relevant to the survival of all people, not just a privileged few; it could be the new ethics for the public's health.
de Chavez, Manuel Ruiz; Orozco, Aidee; Olaiz, Gustavo
The establishment of Mexico's National Bioethics Commission (Comisión Nacional de Bioética), in 1992, was conceived within the context of a global movement aimed at raising awareness of the ethical implications of technological and scientific development, especially in biomedicine. In 2005, a new decree put the commission under the scope of the Secretariat of Health and granted it technical and operational autonomy, allowing it to become a regulatory agency aimed at promoting a culture of bioethics, encouraging reflection on human health, and developing guidelines for health care, research, and education, through a global, secular, and democratic perspective. The commission became the leading actor in the strategy for institutionalizing bioethics in Mexico after reforms to the country's General Health Act in 2011, which required that public, social assistance, or private health care facilities establish a hospital bioethics committee to address bioethical dilemmas or issues and, when relevant, a research ethics committee to address research with human subjects. This assignment has shifted the focus of the activities and goals of the National Bioethics Commission toward establishing these committees in line with current regulations and developing mechanisms to ensure that they operate with the highest standards of ethical conduct, performance, and accountability. © 2017 The Hastings Center.
Peterson, Paul Silas
The account of nature and humanity's relationship to nature are of central importance for bioethics. The Scientific Revolution was a critical development in the history of this question and many contemporary accounts of nature find their beginnings here. While the innovative approach to nature going out of the seventeenth century was reliant upon accounts of nature from the early modern period, the Middle Ages, late-antiquity and antiquity, it also parted ways with some of the understandings of nature from these epochs. Here I analyze this development and suggests that some of the insights from older understandings of nature may be helpful for bioethics today, even if there can be no simple return to them.
Full Text Available In this paper the authors analyze the process of negotiating and beginning of the United Nations Declaration on Human Cloning as well as the paragraphs of the very Declaration. The negotiation was originally conceived as a clear bioethical debate that should have led to a general agreement to ban human cloning. However, more often it had been discussed about human rights, cultural, civil and religious differences between people and about priorities in case of eventual conflicts between different value systems. In the end, a non-binding Declaration on Human Cloning had been adopted, full of numerous compromises and ambiguous formulations, that relativized the original intention of proposer states. According to authors, it would have been better if bioethical discussion and eventual regulations on cloning mentioned in the following text had been left over to certain professional bodies, and only after the public had been fully informed about it should relevant supranational organizations have taken that into consideration.
Frank, Arthur W
If bioethics seeks to affect what people do and don't do as they respond to the practical issues that confront them, then it is useful to take seriously people's sense of rightness. Rightness emerges from the fabric of a life-including the economy of its geography, the events of its times, its popular culture-to be what the sociologist Pierre Bourdieu calls a predisposition. It is the product of a way of life and presupposes continuing to live that way. Rightness is local and communal, holding in relationship those who share the same predisposing sense of how to experience. Rightness is an embodied way of evaluating what is known to matter and choosing among possible responses. Bioethics spends considerable time on what people should do and on the arguments that support recommended actions. It might spend more time on what shapes people's sense of the rightness of what they feel called to do. © 2017 The Hastings Center.
Siqueira-Batista, Rodrigo; Souza, Camila Ribeiro; Maia, Polyana Mendes; Siqueira, Sávio Lana
The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. To present review of the ethical aspects of robot use in surgery. Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. A utilização de robôs em procedimentos cirúrgicos tem sido cada vez mais frequente na atualidade, o que permite a emergência de inúmeras questões bioéticas nesse âmbito. Apresentar revisão sobre os aspectos éticos dos usos de robôs em cirurgia. Realizou-se revisão nas bases de dados Pubmed, SciELO e Lilacs cruzando-se os descritores "bioética", "cirurgia", "ética", "laparoscopia" e "robótica". Do total de citações obtidas, selecionou-se 17 artigos, os quais foram utilizados para a elaboração do artigo. Ele contém breve apresentação sobre a robótica, sua inserção na saúde e os aspectos bioéticos da utilização dos robôs em procedimentos cirúrgicos. A cirurgia robótica é uma realidade, hoje, em muitas unidades hospitalares, o que torna essencial a reflexão bioética sobre as relações entre profissionais da saúde, autômatos e pacientes.
Conti, A A
Though the term "bioethics" was coined in 1970-1, it was immediately after World War II that there emerged the idea that the voluntary consent of human beings was absolutely mandatory for medical interventions to be ethically acceptable. The 1964 Declaration of Helsinki asserted that only an explicit consent could morally and ethically justify research on human beings. In the 1978 "Encyclopedia of Bioethics", the US author Warren T. Reich defined bioethics as the systematic study of human behaviour in the fields of health care and life sciences, and carefully differentiated the epistemological profile of bioethics from that of traditional medical ethics deriving from the Hippocratic Oath. An institutional milestone in the Italian evolution of bioethical knowledge and competence was the foundation of the Italian National Bioethics Committee (NBC), established in 1990. The NBC, which answers to the Council of Ministers, provides methodological support to the Italian Government in the field of bioethical issues, elaborating legislative acts and also furnishing information and consultation for other bodies and associations and for the general public. The activity of the NBC is clearly discernible in its free and user-friendly website. Today, the Internet is often the first repository where individuals and patients look for bioethical information. Given that the quality of this information is extremely variable and not infrequently unreliable, initiatives such as that of the above mentioned NBC website are particularly useful and precious both for health care operators and the entire community.
Nielsen, Linda; Faber, Berit A.
This chapter about bioethics in Denmark focuses on specific Danish characteristics. These are the early start of a bioethics debate, legislation and bioethics councils; the independence of the councils and the parliamentarians voting on ethical issues; the introduction and extraordinary importance...... of laymen as a part of the bioethical debate and decisions; and the strong focus on debate and educational tools....
The last four decades have seen the emergence and flourishing of the field of bioethics and its incorporation into wide-ranging aspects of society, from the clinic or laboratory through to public policy and the media. Yet considerable debate still exists over what bioethics is and how it should be done. In this paper I consider the question of what makes good bioethics. Drawing on historical and contemporary examples, I suggest that bioethics encompasses multiple modes of responding to moral disagreement, and that an awareness of which mode is operational in a given context is essential to doing good bioethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Navarini, Claudia; Poltronieri, Elisabetta
The article aims at illustrating the characteristics and functions of a monolingual thesaurus, focusing on the Italian Thesaurus of Bioethics (Thesaurus Italiano di Bioetica, TIB) the controlled vocabulary used to index and retrieve documents within SIBIL (Italian Online Bioethics Information System). TIB includes controlled terms (descriptors) translated from the Bioethics Thesaurus adopted by the Kennedy Institute of Ethics of the Georgetown University of Washington and revised according to the Italian context of study and scientific debate in the field of bioethics. The overall amount of TIB terms consists in over 1600 headings. Methods to link thesaurus terms hierarchically, by association and by showing synonyms as recommended in ISO standards are applied with reference to descriptors drawn from TIB. Future plans to make the English version of TIB available online within European networks are also illustrated, aiming at spreading information relating to bioethics at an international level.
Busquets, Ester; Roman, Begoña; Terribas, Núria
This article presents a view of bioethics in the Spanish context. We may identify several features common to Mediterranean countries because of their relatively similar social organisation. Each country has its own distinguishing features but we would point two aspects which are of particular interest: the Mediterranean view of autonomy and the importance of Catholicism in Mediterranean culture. The Spanish experience on bioethics field has been marked by these elements, trying to build a civic ethics alternative, with the law as an important support. So, Spanish bioethics has been developed in two parallel levels: in the academic and policy maker field (University and Parliament) and in clinical practice (hospitals and healthcare ethics committees), with different paces and methods. One of the most important changes in the paternalistic mentality has been promoted through the recognition by law of the patient's rights and also through the new generation of citizens, clearly aware on the exercise of autonomy. Now, the healthcare professionals have a new challenge: adapt their practice to this new paradigm.
This essay roughly sketches two major conceptions of autonomy in contemporary bioethics that promote the resourcification of human body parts: (1) a narrow conception of autonomy as self-determination; and (2) the conception of autonomy as dissociated from human dignity. In this paper I will argue that, on the one hand, these two conceptions are very different from that found in the modern European tradition of philosophical inquiry, because bioethics has concentrated on an external account of patient's self-determination and on dissociating dignity from internal human nature. However, on the other hand, they are consistent with more recent European philosophy. In this more recent tradition, human dignity has gradually been dissociated from contextual values, and human subjectivity has been dissociated from objectivity and absolutized as never to be objectified. In the concluding part, I will give a speculative sketch in which Kant's internal inquiry of maxim of ends, causality and end, and dignity as iirreplaceability is recombined with bioethics' externalized one and used to support an extended human resourcification.
Full Text Available Why are we lawyers still dealing with Bioethics? Who has given us the opportunity to, out of our own self-sufficiency, which legal doctrine and practice have enabled, make a journey towards the field of Bioethics? The separation of the law from Bioethics, understood as Pluri-Perspectivistic field of action of a wide range of science and teaching, leaves the law isolated and limited to its own frames that become insufficient for the development of the legal thought. This causes an irreparable damage to the law, as well as to Bioethics which does not get legal solutions to its problems, which is necessary. Since Bioethics is not a mere presentation of views, comprehending the problem, but also their reflexion and, eventually, their standardization, i.e. the providing of legal answers to the social issues that arise from the field of Bioethics. Thus, not only the theory and philosophy of law find their place in the field of Bioethics, but the same goes for the theory of criminal law, which, also, even in the practical sphere of jurisprudence, is most likely to protect the life. Such a non-isolation of jurisprudence enables it to step out of its own constrains and accept the 'Bioethical sensibility.' This is possible only if we recognize the Pluri-Perspectivism as a starting point in both Bioethics and the law. Is it possible that the law be understood as a field of activity of the various value orientations? Pluri-Perspectivism, which does not go into relativism, will claim that it is possible, and we are inclined to believe it, given the proper results obtained in the field of Bioethics via such a postulate.
This article aims to develop a Lacanian approach to bioethics. Point of departure is the fact that both psychoanalysis and bioethics are practices of language, combining diagnostics with therapy. Subsequently, I will point out how Lacanian linguistics may help us to elucidate the dynamics of both psychoanalytical and bioethical discourse, using the movie One flew over the Cuckoo's Nest and Sophocles' tragedy Antigone as key examples. Next, I will explain the 'topology' of the bioethical landscape with the help of Lacan's three dimensions: the imaginary, the symbolical and the real. This will culminate in an assessment of the dynamics of bioethical discourse with the help of Lacan's theorem of the four discourses. Bioethics, I will argue, is not a homogeneous discourse. Rather, four modalities of bioethical discourse can be distinguished, all of them displaying specific weaknesses and strengths, opportunities and threats. This will be elucidated with the help of two case studies, namely the debates on human reproductive technologies and on the use of animals as biomedical research models.
Pastor, Luis Miguel
In this article we analyze how the idea of virtue as an important element of human ethical action is slowly being lost. There are proposals both in ethics and in bioethics to rehabilitate virtue and to consider it as a very important element of human morality. In particular, in the health sector the rehabilitation of virtue, would imply greater focus on the ethical character of professionals and personal improvement rather than on training for the resolution of ethical cases. Such guidance would also improve the health professional-patient relationship with an increase not only in the technical quality but also in human dimension of health sciences. However, this orientation or tendency in bioethics suffers from a deficit in reasoning due to lack of a complete theory of human action that covers the good and also norms. The second part of the article looks at the relation between of virtue and personalistic bioethics. Virtue is considered as an important element of human action and is integrated with the good and norms. After analyzing and distinguishing between what is today considered personalistic bioethics and the contributions of personalism to bioethics, the paper concludes that the integration of virtue in personalistic bioethics is not only possible but desirable to overcome the ethical minimalism that has resulted from modern day principlism driven bioethics.
Bioethics can be considered as a topic, an academic discipline (or combination of disciplines), a field of study, an enterprise in persuasion. The historical specificity of the forms bioethics takes is significant, and raises questions about some of these approaches. Bioethics can also be considered as a governance practice, with distinctive institutions and structures. The forms this practice takes are also to a degree country specific, as the paper illustrates by drawing on the author's UK experience. However, the UNESCO Universal Declaration on Bioethics can provide a starting point for comparisons provided that this does not exclude sensitivity to the socio-political context. Bioethics governance practices are explained by various legitimating narratives. These include response to scandal, the need to restrain irresponsible science, the accommodation of pluralist views, and the resistance to the relativist idea that all opinions count equally in bioethics. Each approach raises interesting questions and shows that bioethics should be studied as a governance practice as a complement to other approaches.
Lovy, Andrew; Paskhover, Boris; Trachtman, Howard
Although bioethics is considered essential to the practice of medicine, medical students often view it as a "soft" subject that is secondary in importance to the other courses in their basic science and clinical curriculum. This perspective may be a consequence of the heavy reliance on students' aptitude in the quantitative sciences as a criterion for entry into medical school and as a barometer of academic success after admission. It is exacerbated by the widespread impression that bioethics is imprecise and culturally relativistic. In an effort to redress this imbalance, we propose an approach to teaching bioethics to medical students which emphasizes that the intellectual basis and the degree of certainty of knowledge is comparable in all medical subjects ranging from basic science courses to clinical rotations to bioethics tutorials. Adopting these pedagogical steps may promote greater integration of the various elements-bioethics and clinical science-in the medical school curriculum.
The author uses the essays in this issue as a springboard for making three points. First, he argues that most, if not all, current institutional versions of Christianity have failed to provide a meaningful framework for the spiritual life. Second, he argues that there is no ethics other than Judeo-Christian ethics and that there can be no bioethics other than Judeo-Christian bioethics. Finally, he argues that the overriding issue we face is not whether to address bioethical issues from a Christian perspective or from a non-Christian perspective, but rather whether we shall address biological and medical issues from an ethical or a scientific-technological perspective.
Blustein, Jeffrey; Fleischman, Alan R
Urban bioethics is an area of inquiry within the discipline of bioethics that focuses on ethical issues, problems, and conflicts relating to medicine, science, health care, and the environment that typically arise in urban settings. Urban bioethics challenges traditional bioethics (1) to examine value concerns in a multicultural context, including issues related to equity and disparity, and public health concerns that may highlight conflict between individual rights and the public good, and (2) to broaden its primary focus on individual self-determination and respect for autonomy to include examination of the interests of family, community, and society. Three features associated with urban life-density, diversity, and disparity-affect the health of urban populations and provide the substrate for identifying ethical concerns and value conflicts and creating interventions to affect population health outcomes. The field of urban bioethics can be helpful in creating ethical foundations and principles for public health practice, developing strategies to respect diversity in health policy in a pluralistic society, and fostering collaborative work among educators, social scientists, and others to eliminate bias among health professionals and health care institutions to enhance patients' satisfaction with their care and ultimately affect health outcomes. Educational programs at all levels and encompassing all health professions are needed as a first step to address the perplexing and important problem of eliminating health disparities. Urban bioethics is both contributing to the social science literature in this area and helping educators to craft interventions to affect professional attitudes and behaviors.
Rennie, Stuart; Mupenda, Bavon
In the last decade, there have been efforts to globalize the field of bioethics, particularly in developing countries, where biomedical and other research is increasingly taking place. We describe and evaluate some key ethical criticisms directed towards these initiatives, and argue that while they may be marked by ethical, practical, and political tensions and pitfalls, they can nevertheless play an important role in stimulating critical bioethics culture in countries vulnerable to exploitation by foreign agencies and/or their own authorities. PMID:25632370
Ogundiran Temidayo O
Full Text Available Abstract Background Medical ethics has existed since the time of Hippocrates. However, formal training in bioethics did not become established until a few decades ago. Bioethics has gained a strong foothold in health sciences in the developed world, especially in Europe and North America. The situation is quite different in many developing countries. In most African countries, bioethics – as established and practiced today in the west- is either non-existent or is rudimentary. Discussion Though bioethics has come of age in the developed and some developing countries, it is still largely "foreign" to most African countries. In some parts of Africa, some bioethics conferences have been held in the past decade to create research ethics awareness and ensure conformity to international guidelines for research with human participants. This idea has arisen in recognition of the genuine need to develop capacity for reviewing the ethics of research in Africa. It is also a condition required by external sponsors of collaborative research in Africa. The awareness and interest that these conferences have aroused need to be further strengthened and extended beyond research ethics to clinical practice. By and large, bioethics education in schools that train doctors and other health care providers is the hook that anchors both research ethics and clinical ethics. Summary This communication reviews the current situation of bioethics in Africa as it applies to research ethics workshops and proposes that in spite of the present efforts to integrate ethics into biomedical research in Africa, much still needs to be done to accomplish this. A more comprehensive approach to bioethics with an all-inclusive benefit is to incorporate formal ethics education into health training institutions in Africa.
Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.
Bioethics and the public debate is certainly a nonsense for those who still believe that medical practice should only be a matter of individual relationship between a physician and his/her patient, such a relationship being regulated by the awareness that the medical practitioner has of his/her ethical duties. However for those who believe that physicians and other health care providers cannot find any more the replies to the problems raised by the development of new biomedical techniques in their own professional ethics, at least three questions should be posed. Can the traditional democratic institutions face those issues? Is there a need for new institutions to be built? Are such mechanisms--both old and new--appropriate to support a public debate?
The author describes the events surrounding his attempts to lecture on the subject of euthanasia in West Germany in June 1989. Singer, who defends the view that active euthanasia for some newborns with handicaps may be ethically permissible, had been invited to speak to professional and academic groups. Strong public protests against Singer and his topic led to the cancellation of some of his engagements, disruptions during others, and harrassment of the German academics who had invited him to speak. These incidents and the subject of euthanasia became matters of intense national debate in West Germany, but there was little public or academic support for Singer's right to be heard. Singer argues that bioethics and bioethicists must have the freedom to challenge conventional moral beliefs, and that the events in West Germany illustrate the grave danger to that freedom from religious and political intolerance.
Marcelo Pereira dos Santos
Full Text Available The dynamics of medicine has causing great shiver in society, given the progress made in the context of biomedicine and genetic events that provided before thoughtless as the assisted reproduction techniques, therapeutic cloning, surgery for transmutation of sex, as well as focused clinical procedures prolonging life. These events do not occur without causing ethical dilemmas that require a reflection on the limits and degrees of acceptability in the methods and practices used by health professionals, biologists, scientists, pharmacists and others involved in the manipulation of genetic material and trials with humans. From this perspective, this paper, from the analytical assessment of the Bioethics paradigms, promotes the correlation between human dignity, scientific progress and rights of future generations under inflows arising from advances in science and technology in a society of risk and the ambivalence. The analysis of the issues is promoted with the use of dialectical-descriptive methodology, based on the literature about the above issues, involving books, articles, dissertations and theses published in the last ten years. The theoretical framework sits in the design of risks and ambivalences, outlined by Ulrich Beck, Franz Josef Brüseke, Anthony Giddens, Zygmunt Bauman. The study aims to understand the necessary effect bioethics of the precautionary principle as a guiding ethical beacon of scientific and technical progress and the necessary reconciliation between trials and legitimacy of choices for the maintenance and evolution of the human species.
UNESCO’s Bioethics Programme was established in 1993. In twenty years it has adopted three international declarations, on the human genome (1997), human genetic data (2003) and bioethics (2005); produced reports on a wide range of bioethics issues; and developed capacity building and public education programmes in bioethics. Yet UNESCO has sometimes struggled to assert its authority in the wider bioethics world. Some bioethicists have criticized the 2005 declaration and suggested that the World Health Organization might be better placed to advance bioethics. In 2011, after four years of debate, UNESCO decided not to draft a convention on human reproductive cloning, because consensus on the issue proved impossible. This article reviews the standard setting and capacity building activities of the UNESCO Bioethics Programme. While the Programme faces challenges common to most intergovernmental organizations, its achievements in expanding international law and building bioethics capacity should not be underestimated. PMID:24979873
UNESCO's Bioethics Programme was established in 1993. In twenty years it has adopted three international declarations, on the human genome (1997), human genetic data (2003) and bioethics (2005); produced reports on a wide range of bioethics issues; and developed capacity building and public education programmes in bioethics. Yet UNESCO has sometimes struggled to assert its authority in the wider bioethics world. Some bioethicists have criticized the 2005 declaration and suggested that the World Health Organization might be better placed to advance bioethics. In 2011, after four years of debate, UNESCO decided not to draft a convention on human reproductive cloning, because consensus on the issue proved impossible. This article reviews the standard setting and capacity building activities of the UNESCO Bioethics Programme. While the Programme faces challenges common to most intergovernmental organizations, its achievements in expanding international law and building bioethics capacity should not be underestimated.
Barman, Charles R.; Rusch, John J.
Discusses the rationale for and development of an undergraduate bioethics course. Based on experiences with the course, general suggestions are offered to instructors planning to add bioethics to existing curricula. (MA)
Appel, Jacob M
Although many first-generation bioethicists were psychiatrists and some received psychoanalytic training, the field of bioethics has developed largely in isolation from psychodynamic theory. While much has been written regarding the ethics of psychoanalysis, only a few scholars have attempted to explain bioethical phenomena in psychodynamic terms. This paper argues for the development of a comprehensive theory of "psychodynamic bioethics" that attempts to explain individual and collective attitudes toward bioethical controversy in psychodynamic terms.
De Vries, Raymond
C. Wright Mills said that when done well, sociology illuminates the intersection of biography and history. This essay examines how the author's vocational choices and career path were shaped by historical circumstance, leading him to a degree in sociology and to participation in the odd and interesting interdiscipline of bioethics. Drawing on a distinction between sociology in bioethics and sociology of bioethics, the essay considers the value of sociology to the bioethical project.
Explains the importance of integrating bioethics into the science curriculum for student learning. Introduces a workshop designed for middle and high school science teachers teaching bioethics, its application to case studies, and how teachers can fit bioethics into their classroom. (YDS)
Full Text Available By opening the field of bioethics followed a new wave of intense debate on the theological, philosophical and legal significance of the concept of human dignity . Exactly ten years ago (December 2003 American bioethicist Ruth Maclin has proposed to divest ourselves of the concept of human dignity because it is vague, useless and redundant and that, without any loss, we can replace it by the ethical principle of personal autonomy. Her article was followed by harsh reactions and opposite views. What is this term in so broad, almost inflationary and opposite use is not a reason to deprive him, but, on the contrary, it shows how important it is and that it should be determined at least outline. As universal values and general concept, the human dignity has no pre-defined and narrow, precise meaning. It is more an evaluation horizon, the guiding principle and regulatory ideas that must constantly define and codify by many guaranted human rights and fundamental freedoms. As generic notion of each reasonable law, it is their foundation and a common denominator, legitimising basis of natural but also of positive law. As intrinsic and static value which means the humaneness, the humanity it is absolute, inherent to every human being without distinction and conditioning, as a unique and unrepeatable creation. In this meaning, the dignity is the obligation and limitation of the state, society and each of us. As an ethical and dynamic category, it is not given to us, but it is assign to us, and it is not in us, but always before us, as a guide of our actions in accordance with virtues, to treat ourselves, each other and the nature in a human way. The century in which we live is named the century of molecular biology and genetic engineering because of the enormous potential but also risks to human dignity. Because of that human dignity has become a central principle in all international documents relating to the human genome, genetics and bioethics, adopted
Islamic religious norms are important for Islamic bioethical deliberations. In Muslim societies religious and cultural norms are sometimes confused but only the former are considered inviolable. I argue that respect for Islamic religious norms is essential for the legitimacy of bioethical standards in the Muslim context. I attribute the legitimating power of these norms, in addition to their purely religious and spiritual underpinnings, to their moral, legal, and communal dimensions. Although diversity within the Islamic ethical tradition defies any reductionist or essentialist reconstruction, legitimacy is secured mainly by approximation of Islamic ethical ideals believed to be inherent in the scriptural texts, rather than by the adoption of particular dogmatic or creedal views. With these characteristics, Islamic (bio) ethics may provide useful insights for comparative ethics and global bioethics.
Transhumanism is a "technoprogressive" socio-political and intellectual movement that advocates for the use of technology in order to transform the human organism radically, with the ultimate goal of becoming "posthuman." To this end, transhumanists focus on and encourage the use of new and emerging technologies, such as genetic engineering and brain-machine interfaces. In support of their vision for humanity, and as a way of reassuring those "bioconservatives" who may balk at the radical nature of that vision, transhumanists claim common ground with a number of esteemed thinkers and traditions, from the ancient philosophy of Plato and Aristotle to the postmodern philosophy of Nietzsche. It is crucially important to give proper scholarly attention to transhumanism now, not only because of its recent and ongoing rise as a cultural and political force (and the concomitant potential ramifications for bioethical discourse and public policy), but because of the imminence of major breakthroughs in the kinds of technologies that transhumanism focuses on. Thus, the articles in this issue of The Journal of Medicine and Philosophy are either explicitly about transhumanism or are on topics, such as the ethics of germline engineering and criteria for personhood, that are directly relevant to the debate between transhumanists (and technoprogressives more broadly) and bioconservatives. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: email@example.com.
Biosciences and their applications, which we call biotechnology, have affected human society in many ways. Great hopes have been set on future biotechnology. The future depends on three key issues. First, we need good science. Recent developments in biosciences have surprised us in many ways. I shall explain in this article how. Secondly, we need structured innovation systems in order to commercialize our discoveries. Europe is slow in this respect compared to our Japanese and American competitors and may lose in the competition. I shall describe the Finnish innovation chain using the rewarded Otaniemi model as an example of how commercialization can be done in a systematic way. Thirdly, we need norms to guide what to do and where to go. Bioethics is probably the most neglected of the three key issues. With modern biotechnology we are able to do things that should worry every citizen, but the ethical discussion has been largely neglected or the discussion in our pluralistic society is leading nowhere. I shall finally discuss these problems from a historical perspective.
This article details the relationship between history and bioethics. I argue that historians' reluctance to engage with bioethics rests on a misreading of the field as solely reducible to applied ethics, and overlooks previous enthusiasm for historical perspectives. I claim that seeing bioethics as its practitioners see it - as an interdisciplinary meeting ground - should encourage historians to collaborate in greater numbers. I conclude by outlining how bioethics might benefit from new histories of the field, and how historians can lend a fresh perspective to bioethical debates. © 2011 Blackwell Publishing Ltd.
Popular fiction responds to, and may exacerbate, public anxieties in ways that more highbrow literary texts may not. Robin Cook's 1977 novel Coma exemplifies the ways in which medical thrillers participate in the public discourse about health care. Written shortly after the medical establishment promoted "irreversible coma," or brain death, as a new definition of dying, and at a time when the debate over the removal of Karen Ann Quinlan from life support was the subject of popular attention, Coma crystallized public fears over the uses of medical technology. While Cook hoped that Coma would encourage public participation in health-care decision-making, the book may have fueled public concerns about medicine in ways that he did not anticipate. The public engagement that accompanied the rise of bioethics and that led to increased transparency and patient autonomy in medical decision-making had its birth, in part, in the distrust and paranoia reflected in the medical thriller. Because fiction can shape public perceptions of health-care dilemmas and may affect decision-making on bioethical issues, bioethicists need to pay attention to popular fictional accounts of medicine.
Benefiting from a widely recognised experience of the field of bioethics, the Council of Europe which represents all the democratic countries of Europe, has embarked on the ambitious task of drafting a European Convention on bioethics. The purpose of this text is to set out fundamental values, such as respect for human dignity, free informed consent and non-commercialisation of the human body. In addition to this task, protocols will provide specific standards for the different fields concerned with the application of biomedical sciences. The convention and the first two protocols (human experiments and organ transplants) are due to be ready for signature by mid 1994.
Sheehan, Mark; Dunn, Michael
Much has been written in the last decade about how we should understand the value of the sociology of bioethics. Increasingly the value of the sociology of bioethics is interpreted by its advocates directly in terms of its relationship to bioethics. It is claimed that the sociology of bioethics (and related disciplinary approaches) should be seen as an important component of work in bioethics. In this paper we wish to examine whether, and how, the sociology of bioethics can be defended as a valid and justified research activity, in the context of debates about the nature of bioethics. We begin by presenting and arguing for an account of bioethics that does justice to the content of the field, the range of questions that belong within this field, and the justificatory standards (and methodological orientations) that can provide convincing answers to these questions. We then consider the role of sociology in bioethics and show how and under what conditions it can contribute to answering questions within bioethics. In the final section, we return to the sociology of bioethics to show that it can make only a limited contribution to the field.
Díaz de Terán Velasco, M Cruz
Within the context of the contemporary plural debate, it is common to use the adjective secular as if it were the only manner to participate in the bioethical debate of Western multi-ethnic society. This situation gives rise to the question of whether there can be a religious contribution to the current bioethical debate. There are two possible answers. The first, an affirmative one, is centered on the fact that contemporary society is characterized by pluralistic and secular values on which is based the obligations of its members, defined by consensus through democratic procedures. In this context, religious contribution, as something from the private sphere, must be excluded. The alternative response to our central question may be negative, based on the assertion that human beings are identified as members of different value systems, many of them imbued with religious elements. From this point of view, the religious phenomenon would be one of the most important elements in the debate on cultural pluralism, because it guides, and serves as an inspiration of our conduct. This article aims to answer our central question by analyzing each of the two possible positions. The article is divided into two sections; the first analyses the significance of the term secular when it is employed in the sphere of bioethics and the second examines whether, within the scope of democratic societies, the current religious contribution to the bioethics debate has any legitimacy. The article ends with some conclusions.
Nie, Jing-Bao; Fitzgerald, Ruth P
From the outset, cross-cultural and transglobal bioethics has constituted a potent arena for a dynamic public discourse and academic debate alike. But prominent bioethical debates on such issues as the notion of common morality and a distinctive "Asian" bioethics in contrast to a "Western" one reveal some deeply rooted and still popular but seriously problematic methodological habits in approaching cultural differences, most notably, radically dichotomizing the East and the West, the local and the universal. In this paper, a "transcultural" approach to bioethics and cultural studies is proposed. It takes seriously the challenges offered by social sciences, anthropology in particular, towards the development of new methodologies for comparative and global bioethics. The key methodological elements of "transculturalism" include acknowledging the great internal plurality within every culture; highlighting the complexity of cultural differences; upholding the primacy of morality; incorporating a reflexive theory of social power; and promoting changes or progress towards shared and sometimes new moral values.
Godard, Béatrice; Moubé, Zéphirin
It is inmportant to emphasize three aspects concerning the construction and teaching of 'French bioethics: the maintenance and promotion ofa multidisciplinary approach; a greater autonomy in the management and development of training programs; positioning a power of attraction and development in French-speaking countries. Bioethics is defined as a field of interdisciplinary studies at the junction of the health sciences and the humanities and, more importantly, directly connected to the reality of the health community, research and public Policy. A greater autonomy in the management and development of training programs is also capital. The danger of being dominated by one discipline involved whether medicine, law, philosophy, theology is real and prevents from promoting methodological approaches that are both theoretical and empirical. Finally, compliance with local and national, but also disciplinary diversity is essential to the construction and teaching of French bioethics. As such, the University of Montreal has positioned itself as a leader in the French-speaking countries: at the junction of North America and European countries, Quebec has developed its own specificity in bioethics, which is a force of attraction for many countries of the French-speaking world. In this context, the Bioethics Programs at the University of Montreal rely heavily on knowledge transfer to other cultures. Moreover, the internationalization of training programs in French bioethics is a major issue in the current context of globalization and transmission of knowledge.
shyness (that does not meet criteria for social anxiety disor- der) or from general dissatisfaction with themselves and ... dysthymia, social anxiety disorder, and personality disorders, it may be argued by extrapolation that these .... Berkeley, CA, University of California Press. 11. The President's Council on Bioethics. Beyond ...
Uncertainty as to how we should articulate empirical data and normative reasoning seems to underlie most difficulties regarding the 'empirical turn' in bioethics. This article examines three different ways in which we could understand 'empirical turn'. Using real facts in normative reasoning is trivial and would not represent a 'turn'. Becoming an empirical discipline through a shift to the social and neurosciences would be a turn away from normative thinking, which we should not take. Conducting empirical research to inform normative reasoning is the usual meaning given to the term 'empirical turn'. In this sense, however, the turn is incomplete. Bioethics has imported methodological tools from empirical disciplines, but too often it has not imported the standards to which researchers in these disciplines are held. Integrating empirical and normative approaches also represents true added difficulties. Addressing these issues from the standpoint of debates on the fact-value distinction can cloud very real methodological concerns by displacing the debate to a level of abstraction where they need not be apparent. Ideally, empirical research in bioethics should meet standards for empirical and normative validity similar to those used in the source disciplines for these methods, and articulate these aspects clearly and appropriately. More modestly, criteria to ensure that none of these standards are completely left aside would improve the quality of empirical bioethics research and partly clear the air of critiques addressing its theoretical justification, when its rigour in the particularly difficult context of interdisciplinarity is what should be at stake.
Cook, Kristin; Keller, Donna; Myers, Alyce
In this guided inquiry, students investigate advantages and disadvantages of genetic engineering by integrating popular fiction into their study of bioethics. What are the effects of artificially created hybrid creatures on characters in "The Hunger Games" and in our society? What are the effects on and basic rights of the organisms…
Martin, Cathy, Comp.; Cadoree, Michelle
This guide lists published materials on many aspects of bioethics, the literature of which is varied and scattered. Related guides in the LC Science Tracer Bullet series are TB 80-9, Terminal Care, TB 80-11, Drug Research on Human Subjects, TB 83-4, Science Policy, and TB 84-7, Biotechnology. Not intended to be a comprehensive bibliography, this…
Ssebunnya, Gerald M
In the current debate on the future of bioethics in Africa, several authors have argued for a distinct communitarian African bioethics that can counter the dominancy of Western atomistic principlism in contemporary bioethics. In this article I examine this rather contentious argument and evaluate its validity and viability. Firstly, I trace the contextual origins of contemporary bioethics and highlight the rise and dominance of principlism. I particularly note that principlism was premised on a content-thin notion of the common morality that is in need of enrichment. I also contend that bioethics is essentially two-dimensional, being both conceptual and empirical, and indicate the lag in Africa with regard to conceptual bioethics. I then appeal for authentic engagement by 1) African health care professionals, 2) African health care training institutions, 3) Africa's bioethics development partners, and 4) African bioethicists and philosophers, towards addressing this critical lag. I underline the need to maintain the essential universality of bioethics as a discipline. I particularly argue against the pursuit of a distinct African bioethics, as it appears to be rooted in sterile African ethno-philosophy. Rather, African bioethicists and philosophers would do well to elucidate the universalisability of insights from traditional African thought, for the benefit of bioethics as a whole. Thus we must engage beyond the sterility of a distinct African bioethics - authentically reflecting on the essentially universal contemporary bioethical concerns - to effectively articulate a viable trajectory for bioethics in Africa. © 2016 John Wiley & Sons Ltd.
Urban bioethics has two goals. First, it aims to focus attention on neglected bioethical problems that have particular salience in urban settings. Three problems are highlighted: socioeconomic inequality as a major determinant of health inequality, the foundations of an ethic for public health, and the impact of social context on the therapeutic alliance between patients and physicians. Second, urban bioethics serves as a vehicle for raising deep theoretical and methodological questions about the dominant assumptions and approaches of contemporary bioethics. Demands for cultural sensitivity, so pronounced in the urban context, compel us to reexamine the central commitment in bioethics to personal autonomy. The multiculturalism of urban life also argues for a dialogic approach to bioethical problem solving rather than the monologic approach that characterizes most bioethical thinking. Although my brief for redirecting bioethics will resonate with many critics who do not consider themselves urban bioethicists, I argue that there are special advantages in using urban bioethics to expose the limitations of contemporary bioethical paradigms.
del Barrio Seoane, Jaime
On 4 April 2011, as part of the XVIII Conference in Law and the Human Genome, the official presentation took place of the first Spanish language Encyclopedia of Biolaw and Bioethics, in an event organised by the Inter-University Chair in Law and the Human Genome held, on this occasion, in the new Auditorium of the University of the Basque Country. The Encyclopedia of Biolaw and Bioethics is a project which was conceived and driven forward by the Inter-University Chair in Law and the Human Genome. It was an ambitious project which was supported by the Roche Institute Foundation. It was therefore a magnum opus which began more than three years ago and which has required the work of more than 200 professionals from various disciplines in Spain, Latin America and Portugal. The encyclopaedia tries to make up for the lack of a suitable publication in the Spanish language that could be used as a reference and be consulted by different experts who have to tackle controversies and doubts posed in the field of biolaw and bioethics as part of their everyday work. The work makes it possible to ascertain the situation in this field regarding the most controversial issues and emerging conflicts, find out which values, assets or rights are involved or confronted, what solutions have been proposed by bioethics and the social positions that have been established through legal regulations. All in all, the encyclopaedia was the culmination of an ambitious undertaking, a pioneering work in the Spanish speaking countries due to its characteristics and scope. It is essential to have such a resource in today's cultural environment. The presentation of the Encyclopedia of Biolaw and Bioethics given by Mr. Del Barrio Seoane as Director General of the Roche Institute Foundation during the Conference deservers a special mention. The project has been consolidated through the support of this institution.
Full Text Available INTRODUCTION[|]This paper has been planned as a critical response to Murat Civaner's article entitled 'Medical Ethics arguments should be concordant with scientific knowledge and certain values', published in the Autumn 2015 issue of Turkish Journal of Bioethics. It also aims to provide an evaluation of the way the authoritarian discourse manifests itself in ethical arguments.[¤]METHODS[|]For this purpose, the paper first presents the views of Orhan Hançerlioğlu on Karl Marx and Karl Popper and treats these views as a written example of such authoritarian discourse, which is essentially a problematic attitude that results from an inability to acknowledge the value-laden aspects of a given perspective. [¤]RESULTS[|]In order to show that problems in Hançerlioğlu's approach is also present in Civaner's arguments, several examples where the author did not recognize the value-laden aspects and the subjective nature of information are provided. The paper then examines the recent claim by Celal Şengör, who asserted that force feeding of feces to individuals do not qualify as torture. Based on the presentation and the justification of this reductionist claim, it is emphasized that the relationship between information and values is much more complicated than those presented by Civaner. Civaner's claim, which asserts that the concept of conscience should have no place in medical ethics arguments, is also evaluated on this basis and the dangers of excluding the moral agent in ethical evaluation are underlined. In addition, the relationship of the paternalist tradition with the perspective which I refer to as the 'macro axis' is examined. Last but not least, the paper deals with the concept of 'ethics of ethics' by using examples from national and international ethics literature and emphasizes the reason why it is important for the ethicist to become aware of her own scheme of values. [¤]DISCUSSION AND CONCLUSION[|]The paper concludes that contrary
Urionabarrenetxea, K Martínez
One of the elements that have historically defined professions making them different from mere occupations is the fact that their responsibilities have been defined more in moral than juridical terms. Because it is not the due respect to the law but the tendency to moral excellence the fundamental characteristic of professions. Professionalism is the base of medicine's contract with society and it obliges to put patients' interests above the doctors' ones, supplying competence and integrity standards, and providing expert help to society in health matters. Education in bioethics is an appropriate instrument to reach this goal, as it promotes an interdisciplinary analysis of the problems created by the medical and biological progress and its correspondent technologies, to find what is most human in its practical application. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.
Chattopadhyay, Subrata; Myser, Catherine; De Vries, Raymond
Who are the gatekeepers in bioethics? Does editorial bias or institutional racism exist in leading bioethics journals? We analyzed the composition of the editorial boards of 14 leading bioethics journals by country. Categorizing these countries according to their Human Development Index (HDI), we discovered that approximately 95 percent of editorial board members are based in (very) high-HDI countries, less than 4 percent are from medium-HDI countries, and fewer than 1.5 percent are from low-HDI countries. Eight out of 14 leading bioethics journals have no editorial board members from a medium- or low-HDI country. Eleven bioethics journals have no board members from low-HDI countries. This severe underrepresentation of bioethics scholars from developing countries on editorial boards suggests that bioethics may be affected by institutional racism, raising significant questions about the ethics of bioethics in a global context.
This paper discusses the viability of a virtue-based approach to bioethics. Virtue ethics is clearly appropriate to addressing issues of professional character and conduct. But another major remit of bioethics is to evaluate the ethics of biomedical procedures in order to recommend regulatory policy. How appropriate is the virtue ethics approach to fulfilling this remit? The first part of this paper characterizes the methodology problem in bioethics in terms of diversity, and shows that virtue ethics does not simply restate this problem in its own terms. However, fatal objections to the way the virtue ethics approach is typically taken in bioethics literature are presented in the second section of the paper. In the third part, a virtue-based approach to bioethics that avoids the shortcomings of the typical one is introduced and shown to be prima facie plausible. The upshot is an inviting new direction for research into bioethics' methodology. © 2009 Blackwell Publishing Ltd.
Manchola-Castillo, Camilo; Garrafa, Volnei
Recently, bioethics and international relations have gotten closer to one an other, probably as a result of the motivation of bioethics to intervene in global affairs. However, this relationship has only been on the practical level.This study's objective, through a literature review, is to highlight the huge potential that the epistemologies of both areas have to build a more fruitful dialogue. 18 articles relating both areas were retrieved from databases Scopus, Web of Science, Bireme and PubMed. The articles were then grouped in three categories of analysis: bioethics and global health; international organizations and bioethics; and international relations and bioethics. This study concludes that an epistemological approaching between these areas is desirable and proposes the establishment of two new areas of study: international relations in health and international relations from the South, drawing upon the conceptual basis developed by Latin-American bioethics.
Corral García, Eduardo
The impact is analyzed that on the Spanish Law relative to questions bioethics--as the Law on artificial reproduction, the Law of biomedical investigation, and the Law on sexual and reproductive health--can have the conception of human embryo enunciated by the Court of Justice of the European Union in his judgment of October 18, 2011, considering it to be any ovum fertilized with independence of the degree of reached development.
Full Text Available Abstract Background There has been debate on whether a global or unified field of bioethics exists. If bioethics is a unified global field, or at the very least a closely shared way of thinking, then we should expect bioethicists to behave the same way in their academic activities anywhere in the world. This paper investigates whether there is a 'global bioethics' in the sense of a unified academic community. Methods To address this question, we study the web-linking patterns of bioethics institutions, the citation patterns of bioethics papers and the buying patterns of bioethics books. Results All three analyses indicate that there are geographical and institutional differences in the academic behavior of bioethicists and bioethics institutions. Conclusion These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects.
Human rights are closely related to the notion of human dignity, to such a point that it is very difficult, if not impossible, to promote them without appealing, at least implicitly, to the idea that each individual has intrinsic worth simply by virtue of being human. This relationship between dignity and rights is even stronger in the field of bioethics, which deals directly with some of the most basic human rights, such as the rights to life and to physical integrity. It is therefore not by chance that the international norms relating to bioethics give a central role to the concept of human dignity. However, one should not expect from dignity more than it can offer; dignity is a "principle", not a "rule"; it embodies a fundamental value, but it alone does not determine the content of a particular decision.
Adler, Daniel; Shaul, Randi Zlotnik
Contemporary bioethics research is often described as multi- or interdisciplinary. Disciplines are characterized, in part, by their methods. Thus, when bioethics research draws on a variety of methods, it crosses disciplinary boundaries. Yet each discipline has its own standard of rigor—so when multiple disciplinary perspectives are considered, what constitutes rigor? This question has received inadequate attention, as there is considerable disagreement regarding the disciplinary status of bioethics. This disagreement has presented five challenges to bioethics research. Addressing them requires consideration of the main types of cross-disciplinary research, and consideration of proposals aiming to ensure rigor in bioethics research. PMID:22686634
Capron, Alexander M
At every moment, somewhere in the world, a group of men and women are sitting around a table deliberating about an ethical issue posed by medicine and research, whether as a research ethics committee; a hospital or clinical ethics committee; a stem-cell review committee; a gene transfer research committee; a biobank ethics committee; an ethics advisory committee for a medical or nursing association or nongovernmental organization; a state, provincial, national, or intergovernmental bioethics committee; or an ad hoc panel examining a particular development or case. However, the last national committee in the United States, the Presidential Commission for the Study of Bioethical Issues, held its final meeting at the end of August 2016 and closed its doors. Should we regret its departure? I believe that the United States would benefit from having another national bioethics advisory body, but I do not think that the commission should simply have continued under a new president in the same form. Instead, looking at the experience of that commission and its six predecessors-who they were, how they worked, the functions they served, and the problems they experienced-we can derive some useful ideas for anyone planning to build the next commission. © 2017 The Hastings Center.
Ivanković, Viktor; Savić, Lovro
This article provides a critical evaluation of the central components of Integrative Bioethics, a project aiming at a bioethical framework reconceptualization. Its proponents claim that this new system of thought has developed a better bioethical methodology than mainstream Western bioethics, a claim that we criticize here. We deal especially with the buzz words of Integrative Bioethics - pluriperspectivism, integrativity, orientational knowledge, as well as with its underlying theory of moral truth. The first part of the paper looks at what the claims of a superior methodology consist in. The second reveals pluriperspectivism and integrativity to be underdeveloped, hazy terms, but which seem to be underpinned by two theses - the incommensurability and the inclusiveness theses. These theses we critically scrutinize. We then consider strategies the project's proponents might apply to curb these theses in order to acquire minimal consistency for their framework. This part of the article also deals with the conception of moral truth that drives the theory, a position equally burdened with inconsistencies. In the last part of the article, we observe the concept of orientational knowledge, and develop two interpretations of its possible meaning. We claim that, following the first interpretation, Integrative Bioethics is completely descriptive, in which case it is informative and important, but hardly bioethics; if it is normative, following the second interpretation, it is bioethics as we already know it, but merely clad in rhetorical embellishments. We conclude that there is nothing new about this project, and that its inconsistencies are reason enough for its abandonment. © 2015 John Wiley & Sons Ltd.
Murray, Kevin J.
Describes the implementation of a bioethics laboratory exercise that incorporates a variety of instructional strategies. In the activity, General Biology students consider relevant and interesting topics of bioethical importance and prepare classroom presentations on the different viewpoints normally attendant to ethical topics. Includes an…
Pearce, Roger S.
Developing critical thinking is a perceived weakness in current education. Analysis and reasoning are core skills in bioethics making bioethics a useful vehicle to address this weakness. Assessment is widely considered to be the most influential factor on learning (Brown and Glasner, 1999) and this piece describes how analysis and reasoning in…
Häyry, Matti; Takala, Tuija
The authors analyse and assess the Universal Draft Declaration on Bioethics and Human Rights published by UNESCO. They argue that the Draft has two main weaknesses. It unnecessarily confines the scope of bioethics to life sciences and their practical applications. And it fails to spell out the intended role of human dignity in international ethical regulation.
DuBois, James M; Iltis, Ana S; DuBois, Susan G
Twelve personal narratives address the impact of political influence on bioethics. Three commentary articles explore these stories and suggest lessons that can be learned from them. The commentators come from backgrounds that include bioethics, medicine, educational psychology, health care management, and philosophy.
In 1927, Fritz Jahr, a Protestant pastor, philosopher, and educator in Halle an der Saale, published an article entitled "Bio-Ethics: A Review of the Ethical Relationships of Humans to Animals and Plants" and proposed a "Bioethical Imperative," extending Kant's moral imperative to all forms of life. Reviewing new physiological knowledge of his times and moral challenges associated with the development of secular and pluralistic societies, Jahr redefines moral obligations towards human and nonhuman forms of life, outlining the concept of bioethics as an academic discipline, principle, and virtue. Although he had no immediate long-lasting influence during politically and morally turbulent times, his argument that new science and technology requires new ethical and philosophical reflection and resolve may contribute toward clarification of terminology and of normative and practical visions of bioethics, including understanding of the geoethical dimensions of bioethics.
Choe, Kwisoon; Kang, Youngmi; Lee, Woon-Yong
The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education.
Full Text Available Bioethics faces the challenge of collaborating in building a just and sustainable world. This article analyzes the birth of bioethics as a civic bioethics of pluralistic societies in the context of applied ethics, its evolution to become a global bioethics, its current structure, the challenges it faces, and finally the kind of practical reasoning that should guide its task if bioethics is to achieve its goals.
Boury, D; Dei-Cas, E
Parasitic diseases constitute the most common infections among the poorest billion people, entailing high mortality rates and leading to long-term infirmities and poverty. Although the setting-up of public health programs implies many ethical consequences, the range of specific questions in parasitology that can be attributed to bioethics remains, to a large extent, unexplored. From the present analysis, it emerged three main issues which characterize ethical stakes in parasitology: accounting the complexity of the field of intervention, putting the principle of justice into practice and managing the changing context of research. From the research angle, medical parasitology-mycology, as other biological disciplines, is undergoing tensions derived from biological reductionism. Thanks to its links with the history and philosophy of the sciences, bioethics can help to clarify them and to explain the growing hold that technologies have over scientific thinking. On the whole, researchers as well as clinicians are called on to assume a specific responsibility, proportional to their competence and their place in the making of scientific, health, economic and social decisions.
MacDougall, D Robert
Bioethicists working on national ethics commissions frequently think of themselves as advisors to the government, but distance themselves from any claims to actual authority. Governments however may find it beneficial to appear to defer to the authority of these commissions when designing laws and policies, and might appoint such commissions for exactly this reason. Where does the authority for setting laws and policies come from? This question is best answered from within a normative political philosophy. This paper explains the locus of moral authority as understood within one family of normative political theories--liberal political theories--and argues that most major "liberal" commentators have understood both the source and scope of ethics commissions' authority in a manner at odds with liberalism, rightly interpreted. The author argues that reexamining the implications of liberalism for bioethics commissions would mean changing what are considered valid criticisms of such commissions and also changing the content of national bioethics commission mandates. The author concludes that bioethicists who participate in such commissions ought to carefully examine their own views about the normative limits of governmental authority because such limits have important implications for the contribution that bioethicists can legitimately make to government commissions.
Full Text Available Parasitic diseases constitute the most common infections among the poorest billion people, entailing high mortality rates and leading to long-term infirmities and poverty. Although the setting-up of public health programs implies many ethical consequences, the range of specific questions in parasitology that can be attributed to bioethics remains, to a large extent, unexplored. From the present analysis, it emerged three main issues which characterize ethical stakes in parasitology: accounting the complexity of the field of intervention, putting the principle of justice into practice and managing the changing context of research. From the research angle, medical parasitology-mycology, as other biological disciplines, is undergoing tensions derived from biological reductionism. Thanks to its links with the history and philosophy of the sciences, bioethics can help to clarify them and to explain the growing hold that technologies have over scientific thinking. On the whole, researchers as well as clinicians are called on to assume a specific responsibility, proportional to their competence and their place in the making of scientific, health, economic and social decisions.
Carolyn P Neuhaus
Full Text Available When some scientists hear the word "bioethics," they break out in intellectual hives. They shouldn't. Good bioethics is about enabling science to move forward. Bioethics pushes scientists to acknowledge that they operate not within a vacuum but within a society in which diverse perspectives and values must be engaged. Bioethicists give voice to those divergent perspectives and provide a framework to facilitate informed and inclusive discussions that spur progress, rather than stall it. The field is needed to advance cutting-edge biomedical research in domains in which the benefits to be had are enormous, such as genome editing, but ethical concerns persist.
Neuhaus, Carolyn P; Caplan, Arthur L
When some scientists hear the word "bioethics," they break out in intellectual hives. They shouldn't. Good bioethics is about enabling science to move forward. Bioethics pushes scientists to acknowledge that they operate not within a vacuum but within a society in which diverse perspectives and values must be engaged. Bioethicists give voice to those divergent perspectives and provide a framework to facilitate informed and inclusive discussions that spur progress, rather than stall it. The field is needed to advance cutting-edge biomedical research in domains in which the benefits to be had are enormous, such as genome editing, but ethical concerns persist.
Alejandra T Rabadán
Full Text Available In healthcare, an ethical concern that arises during the decision making process is considered to be a bioethical dilemma. It is often the case that in the absence of proper deliberation, the problem is transferred to a bioethics committee, not even representing precisely a dilemma. Bioethics emerged as a discipline in the mid-20th century. It is defined as a support to decision-making in ethical dilemmas centered on two aspects: ethics of clinical investigation, focused on protecting the rights of research subjects, and bioethics in medical practice, of an advisory nature. To recognize the difference among difficult or complex clinical circumstances and ethical dilemmas could allow knowing when it is necessary to request for advice of a committee. It is not so much a question of deciding what is right or wrong, but which is the most advisable solution to a problem. We review the history of Bioethics Committees in Argentina that are facing today the challenge of promoting social responsibility and opening deliberations to community and health professionals. In the 20th century two historical moments are recognized: a pioneering and slow first period, and a second one of legal regulatory framework. Considering deliberation as a method of ethics, this article proposes a case analysis procedure and the deliberative method to elucidate dilemmas, with or without the help of a Committee.
In 2005 the representatives of 191 states meeting for the General Conference of UNESCO unanimously approved the "Universal Declaration on Bioethics and Human Rights". The Declaration is the only instrument of its kind: it was the first document adopted by a global organisation that addressed the whole range of issues with which bioethics is concerned and that is a legal instrument. Many of the principles affirmed in the Declaration had already been amply absorbed into the discipline of bioethics. All of them can be traced to the dignity and equality of every individual. The most evident novelty is to be found less in the content of the principles than in the balancing of individual and societal perspectives. Also in evidence are several compromises that were adopted in order to promote dialogue and mutual understanding.
It is the JME's 40th anniversary and my 20th anniversary working in the field. I reflect on the nature of bioethics and medical ethics. I argue that both bioethics and medical ethics together have, in many ways, failed as fields. My diagnosis is that better philosophy is needed. I give some examples of the importance of philosophy to bioethics. I focus mostly on the failure of ethics in research and organ transplantation, although I also consider genetic selection, enhancement, cloning, futility, disability and other topics. I do not consider any topic comprehensively or systematically or address the many reasonable objections to my arguments. Rather, I seek to illustrate why philosophical analysis and argument remain as important as ever to progress in bioethics and medical ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Capron, Alexander Morgan
The reasons for offering a course in bioethics to law students and some approaches to take in addressing controversial issues are examined. The use of hypothetical vs. real cases, emphasis on clinical problems, and overall course objectives are discussed. (MSE)
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Robles Morejón, Jeannette Beatriz
Dr. Juan Manuel Burgos proposes ″a challenge″ to whom aims to consolidate the dignity of the human person as the center of a thought structure. Burgos presents a well-founded trilogy, citing Wojtyla, Sgreccia and he himself, as a perfect combination to support personalist bioethics. However, the possibility of giving a solid anthropological support to this bioethics remains open provided that a substantial list of personalistic authors is revised. This research seeks to collate Stein's anthropological proposal to personalist bioethics needs expressed by Burgos. The study aims to prove how Stein's anthropology can be assembled to the characteristics of personalism, and thus infer that more specific levels of the personalist bioethics can be based on this anthropology.
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Singleton, Rivers, Jr.; Brock, D. Heyward
Outlines an interdisciplinary workshop in bioethics for secondary teachers taught by a team consisting of a scientist, a philosopher, and a literary critic. Discusses definitions, topics, reading selections, problems, and value. (DC)
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Cooke, Elizabeth F
Pragmatic bioethics represents a novel approach to the discipline of bioethics, yet has met with criticisms which have beset the discipline of bioethics in the past. In particular, pragmatic bioethics has been criticized for its excessively fuzzy approach to fundamental questions of normativity, which are crucial to a field like bioethics. Normative questions need answers, and consensus is not always enough. The approach here is to apply elements of the discourse ethics of Habermas and Putnam to the sphere of bioethics, in order to develop a normative structure out of the framework of bioethical inquiry as it stands. The idea here is that the process of inquiry contains its own normative structure as it aims to discover norms. Such an approach, which fuses pragmatic bioethics with discourse ethics (which equally draws on pragmatism), may rightly be called a "Pragmatic Discourse Bioethics."
This article analyzes problems and implications for man and nature connected with the formation of a new architecture of science, based on the convergence of nanotechnology, biotechnology, information technology, and cognitive science (NBIC). It also describes evolution and genesis of bioethics, a scientific discipline and social practice with a special role of ethical management of potential risks of scientific research. The aim was to demonstrate the necessity of bioethical social control in the development of a global bioeconomy driven by NBIC technologies.
Full Text Available In their search for answers to the relevant theoretical questions on importing knowledge in practical ethics, the authors take an instrumental approach to metaphor. This figure of language allows one to compare language and linguistic variants to bioethics and knowledge. As defined by the dictionary, an 'idiom' is the official language of a nation, a 'dialect' is a regional variant of an idiom, and an 'idiolect' is an individual variant of a dialect. The bioethical idiom is thus seen as a linguistic set constituting a 'bioethical nation'. Since it is situated above particular dialects, it exercises more than a regulatory role over the discipline. In this article, in order to focus on the process of transmission of knowledge in bioethics, the authors chose Diego Gracia's work as a paradigmatic reference to the question on the transculturation of dialects and the relations in bioethics which are considered 'peripheral' or 'central'. Although this researcher found the key question pointing to the core of the problem of importing dialects, he is still searching for a proper answer to the cultural/bioethical context/contradiction
Full Text Available In their search for answers to the relevant theoretical questions on importing knowledge in practical ethics, the authors take an instrumental approach to metaphor. This figure of language allows one to compare language and linguistic variants to bioethics and knowledge. As defined by the dictionary, an 'idiom' is the official language of a nation, a 'dialect' is a regional variant of an idiom, and an 'idiolect' is an individual variant of a dialect. The bioethical idiom is thus seen as a linguistic set constituting a 'bioethical nation'. Since it is situated above particular dialects, it exercises more than a regulatory role over the discipline. In this article, in order to focus on the process of transmission of knowledge in bioethics, the authors chose Diego Gracia's work as a paradigmatic reference to the question on the transculturation of dialects and the relations in bioethics which are considered 'peripheral' or 'central'. Although this researcher found the key question pointing to the core of the problem of importing dialects, he is still searching for a proper answer to the cultural/bioethical context/contradiction
Koplin, Julian J; Selgelid, Michael J
A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.
A communitarian approach to bioethics adds a core value to a field that is often more concerned with considerations of individual autonomy. Some interpretations of liberalism put the needs of the patient over those of the community; authoritarian communitarianism privileges the needs of society over those of the patient. Responsive communitarianism's main starting point is that we face two conflicting core values, autonomy and the common good, and that neither should be a priori privileged and that we have principles and procedure that can be used to work out this conflict but not to eliminate it. Additionally, it favours changing behaviour mainly through the creation of norms and by drawing on informal social control rather than by coercion.
Murphy, Timothy F
Queer perspectives have typically emerged from sexual minorities as a way of repudiating flawed views of sexuality, mischaracterized relationships, and objectionable social treatment of people with atypical sexuality or gender expression. In this vein, one commentator offers a queer critique of the conceptualization of children in regard to their value for people's identities and relationships. According to this account, children are morally problematic given the values that make them desirable, their displacement of other beings and things entitled to moral protection, not to mention the damaging environmental effects that follow in the wake of population growth. Objectionable views of children are said even to have colonized the view of lesbian, gay, bisexual, and trans (LGBT) people who - with the enthusiastic endorsement of bioethics - increasingly turn to assisted reproductive treatments to have children. In the face of these outcomes, it is better - according to this account - that people reconsider their interest in children. This account is not, however, ultimately strong enough to override people's interest in having children, relative to the benefits they confer and relative to the benefits conferred on children themselves. It is certainly not strong enough to justify differential treatment of LGBT people in matters of assisted reproductive treatments. Environmental threats in the wake of population growth might be managed in ways other than devaluing children as such. Moreover, this account ultimately damages the interests of LGBT people in matters of access, equity, and children, which outcome is paradoxical, given the origins of queer perspectives as efforts to assert and defend the social interests of sexual and gender minorities. © 2017 The Authors. Bioethics Published by John Wiley & Sons Ltd.
Nanoscale science, research, and technology present a complex set of circumstances. First of all, this field involves many different subjects, including biology, chemistry, physics, and environment sciences. Secondly, although scientists are working increasingly at a molecular level, nanotechnology is about much more than a reduction of scale. Indeed, nanoscience and Nanotechnologies offer an unprecedented ability to control and manipulate nature, offering hope for progress. Ethical perspectives vary considerably in this field, but commentators and researchers share a concern about a specific worrisome issue: the lack of appropriate ethical and legal principles and processes (associated with issues including health risks, human body manipulation, and private life violation), to guide nanotechnological R&D, commercialization, and final use. Some authors partially reject this concern by suggesting that Nanoscience and Nanotechnologies do not constitute an autonomous category, and that they are instead just the operative result of combining other traditional areas of study. However the nanotechnological debate brings up the semantic and content issues of bioethics and foments a contentious discussion emphasizing human dignity. Issues include enhancement versus therapeutic intervention, traceability versus privacy, and societal benefits versus risks. From these preliminary considerations, we will move on to discuss (I) the traditional, although still controversial, relationship between bioethics and human dignity, and (II) return to the subject of nanotechnology. We will discuss how today in Europe, although still indefinite, the principle of respect for human dignity is a welcomed contributor to "ethical vigilance" about the uncertain development of new nano-scale technologies. We will also note how U.S. strategy in this regard is simply lacking and appears only as a purely discursive "key issue in long term ".
Schwartz, Jason L
Comparative assessments of national bioethics commissions in the United States commonly look at the differences among these groups over their forty-year history. A particular focus has been differences in the membership, mission, methods, and reports of the President's Council on Bioethics, which was active from 2001 until 2009, compared to those of its predecessors and the recent Presidential Commission for the Study of Bioethical Issues, active from 2009 until 2016. The differences are real, but disproportionate attention to them can obscure the substantial similarities in commissions' structure and function throughout the history of expert bioethics advice to government. As the Trump administration considers what role, if any, a bioethics commission will play in its work, it would be well served to consider how choices regarding the design of such a group and the topics it examines can best facilitate the unique contributions it can make to the government and to the country. © 2017 The Hastings Center.
Snead, O Carter
The following article analyzes the process of conception, elaboration, and adoption of the Universal Declaration of Bioethics and Human Rights, and reflects on the lessons it might hold for public bioethics on the international level. The author was involved in the process at a variety of levels: he provided advice to the IBC on behalf of the President's Council of Bioethics; he served as the U.S. representative to UNESCO's Intergovernmental Bioethics Committee; and led the U.S. Delegation in the multilateral negotiation of Government experts that culminated in the adoption of the declaration in its final form. The author is currently serving a 4-year term as a member of UNESCO's International Bioethics Committee.
s Universal Declaration on Bioethics and Human Rights (UDBHR) was accepted unanimously in 2005 by the world community, consisting of 191 member nations. This means that the declaration is currently the first and only bioethical text to ...
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There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a systematic review, I suggest that complete comprehensiveness may not always be an appropriate goal of a literature review in bioethics, depending on the research question. In some cases, all the relevant ideas may be captured without capturing all the relevant literature. I conclude that systematic reviews in bioethics have an important role to play alongside the traditional broadbrush approach to reviewing literature in bioethics.
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This article is critical of "bioethics" as it is widely understood and taught, noting in particular an emphasis given to philosophical justification, reason and rationality. It is proposed that "balancing" bioethics be achieved by giving greater weight to practice and the aesthetic: Defined in terms of sensory perception, emotion and feeling. Each of those three elements is elaborated as a non-cognitive capacity and, when taken together, comprise aesthetic sensitivity and responsiveness. This is to recognise the aesthetic as a productive element in bioethics as practice. Contributions from the philosophy of art and aesthetics are drawn into the discussion to bring depth to an understanding of "the aesthetic". This approach is buttressed by philosophers - including Foucault and 18th century German philosophers (in particular Kant) - who recognized a link between ethics and aesthetics. The article aims to give substance to a claim that bioethics necessarily comprises a cognitive component, relating to reason, and a non-cognitive component that draws on aesthetic sensibility and relates to practice. A number of advantages of bioethics, understood to explicitly acknowledge the aesthetic, are proffered. Having defined bioethics in conventional terms, there is discussion of the extent to which other approaches to bioethics (including casuistry, virtue ethics, and narrative ethics) recognize aesthetic sensitivity in their practice. It is apparent that they do so to varying extents although not always explicitly. By examining this aspect of applied ethics, the paper aims to draw attention to aesthetic sensitivity and responsiveness as integral to ethical and effective health care. © 2017 John Wiley & Sons Ltd.
Bergman, Edward J
This article describes, analyzes, and advocates for management of clinical healthcare conflict by a process commonly referred to as bioethics mediation. Section I provides a brief introduction to classical mediation outside the realm of clinical healthcare. Section II highlights certain distinguishing characteristics of bioethics mediation. Section III chronicles the history of bioethics mediation and references a number of seminal writings on the subject. Finally, Section IV analyzes barriers that have, thus far, limited the widespread implementation of bioethics mediation.
Striedinger-Meléndez, Martha Patricia
The present article analyzes the problematic of teaching and learning bioethics in the context of higher education, with an emphasis in medicine and aiming towards sustainable development. The objective is to expose that one of the alternatives to get to know bioethics in higher education institutions, is to coach each community bioethically. This means that the educator must be a role model for the students: not only teaching, but, living bioethically. In the beginning, it makes refe...
principles and values, which are the ethical responsibility of the community. Bioethics in the real sense cannot function where there is no culture. Most culture is based on the principles of the. “golden rules” do unto others what you will like them do unto you. This is the basis for bioethics because bioethical judgments.
Chemical and Engineering News, 1974
The functioning of the Kennedy Institute, which aims at dealing with ethical and social questions raised by advances in biosciences and medicine, is described. Three major projects now underway are briefly discussed: a core reference library in bioethics, an Encyclopedia of Bioethics, and a bioethics information retrieval system. (DT)
Eckenwiler, Lisa A; Cohn, Felicia G
... to the State House david orentlicher 74vi contents 7 Democratic Ideals and Bioethics Commissions: The Problem of Expertise in an Egalitarian Society mark g. kuczewski 83 8 The Endarkenment r. alta charo 95 9 Left Bias in Academic Bioethics: Three Dogmas griffin trotter 108 10 Bioethics as Politics: A Critical Reassessment h....
Dos Anjos, Márcio Fabri; Lepargneur, Hubert François
A Christian theology is important to bioethics in Brazil not only because Brazil is a country of strong Christian traditions, but also because of its theological method and because of many practices in their Christian communities. In fact, the interaction within practice and theory is a big point of its methodology. A heritage of a long history of colonialism in South America comes to our times as enormous social inequalities. In such a context, the silent cry of poor people is heard as a question of coherence to the Christian faith and to the neighbor love. Through a constant dialog with human sciences, the method of theology, known as liberation theology, seeks the roots of social inequalities and the alternatives to a movement of spiritual and social liberation. In touch with the modern bioethics, this theology has strongly contributed to understand all the questions of bioethics in the frame of social structures and systems. On the other hand, many actual practices of the Catholic Church in Brazil with popular impact, like its annual Fraternity Campaign, develop social themes and problems that are also big concerns of bioethics. In this article we try to expose some aspects of this dialog, where theology has a well considered contribution to Brazilian bioethics, at the same time his religious discourse is open to interact with a lay discourse.
Full Text Available Development of biopharmaceuticals is a challenging issue in bioethics. Unlike conventional, small molecular weight drugs, biopharmaceuticals are proteins derived from DNA technology and hybrid techniques with complex three dimensional structures. Immunogenicity of biopharmaceuticals should always be tested in clinical settings due to low predictive value of preclinical animal models. However, non-human primates (NHP and transgenic mice could be used to address certain aspects of immunogenicity. Substantial efforts have been made to reduce NHP use in biopharmaceutical drug development, e.g. study design improvements and changes in regulatory policy. In addition, several expert groups are active in this field (e.g. NC3Rs, BioSafe, and Biopharmaceutical Technical Group. Despite that, there is an increasing trend of use of NHP in preclinical safety testing of biopharmaceuticals, especially regarding monoclonal antibodies. Other potential bioethical issues related biopharmaceutical drug development are their cost/effectiveness ratio, clinical safety assessment, production of biosimilars, and comparison of their efficacy with placebo in countries without intention to market. Identification of the human genome has opened many new bioethical issues. Development of biopharmaceuticals is an important bioethical issue for several reasons. It connects all aspects of contemporary bioethics: biomedicine (e.g. clinical trials in vulnerable subjects, animal welfare and the most recent advances in biotechnology. In particular, biopharmaceutical drug development is a challenging issue regarding treatment of rare diseases.
This paper considers the disciplines of literature and history and the contributions each makes to the discourse of bioethics. In each case I note the pedagogic ends that can be enacted though the appropriate use of the each of these disciplines in the sphere of medical education, particularly in the medical ethics classroom.(1) I then explore the contribution that both these disciplines and their respective methodologies can and do bring to the academic field of bioethics. I conclude with a brief consideration of the relations between literature and history with particular attention to the possibilities for a future bioethics informed by history and literature after the empirical turn. © 2010 Blackwell Publishing Ltd.
Wendler, David; Miller, Franklin
A good deal has been written on the ethics of peer review, especially in the scientific and medical literatures. In contrast, we are unaware of any articles on the ethics of peer review in bioethics. Recognising this gap, we evaluate the extant proposals regarding ethical standards for peer review in general and consider how they apply to bioethics. We argue that scholars have an obligation to perform peer review based on the extent to which they personally benefit from the peer review process. We also argue, contrary to existing proposals and guidelines, that it can be appropriate for peer reviewers to benefit in their own scholarship from the manuscripts they review. With respect to bioethics in particular, we endorse double-blind review and suggest several ways in which the peer review process might be improved. PMID:24131903
This paper seeks to respond to some of the recent criticisms directed toward bioethics by offering a contribution to a "critical bioethics". Here this concept is principally defined in terms of the three features of interdisciplinarity, self-reflexivity and the avoidance of uncritical complicity. In a partial reclamation of the ideas of V.R. Potter, it is argued that a critical bioethics requires a meaningful challenge to culture/nature dualism, expressed in bioethics as the distinction between medical ethics and ecological ethics. Such a contesting of the "bio" in bioethics arrests its ethical bracketing of environmental and animal ethics. Taken together, the triadic definition of a critical bioethics offered here provides a potential framework with which to fend off critiques of commercial capture or of being "too close to science" commonly directed toward bioethics.
Full Text Available The The main objective of the present work is selection of ethical issues that should be addressed with first year undergraduate and K-12 students. Since K-12 Sciences’ curriculum, in Portugal, does not include bioethics content in any discipline explicitly, teachers need to make an effort to include it. Some online materials are available to use in high school classes and will be discussed. My proposal combines inquiry learning-teaching methods with the aim of promoting the discussion of bioethics issues in accordance to UNESCO Bioethics Core Curriculum already adopted by twenty universities throughout the world (Darwish 2015. Some of the issues that are addressed are: ecology and environment ethics, infectious diseases and vaccination, water for all, intellectual property, genomes and patents, biotechnological advances (genetic modified organisms and synthesis of genomes, future generations, climate hanges and natural resources, biomedical advances and human rights, authorship and contributions in scientific publications, and biobanks. In conclusion, this study may constitute an example to facilitate the implementation, by K-12 teachers, of active inquiry strategies, using features of science such as values and socio-scientific issues, and focused on the discussion of concrete ethical issues facing humanity. It also constitutes a proposal of integrating Bioethics in undergraduate sciences’ curricula.
In October 2005 the General Conference of UNESCO adopted the Universal Declaration on Bioethics and Human Rights. The aim of this Declaration was to assist in the realization ofprinciples and support the thorough understanding of the consequences of the ethics of scientific and technical progress, especially for youth. In 2008, the Division of Ethics of Science and Technology Sector for Social and Human Sciences of UNESCO worked out an Educational Program (Bioethics Core Curriculum). On November 23, 2010 a Memorandum was signed between UNESCO and the Yerevan State Medical University after M. Heratsi. The Memorandum was aimed to test the Bioethics Core Curriculum of UNESCO. In this article we will analyze the aims and goals of studying the course, as well as disputable shortcomings of the Program, make recommendations for the improvement of the course of bioethics, and highlight the positive aspects of this Educational Program.
The Universal Declaration on Bioethics and Human Rights adopted by the United Nations Educational, Scientific, and Cultural Organisation (UNESCO) on 19 October 2005 is an important step in the search for global minimum standards in biomedical research and clinical practice. As a member of UNESCO International Bioethics Committee, I participated in the drafting of this document. Drawing on this experience, the principal features of the Declaration are outlined, before responding to two general charges that have been levelled at UNESCO's bioethical activities and at this particular document, are outlined. One criticism is to the effect that UNESCO is exceeding its mandate by drafting such bioethical instruments—in particular, the charge is that it is trespassing on a topic that lies in the responsibility of the World Health Organization. The second criticism is that UNESCO's reliance on international human rights norms is inappropriate. PMID:17329385
The Universal Declaration on Bioethics and Human Rights adopted by the United Nations Educational, Scientific, and Cultural Organisation (UNESCO) on 19 October 2005 is an important step in the search for global minimum standards in biomedical research and clinical practice. As a member of UNESCO International Bioethics Committee, I participated in the drafting of this document. Drawing on this experience, the principal features of the Declaration are outlined, before responding to two general charges that have been levelled at UNESCO's bioethical activities and at this particular document, are outlined. One criticism is to the effect that UNESCO is exceeding its mandate by drafting such bioethical instruments--in particular, the charge is that it is trespassing on a topic that lies in the responsibility of the World Health Organization. The second criticism is that UNESCO's reliance on international human rights norms is inappropriate.
Piasecki, Jan; Dirksen, Kevin; Inbadas, Hamilton
Designing bioethics curriculum for international postgraduate students is a challenging task. There are at least two main questions, which have to be resolved in advance: (1) what is a purpose of a particular teaching program and (2) how to respectfully arrange a classroom for students coming from different cultural and professional backgrounds. In our paper we analyze the case of the Erasmus Mundus Master of Bioethics program and provide recommendations for international bioethics education. In our opinion teaching bioethics to postgraduate international students goes beyond curriculum. It means that such a program requires not only well-defined goals, including equipping students with necessary skills and knowledge, but also it should first and foremost facilitate positive group dynamics among students and enables them to engage in dialogue to learn from one another.
...: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... Bioethical Issues (the Bioethics Commission). The meeting will be held from 9:00 a.m. to approximately 5:15 p... attendance limited to space available. The meeting will also be webcast at www.bioethics.gov . Under...
Markowitz, Dina G.; DuPre, Michael J.; Holt, Susan; Chen, Shaw-Ree; Wischnowski, Michael
This article discusses "Family Secrets," a problem-based learning (PBL) curriculum module that focuses on the bioethical implications of genetic testing. In high school biology classrooms throughout New York State, students are using "Family Secrets" to learn about DNA testing; Huntington's disease (HD); and the ethical, legal,…
Ceylan, Özge; Topsakal, Ünsal Umdu
This research was carried out to reveal the bioethical values that special, talented students have about the socioscientific issues that they may encounter in everyday life. Scanning model was used in the research from quantitative research methods. The study's working group is composed of special talented fifth, sixth, seventh, eighth, ninth, and…
Cardona Vélez, Jonathan
The role of ethics in our everyday life responds to the need to understand a decisive reality, especially for us as physicians, a reality that we know as the human person. So, a personalized bioethical approach plays an important role against the accelerated dehumanization that we are experiencing, because every one of our actions has a direct impact on our patients.
Shapiro, Robyn S.
Bioethics--the study of ethical issues in science and medicine--has grown to become a significant academic and service-oriented discipline with its own research centers, conferences, journals, and degree programs. As these issues have moved to the center of public debate, the law has assumed an increasingly important place in the discipline of…
Ellerby, Jonathan H.; McKenzie, John; McKay, Stanley; Gariépy, Gilbert J.; Kaufert, Joseph M.
Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community. PMID:11033715
Willmott, Christopher J. R.; Wellens, Jane
There is growing awareness of the need to equip students to think through the ethical implications of developments in biology. We describe an exercise in which students work in teams to produce websites about current controversial issues within the subject. Participants report a significant improvement in their knowledge of bioethics and…
Gallegos, Tom; Mrgudic, Kate
Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…
The paper highlights the poignancy with which problems and issues surface as the fields of special education and bioethics (the combination of ethics and the life sciences) intersect, and touches upon professionals' responsibility for protection of the persons in their care. (Author/SBH)
Purdy, L M
Feminist criticism of health care and of bioethics has become increasingly rich and sophisticated in the last years of the twentieth century. Nonetheless, this body of work remains quite marginalized. I believe that there are (at least) two reasons for this. First, many people are still confused about feminism. Second, many people are unconvinced that significant sexism still exists and are therefore unreceptive to arguments that it should be remedied if there is no larger benefit. In this essay I argue for a thin, "core" conception of feminism that is easy to understand and difficult to reject. Core feminism would render debate within feminism more fruitful, clear the way for appropriate recognition of differences among women and their circumstances, provide intellectually compelling reasons for current non-feminists to adopt a feminist outlook, and facilitate mutually beneficial cooperation between feminism and other progressive social movements. This conception of feminism also makes it clear that feminism is part of a larger egalitarian moral and political agenda, and adopting it would help bioethics focus on the most urgent moral priorities. In addition, integrating core feminism into bioethics would open a gateway to the more speculative parts of feminist work where a wealth of creative thinking is occurring. Engaging with this feminist work would challenge and strengthen mainstream approaches: it should also motivate mainstream bioethicists to explore other currently marginalized parts of bioethics.
March, B. E.
Discusses various bioethical issues and problems related to animal welfare and animal rights. Areas examined include: Aristotelian views; animal welfare legislation; Darwin and evolutionary theory; animal and human behavior; and vegetarianism. A 14-point universal declaration of the rights of animals is included. (JN)
In recent years legal intervention in bioethical matters has increased notably following various paths: court decisions, parliamentary acts, codes of conduct and solemn declarations (i.e. European Bioethics Convention, 1997, or the UNESCO Genome Declaration, 1997). Body and liberty, as a question of fundamental legal rights, are constitutionalized along two paths. The former is vertical (a text created at central level is open to ratification and domestic implementation to finally become the rule in concrete cases). The latter is, above all, horizontal. It is characterized by the existence at world level of a number of centres and institutions, with the judiciary and judge-made law playing a major role. The most important new rights and freedoms in bioethics have been recognized in this ever-changing and troubled environment. The horizontal way has the great advantage of considering the differences as a resource and not as a limit. In the case law on bioethics a sort of jurisprudential model seems to be at work, that goes some way toward a judge-made law at a universal level. Cases such as Cruzan, Bland and Massimo held the fundamental concept of self-determination with surprising similarity. But we don't know if one of them has influenced the others, always supposing that the judges were aware of them. Today's first duty is to raise the consciousness of judges as to how common their problems are and how often their rulings are similar to each other's.
Full Text Available Bioethics, as a discipline, has developed mainly, but not exclusively, around themes of moral importance for the medical practice, such as abortion and euthanasia, a never ending discussion that has been shaped by social mores and influenced by scientific and technological advance. However, in the past 20 years an important shift has been taking place, one where bioethical issues and their discussion are starting to being driven by the so-called emerging biotechnologies, from cloning to genome sequencing and editing. If Bioethics is concerned with human beings, and their interaction with other living beings and the environment, it makes sense for Biotechnology, by definition the use of living systems or organisms to develop products, to become an important, if not the most important, source of bioethical conflicts in modern era and for future society. As Biotechnology keeps expanding and becomes entangled in everyday life, so does the need for ethical competent biotechnologists, with competencies built not only on ethical principles but also on a realistic grasp of the impact these technologies could have on human society and the world we inhabit.
Garrett, Jeremy R
Many bioethicists view the primary task of bioethics as 'value clarification'. In this article, I argue that the field must embrace two more ambitious agendas that go beyond mere clarification. The first agenda, critique, involves unmasking, interrogating, and challenging the presuppositions that underlie bioethical discourse. These largely unarticulated premises establish the boundaries within which problems can be conceptualized and solutions can be imagined. The function of critique, then, is not merely to clarify these premises but to challenge them and the boundaries they define. The second agenda, integration, involves honoring and unifying what is right in competing values. Integration is the morally ideal response to value conflict, offering the potential for transcending win/lose outcomes. The function of integration, then, is to envision actions or policies that not only resolve conflicts, but that do so by jointly realizing many genuine values in deep and compelling ways. My argument proceeds in stages. After critically examining the role and dominant status of value clarification in bioethical discourse, I describe the nature and value of the two agendas, identify concrete examples of where each has been and could be successful, and explain why a critical integrative bioethics--one that appreciates the joint necessity and symbiotic potential of the two agendas--is crucial to the future of the field. The ultimate goal of all of this is to offer a more compelling vision for how bioethics might conduct itself within the larger intellectual and social world it seeks to understand and serve. © 2014 John Wiley & Sons Ltd.
Abma, Tineke A; Voskes, Yolande; Widdershoven, Guy
In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are tailored to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct (not merely the results) of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. © 2017 John Wiley & Sons Ltd.
Nikulina Marina Alekseevna
The interpretation of social reality is a classical problem of sociology, which solution helps perception and understanding of social phenomena. In the article phenomenological interpretation of bioethical reality is shown. Phenomenological sociology, being one of the perspective directions of development of social knowledge, it is characterized by aspiration to show «artificial», that is designed, nature of bioethical reality, its semantic structure, and thus, to «humanize» bioethical realit...
Hellsten, Sirkku K
This article examines the relationship between philosophy and culture in global bioethics. First, it studies what is meant by the term "global" in global bioethics. Second, the author introduces four different types, or recognizable trends, in philosophical inquiry in bioethics today. The main argument is that, in order to make better sense of the complexity of the ethical questions and challenges we face today across the globe, we need to embrace the universal nature of self-critical and analytical philosophical analysis and argumentation, rather than using seemingly philosophical approaches to give unjustified normative emphasis on different cultural approaches to bioethics.
Miller, Franklin G
Philosophy is a core discipline that has contributed importantly to bioethics. In this essay, the author traces his trajectory from philosophy to bioethics, oriented around the theme of challenging the conventional wisdom. Three topics are discussed to illustrate this theme: the ethics of randomized trials, determination of death and organ transplantation, and pragmatism as a method of bioethics. In addition, the author offers some general reflections on the relationship between philosophy and bioethics. Philosophy recovers itself when it ceases to be a device for dealing with the problems of philosophers and becomes a method, cultivated by philosophers, for dealing with the problems of men.-John Dewey (1917).
Kahn, Peter A
Bioethics in America positions itself as a totalizing discipline, capable of providing guidance to any individual within the boundaries of a health or medical setting. Yet the religiously observant or those driven by spiritual values have not universally accepted decisions made by "secular" bioethics, and as a result, religious bioethical thinkers and adherents have developed frameworks and rich counter-narratives used to fend off encroachment by policies perceived as threatening. This article uses brain death in Jewish law, the case of Jahi McMath, and vaccination refusal to observe how the religious system of ethics is presently excluded from bioethics and its implications.
Bioethics was born not only as an aftermath of medical technological advance but also from underlying philosophical conceptions about man, that determine scientific research. Analyzing occidental ethics, Heidegger showed that animalism was the only human dimension considered and thereby the domain of measurable objectiveness. He postulated that the essence of human existence as being-in-the-world is ethical and revealed through an original consciousness. Unlike moral conscience, original conscience calls to authenticity, to hear his constitutive nihilism as a "Being-referred-to-death". The founding ground of bioethics may be to listen to this primary being-guilty prior to the derived guilts, e.g. faults, deficiencies and shortcomings of specific daily actions.
Figueroa Yáñez, Gonzalo
The jurist's work is to detect the legal guiding principles, analize them and to anticipate what kind of acceptance they will have. The legislator must be prudent if the subject studied is changeable as it happens with the norms applied in Bioethics. This detection process is more delicate if the guiding principles that have to be detected are valid for such an extensive region, as it is Latin America, where the legislation of the different countries that form it would adopt them. The two problems that will be studied here are: a) if it is advisable or not to raise some Bioethic basic principles to the constitutional level. b) which are the main principles that have been adopted by the juridical legislations of Latin America and who, in some way, guide the legal regulation.
Devaiah, Vishwas H
This paper examines the impact of bioethics on patent claims. The increase in research activities involving human biological materials, and the rush to commercialise inventions derived from such biological materials, can at times result in unethical conduct of research. Questions arise as to whether patent law should concern itself with tainted research that has resulted in an invention or whether it should grant patent rights solely on the basis of the technical improvements resulting from such research. This paper highlights the significance of ethical practice in biomedical research, an issue that may influence the decision to grant patents on inventions. It explores the relation between morality, bioethics and patents from the perspective of the objectives of the patent system and current developments in the law on patents. The inclusion of the morality provision in patent law introduces a mechanism through which inventions derived from tainted research can be filtered at an early stage.
Kon, Alexander A.
There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120
Brody, Howard; Macdonald, Arlene
Before asking what U.S. bioethics might learn from a more comprehensive and more nuanced understanding of Islamic religion, history, and culture, a prior question is, how should bioethics think about religion? Two sets of commonly held assumptions impede further progress and insight. The first involves what "religion" means and how one should study it. The second is a prominent philosophical view of the role of religion in a diverse, democratic society. To move beyond these assumptions, it helps to view religion as lived experience as well as a body of doctrine and to see that religious differences and controversies should be welcomed in the public square of a diverse democratic society rather than merely tolerated.
Moreno, Jonathan D
In previous work, I have described the history and ethics of human experiments for national security purposes during he cold war and developed the bioethical issues that will be apparent in the "war on terror". This paper is an attempt to bring these two previous lines of work together under the rubric of the "national security state," a concept familiar to Cold War historians and political scientists. The founding of the national security state was associated with the first articulations of informed consent requirements by national security agencies. My analysis indicates that strengthened consent standards, though conventionally thought to be antithetical crisis, can be seen as an attempt by the postwar national security state to protect itself from critics of expanded governmental power. During the coming years the renewed mission of the national security state in the war on terror should impel students of bioethics to consider its implications for the field.
The aim of this study is to determine the preventive function of bioethics as an independent scientific discipline in terms of predicting the future of mankind, figuring the patterns of potential bioethical problems and other global challenges and dilemmas. Wide diversity of axiological issues, mental representations and principles of world vision, as well as various spiritual, ontological and existential concepts of solution of them, are described as the causes of different approaches to the problem of the future of mankind. In the article, along with theoretical questions, the negative spiritual and moral values, which influence the emergence of global problems of humankind (including the field of Biomedicine), are presented. The reasons of their formation and implementation are depicted, and the ways of their prevention are proposed.
José Roque Junges
Full Text Available The right to health is being more and more affected by the Biopower new configurations, no more only determined by the State, as in Foucault's analyses, but mainly by the symbolic power of the market. The biotechnological enterprises stir up increasing claims for consuming in health. These products are techno-semiotic agencies of the subjectivity in health, rendering their use as a right. In this situation it is important to return to the Right to Health comprehension of the International Conventions and the Alma-Ata Conference, proving the interdependence between Human Rights in general and the Right to Health in particular, mainly aiming at the social determinants of health that define more basic rights. The Human Rights perspective permits the proposal of a public health bioethics, different from the clinical bioethics, more appropriate for considering the collective implications of the right to Health, not reduced to a mere consumption of technologies.
Tomar Romero, Francisca
From the analysis of its epistemological status, the article focuses on the philosophical fundament of bioethics, stressing the need for an authentic anthropology as a reference or starting point. Being an applied ethics, the first fundament of bioethics is in ethics. It shows how only personalistic ethics, which takes as reference the nature or essence of man, can offer objective and universal criteria. Philosophical anthropology studies man as a whole, in an integral manner, from the perspective of its nature or fundamental aspects of his being. It analyzes the distinction and relationship between the philosophical anthropology and the positive anthropologies, as well as with the physical, human and social sciences. Finally, it reflects on the current anthropological crisis and its ethical consequences.
Magalhães, Susana; Araújo, Joana; Carvalho, Ana Sofia
Since the focus of Bioethics is the bridge between Humanities and the Life Sciences and bearing in mind that this bridge is often difficult to build, those who believe that this dialogue is important in our days should promote it through Education. By educating in Bioethics it is possible to improve the participation of the citizens in debates on the ethical issues raised by new technologies and scientific research. It is our conviction that literary texts are laboratories of ethical judgment, where the ethical questions concerning specific scientific/ technological issues are addressed in an imaginary world. Therefore our purpose is to present a framework for ethical deliberation through the use of literature. Fiction allows us to "practise" ethical decision making, by focusing on the particular cases of the characters of the story and by checking how the principles/theories working in the background apply to the narrated cases.
Stripling, Mahala Yates
Many of the bioethical and medical issues challenging society today have been anticipated and addressed in literature ranging from Mary Shelley's Frankenstein, Albert Camus’s The Plague, to Margaret Edson's Wit. The ten works of fiction explored in this book stimulate lively dialogue on topics like bioterrorism, cloning, organ transplants, obesity and heart disease, sexually transmitted diseases, and civil and human rights. This interdisciplinary and multicultural approach introducing literat...
In October, in an unexpected development, U.S. President Bill Clinton created a national ethics advisory board, the National Bioethics Advisory Commission (NBAC, Washington, DC), to study both research ethics and the management and use of genetic information. Of particular interest to biotechnology companies and researchers is the fact that the commission`s brief encompasses issues about human gene patenting, a subject not contained in earlier proposals for the commission.
What is Christian about Christian bioethics? The short answer to this question is that the Incarnation should shape the form and content of Christian bioethics. In explicating this answer it is argued that contemporary medicine is unwittingly embracing and implementing the transhumanist dream of transforming humans into posthumans. Contemporary medicine does not admit that there are any limits in principle to the extent to which it should intervene to improve the quality of human life. This largely inarticulate, yet ambitious, agenda is derived first in late modernity's failed, but nonetheless ongoing, attempt to transform necessity into goodness, and second the loss of any viable concept of eternity, thereby stripping temporal existence of any normative significance. In short, medicine has become the vanguard of a profane attempt to save humankind by extracting data from flesh. In response, it is contended that an alternative Christian bioethics must be shaped by the Incarnation, the Word made flesh. This assertion does not entitle Christians to oppose the posthuman trajectory of contemporary medicine on the basis of any natural or biological essentialism. Rather, it is an evangelical witness to the grace of Christ's redemption instead of the work of self-transformation. It is Christ alone who thereby makes the vulnerability and mortality of finitude a gift and blessing. Specifically, it is maintained that the chasm separating necessity and goodness cannot be filled but only bridged through the suffering entailed in Christ's cross, and through Christ's resurrection eternity becomes the standard against which the temporal lives of human creatures are properly formed and measured. Consequently, Christian bioethics should help us become conformed to Christ rather than enabling self-transformation.
Amzat, Jimoh; Grandi, Giovanni
Personalism is one of the philosophical perspectives which hold that the reality in person and the human person has the highest intrinsic value. This paper makes reference to Louis Janssens' eight criteria in adequate consideration of the human person but further argues that there is need to consider people as situated agents especially within gender relational perspectives. The paper identifies gender as an important social construction that shapes the consideration of the human persons within socio-spatial spheres. The main crux of the paper is that there is a gender context of personalism and this has profound implications for bioethical agendas. Gender is part of the human condition, especially when we philosophically or sociologically engage the notion of equity and equality within the social system, because social realities in the relational perspective are not impartial, impersonal and equal. Gender does not determine morality but it plays a role in morality and expectations from moral agents. Women have been categorised as a sociological group because their integrity, freedom/autonomy and dignity (which are basic concerns of bioethics) are capable of being threatened. A gender perspective provides important incentives for moral theory which searches for possible conceptual imbalances or blind spots in ethical reflections. The paper refers to Sen's faces of gender inequality and expands on the notion that natality inequality is one of the fundamental levels of gender inequality, which in turn is the primary starting agenda in bioethics. The paper avers that the recognition of the fundamental importance of gender to the organization of social reality and the development of personal identities have important practical implications for bioethics. © 2011 Blackwell Publishing Ltd.
Solomons, Noel W
Advances in technology and understanding of fundamental human biology allow for an increasingly innovative research agenda in pediatric nutrition. All human research is governed by the norms of bioethics, which are in turn based on four primary principles: free will in participation, freedom from harm, opportunity to benefit, and non-discrimination in access. Legally, if not essentially, juveniles do not have free will to affirm their participation as research subjects. They have an absolute right, in nontherapeutic research, however, to decline. Pivotal in the discussion in nontherapeutic research in healthy children is the tolerance for risky procedures. Complicated situations include: multi-national protocols, choice of developing country sites, the inclusion of placebo treatment arms, analysis of genetic biomarkers, and research for commercial enterprises. The overly stringent interpretation of bioethical principles, as adapted to children, would stifle innovation in research. A relaxed bioethical attitude in pursuit of advancing science, by contrast, could violate essential human rights and expose a population worthy of special protection to undue risk and harm. By following the course of utility, seeking the steepest benefit-to-risk ratios, weighted toward safety and child welfare, the divergent nature of the considerations should be brought into convergence for the sake of continuing innovation. Copyright © 2010 S. Karger AG, Basel.
The discussions of these past twenty years have significantly improved our knowledge about the foundation of bioethics and the meaning of the four bioethical principles with concern to at least three different points: that they are organised hierarchically, and therefore not "prima facie" of the same level; that they have exceptions, and consequently lack of absolute character; and that they are neither strictly deontological nor purely teleological. The only absolute principle of moral life can be the abstract and unconcrete respect of human beings. But when determining the material content of this respect, principles become contingent and relative. Therefore, moral reasoning must have necessarily no less than three moments, one absolute but merely formal, namely respect for all human beings, and the other two relative and material. The first material moment is comprised of the four bioethical principles, divided into two levels, one private, including the principles of autonomy and beneficence, and the other one public, including those of nonmaleficence and justice. The second material moment deals with specific cases, and requires analysis of their context, including their circumstances and consequences. Only when following these steps, and therefore balancing principlism and contextualism, can moral reasoning be correct and complete.
Many international organizations and countries have adopted the principles of American bioethics as their own principles. However, further analysis of what is going on in the United States shows that what we have come to call principlism is only one expression among many other health care ethics approaches that are found in the U.S. The first section of the text presents American bioethics from the point of view of principlism, the main focus being the creation of this vision, and its meaning. The second section examines, first of all, the critiques that from the beginning have been addressed to this approach; and secondly, other visions developed as much in response to the limits intrinsic to principlism as to the major changes that drive the American health system. In the third section, I will attempt to indicate that the real challenge of American bioethics is not a consequence of the tension existing between principlism and the other approaches, but that it arises in the political domain: the polarization between liberals and conservatives.
This paper begins by acknowledging the interest taken by various international organisations in genetic enhancement and sport, including the US President's Council on Bioethics (July, 2002) and the World Anti-Doping Agency (March, 2002). It is noticed how sporting organisations have been particularly concerned to emphasize the 'threat' of genetics to sport, whereas other institutions have recognised the broader bioethical issues arising from this prospect, which do not readily reject the use of genetic technology in sport. Sports are identified as necessarily 'human' and 'moral' practices, the exploration of which can reveal greater insight into the intuitive fears about genetic modification. It is argued that anti-doping testing measures and sanctions unacceptably persecute the athlete. While there are substantial reasons to be concerned about the use of genetic modification in sport, the desire for policy ought not diminish the need for ethical research; nor ought such research embody the similar guise of traditional 'anti' doping strategies. Rather, the approach to genetics in sport must be informed more by broader social policies in bioethics and recognition of the greater goods arising from genetic technology.
Wendler, David; Miller, Franklin
A good deal has been written on the ethics of peer review, especially in the scientific and medical literatures. In contrast, we are unaware of any articles on the ethics of peer review in bioethics. Recognising this gap, we evaluate the extant proposals regarding ethical standards for peer review in general and consider how they apply to bioethics. We argue that scholars have an obligation to perform peer review based on the extent to which they personally benefit from the peer review process. We also argue, contrary to existing proposals and guidelines, that it can be appropriate for peer reviewers to benefit in their own scholarship from the manuscripts they review. With respect to bioethics in particular, we endorse double-blind review and suggest several ways in which the peer review process might be improved. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Chowning, Jeanne Ting; Griswold, Joan Carlton; Kovarik, Dina N.; Collins, Laura J.
Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001) between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001) in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student motivation and
Chowning, Jeanne Ting; Griswold, Joan Carlton; Kovarik, Dina N; Collins, Laura J
Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001) between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001) in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student motivation and
Jeanne Ting Chowning
Full Text Available Developing a position on a socio-scientific issue and defending it using a well-reasoned justification involves complex cognitive skills that are challenging to both teach and assess. Our work centers on instructional strategies for fostering critical thinking skills in high school students using bioethical case studies, decision-making frameworks, and structured analysis tools to scaffold student argumentation. In this study, we examined the effects of our teacher professional development and curricular materials on the ability of high school students to analyze a bioethical case study and develop a strong position. We focused on student ability to identify an ethical question, consider stakeholders and their values, incorporate relevant scientific facts and content, address ethical principles, and consider the strengths and weaknesses of alternate solutions. 431 students and 12 teachers participated in a research study using teacher cohorts for comparison purposes. The first cohort received professional development and used the curriculum with their students; the second did not receive professional development until after their participation in the study and did not use the curriculum. In order to assess the acquisition of higher-order justification skills, students were asked to analyze a case study and develop a well-reasoned written position. We evaluated statements using a scoring rubric and found highly significant differences (p<0.001 between students exposed to the curriculum strategies and those who were not. Students also showed highly significant gains (p<0.001 in self-reported interest in science content, ability to analyze socio-scientific issues, awareness of ethical issues, ability to listen to and discuss viewpoints different from their own, and understanding of the relationship between science and society. Our results demonstrate that incorporating ethical dilemmas into the classroom is one strategy for increasing student
Macpherson, Cheryl Cox
This paper explores the evolution of the Universal Declaration on Bioethics and Human Rights (UDBHR), which was adopted by the United Nations Educational, Scientific and Cultural Organization (Unesco) in 2005. While the draft UDBHR generated controversy among bioethicists, the process through which it evolved excluded mainstream bioethicists. The absence of peer review affects the declaration's content and significance. This paper critically analyses its content, commenting on the failure to acknowledge socioeconomic and other factors that impede its implementation. The UDBHR outlines ideal standards but fails to provide guidance that can be readily applied in different settings. It strives for universality but does not contribute to understanding of universal or global bioethics.
'Bioethics still has important work to do in helping to secure status equality for LGBT people' writes Timothy F. Murphy in a recent Bioethics editorial. The focus of his piece, however, is much narrower than human rights, medical care for LGBT people, or ending the HIV/AIDS pandemic. Rather, he is primarily concerned with sexuality and gender identity, and the medical intersections thereof (i.e. DSM diagnosis; access to SrS or ARTs). It is the objective of this response to provide an alternate account of bioethics from a Queer perspective. I will situate Queer bioethics within Queer studies, and offer three 'lessons' that bioethics can derive from this perspective. These are not definitive rules for Queer bioethics, since it is a field which fundamentally opposes categorizations, favoring pastiche over principles. These lessons are exploratory examples, which both complement and contradict LGBT bioethics. My latter two lessons - on environmental bioethics and disability - overlap with some of Murphy's concerns, as well as other conceptions of LGBT bioethics. However, the first lesson takes an antithetical stance to Murphy's primary focus by resisting all forms of heteroconformity and disavowing reproduction as consonant with Queer objectives and theory. The first lesson, which doubles as a primer in Queer theory, does heavy philosophical lifting for the remainder of the essay. This response to Timothy F. Murphy, whose work is certainly a legacy in bioethics, reveals the multiplicity of discourses in LGBT/Queer studies, many of which are advantageous - even essential - to other disciplines like bioethics. © 2016 John Wiley & Sons Ltd.
Allen, Anita L; Strand, Nicolle K
Media outlets are reporting that cognitive enhancement is reaching epidemic levels, but evidence is lacking and ethical questions remain. The US Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has examined the issue, and we lay out the commission's findings and their relevance for the scientific community. Published by Elsevier Ltd.
Padela, Aasim I
There is burgeoning interest in the field of "Islamic" bioethics within public and professional circles, and both healthcare practitioners and academic scholars deploy their respective expertise in attempts to cohere a discipline of inquiry that addresses the needs of contemporary bioethics stakeholders while using resources from within the Islamic ethico-legal tradition. This manuscript serves as an introduction to the present thematic issue dedicated to Islamic bioethics. Using the collection of papers as a guide the paper outlines several critical questions that a comprehensive and cohesive Islamic bioethical theory must address: (i) What are the relationships between Islamic law (Sharī'ah), moral theology (uṣūl al-Fiqh), and Islamic bioethics? (ii) What is the relationship between an Islamic bioethics and the lived experiences of Muslims? and (iii) What is the relationship between Islamic bioethics and the state? This manuscript, and the papers in this special collection, provides insight into how Islamic bioethicists and Muslim communities are addressing some of these questions, and aims to spur further dialogue around these overaching questions as Islamic bioethics coalesces into a true field of scholarly and practical inquiry.
In light of the lack of scholarly studies on the determination of quality in bioethics education, this paper aims to elaborate the concept of quality, focus on its understanding in education and explore a definition of quality in bioethics education. The findings of the literature-based research indicate that quality is a multidimensional concept…
Bioethics principles and practice can be influenced by different cultural background. This is because the four globally accepted bioethics principles are often based on basic ethical codes such as autonomy, beneficence, nonmaleficence and justice. Beneficence/nonmaleficence requires us to maximize possible benefits, ...
Hanegan, Nikki L.; Price, Laura; Peterson, Jeremy
This study examines how student practice of scientific argumentation using socioscientific bioethics issues affects both teacher expectations of students' general performance and student confidence in their own work. When teachers use bioethical issues in the classroom students can gain not only biology content knowledge but also important…
Medical ethics is becoming an increasingly integral part of undergraduate medical curricula world-wide. The recent social, educational and political changes in South Africa have emphasised the place of bioethics within the emerging integrated medical curricula in southern Africa. The bioethics programmes that are ...
One way is for African bioethicists to begin to apply indigenous African philosophy, thought and values to ethical issues. This project is important (i) to restore dignity; (ii) because a bioethics grounded in indigenous ideas is more likely to be accepted by Africans; and (iii) because such ideas can enrich bioethical discourse.
This article examines the use of the notions of "Asian" and "East Asian" in definitions of bioethics. Using examples from East Asia, I argue that the verbal Asianization of bioethics is based on the notion of "Asia" as a family metaphor and serves as a platform of bioethical debate, networking, and political change. I maintain that the use of "Asia" and "East Asia" to shape bioethics is not so much a sign of inward-looking regionalism, but an attempt to build bridges among Asian countries, while putting up a common stance against what educated elites interpret as undesirable global trends of Westernization through bioethics. Using the notions of "grouping" and "segmentary systems" to show the performative nature of characterizations of (East) Asian bioethics, allowing users to mark regional identity, share meanings, take political positions, and network. Deploying Peter Haas's notion of "epistemic communities," I argue that academic and political elites translate "home" issues into "Asia speak," while at the same time, introducing and giving shape to "new" bioethical issues. Although the "Asianisms" and group-marking activities of Asian networks of bioethics are ideological, thereby engaging in the politics of in/exclusion, they succeed in putting politically sensitive topics on the agenda.
Bioethics and organisational ethics* are applied ethics disciplines with different objects of investigation. Bioethics focuses on the moral aspects of caring for the health of individuals and populations, and organisational ethics on the moral aspects of organisations' strategies and operations. So these two disciplines converge ...
The need for clarity and analysis of the principles underlying those theories that guide or should guide their decision-making and pastoral care in dealing with bioethical dilemmas was emphasised. The findings highlighted the need for appropriate courses in Bioethics to be taught during initial theological training, as well as ...
Diaz, Jose Luis
Bioethics is concerned with the moral aspects of biology and medicine. The bioethical relevance of aggression and violence is clear, as very different moral and legal responsibilities may apply depending on whether aggression and violence are forms of behaviour that are innate or acquired, deliberate or automatic or not, or understandable and…
Objective: To outline the bioethical challenges specific to rheumatology in resource poor areas. Data source: Published articles and selected personal communications on bioethical challenges and education in rheumatology. Study design: A narrative commentary. Data extraction: Online searches using PubMed and ...
This book, a valuable addition to the slowly increasing bioethical literature on climate change, provides an excellent overview of the ethical dimensions pertinent to climate change. Bioethics, in the main, focuses on individual autonomy and the use of emerging technologies in medical practice and research. Even though ...
...: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... also be webcast at www.bioethics.gov . Under authority of Executive Order 13521, dated November 24... access to the webcast, will be available at www.bioethics.gov . The Commission welcomes input from anyone...
[email protected]bioethics.gov . Additional information may be obtained at http://www.bioethics.gov . SUPPLEMENTARY... will also be webcast at http://www.bioethics.gov . Under authority of Executive Order 13521, dated... information about access to the webcast, will be available at http://www.bioethics.gov . The Commission...
...-233-3960. Email: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics... with attendance limited to space available. The meeting will also be webcast at www.bioethics.gov....bioethics.gov . The Commission welcomes input from anyone wishing to provide public comment on any issue...
[email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... also be webcast at www.bioethics.gov . Under authority of Executive Order 13521, dated November 24... access to the webcast, will be available at www.bioethics.gov . The Commission welcomes input from anyone...
[email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY INFORMATION... will also be webcast at http://www.bioethics.gov . Under authority of Executive Order 13521, dated... available at http://www.bioethics.gov . The Commission welcomes input from anyone wishing to provide public...
...: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... with attendance limited to space available. The meeting will also be webcast at www.bioethics.gov... bioethics, science, medicine, technology, engineering, law, philosophy, theology, or other areas of the...
[email protected]bioethics.gov . Additional information may be obtained at http://www.bioethics.gov . SUPPLEMENTARY... will also be webcast at http://www.bioethics.gov . Under authority of Executive Order 13521, dated....bioethics.gov . The Commission welcomes input from anyone wishing to provide public comment on any issue...
Fascination with In re Quinlan, the first high-profile right-to-die case in the United States, led the author to law school. By the time she received her law degree, bioethics was emerging as a field of study, and law and bioethics became her field. The mission of legal education is to teach students to "think like a lawyer," which can be a productive way to approach issues in many fields, including bioethics. Legal education can also teach individuals to respect people whose views on bioethics issues differ from their own. This essay describes three areas in which legal training influenced the author's work in bioethics: treatment decisions, research misconduct, and stem cell research.
Keskin-Samanci, Nilay; Özer-Keskin, Melike; Arslan, Orhan
This study has led to the development of the "Bioethical Values Inventory" that can be used to reveal secondary school students' ethical values in decisions that they make during ethical debates regarding the application of biological sciences. An original inventory development model was used, consisting of four steps and involving…
Solomon, Mildred Z; Vannier, David; Chowning, Jeanne Ting; Miller, Jacqueline S; Paget, Katherine F
A belief that high school students have the cognitive ability to analyze and assess moral choices and should be encouraged to do so but have rarely been helped to do so was the motivation for developing Exploring Bioethics, a six-module curriculum and teacher guide for grades nine through twelve on ethical issues in the life sciences. A multidisciplinary team of bioethicists, science educators, curriculum designers, scientists, and high school biology teachers worked together on the curriculum under a contract between the National Institutes of Health and Education Development Center, a nonprofit research and development organization with a long history of innovation in science education. At the NIH, the Department of Bioethics within the Clinical Center and the Office of Science Education within the Office of the Director guided the project.Our overarching goal for Exploring Bioethics was to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they could move beyond "gut reactions" to more nuanced positions. © 2016 The Hastings Center.
Pratt, Bridget; Loff, Bebe
Health research has been identified as a vehicle for advancing global justice in health. However, in bioethics, issues of global justice are mainly discussed within an ongoing debate on the conditions under which international clinical research is permissible. As a result, current ethical guidance predominantly links one type of international research (biomedical) to advancing one aspect of health equity (access to new treatments). International guidelines largely fail to connect international research to promoting broader aspects of health equity - namely, healthier social environments and stronger health systems. Bioethical frameworks such as the human development approach do consider how international clinical research is connected to the social determinants of health but, again, do so to address the question of when international clinical research is permissible. It is suggested that the narrow focus of this debate is shaped by high-income countries' economic strategies. The article further argues that the debate's focus obscures a stronger imperative to consider how other types of international research might advance justice in global health. Bioethics should consider the need for non-clinical health research and its contribution to advancing global justice. © 2011 Blackwell Publishing Ltd.
The principle of respect for human dignity plays a crucial role in the emerging global norms relating to bioethics, in particular in the UNESCO Universal Declaration on Bioethics and Human Rights. This instrument, which is a legal, not merely an ethical document, can be regarded as an extension of international human rights law into the field of biomedicine. Although the Declaration does not explicitly define human dignity, it would be a mistake to see the emphasis put on this notion as a mere rhetorical strategy. Rather, the appeal to dignity reflects a real concern about the need to promote respect both for the intrinsic worth of human beings and for the integrity of the human species. But dignity alone cannot solve most of the dilemmas posed by biomedical practice. This is why international biolaw combines, on the one hand, the appeal to human dignity as an overarching principle with, on the other hand, the recourse to human rights, which provide an effective and practical way forward for dealing with bioethical issues at a global level.
Chukwuneke, Fn; Umeora, Ouj; Maduabuchi, Ju; Egbunike, N
Bioethics principles and practice can be influenced by different cultural background. This is because the four globally accepted bioethics principles are often based on basic ethical codes such as autonomy, beneficence, nonmaleficence and justice. Beneficence/nonmaleficence requires us to maximize possible benefits, while minimizing possible harms and consequently secure the well-being of others by refraining from harming them. Autonomy gives individuals the right to self-actualization and decision-making, while justice is concerned with the fair selection and distribution of the burdens and benefits of research among participants. Applications of these principles in cultural settings vary more often from one cultural perspective to the other because of the different understanding and practices of "what is good." The proponents of global ethics may argue that these principles should be universally generalizable and acceptable, but this is not possible because of the existing cultural diversities. In the African set-up, despite the existence of major common cultural practices, there are other norms and practices, which differ from one society to the other within the communities. Therefore, the word "global" bioethics may not be applicable generally in practice except if it can account for the structural dynamics and cultural differences within the complex societies in which we live in. However, the extent to which cultural diversity should be permitted to influence bioethical judgments in Africa, which at present is burdened with many diseases, should be of concern to researchers, ethicist and medical experts taking into considerations the constantly transforming global society. This topic examines the cultural influence on principles and practice of bioethics in Africa.
Teresa Sosa Sánchez
Full Text Available Introduction Family and labor disputes in epileptic patients hinder their quality of life and may become cause of loss of seizure control. The use of the 4 Anglo-Saxon principles of bioethics and the 28 principles of the Universal Declaration on Bioethics and Human Rights are necessary to help manage conflicts and problems that arise in the social environment of epileptic patients. Case report We present the case of a 34-year-old female patient with a degree in Economics, married, and lives in Havana. Two years ago, she suffered head trauma and one year later, she developed late onset lesional epilepsy. The patient wishes to become pregnant again and take on a job promotion. However, these two changes present difficulties and resistances directly related to her health condition. Attending physicians decide to take the case to a bioethics committee. Discussion People with epilepsy encounter difficulties in social insertion and a compromised quality of life. Ethics committees play an important role in clarifying conflicts and dilemmas that arise in medical practice. Renowned professionals, trained in issues of medical ethics and bioethics, should integrate these committees. It is necessary that the professionals in medical ethics committees or committee chairs conduct scientific research in order to better guide healthcare professionals.
Mainetti, J A
De nobis ipsis silemus: About ourselves-we keep silent. If we violate this prudent rule by the least modest of literary exercises-the autobiography-we must be able to say that we do so to bear witness. From my intellectual vocation of physician and philosopher, I have received the Chinese blessing of "living in interesting times." I received two degrees in 1962 and spent thirty years developing a previously unimaginable encounter between medicine and humanism. That which follows tells the story of the development of bioethics in Ibero-America from the perspective of a testifying witness.
Lerner, Barron H; Caplan, Arthur L
Bioethics has become a common course of study in medical schools, other health professional schools, and graduate and undergraduate programs. An analysis of past ethical scandals, as well as the bioethics apparatus that emerged in response to them, is often central to the discussion of bioethical questions. This historical perspective on bioethics is invaluable and demonstrates how, for example, the infamous Tuskegee syphilis study was inherently racist and how other experiments exploited mentally disabled and other disadvantaged persons. However, such instruction can resemble so-called Whig history, in which a supposedly more enlightened mindset is seen as having replaced the "bad old days" of physicians behaving immorally. Bioethical discourse-both in the classroom and in practice-should be accompanied by efforts to historicize but not minimize past ethical transgressions. That is, bioethics needs to emphasize why and how such events occurred rather than merely condemning them with an air of moral superiority. Such instruction can reveal the complicated historical circumstances that led physician-researchers (some of whom were actually quite progressive in their thinking) to embark on projects that seem so unethical in hindsight. Such an approach is not meant to exonerate past transgressions but rather to explain them. In this manner, students and practitioners of bioethics can better appreciate how modern health professionals may be susceptible to the same types of pressures, misguided thinking, and conflicts of interest that sometimes led their predecessors astray.
Striedinger-Meléndez, Martha Patricia
Full Text Available The present article analyzes the problematic of teaching and learning bioethics in the context of higher education, with an emphasis in medicine and aiming towards sustainable development. The objective is to expose that one of the alternatives to get to know bioethics in higher education institutions, is to coach each community bioethically. This means that the educator must be a role model for the students: not only teaching, but, living bioethically. In the beginning, it makes reference to the general aspects of bioethics and sustainable development to explain the evolution of these concepts, its situation in the present and the challenges of the future. Further, it focuses on the methodological strategies in the process of educating bio ethically, directed in leading students of higher education institutions with the purpose of achieving sustainable development. Yet, not achieving it in a traditional manner, since sustainable development also refers to wellbeing. Thus, coaching bioethically, which improves the way society functions. The conclusion is that institutions must give educators and students the tools for problem solving the priorities of humanity, such sustainable development. This can be achieved through bioethics.
Verkerk, Marian A; Lindemann, Hilde
In an age of global capitalism, pandemics, far-flung biobanks, multinational drug trials and telemedicine it is impossible for bioethicists to ignore the global dimensions of their field. However, if they are to do good work on the issues that globalisation requires of them, they need theoretical resources that are up to the task. This paper identifies four distinct understandings of 'globalised' in the bioethics literature: (1) a focus on global issues; (2) an attempt to develop a universal ethical theory that can transcend cultural differences; (3) an awareness of how bioethics itself has expanded, with new centres and journals emerging in nearly every corner of the globe; (4) a concern to avoid cultural imperialism in encounters with other societies. Each of these approaches to globalisation has some merit, as will be shown. The difficulty with them is that the standard theoretical tools on which they rely are not designed for cross-cultural ethical reflection. As a result, they leave important considerations hidden. A set of theoretical resources is proposed to deal with the moral puzzles of globalisation. Abandoning idealised moral theory, a normative framework is developed that is sensitive enough to account for differences without losing the broader context in which ethical issues arise. An empirically nourished, self-reflexive, socially inquisitive, politically critical and inclusive ethics allows bioethicists the flexibility they need to pick up on the morally relevant particulars of this situation here without losing sight of the broader cultural contexts in which it all takes place.
Inhorn, Marcia C; Tremayne, Soraya
Assisted reproductive technologies (ARTs), including in vitro fertilization to overcome infertility, are now widely available across the Middle East. Islamic fatwas emerging from the Sunni Islamic countries have permitted many ARTs, while prohibiting others. However, recent religious rulings emanating from Shia Muslim-dominant Iran have created unique avenues for infertile Muslim couples to obtain donor gametes through third-party reproductive assistance. The opening of Iran to gamete donation has had major impacts in Shia-dominant Lebanon and has led to so-called reproductive tourism of Sunni Muslim couples who are searching for donor gametes across national and international borders. This paper explores the "bioethical aftermath" of donor technologies in the Muslim Middle East. Other unexpected outcomes include new forms of sex selection and fetal "reduction." In general, assisted reproduction in the Muslim world has been a key site for understanding how emerging biomedical technologies are generating new Islamic bioethical discourses and local moral responses, as ARTs are used in novel and unexpected ways.
Tsai, D F-C
This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy-the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius' teachings. However, Confucius' emphasis on the filial piety, family values, the "love of gradation", altruism of people, and the "role specified relation oriented ethics" will inevitably influence the "specification" and application of these bioethical principles and hence tend to grant "beneficence" a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of "first among equals" are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian "doctrine of Mean" (chung-yung) and a balanced "two dimensional personhood" approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing "giving beneficence a priority" or "asserting autonomy must triumph".
Daniel M. Varghese
Full Text Available The secular and theological prominence of the word “person” in bioethics creates ambiguity. This is perceptible in the conclusions of the scholars who asses the cognitive abilities of a human to define whether that human is a person or not. The very ancient philosophical thought ‘a human being is a rational being’ is ingrained in the analysis. This article studies how this methodology is pertinent in the light of Eastern Christian theology. The theological anthropology affirms that each human is the image and likeness of God and hence it prevents to separate a human from the state of ‘personhood’. A human should be considered beyond his / her physical and cognitive abilities and understood as a burgeoning being towards theosis. It affirms that a human has the capability to represent the whole universe and to engage in dialogue with the creator. This approach presents a human as a unique person and calls for a holistic perception pertaining to human beings in bioethics discussion.
Newton, Aquiles von Zuben
Bioethics as a cultural phenomenon is nowadays presented as a paradigmatic locus of reflection, critical analysis, inquiries and debates about ethical problems and moral dilemmas provoked by scientific researches in the field of Biotechnology, with its innovations and applications. Humanity, since the middle of X X Th Century, lives under uncertainty and fear. Bioethics responds to the need of a ethical reflection which follows such inquiries and technological applications. One of the subjects of Bioethics is the biosafety, which deals with biohazards. In this process, there is a privileged place many questions such as technological evaluation, risk management and, in a special way, the precautionary principle. This study focus on these questions
Are we able, today, to take a step closer to bringing together the French speaking world and bioethics by realizing that their association could provide a profound view of the current evolution of our world characterized by what is referred to as globalization? Could we be even more ambitious and register the specificity of the rapport between the French speaking world and bioethics confronted with this global phenomenon of deconstruction/reconstruction of the planetary order by setting as its path a dynamic balance, which is an integral part of the use of the French language and cultural diversity, a central point in a truly pluridisciplinary and pluralist bioethics?
The Holocaust arose, in part, because of a profound and pervasive breakdown of medical professional ethics. This history is complex and powerfully instructive. The value judgments and moral actions of the Nazi doctors can inform current debate and practices and also prevent the use of inaccurate analogies in current bioethical debates. Under the auspices of the International Center for Health, Law and Ethics at Haifa University, we are in the process of publishing a casebook on bioethical topics, using personal cases from the Third Reich and the Holocaust. The casebook will provide a platform for deep reflection and discourse on historical ethical issues and their relevance for today. This teaching tool can also inspire healthcare professionals and students to practice with greater compassion, knowledge, tolerance, respect and justice on behalf of their patients.
Fayemi, Ademola K
It is nearly two decades now since the publication of Godfrey Tangwa's article, 'Bioethics: African Perspective', without a critical review. His article is important because sequel to its publication in Bioethics, the idea of 'African bioethics' started gaining some attention in the international bioethics literature. This paper breaks this relative silence by critically examining Tangwa's claim on the existence of African bioethics. Employing conceptual and critical methods, this paper argues that Tangwa's account of African bioethics has some conceptual, methodic and substantive difficulties, which altogether do not justify the idea of African bioethics, at least for now. Contra Tangwa, this article establishes that while African bioethics remains a future possibility, it is more cogent that current efforts in the name of 'African bioethics' be primarily re-intensified towards 'Healthcare ethics in Africa'. © 2015 John Wiley & Sons Ltd.
Bórquez Polloni, B
Contrary to what one may think health and equity are not issues that have always gone hand in hand following the formal recognition of the former by the Universal Declaration of Human Rights (1948). It was not until the Alma Ata Declaration in 1978 when the close ties between both began to be seriously considered, and in 2000 this led to several international organizations formalizing their concern for the factors that determine whether a health system is fair or not. Since then, the term «equity in health» has taken on a special meaning when weighing up the strength or weaknesses of certain health systems. However, over the years, equity in health has gradually been identified almost exclusively with a financial issue that focuses on distributing health resources. As a result, one often forgets to provide the necessary care for those in other unfair situations, which, as regards access to and providing health care, leads to unfair situations that are not directly related to financial reasons and do not require investments, but consensus and the honest determination to make changes. This leads the Bioethics of the 21st century to face two challenges: to warn of these inequities and to promote initiatives that are able to make effective changes. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
Schramm, Fermin Roland
Bioethics of protection (BP) was proposed in the early 21st century in bioethics, built in Latin America following attempts by researchers to work on the possibilities of public health policies being morally legitimate, socially fair (equitable) and respectful of human rights, after noting the limits of traditional bioethical tools, essentially implemented in and restricted to interpersonal conflicts between moral agents and patients involved in the practice of biomedicine. Methodologically, BP tries to negotiate distinct problematic disciplinary realms that are, however, interlinked through interdisciplinary dialogue and common concern with the quality of life of the human population, considered in its natural, technological, social and cultural contexts: Public Health, concerned with the health and well-being of individuals and populations; Bioethics, concerned primarily with the moral legitimacy of practices that affect their quality of life; Biopolitics, concerned with the social effects of health policies.
College and University, 1985
Examples are given of points hospitals must consider when adopting and implementing infant bioethics committees, including committee functions (educational, policy development, and consultative), structure, membership, jurisdiction, recordkeeping, and legal issues. (MSE)
South African Journal of Bioethics and Law. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 2 (2015) >. Log in or Register to get access to full text downloads.
South African Journal of Bioethics and Law. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 10, No 1 (2017) >. Log in or Register to get access to full text downloads.
T. N. Ketova
Full Text Available This article uncovers humanistic substance of bioethics - a discipline which originated in 1960's. Bioethics has an interdisciplinary character and presents itself as a reflection on problematic situations, which can appear as a result of biomedical progress. Bioethics in a wider sense can be viewed as ethics of life, which highlights its ecological substance. This article analyses the problem of consequences of radical human transformation and also the article shows significance of leading principle of «personal autonomy of the patient». In the article functions and goals of ethical committees, existing in various countries, are highlighted. In conclusion, the article highlights specifics of bioethics as a syncretic discipline, which assists development of humanism and responds to modern civilization's challenges.
This essay contrasts the notions of charity employed by Traditional Christianity and by liberal cosmopolitan bioethics, arguing that: (1) bioethics attempts to reconstruct the notion of charity in a manner that is caustic to the Traditional Christian moral vision, (2) Christians are, on the whole, more charitable than proponents of bioethics' reconstructed view (even given the standards of the latter), and (3) the theistically oriented conception of charity employed by Traditional Christianity cannot be expressed in bioethics' purportedly neutral public vocabulary. The upshot is that, in the name of neutrality and pluralism, liberal cosmopolitan bioethicists seek to impose an impoverished moral vocabulary that reflects liberal cosmopolitan ideology while excluding input from Traditional Christianity and other non-liberal-humanistic moral visions.
Zhanna V. Chashina
Full Text Available Introduction: the article discusses significance of use of new technologies in the learning process for realisation of goals of cognitive and affective domain of knowledge. The paper explores the methods of development of educational knowledge, which is achieved by information, reproductive and research means. Based on example of bioethics the paper demonstrates the use of visuals technology (charts, graphs, tables, illustrations, specification, etc., which performs the following tasks: memorising, analysis and synthesis, comparison and differentiation, categorisation and classification, identification of relationships between facts, and for the revision of the material studied, acquisition of the new knowledge, memo risation of educational material. Materials and Methods: on the basis of the dialectical approach the object of research is new technologies in the learning process, in particular the study of bioethics. By using methods of observation, survey, analysis and synthesis in the educational process the authors prove the efficiency of such technologies as the use of visualisation (diagrams, illustrations, problem-based learning (issues, tasks and situations and research tasks (case study method. Results: visual method complements the learning process. It allows a deeper understanding of the subject. This method deals with feelings, emotions and consciousness of students. It encourages creativity. In addition this method of material presentation allows reducing the amount of material of an ordinary lecture. It is underscored that in the study of bioethics it is recommended to use a technology of a problem-based learning, which is able to implement the intellectual activity of students by means of questions¸ case-studies, tasks and situations. The most vivid form of such technology is a case method. The basis for the emergence of technology of problembased learning is a certain contradiction between knowledge and practice. This method can
Turina, Iva Sorta-Bilajac; Brkljacić, Morana; Grgas-Bile, Cecilija; Gajski, Domagoj; Racz, Aleksandar; Cengić, Tomislav
In the context of modern scientific and technological developments in biomedicine and health care, and the potential consequences of their application on humans and the environment, Potter's global bioethics concept resurfaces. By actualizing Potter's original thoughts on individual bioethical issues, the universality of two of his books, which today represent the backbone of the world bioethical literature, "Bioethics--Bridge to the Future" and "Global Bioethics: Building on the Leopold Legacy", is emphasized. Potter's global bioethics today can legitimately be viewed as a bridge between clinical personalized ethics on the one hand and ethics of public health on the other.
This essay is devoted to the problem of theological discourse in bioethics. We focus both on general positions shared across major existing religions and substantial confessional differences among them. Among the major categories determining relationship between bioethics and religion we studied the following: “image of God” (imago Dei), casuistry, primacy of procreation, “playing God”, artificial procreation and others. After analyzing Christian, Jewish and Islamic positions on the theologic...
This study explains the appearance of a new ethical branch and practice called Bioethics, which task is life defense and development of human appearances and functions. In compliance with Bioethics, the concept of Special needs Education and Rehabilitation as a science and activity is investigated.Special needs Education and Rehabilitation is considered as a top of contemporary human ethics. The paper exposes the basic meanings professional ethics in Special Education and Rehabilitation. Many...
Piekarewicz Sigal, Mina
Bioethics in Latin America is strongly influenced by religious beliefs, leading to the most restrictive regulation globally of sexual and reproductive health and, most particularly, of abortion. Legal obstacles donot dissuade women from terminating unwanted pregnancies; each year more than 4 million illegal abortions take place, in which the poorest Latin American women risk their health and lives. This text employs the term bioethics within the meaning given to it by its creator, V. R. Potte...
Jafarey, Aamir M
The success of degree-level bioethics programmes, a recent development across the world, is generally evaluated on the basis of their quantifiable impact; for instance, the number of publications graduates produce. The author conducted a study of Pakistani graduates who had pursued a higher qualification in bioethics, and on the basis of the respondents' written and verbal narratives, this paper presents an analysis of their perceptions of the internal impact of bioethics degree programmes. Using these narratives, the paper also analyses the reactions of their colleagues to their new qualification.The respondents reported significant changes in their thinking and actions following their education in bioethics. They exhibited more empathy towards their patients and research subjects, and became better "listeners~ They also reported changes in practices,the most significant being the discontinuation of the linkages they had established with pharmaceutical firms to seek support,because of concerns related to conflict of interest. Although some respondents believed that their new qualification was generally welcomed by their colleagues, who considered them aesthetics resources, others reported that their colleagues harboured unreasonable and impractical expectations from them, and that these were impossible to fulfil. They also got the feeling of being ostracized and regarded as "ethics watchdogs~ Whereas the internalisation of bioethics is an encouraging finding in this cohort, the mixed reception that bioethics and those involved in it received indicates a Jack of understanding of the field and is a source of concern.
De Melo-Martín, Inmaculada
In a recent article, Alasdair Cochrane argues for the need to have an undignified bioethics. His is not, of course, a call to transform bioethics into an inelegant, pathetic discipline, or one failing to meet appropriate disciplinary standards. His is a call to simply eliminate the concept of human dignity from bioethical discourse. Here I argue that he fails to make his case. I first show that several of the flaws that Cochrane identifies are not flaws of the conceptions of dignity he discusses but rather flaws of his, often problematic, understanding of such conceptions. Second, I argue that Cochrane's case against the concept of human dignity goes too far. I thus show that were one to agree that these are indeed flaws that require that we discard our ethical concepts, then following Cochrane's recommendations would commit us not only to an undignified bioethics, i.e. a bioethics without dignity, but to a bioethics without much ethics at all. © 2010 Blackwell Publishing Ltd.
Carvalho, Fatima Lampreia
This article presents an overview of the Portuguese transposition of the European Directive on Good Clinical Practice (2001/20/E) concerning scientific and academic debates on bioethics and clinical investigation. Since the Directive was transposed into Portuguese law by its National Assembly, the bureaucracy of clinical trials has been ever more complex. Despite demands for swift application processes by the Pharmaceutical industry, supported by the European Parliament, the Directive's transcription to the national law has not always delivered the expected outcome. However, this has led to an increased number of applications for clinical trials in Portuguese hospitals. In this article I revise bioethical publications and decree-laws enabling an informed appraisal of the anxieties and prospects for the implementation of the clinical trials Directive in Portugal. This article also places the European Directive in the field of sociology of bioethics, arguing that Portuguese bioethical institutions differ from those of the US, and also from Northern European counterparts. The main divergence is that those people in Portugal who claim expertise in 'legal' bioethics do not dominate either the bureaucratic structure of research or ethics committees for health. Even experts in the applied ethics field now claim that 'professional bioethicists do not exist'. The recent creation of a national Ethics Committee for Clinical Investigation (CEIC) in line with the European Directive on Good Clinical Practice (GCP) will not change the present imbalance between different professional jurisdictions in the national bioethical debate in Portugal.
González-de Paz, L
The clinical decision making process with ethical implications in the area of primary healthcare differs from other healthcare areas. From the ethical perspective it is important to include these issues in the decision making model. This dissertation explains the need for a process of bioethical deliberation for Primary Healthcare, as well as proposing a method for doing so. The decision process method, adapted to this healthcare area, is flexible and requires a more participative Healthcare System. This proposal involves professionals and the patient population equally, is intended to facilitate the acquisition of responsibility for personal and community health. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Marcolino, José Alvaro Marques; Cohen, Claudio
The authors make a study about the correlation between bioethics and medical psychology. They divide the study in two parts. The first part they discuss the philosophical concepts about the distinction between morals and ethics, they deal with ethics applied to medicine and they are trying to define what is meant by subject and describe its three basic principles: autonomy, beneficence, non maleficence and justice. Consequently in this part they trace route that started from ethics in its philosophical origins and moved on to ethics in its application to medicine. The second part is dedicated to the definition of the field of study of medical psychology, they study some aspects of the emotional relation of the patient with his illness, the relation of the doctors of his medicine and the relationship between doctor and his patient. They discussed some clinical issues where they observe this correlation. At last, they try to draw some conclusions.
... expert panel composed of not more than 13 members, who will be drawn from fields of bioethics, science.... The Commission has been established to replace the President's Council on Bioethics. The Council was...
Bioethical courses were introduced in the curricula in medical universities in Bulgaria in 1990s. In the beginning, the courses were mainly theoretical, and systematic case analyses and discussions of movies were introduced later on. The benefits of using films to teach ethics have been previously analyzed in the literature; however, to our knowledge such studies in Bulgaria are yet lacking. The aim of this study was to survey the opinions of students and analyze the results from the application of movies in bioethics teaching in a medical university in the north of Bulgaria. A survey was carried out among 92 students in the management of healthcare. Two movies were used, and separate protocols for film discussion were developed. The study was conducted anonymously and with students' free informed consent. The students distinguished in total 21 different dilemmas and concepts in the first movie. The ethical dilemmas were classified into five groups: general ethical issues, deontological issues, special ethical issues, principles of bioethics, and theories of ethics. The second movie focused students' attention on the issues of death and dying. In total, 18 elements of palliative care were described by the students. The range of different categories was a positive indicator of an increased ethical sensitivity. The students evaluated the movies' discussions as a generally positive educational approach. They perceived the experience as contributing to their better understanding of bioethical issues. The innovative approach was well accepted by the students. The introduction of movies in the courses of bioethics had the potential to provide vivid illustrations of bioethical issues and to contribute to the exploration of specific theses and arguments. The presentation and discussion should be preceded by accumulation of theoretical knowledge. The future of effective bioethics education lays in the interactive involvement of students. © The Author(s) 2014.
..., DC 20005. Telephone: 202-233-3960. E-mail: [email protected]bioethics.gov . Additional information may be obtained at http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: Pursuant to the Federal Advisory... attendance limited to space available. The meeting will also be webcast at http://www.bioethics.gov . Under...
Pearce, Roger S.
The article describes a compulsory bioethics module delivered to [approximately] 120 biology students in their final year. The main intended learning outcome is that students should be able to analyse and reason about bioethical issues. Interactive lectures explain and illustrate bioethics. Underlying principles and example issues are used to…
.... Telephone: 202/233-3960. E-mail: [email protected]bioethics.gov . Additional information may be obtained by viewing the Web site: http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: Pursuant to the Federal Advisory..., including information about access to the Web cast, will be available at http://www.bioethics.gov . The...
..., 2013. At this meeting, the Bioethics Commission will continue to discuss the ethical implications of incidental findings. The Bioethics Commission will also discuss the BRAIN Initiative and ongoing work in.... Telephone: 202-233-3960. Email: [email protected]bioethics.gov . Additional information may be obtained at www...
...., Suite C-100, Washington, DC 20005. Telephone: 202/233-3960. E-mail: [email protected]bioethics.gov . Web site: http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: The meeting agenda will be posted at http://www.bioethics.gov . The Commission encourages public comment, either in person or in writing. Interested members...
de Oliveira, Aline Albuquerque S
This article aims to explore the increasing interconnection between bioethics and human rights that can be observed in recent international norms relating to biomedicine. To this end, the analysis has been focused on the Universal Declaration on Bioethics and Human Rights (UDBHR) adopted by UNESCO in 2005. Investigating the meanings of the intersection perceived in the UDBHR has led to the understanding of how bioethics and human rights are in accordance, under the normative perspective. Hence, in normative terms, the intersection between bioethics and human rights is clearly undisputable. However, there is no way to affirm that it is consolidated, as UDBHR's adoption is recent and its consolidation, together with its precepts, depends on state and non-state agents. The efficacy of a norm and its content depends on social, cultural and economic conditions, that is, it depends on a series of factors that influence the normative system. In the case of the UDBHR, its effective application and assimilation of its principles are directly linked to the use that bioethical institutions make of them and to how the community of bioethicists will project them in their thoughts and theory production. If, on the one hand UDBHR symbolizes the intersection confirmation--which is of extreme importance for its consolidation--on the other hand its range and consequent stabilization are submitted to the actions from governments, social institutions and bioethicists. Hence, there is still a lot to do in terms of introducing the human rights precepts into bioethics. The aim of this paper is to contribute to this goal. Thus based on the meanings of the intersection between bioethics and human rights identified in the UDBHR, this article presents five ways to understand the connection between these two fields.
Gefenas, Eugenijus; Lukaseviciene, Vilma
During the last two decades, national bioethics committees have been established in many countries all over the world. They vary with respect to their structure, composition, and working methods, but the main functions are similar. They are supposed to facilitate public debate on controversial bioethical issues and produce opinions and recommendations that can help inform the public and policy-makers. The dialogue among national bioethics committees is also increasingly important in the globalized world, where biomedical technologies raise ethical dilemmas that traverse national borders. It is not surprising, therefore, that the committees are established and active in the technologically advanced countries. There have also been a few international capacity-building initiatives in bioethics that have had a dual task: networking among existing national bioethics committees and helping establish such committees in those countries that still lack them. The problem is that, due to a lack of information, it is not clear what problems and challenges committees face in the transitioning societies often characterized as low- and middle-income countries. © 2017 The Hastings Center.
Distinguishing within "sin" the dimensions of anomia, hamartia, and asthenia makes it possible to analyze in greater detail the contrary manners in which traditional and post-traditional Christianities in this issue of Christian Bioethics endeavor to recapture what was lost when secular bioethics reconstructed the specifically spiritual-context-oriented normative commitments of Christianity in one-dimensionally moral terms. Various post-traditional attempts at securing moral orientation and resources for forgiveness, both of which secular bioethics finds increasingly difficult to provide, are critically reviewed. Their engagement of secular moral concepts and concerns, and even their adoption of an academically philosophical posture and language, is presented as responsible for their failure to adequately preserve what in traditional Christianity would count as prohibited vs. permitted, and advisable vs. non-advisable, or what would allow to resolve "tragic conflicts." The deeper reason for this failure lies in post-traditional Christianity's restricting the Christian life (with its central tension between love and the law) to what can be captured by cognitive categories. As the survey of several traditionally Christian accounts of sin in bioethics makes clear, both moral orientation (along with the resolution of "tragic" conflicts) and the sources of forgiveness are available, once that Christian life is framed in terms of persons' spirit-supported practical involvement in ascesis and liturgy, and once bioethical reflections are situated in the experiential context of such involvement.
Goldhagen, Jeffrey; Mercer, Raul; Webb, Elspeth; Nathawad, Rita; Shenoda, Sherry; Lansdown, Gerison
This article offers a child rights theory in pediatric bioethics, applying the principles, standards, and norms of child rights, health equity, and social justice to medical and ethical decision-making. We argue that a child rights theory in pediatric bioethics will help pediatricians and pediatric bioethicists analyze and address the complex interplay of biomedical and social determinants of child health. These core principles, standards and norms, grounded in the U.N. Convention on the Rights of the Child (CRC), provide the foundational elements for the theory and a means for better understanding the complex determinants of children's health and well-being. Rights-based approaches to medical and ethical decision-making provide strategies for applying and translating these elements into the practice of pediatrics and pediatric bioethics by establishing a coherent, consistent, and contextual theory that is relevant to contemporary practice. The proposed child rights theory extends evolving perspectives on the relationship between human rights and bioethics to both child rights and pediatric bioethics.
Chauncey D. Leake (1896-1978) occupies a unique place in the history of American bioethics. A pharmacologist, he was largely an autodidact in both history and philosophy, and believed that ethics should ideally be taught to medical students by those with philosophical training. After pioneering work on medical ethics during the 1920s, he helped to lay the groundwork for important centers for bioethics and medical humanities at two institutions where he worked, the University of California-San Francisco and the University of Texas Medical Branch-Galveston. Understanding Leake's role in American bioethics requires navigating a number of paradoxes--why he was described respectfully in his time but largely forgotten today; how in the 1920s he could write forward-looking pieces that anticipated many of the themes taken up by bioethics a half-century later, yet played largely a reactionary role when the new bioethics actually arrived; and why he advocated turning to philosophy and philosophers for a proper understanding of ethics, yet appeared often to misunderstand philosophical ethics.
In this paper I intend to put forward some criticism of the purely procedural model of bioethics, which, in fact, leads to delegating to biopolitics and biolaw the finding of a purely pragmatic solution to the issues for which bioethics was "invented" over forty years ago. This delegating takes place after the transition from the thesis, dear to modernity, whereby in ethics reasoning should avoid any discussion regarding its foundation or ultimate justification (Etsi Deus non daretur) to the contemporary affirmation of a substantial ethical agnosticism, which, in the name of the incommensurability of morals, should construct procedures as if no sole substantial moral were possible (Etsi ethos non daretur) and act as a guarantor of ethical pluralism. These theses will be discussed and an attempt will be made to demonstrate why it is necessary to establish a link between true and good, and how this is possible only by referring to ontology. The conclusion points to the need to propose bioethics explicitly in terms of content that satisfies the presumed axiological neutrality of procedural bioethics, which however, turns out to be theoretically weak and practically unable to protect the ethical pluralism for which it would like to be the guarantor. The conclusion is that only by referring to ontology can bioethics, which is a fully fledged form of moral philosophy, act as a guarantor of pluralism within the truth and oppose the authoritarian tendencies concealed under the liberal guise of ethical agnosticism.
Now, in the beginning of the 21st century, bioethics must be urgently globalized into a Global Bioethics which combines the ongoing Bioethics based on the modern European humanism with the newly arising Environmental Ethics based on the rather communitarian (or Asian) ways of thinking. This does not always mean that the new global bioethics is necessarily universalistic, for we should stand on the recognition of the wide spread variety of value systems in the world, north and south, east and west. However, it is not particularistic either, for in order to establish a post-modern global ethics, we have to accept and harmonize every kind of antagonistic values on the Globe. For this purpose we have to cultivate a new social technology of tuning social disorder of not only international but also inter-ethnic and inter-cultural level of ideology beyond the modern European humanism. Here the concept of "human rights" or the concept of "human dignity" may lose its significance as it has held in the past bioethical thinking in the western world.
Engelhardt, H Tristram
In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism.
This paper shows how critical realism can be used to integrate empirical data and philosophical analysis within 'empirical bioethics'. The term empirical bioethics, whilst appearing oxymoronic, simply refers to an interdisciplinary approach to the resolution of practical ethical issues within the biological and life sciences, integrating social scientific, empirical data with philosophical analysis. It seeks to achieve a balanced form of ethical deliberation that is both logically rigorous and sensitive to context, to generate normative conclusions that are practically applicable to the problem, challenge, or dilemma. Since it incorporates both philosophical and social scientific components, empirical bioethics is a field that is consistent with the use of critical realism as a research methodology. The integration of philosophical and social scientific approaches to ethics has been beset with difficulties, not least because of the irreducibly normative, rather than descriptive, nature of ethical analysis and the contested relation between fact and value. However, given that facts about states of affairs inform potential courses of action and their consequences, there is a need to overcome these difficulties and successfully integrate data with theory. Previous approaches have been formulated to overcome obstacles in combining philosophical and social scientific perspectives in bioethical analysis; however each has shortcomings. As a mature interdisciplinary approach critical realism is well suited to empirical bioethics, although it has hitherto not been widely used. Here I show how it can be applied to this kind of research and explain how it represents an improvement on previous approaches.
The author attempts to give a general picture of corruption, especially in the area of healthcare. Corruption ranges from fraud, through deceit, bribery and dehumanisation, to immeasurable moral decay. As a bioethicist who has challenged corruption in various ways, the author approaches this worldwide plague mainly on the basis of his personal experience. He does not offer a recipe for successfully combating corruption, but tries to provide some ways and means to fight immorality without self-defeat. Bioethics is not a discipline whose task is to investigate, expose, or punish corrupt people. A number of agencies exist for this "noble" job. Nevertheless, an ethics teacher should not be completely indifferent to obvious and harmful immoral behaviour, regardless of his/her personal compulsions. It is not the "patient rights" that threaten the prestige of the medical profession; it is rather the bad apples that infiltrate the moral mission of this esteemed work. It seems that the hardest challenges in the struggle against corruption are bad laws-laws that provide loopholes and immunity to immoral dealings. In a stable, strong democracy, morally unfounded laws can, and will be changed. Where real democracy exists, they would not even have come into effect.
Smith, William R
Several prominent writers including Norman Daniels, James Sabin, Amy Gutmann, Dennis Thompson and Leonard Fleck advance a view of legitimacy according to which, roughly, policies are legitimate if and only if they result from democratic deliberation, which employs only public reasons that are publicised to stakeholders. Yet, the process described by this view contrasts with the actual processes involved in creating the Affordable Care Act (ACA) and in attempting to pass the Health Securities Act (HSA). Since the ACA seems to be legitimate, as the HSA would have been had it passed, there seem to be counterexamples to this view. In this essay, I clarify the concept of legitimacy as employed in bioethics discourse. I then use that clarification to develop these examples into a criticism of the orthodox view-that it implies that legitimacy requires counterintuitively large sacrifices of justice in cases where important advancement of healthcare rights depends on violations of publicity. Finally, I reply to three responses to this challenge: (1) that some revision to the orthodox view salvages its core commitments, (2) that its views of publicity and substantive considerations do not have the implications that I claim and (3) that arguments for it are strong enough to support even counterintuitive results. My arguments suggest a greater role for substantive considerations than the orthodox view allows. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
The adoption of guidelines in clinical practice raises questions that can be answered against a background in which professional conduct is compared with deontology, law, and the specific sociocultural context and health policies of institutions. In the scientific community, doubts are raised regarding the relationships between the general recommendations laid down in the Guidelines and the specific nature of every clinical condition; between the "duty of adhering" to Guidelines and the doctor's autonomy, as well as between the adoption, discrepancy and non-adoption of Guidelines and the juridical evaluation of medical liability. The information and individual consent of patients and citizens is of particular importance both with regard to clinical procedures and choices of allocation. In the light of these comments, the authors conclude that Guidelines should not be reduced to a form of automated procedure lacking any responsibility, but should represent a correct synthesis between the objective nature of scientific findings, the subjective condition of the patient and the doctor's autonomy. The application of correctly formulated Guidelines shared by the community means acting in such a way that the "right to health" and "freedom of treatment" can be exercised in respect of shared bioethical principles based on beneficence, autonomy and justice.
Ventura-Juncá, Patricio; Erices, Alejandro; Santos, Manuel J
Stem cells have drawn extraordinary attention from scientists and the general public due to their potential to generate effective therapies for incurable diseases. At the same time, the production of embryonic stem cells involves a serious ethical issue concerning the destruction of human embryos. Although adult stem cells and induced pluripotential cells do not pose this ethical objection, there are other bioethical challenges common to all types of stem cells related particularly to the clinical use of stem cells. Their clinical use should be based on clinical trials, and in special situations, medical innovation, both of which have particular ethical dimensions. The media has raised unfounded expectations in patients and the public about the real clinical benefits of stem cells. At the same time, the number of unregulated clinics is increasing around the world, making direct offers through Internet of unproven stem cell therapies that attract desperate patients that have not found solutions in standard medicine. This is what is called stem cells tourism. This article reviews this situation, its consequences and the need for international cooperation to establish effective regulations to prevent the exploitation of patients and to endanger the prestige of legitimate stem cell research.
Eduardo Rafael Medina Márquez
Full Text Available Introduction: Dentistry has been presenting the changes that involve not only the discipline, but also the decision–making at both the professional–patient relationship and research processes. Given these new challenges, the bioethics foundation (theory and practice plays a major role and promotes integral formation. Objective: To identify the knowledge possessed by the graduate students of the Faculty of Dentistry at the University of Cartagena about principles and foundations of bioethics, and ethics of health research. Material and methods: quantitative empirical–analytical study. 46 students from different specializations of dentistry were surveyed. Results: the category “Research ethics in health” had the highest percentage of correct answers (53% pediatric dentistry students had the highest percentage of correct answers (49%, the performance of female participants was better. Discussion and conclusions: It is important for dental schools to emphasis on the disciplinary area and development of clinical skills, but also in your foundations bioethics. The actuals societies require health professionals who know their discipline, quality and excellence ethics, human and critical thinking.
Hostiuc, Sorin; Moldoveanu, Alin; Dascălu, Maria-Iuliana; Unnthorsson, Runar; Jóhannesson, Ómar I; Marcus, Ioan
Translational research tries to apply findings from basic science to enhance human health and well-being. Many phases of the translational research may include non-medical tasks (information technology, engineering, nanotechnology, biochemistry, animal research, economy, sociology, psychology, politics, and so on). Using common bioethics principles to these areas might sometimes be not feasible, or even impossible. However, the whole process must respect some fundamental, moral principles. The purpose of this paper is to argument the need for a different approach to the morality in translational bioethics, and to suggest some directions that might be followed when constructing such a bioethics. We will show that a new approach is needed and present a few ethical issues that are specific to the translational research.
This article analyses, from a bioethics journal editor's perspective, the threats to academic freedom and freedom of expression that academic bioethicists and academic bioethics journals are subjected to by political activists applying pressure from outside of the academy. I defend bioethicists' academic freedom to reach and defend conclusions many find offensive and 'wrong'. However, I also support the view that academics arguing controversial matters such as, for instance, the moral legitimacy of infanticide should take clear responsibility for the views they defend and should not try to hide behind analytical philosophers' rationales such as wanting to test an argument for the sake of testing an argument. This article proposes that bioethics journals establish higher-quality requirements and more stringent mechanisms of peer review than usual for iconoclastic articles.
Full Text Available This essay is devoted to the problem of theological discourse in bioethics. We focus both on general positions shared across major existing religions and substantial confessional differences among them. Among the major categories determining relationship between bioethics and religion we studied the following: “image of God” (imago Dei, casuistry, primacy of procreation, “playing God”, artificial procreation and others. After analyzing Christian, Jewish and Islamic positions on the theological interpretation of the reproductive technologies and human cloning, we came to a conclusion that differences in views depend rather on orthodox, conservative, traditional or liberal viewpoint within a given church than on differences between particular religions. Despite substantial faith-related differences, occasionally, views on reproductive technologies and other problems of bioethics seem closer between liberal Protestants and liberal Judaists than between orthodox and reformist Judaists.
Ives, Jonathan; Dunn, Michael
In this paper we set forth what we believe to be a relatively controversial argument, claiming that 'bioethics' needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly that bioethics is an embedded socio-cultural practice, shaped by the ever-changing intuitions of individual philosophers, which cannot be viewed as a detached intellectual endeavour. This said, we argue that in order to manage the personal, social and cultural embeddedness of bioethics, philosophical bioethicists should openly acknowledge how their practices are constructed and should, in their writing, explicitly deal with issues of bias and conflict of interest, just as empirical scientists are required to do.
Resnik, David B
Two articles published in Bioethics recently have explored the ways that bioethics can contribute to the climate change debate. Cheryl Cox Macpherson argues that bioethicists can play an important role in the climate change debate by helping the public to better understand the values at stake and the trade-offs that must be made in individual and social choices, and Sean Valles claims that bioethicists can contribute to the debate by framing the issues in terms of the public health impacts of climate change. While Macpherson and Valles make valid points concerning a potential role for bioethics in the climate change debate, it is important to recognize that much more than ethical analysis and reflection will be needed to significantly impact public attitudes and government policies. © 2016 John Wiley & Sons Ltd.
In contemporary debates about the nature of bioethics there is a widespread view that bioethical decision making should involve certain knowledge of and respect for cultural diversity of persons to be affected. The aim of this article is to show that this view is untenable and misleading. It is argued that introducing the idea of respect for cultural diversity into bioethics encounters a series of conceptual and empirical constraints. While acknowledging that cultural diversity is something that decision makers in bioethical contexts should try to understand and, when possible, respect, it is argued that this cultural turn ignores the typically normative role of bioethics and thus threatens to undermine its very foundations.
Williams, Arthur Robin
Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. © 2015 John Wiley & Sons Ltd.
Chattopadhyay, Subrata; De Vries, Raymond
The field of bioethics continues to struggle with the problem of cultural diversity: can universal principles guide ethical decision making, regardless of the culture in which those decisions take place? Or should bioethical principles be derived from the moral traditions of local cultures? Ten Have and Gordijn (2011) and Bracanovic (2011) defend the universalist position, arguing that respect for cultural diversity in matters ethical will lead to a dangerous cultural relativity where vulnerable patients and research subjects will be harmed. We challenge the premises of moral universalism, showing how this approach imports and imposes moral notions of Western society and leads to harm in non-western cultures. PMID:22955969
The steps toward the adoption by the United Nations Educational, Scientific and Cultural Organisation (UNESCO) of the Universal Declaration on Bioethics and Human Rights took a number of years and generated considerable controversy. This editorial reviews the principal provisions in the Declaration and argues that the Declaration constitutes an important formalisation on the basis of international consensus of the fundamental attributes of bioethical work undertaken by medical practitioners and scientists. However, the Declaration is only a beginning; many challenges lie ahead to ensure its effective implementation.
Full Text Available The principle of vulnerability is a specific principle within European Bioethics. On the one hand, vulnerability expresses human limits and frailty on the other hand it represents moral and ethical action principles. In this paper a discussion on the relationship between the concepts of autonomy, vulnerability and responsibility is proposed and presentation of some possible applications of the principle of vulnerability within bioethics. In conclusion, some potential benefits of applying the principle of vulnerability as well as possible difficulties in its application are highlighted.
Recent work has stressed the importance of the concept of solidarity to bioethics and social philosophy generally. But can and should it feature in documents such as the Universal Declaration on Bioethics and Human Rights as anything more than a vague notion with multiple possible interpretations? Although noting the tension between universality and particularity that such documents have to deal with, and also noting that solidarity has a political content, the paper explores the suggestion that solidarity should feature more centrally in international regulations. The paper concludes with the view that when solidarity is seen aright, the UDBHR is an implicitly solidaristic document.
UNESCO’s Universal Declaration on Bioethics and Human Rights (2005) was drawn up by an independent panel of experts (the International Bioethics Committee) and negotiated by member states. UNESCO aimed for a participatory and transparent drafting process, holding national and regional consultations and seeking the views of various interest groups, including religious and spiritual ones. Furthermore, reflecting UNESCO’s broad interpretation of bioethics, the IBC included medics, scientists, lawyers and philosophers among its membership. Nevertheless, several potential stakeholders—academic scientists and ethicists, government policy-makers and NGO representatives—felt they had not been sufficiently consulted or even represented during the Declaration’s development. Better communications and understanding within and between national, regional and international layers of governance would help to avoid a recurrence of this problem in future negotiations. PMID:22724045
This article by one of the Editors of Bioethics, published in the 25th anniversary issue of the journal, describes some of the revolutionary changes academic publishing has undergone during the last decades. Many humanities journals went from typically small print-runs, counting by the hundreds, to on-line availability in thousands of university libraries worldwide. Article up-take by our subscribers can be measured efficiently. The implications of this and other changes to academic publishing are discussed. Important ethical challenges need to be addressed in areas such as the enforcement of plagiarism-related policies, the so-called 'impact factor' and its impact on academic integrity, and the question of whether on-line only publishing can currently guarantee the integrity of academic publishing histories. © 2010 Blackwell Publishing Ltd.
In this paper I argue that a global bioethics is possible. Specifically, I present the view that there are within feminist approaches to bioethics some conceptual and methodological tools necessary to forge a bioethics that embraces the health-related concerns of both developing and developed nations equally. To support my argument I discuss some of the challenges that have historically confronted feminists. If feminists accept the idea that women are entirely the same, then feminists present as fact the fiction of the essential "Woman." Not only does "Woman" not exist, -she" obscures important racial, ethnic, cultural, and class differences among women. However, if feminists stress women's differences too much, feminists lose the power to speak coherently and cogently about gender justice, women's rights, and sexual equality in general. Analyzing the ways in which the idea of difference as well as the idea of sameness have led feminists astray, I ask whether it is possible to avoid the Scylla of absolutism (imperialism, colonialism, hegemony) on the one hand and the Charybdis of relativism (postmodernism, fragmentation, Balkanization) on the other. Finally, after reflecting upon the work of Uma Narayan, Susan Muller Okin, and Martha Nussbaum, I conclude that there is a way out of this ethical bind. By focusing on women's, children's, and men's common human needs, it is possible to lay the foundation for a just and caring global bioethics.
Pyrrho, Monique; do Prado, Mauro Machado; Cordón, Jorge; Garrafa, Volnei
The Brazilian Dentistry Code of Ethics (DCE), Resolution CFO-71 from May 2006, is an instrument created to guide dentists' behavior in relation to the ethical aspects of professional practice. The purpose of the study is to analyze the above mentioned code comparing the deontological and bioethical focuses. In order to do so, an interpretative analysis of the code and of twelve selected texts was made. Six of the texts were about bioethics and six on deontology, and the analysis was made through the methodological classification of the context units, textual paragraphs and items from the code in the following categories: the referentials of bioethical principlism--autonomy, beneficence, nonmaleficence and justice -, technical aspects and moral virtues related to the profession. Together the four principles represented 22.9%, 39.8% and 54.2% of the content of the DCE, of the deontological texts and of the bioethical texts respectively. In the DCE, 42% of the items referred to virtues, 40.2% were associated to technical aspects and just 22.9% referred to principles. The virtues related to the professionals and the technical aspects together amounted to 70.1% of the code. Instead of focusing on the patient as the subject of the process of oral health care, the DCE focuses on the professional, and it is predominantly turned to legalistic and corporate aspects.
Ives, Jonathan; Draper, Heather
In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached.
Bryant, John; la Velle, Linda Baggott
Points out the importance of awareness among biologists and biology teachers of the ethical and social implications of their work. Describes the bioethics module established at the University of Exeter mainly targeting students majoring in biology and science education. (Contains 18 references.) (Author/YDS)
Wahlberg, Ayo; Rehmann-Sutter, Christoph; Sleeboom-Faulkner, Margaret
standardisation under the rubric of ‘global bioethics’. Such a ‘global’, ‘Western’ or ‘universal’ bioethics has in turn been critiqued as an imposition upon resource-poor, non-Western or local medical settings. In this article, we propose that a different tack is necessary if we are to come to grips...
Growing recognition of bioethics' shortcomings, associated in large part with its heavy reliance on abstract principles, or so-called principlism, has led many scholars to propose that the field should be reformed or reconceptualised. Principlism is seen to de-contextualise the process of ethical decision-making, thus restricting bioethics' contributions to debate and policy on new and emergent biotechnologies. This article examines some major critiques of bioethics and argues for an alternative normative approach; namely, a sociology of bio-knowledge focussing on human rights. The article discusses the need for such an approach, including the challenges posed by the recent rise of 'the bio-economy'. It explores some potential alternative bases for a normative sociology of bio-knowledge, before presenting the elements of the proposed human rights-focused approach. This approach, it is argued, will benefit from the insights and concepts offered by various fields of critical scholarship, particularly the emergent sociology of human rights, science and technology studies, Foucaultian scholarship, and feminist bioethics. Copyright © 2013 Elsevier Ltd. All rights reserved.
Original articles of 3 000 words or less, with up to 6 tables or illustrations, should normally report observations or research of relevance to bioethics, law, human rights and related topics. References should preferably be limited to no more than 15. Short reports or scientific letters, which include case reports, brief or negative ...
Fast forward 50 years into the future. A look back at what occurred in the field of bioethics since 2010 reveals that a conference in 2050 commemorated the death of bioethics. In a steady progression over the years, the field became increasingly fragmented and bureaucratized. Disagreement and dissension were rife, and this once flourishing, multidisciplinary field began to splinter in multiple ways. Prominent journals folded, one by one, and were replaced with specialized publications dealing with genethics, reproethics, nanoethics, and necroethics. Mainstream bioethics organizations also collapsed, giving way to new associations along disciplinary and sub-disciplinary lines. Physicians established their own journals, and specialty groups broke away from more general associations of medical ethics. Lawyers also split into three separate factions, and philosophers rejected all but the most rigorous, analytic articles into their newly established journal. Matters finally came to a head with global warming, the world-wide spread of malaria and dengue, and the cost of medical treatments out of reach for almost everyone. The result was the need to develop plans for strict rationing of medical care. At the same time, recognition emerged of the importance of the right to health and the need for global justice in health. By 2060, a spark of hope was ignited, opening the door to the resuscitation of bioethics and involvement of the global community.
Ahmadi Nasab Emran, Shahram
In Bioethics and Secular Humanism: The Search for a Common Morality, Tristram Engelhardt examines various possibilities of finding common ground for moral discourse among people from different traditions and concludes their futility. In this paper I will argue that many of the assumptions on which Engelhardt bases his conclusion about the impossibility of a content-full secular bioethics are problematic. By starting with the notion of moral strangers, there is no possibility, by definition, for a content-full moral discourse among moral strangers. It means that there is circularity in starting the inquiry with a definition of moral strangers, which implies that they do not share enough moral background or commitment to an authority to allow for reaching a moral agreement, and concluding that content-full morality is impossible among moral strangers. I argue that assuming traditions as solid and immutable structures that insulate people across their boundaries is problematic. Another questionable assumption in Engelhardt's work is the idea that religious and philosophical traditions provide content-full moralities. As the cardinal assumption in Engelhardt's review of the various alternatives for a content-full moral discourse among moral strangers, I analyze his foundationalist account of moral reasoning and knowledge and indicate the possibility of other ways of moral knowledge, besides the foundationalist one. Then, I examine Engelhardt's view concerning the futility of attempts at justifying a content-full secular bioethics, and indicate how the assumptions have shaped Engelhardt's critique of the alternatives for the possibility of content-full secular bioethics.
Mullet, Etienne; Sorum, Paul C.; Teysseire, Nathalie; Nann, Stephanie; Martinez, Guadalupe Elizabeth Morales; Ahmed, Ramadan; Kamble, Shanmukh; Olivari, Cecilia; Sastre, Maria Teresa Munoz
We present, in a synthetic way, some of the main findings from five studies that were conducted in the field of empirical bioethics, using the Functional Measurement framework. These studies were about (a) the rationing of rare treatments, (b) adolescents' abortions, (c) end-of-life decision-making regarding damaged neonates, (d) end-of-life…
Currently, there is no national or global declaration that rejects organ trafficking because of the discriminatory and stigmatising results of the medical practice involved. The Universal Declaration of Bioethics and Human Rights by the United Nations Educational, Scientific and Cultural Organization (UNESCO) addresses the ...
When he is led to intervene in the field of bioethics, the judge tries to find references in both the general principles of law and in the law itself. Although careful, his approach should also show imagination and ensure that all interests involved will be protected as well as possible.
Taking into account their acquired experience, would not health agencies become the place where biomedical practices will be managed on an every day basis? Would in a near future these agencies have the role to interprete the principles of the bioethics law to adapt them to concrete issues?
There is a growing interest in various forms of naturalism in bioethics, but there is a clear need for further clarification. In an effort to address this situation, I present three epistemological stances: anti-naturalism, strong naturalism, and moderate pragmatic naturalism. I argue that the dominant paradigm within philosophical ethics has been a form of anti-naturalism mainly supported by a strong 'is' and 'ought' distinction. This fundamental epistemological commitment has contributed to the estrangement of academic philosophical ethics from major social problems and explains partially why, in the early 1980s, 'medicine saved the life of ethics'. Rejection of anti-naturalism, however, is often associated with strong forms of naturalism that commit the naturalistic fallacy and threaten to reduce the normative dimensions of ethics to biological imperatives. This move is rightly dismissed as a pitfall since ethics is, in part, a struggle against the course of nature. Rejection of naturalism has drawbacks, however, such as deterring bioethicists from acknowledging the implicit naturalistic epistemological commitments of bioethics. I argue that a moderate pragmatic form of naturalism represents an epistemological position that best embraces the tension of anti-naturalism and strong naturalism: bioethics is neither disconnected from empirical knowledge nor subjugated to it. The discussion is based upon historical writings in philosophy and bioethics.
Meadow, William L; Lantos, John D
... intensive care units. We began collecting data and presenting analyses at various scientiﬁc meetings, in particular the Society for Pediatric Research and the American Society of Bioethics and Humanities. Generous grant support from the Greenwall Foundation, the Robert Wood Johnson Foundation, and the MacLean Family helped continue the inquiries. We hav...
Bioethical principles,1 human rights and the law are interlinked. Aspects of the principles of autonomy, beneficence, non-maleficence and justice are included in the South African Constitution2 and the country's statutory and common law. A breach of these ethical principles and the Constitution may lead to an action for ...
Jun 21, 2017 ... Global discrimination against and stigmatisation of individuals and groups in the health environment are continually reported.. In 2014, the International Bioethics Committee (IBC) of the United. Nations Educational, Scientific and Cultural Organization (UNESCO), published the Report of the IBC on the ...
judicially enforceable in SA, its universal nature offers a clear moral force in the bioethical debate in SA. S Afr J BL 2014:7(2)51-54. ... of individual consent arises from the right and ethical value of auto- nomy (freedom), while giving ... It is the duty of the person responsible for the medical inter- vention or the research to ...
Holloway, Karla F. C
... on cultural complexity as the origin of subjectivity. For bioethics, this means a primary and focused consideration of the habits, patterns, and practices in medicine and law that subsequently constitute the discipline's subjects. In other words, cultural ethics acknowledges that the discursive practices of the field- the complexities of history, instituti...
This article attempts to contextualise and highlight the need for integration of philosophical and bioethical perspectives in curriculation for courses at tertiary level in order to provide students with opportunities to engage with these issues in preparing them to be responsible teaching facilitators. To arrive at norms and values ...
Contemporary bioethics is a complex and multidisciplinary combination of medicine, philosophy and law, made more difficult because few, if any, bioethicists are masters of all three disciplines. To further complicate matters, each discipline contains specialised subdisciplines and internal debates. Philosophy is used to ...
Full Text Available Psychiatric neurosurgery or psychosurgery remains as an alternative for treatment of psychiatric disorders. However, its historical antecedents, the vulnerable specific condition of psychiatric patients, the high cost of instrumentation and the ethic dilemma about the autonomy of subjects whose are candidates to this kind of procedures condition to get a interdisciplinary and specialized staff and at less supervision for ethic local committee. There are ablative or deep brain stimulation procedures accepted as compassionate or investigational use. Into systematic review four International Ethic Guides are accepted for the indication, the implantation and the follow up of these treatments. 24 bioethics essays were found them and 9 ethics specific dilemmas were published. Expectancy and development of this medical issue are inherent to financial or biotechnological aspects, consequently is important to promote a scientific and philosophical discussion.
Lee, Lisa M
Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three "fields" of ethics to promote a healthier planet.
Lee, Danny W H; Lai, Paul B S
Mediation is a voluntary process whereby a neutral and impartial third party-t-he mediator--is present to facilitate communication and negotiation between the disputing parties so that amicable settlements can be agreed. Being confidential and non-adversarial in nature, the mediation process and skills are particularly applicable in clinical practice to facilitate challenging communications following adverse events, to assist bioethical decision making and to resolve disputes. Mediation is also a more effective and efficient means of dispute resolution in medical malpractice claims when compared with civil litigation. Health care mediation teams should be set up at individual facilities to provide education and consultation services to frontline staff and patients. At a community level, the Government, the mediation community, and the health care professionals should join forces to promote mediation as a means to settle medical malpractice claims outside of the courtroom.
Full Text Available Aging attracted keen interest in research, health, education as well as cross-sectors approaches. We researched what has been produced by the National Bioethics/Ethics Councils in the form of opinions or other documents, relating to aging and elderly people. In the websi-tes of the 28 EU councils and 12 other countries, we identified 4 documents relating to aging and 8 opinions, which we analyse. The Councils have proposed to draw the attention and reflection of public opinion to the elderly condition; all agree that the age has its own traits and that matters revert to a “culture of old age”, respect and promotion of a positive aging. Enhance the diversity of modes of aging and the importance of preparing all, promoting literacy for aging, creating social and legal protective elements (Elderly Statute, Observatory of the Elderly Conditions. From the analysis, a set of principles and bioethical elements:  respect for human dignity, regardless of the stage of life;  recognition of the person’s situation uniqueness to aging;  freedom of one’s own decision, which is materialized in respect for autonomy;  recognition of the vulnerabilities of the elderly,  ethical commitment and social responsibility in monitoring the elderly,  non-discrimination by age and  the guidance to the conditions of the integral good and quality of life. Aging is an existential step for which we can prepare, on the assumption that human life in its longevity, interweaves those who are older and those younger, on the crucial issue of human existence.
Powell, Tia; Foglia, Mary Beth
Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics has an obligation to discuss that history and to help us as a society take responsibility for it. We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same-sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen-Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating
Islam, Sharmin; Nordin, Rusli Bin; Bin Shamsuddin, Ab Rani; Mohd Nor, Hanapi Bin; Al-Mahmood, Abu Kholdun
The comparative approach regarding the ethics of surrogacy from the Western secular and Islamic bioethical view reveals both commensurable and incommensurable relationship. Both are eager to achieve the welfare of the mother, child and society as a whole but the approaches are not always the same. Islamic bioethics is straightforward in prohibiting surrogacy by highlighting the lineage problem and also other social chaos and anarchy. Western secular bioethics is relative and mostly follows a utilitarian approach.
Islam, Sharmin; Nordin, Rusli Bin; Bin Shamsuddin, Ab Rani; Mohd Nor, Hanapi Bin; Al-Mahmood, Abu Kholdun
The comparative approach regarding the ethics of surrogacy from the Western secular and Islamic bioethical view reveals both commensurable and incommensurable relationship. Both are eager to achieve the welfare of the mother, child and society as a whole but the approaches are not always the same. Islamic bioethics is straightforward in prohibiting surrogacy by highlighting the lineage problem and also other social chaos and anarchy. Western secular bioethics is relative and mostly follows a utilitarian approach. PMID:23864994
This article examines the emergence and consolidation of bioethics as a discipline from a sociological perspective. This reconstruction helps us to understand on the one hand what is meant by bioethics and what its practices and areas of inquiry are, and on the other to identify various concepts and expert opinions about what the field of study for bioethics should be, opinions which lead in practice to different applications of the discipline in health sciences. This becomes relevant for epistemological discussions about the discipline and for consolidating a sociology of bioethics in the context of Ibero-America.
Couture, Vincent; Bélisle-Pipon, Jean-Christophe; Cloutier, Marianne; Barnabé, Catherine
How to engage the public in a reflection on the most pressing ethical issues of our time? What if part of the solution lies in adopting an interdisciplinary and collaborative strategy to shed light on critical issues in bioethics? An example is Art + Bioéthique, an innovative project that brought together bioethicists, art historians and artists with the aim of expressing bioethics through arts in order to convey the "sensitive" aspect of many health ethics issues. The aim of this project was threefold: 1) to identify and characterize mechanisms for the meeting of arts and bioethics; 2) to experiment with and co-construct a dialogue between arts and bioethics; and 3) to initiate a public discussion on bioethical issues through the blending of arts and bioethics. In connection with an exhibition held in March 2016 at the Espace Projet, a non-profit art space in Montréal (Canada), the project developed a platform that combined artworks, essays and cultural & scientific mediation activities related to the work of six duos of young bioethics researchers and emerging artists. Each duo worked on a variety of issues, such as the social inclusion of disabled people, the challenges of practical applications of nanomedicine and regenerative medicine, and a holistic approach to contemporary diseases. This project, which succeeded in stimulating an interdisciplinary dialogue and collaboration between bioethics and arts, is an example of an innovative approach to knowledge transfer that can move bioethics reflection into the public space. © 2017 John Wiley & Sons Ltd.
The UNESCO Universal Declaration on Bioethics and Human Rights of 2005 purports to articulate universal norms for bioethics. However, this document has met with mixed reviews. Some deny that the elaboration of universal bioethics norms is needed; some deny that UNESCO has the expertise or authority to articulate such norms; some regard the content of the UNESCO document as too vague or general to be useful; and some regard the document as a cog in the effort of like-minded cosmopolitans to codify their particular moral intuitions in international law. This issue examines the potential merits and pitfalls of the Universal Declaration on Bioethics and Human Rights.
Schlairet, Maura C
Ethics consultations are utilized in health care to identify and manage conflict, difficult decision-making, and ethical issues. In bioethics mediation, a more updated approach using interpersonal, mediative, conflict management, and dispute resolution skills is merged with ethical principles to manage dilemmas arising in healthcare settings. This article argues, based on a professional obligation to advocate for the good of the client, that nurses must assume leadership roles in mediation processes. Nurses can initiate and fully participate in formal bioethics mediation and other mediative interventions. Nurse administrators can work to evolve existing ethics consult models to mediation models. Nonetheless, mediative efforts of individual nurses must be grounded in realization of the multifactorial nature of conflict and dilemma in healthcare settings. Multidisciplinary mediative interventions, framed by sound institutional policies, may best serve the complex needs of ethically vulnerable clients. To best advocate for these at-risk clients, nurses must assume various leadership roles in mediation processes.
Chattopadhyay, Subrata; De Vries, Raymond
The field of bioethics continues to struggle with the problem of cultural diversity: can universal principles guide ethical decision making, regardless of the culture in which those decisions take place? Or should bioethical principles be derived from the moral traditions of local cultures? Ten Have and Gordijn (Medicine, Health Care and Philosophy 14:1-3, 2011) and Bracanovic (Medicine, Health Care and Philosophy 14:229-236, 2011) defend the universalist position, arguing that respect for cultural diversity in matters ethical will lead to a dangerous cultural relativity where vulnerable patients and research subjects will be harmed. We challenge the premises of moral universalism, showing how this approach imports and imposes moral notions of Western society and leads to harm in non-western cultures.
Prainsack, Barbara; Buyx, Alena
This paper, which is based on an extensive analysis of the literature, gives a brief overview of the main ways in which solidarity has been employed in bioethical writings in the last two decades. As the vagueness of the term has been one of the main targets of critique, we propose a new approach to defining solidarity, identifying it primarily as a practice enacted at the interpersonal, communal, and contractual/legal levels. Our three-tier model of solidarity can also help to explain the way in which crises of solidarity can occur, notably when formal solidaristic arrangements continue to exist despite 'lower tiers' of solidarity practices at inter-personal and communal levels having 'broken away'. We hope that this contribution to the growing debate on the potential for the value of solidarity to help tackle issues in bioethics and beyond, will stimulate further discussion involving both conceptual and empirically informed perspectives. © 2012 Blackwell Publishing Ltd.
Pragmatism has been understood by bioethicists as yet another rival in the "methods wars," as yet another theory of moral deliberation. This has led to criticism of pragmatic bioethics as both theoretically and practically inadequate. Pragmatists' responses to these objections have focused mainly on misunderstandings of pragmatism's epistemology. These responses are insufficient. Pragmatism's commitment to radical empiricism gives it theoretical resources unappreciated by critics and defenders alike. Radical empiricism, unlike its more traditional ancestors, undercuts the gaps between theory and practice, and subjective and objective accounts of experience, and in so doing provides the metaphysical and epistemological basis for a thoroughgoing empirical naturalism in ethics. Pragmatism's strength as an approach to moral problems thus emerges as a result of a much wider array of resources than contemporary interpreters have acknowledged, which makes it a richer, deeper framework for understanding moral deliberation in general and bioethical decision making in particular.
Keith A. Johnson
Full Text Available Exposing students to current biotechnological and medical issues is eye-opening for many students in a way that is not always achieved through lecture-based learning. Lecture or investigative teaching styles provide a tremendous knowledge base for the students, but sometimes these teaching styles do not allow the student to fully develop, especially personal attitudes to issues in bioethics. Through online videos, Hollywood movies, guided readings and classroom discussions, students in this course are informed of some bioethical topics, encouraged to learn about other topics, and use this gained knowledge to develop personal positions regarding the value and/or risk of the issues. This course has been well-received by previous students as a favorite in terms of both topics covered and style.
Souza, Layz Alves Ferreira; Pessoa, Ana Paula da Costa; Barbosa, Maria Alves; Pereira, Lilian Varanda
An integrative literature review was developed with the purpose to analyze the scientific production regarding the relationships between pain and the principles of bioethics (autonomy, beneficence, nonmaleficence and justice). Controlled descriptors were used in three international data sources (LILACS, SciELO, MEDLINE), in April of 2012, totaling 14 publications categorized by pain and autonomy, pain and beneficence, pain and nonmaleficence, pain and justice. The adequate relief of pain is a human right and a moral issue directly related with the bioethical principlism standard model (beneficence, non-maleficence, autonomy and justice). However, many professionals overlook the pain of their patients, ignoring their ethical role when facing suffering. It was concluded that principlism has been neglected in the care of patients in pain, showing the need for new practices to change this setting.
David S. Basser
Full Text Available Abstract Background As suggested by Shook and Giordano, understanding and therefore addressing the urgent international governance issues around globalizing bio-medical/technology research and applications is limited by the perception of the underlying science. Methods A philosophical methodology is used, based on novel and classical philosophical reflection upon existent literature, clinical wisdoms and narrative theory to discover a meta-science and telos of humankind for the development of a relevant and defendable global biomedical bioethics. Results In this article, through pondering an integrative systems approach, I propose a biomedical model that may provide Western biomedicine with leadership and interesting insight into the unity beyond the artificial boundaries of its traditional divisions and the limit between physiological and pathological situations (health and disease. A unified biomedicine, as scientific foundation, might then provide the basis for dissolution of similar reflected boundaries within bioethics. A principled and communitarian cosmopolitan bioethics may then be synonymous with a recently proposed principled and communitarian cosmopolitan neuroethics based on a novel objective meta-ethics. In an attempt to help facilitate equal and inclusive participation in inter-, multi-, and transdisciplinary intercultural discourse regarding the aforementioned international governance issues, I offer: (1 a meta-science derived through considering the general behaviour of activity, plasticity and balance in biology and; (2 a novel thought framework to encourage and enhance the ability for self-evaluation, self-criticism, and self-revision aimed at broadening perspective, as well as acknowledging and responding to the strengths and limitations of extant knowledge. Conclusions Through classical philosophical reflection, I evolve a theory of medicine to discover a telos of humankind which in turn provides an ‘internal’ moral
Basser, David S
As suggested by Shook and Giordano, understanding and therefore addressing the urgent international governance issues around globalizing bio-medical/technology research and applications is limited by the perception of the underlying science. A philosophical methodology is used, based on novel and classical philosophical reflection upon existent literature, clinical wisdoms and narrative theory to discover a meta-science and telos of humankind for the development of a relevant and defendable global biomedical bioethics. In this article, through pondering an integrative systems approach, I propose a biomedical model that may provide Western biomedicine with leadership and interesting insight into the unity beyond the artificial boundaries of its traditional divisions and the limit between physiological and pathological situations (health and disease). A unified biomedicine, as scientific foundation, might then provide the basis for dissolution of similar reflected boundaries within bioethics. A principled and communitarian cosmopolitan bioethics may then be synonymous with a recently proposed principled and communitarian cosmopolitan neuroethics based on a novel objective meta-ethics. In an attempt to help facilitate equal and inclusive participation in inter-, multi-, and transdisciplinary intercultural discourse regarding the aforementioned international governance issues, I offer: (1) a meta-science derived through considering the general behaviour of activity, plasticity and balance in biology and; (2) a novel thought framework to encourage and enhance the ability for self-evaluation, self-criticism, and self-revision aimed at broadening perspective, as well as acknowledging and responding to the strengths and limitations of extant knowledge. Through classical philosophical reflection, I evolve a theory of medicine to discover a telos of humankind which in turn provides an 'internal' moral grounding for a proposed global biomedical bioethics.
Singh, Ajai R.; Singh, Shakuntala A.
The paper begins by asserting the need for bioethical and related philosophical considerations in the emerging subspecialty Positive Psychiatry. Further discussion proceeds after offering operational definitions of the concepts fundamental to the field – Bioethics, Positive Psychology, Positive Psychiatry and Positive Mental Health - with their conceptual analysis to show their areas of connect and disconnect. It then studies the implications of positive and negative findings in the field, and presents the Positive Psychosocial Factors (PPSFs) like Resilience, Optimism, Personal Mastery, Wisdom, Religion/Spirituality, Social relationships and support, Engagement in pleasant events etc. It then evaluates them on the basis of the 4-principled bioethical model of Beneficence, Non-malfeasance, Autonomy and Justice (Beauchamp and Childress, 2009, 2013), first offering a brief clarification of these principles and then their bioethical analysis based on the concepts of ‘Common Morality’, ‘Specific Morality’, ‘Specification’, ‘Balancing’ and ‘Double Effects’. The paper then looks into the further development of the branch by studying the connectivity, synergy and possible antagonism of the various Positive Psychosocial Factors, and presents technical terms in place of common terms so that they carry least baggage. It also takes note of the salient points of caution and alarm that many incisive analysts have presented about further development in the related field of Positive Mental Health. Finally, the paper looks at where, and how, the field is headed, and why, if at all, it is proper it is headed there, based on Aristotle's concept of the four causes - Material, Efficient, Formal and Final. Suitable case vignettes are presented all through the write-up to clarify concepts. PMID:28031624
Engelhardt, H Tristram
The project of articulating a coherent, canonical, content-full, secular morality-cum-bioethics fails, because it does not acknowledge sin, which is to say, it does not acknowledge the centrality of holiness, which is essential to a non-distorted understanding of human existence and of morality. Secular morality cannot establish a particular moral content, the harmony of the good and the right, or the necessary precedence of morality over prudence, because such is possible only in terms of an ultimate point of reference: God. The necessity of a rightly ordered appreciation of God places centrally the focus on holiness and the avoidance of sin. Because the cardinal relationship of creatures to their Creator is worship, and because the cardinal corporate act of human worship is the Liturgy, morality in general and bioethics in particular can be understood in terms of the conditions necessary, so as worthily to enter into Eucharistic liturgical participation. Morality can be summed up in terms of the requirements of ritual purity. A liturgical anthropology is foundational to an account of the content-full morality and bioethics that should bind humans, since humans are first and foremost creatures obliged to join in rightly ordered worship of their Creator. When humans worship correctly, when they avoid sin and pursue holiness, they participate in restoring created reality.
An educated guess about the future of academic bioethics can only be made on the basis of the historical conditions of its success. According to its official history, which attributes its success primarily to the service it has done for the patient, it should be safe at least as long as the patient still needs its service. Like many other academic disciplines, it might suffer under the present economic downturn. However, in the plausible assumption that its social role has not been exhausted yet, it should recover as soon as the economy does. But if, as this paper tries to argue, the success of academic bioethics should be attributed first and foremost to the service it has done for the neoliberal agenda, then its future would have to depend on the fate of the latter. The exact implications of the downturn for the neoliberal agenda are obviously impossible to predict. Among the various options, however, the one of going back to 'normal' seems to be the least likely. The other options suggest that the future of academic bioethics, as we have known it, is bleak.
Monlezun, Dominique J.
The increasing globalization of mankind with pluralistic belief systems necessitates physicians by virtue of their profession to partner with bioethics for soundly applying emerging knowledge and technologies for the best use of the patient. A subfield within medicine in which this need is acutely felt is that of surgical implants. Within this subfield such recent promising ethics and medicine partnerships include the International Tissue Engineering Research Association and UNESCO Chair in Bioethics and Human Rights' International Code of Ethics. In this paper, we provide an overview of the emerging human rights framework from bioethics and international law, discussion of key framework principles, their application to the current surgical challenge of implantation of surgical mesh for prolapse, and conclusions and recommendations. Such discussions are meant to facilitate true quality improvement in patient care by ensuring the exciting technologies and medical practices emerging new daily are accompanied by an equal commitment of physicians to ethically provide their services for the chief end of the patient's good. PMID:25973426
Abma, Tineke A; Baur, Vivianne E; Molewijk, Bert; Widdershoven, Guy A M
Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge (embodied, experiential, visual, and cognitive-scientific). In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves.
The article describes the main features of the website SIBIL (Sistema Informativo per la Bioetica In Linea) implemented within the framework of a research project of the ISS for collecting, indexing and disseminating Italian literature on bioethics since 1995 through an integrated electronic system. The site, addressed to a wide range of people interested at different degrees and levels in bioethics, offers a comprehensive overview of the activities, such as courses and meetings, on the major ethical issues at stake in Italy, as well as a survey of the most important activities both at national and international level. The main feature of SIBIL is a database of a large collection of documents retrieved through sources or exploitation of the most important international electronic databases. A thesaurus of 1,600 terms, available in Italian and English, was created in order to organize documents with standardized criteria currently adopted in the Italian scientific environment. Future trends of the website are also discussed for sharing experiences with other countries and laying the basis for a European portal on bioethics.
The history of bioethics rests upon the assumption that, given the growing complexity of medicine, the function of ethics is, first of all, normative: ethics is supposed to help in the solution of concrete problems, and to do so systematically, by relying upon a defined set of principles and rules. The scientific character of such an approach to bioethics complements the very understanding of modern medicine as itself increasingly scientific and technical, that is, as oriented toward the production of effects. Although careful scientific attention to the patho-physiology of disease has unquestionably yielded marvelous advances in modern medicine, its positivist reduction has also created a mind-set that brackets questions of meaning, themselves highly significant to human well-being and to the ethical aspects ofmedicine. The paper claims that, rather than sharing in the "suspension of meaning" pursued by medicine for the sake of scientific objectivity, the main task of bioethics consists in a retrieval, or "anamnesis", of the very questions medicine seems to suspend: the significance of illness and disease, of birth, suffering and death, and of the service to the ethos of generosity that sustains the healing professions. Also, the paper offers a cultural "etiology" of "the suspension of meaning" in bioethics. In addition to a critical integration of positivistic attitudes in medicine and the reduction of moral discourse to the normative, one must mention the basic presumption of a cultural situation that, in the name of post-modernity, raises serious doubts against the possibility of engaging in questions of meaning across moral boundaries. As an alternative, the paper calls for a moral reflection that begins neither with the application of normative principles, nor with an attitude of resignation towards the pursuit of the good; rather with a free and open confrontation with clinical experience that attends to the moral meaning of concrete situations, recognizing
Cherry, Mark J
The United Nations Educational, Scientific, and Cultural Organization's (UNESCO) Universal Declaration on Bioethics and Human Rights announces a significant array of welfare entitlements--to personal health and health care, medicine, nutrition, water, improved living conditions, environmental protection, and so forth--as well as corresponding governmental duties to provide for such public health measures, though the simple expedient of announcing that such entitlements are "basic human rights." The Universal Declaration provides no argument for the legitimacy of the sweeping governmental authority, taxation, and regulation to create and impose such "rights." As this paper explores that some action promotes a purported good, such as "health," does not thereby make the action morally permissible. Just as there are moral limits on legitimate personal actions, there are also moral limits on legitimate governmental actions to promote purported goods, including health. A core question of any governmental regulation, therefore, is whether it is a legitimate application of moral political authority or an unauthorized act of state coercion. Pace UNESCO's wide-ranging assertions, this paper argues that promoting health only falls within the legitimate authority of governments in very narrowly defined circumstances. As the paper critically explores, at stake are foundational moral and political questions concerning the limits of governmental authority to intervene in the consensual interaction of persons. Imposing such duties on others, including citizens of a state through regulatory activity and taxation, must be justified, nonarbitrary, and demonstrably within the limits of moral political authority. UNESCO's assertions do not meet this burden of proof.
animals for research, testing, or training in different countries. In the few that have done so, the measures adopted vary widely: on the one hand, legally enforceable detailed regulations with licensing of experimenters and their premises together with an official inspectorate; on the other, entirely voluntary self-regulation by the biomedical community, with lay participation. Many variations are possible between these extremes, one intermediate situation being a legal requirement that experiments or other procedures involving the use of animals should be subject to the approval of ethical committees of specified composition.The International Guiding Principles are the product of the collaboration of a representative sample of the international biomedical community, including experts of the World Health Organization, and of consultations with responsible animal welfare groups. The International Guiding Principles have already gained a considerable measure of acceptance internationally. European Medical Research Councils (EMRC, an international association that includes all the West European medical research councils, fully endorsed the Guiding Principles in 1984. Here we bring the basic bioethical principles for using animals in biomedical research: Methods such as mathematical models, computer simulation and in vitro biological systems should be used wherever appropriate,Animal experiments should be undertaken only after due consideration of their relevance for human or animal health and the advancement of biological knowledge,The animals selected for an experiment should be of an appropriate species and quality, and the minimum number required to obtain scientifically valid results,Investigators and other personnel should never fail to treat animals as sentient, and should regard their proper care and use and the avoidance or minimization of discomfort, distress, or pain as ethical imperatives,Procedures with animals that may cause more than momentary or minimal
In the interest of developing an adequate and consistent bioethical perspective for reflecting on the ethical issues raised by toxic wastes, this brief paper focuses on the question of whether or not public opposition to past and proposed methods for waste management has been induced as much by technical incompetance as by deficiencies in using risk models for bioethical problem definitions
Notes that life-saving advances in medicine have created difficult ethical and legal dilemmas for health care professionals. Presents beginning knowledge base for bioethical practice, especially in hospital neonatal units. Outlines key elements of bioethical decision making and examines potential social work role from clinical and organizational…
Guyer, Ruth Levy; Dillon, Mary Lou; Anderson, Linda; Szobota, Lola
Discusses the use of bioethics and bioethical dilemmas in different subject areas at the high school level by focusing on the case of Baby K. Includes the story of Baby K, classroom activities for U.S. history, 10th and 11th grade ethics, and anatomy and physiology. (CMK)
Bodensteiner, Karin J.
To systematically investigate whether the inclusion of a bioethical discussion improves the learning and retention of biological content, students in two sections of an introductory zoology class were taught the biology behind emergency contraception and RU-486. Students in one section of the course participated in a bioethical discussion, whereas…
Strong arguments support the notion that much of modern bioethics is a result of appropriation rather than strict application of traditional moral philosophy. Nevertheless, it is important to recognize these sources and approaches associated with them, even when working with appropriated theories, since traditional ethical theory does and should influence modern bioethics.
Full Text Available Abstract Significant inequalities in health between and within countries have been measured over the past decades. Although these inequalities, as well as attempts to improve sub-standard health, raise profound issues of social justice and the right to health, those working in the field of bioethics have historically tended to devote greater attention to ethical issues raised by new, cutting-edge biotechnologies such as life-support cessation, genomics, stem cell research or face transplantation. This suggests that bioethics research and scholarship may revolve around issues that, while fascinating and important, currently affect only a small minority of the world's population. In this article, we examine the accusation that bioethics is largely dominated by Anglophone and industrialized world interests, and explore what kinds of positive contributions a 'bioethics from below' (as Paul Farmer calls it can make to the field of bioethics in general. As our guide in this exploration, we make use of some experiences and lessons learned in our collaborative bioethics project in the Democratic Republic of Congo, Building Bioethics Capacity and Justice in Health. We conclude that while there is some evidence of increased attention to bioethical challenges in developing countries, this development should be further cultivated, because it could help expand the horizons of the field and enhance its social relevance wherever it is practiced.
van Thiel, G.J.M.W.
Many bioethics researchers share the aim to produce moral judgements and theories that actually make a difference in practice. The question of how this aim should be achieved is subject to a longstanding debate. Nonetheless, methodology in bioethics research is still underdeveloped and undervalued.
Ahmadi Nasab Emran, Shahram
Bioethics mediation is increasingly used as a method in clinical ethics cases. My goal in this paper is to examine the implicit theoretical assumptions of the bioethics mediation method developed by Dubler and Liebman. According to them, the distinguishing feature of bioethics mediation is that the method is useful in most cases of clinical ethics in which conflict is the main issue, which implies that there is either no real ethical issue or if there were, they are not the key to finding a resolution. I question the tacit assumption of non-normativity of the mediation method in bioethics by examining the various senses in which bioethics mediation might be non-normative or neutral. The major normative assumption of the mediation method is the existence of common morality. In addition, the four-principle formulation of the theory articulated by Beauchamp and Childress implicitly provides the normative content for the method. Full acknowledgement of the theoretical and normative assumptions of bioethics mediation helps clinical ethicists better understand the nature of their job. In addition, the need for a robust philosophical background even in what appears to be a purely practical method of mediation cannot be overemphasized. Acknowledgement of the normative nature of bioethics mediation method necessitates a more critical attitude of the bioethics mediators towards the norms they usually take for granted uncritically as valid.
Today, bioethics experts have an increasing role in public life. However, the question arises: what does bioethics expertise really mean? Can there be such a thing in our globalised world characterised by ethical pluralism? I will argue that bioethics as a discipline represents the transformation of ethics expertise from a hard to a soft form of it. Bioethics was born as a reaction to the growing awareness of ethical pluralism, and it denied the hard form of normative-prescriptive ethics expertise (the ability to determine what is the right course of action for others), particularly in its medical ethics form. In contrast, the traditional medical ethics model, and pre-modern societies in general, believed in hard normative ethics expertise. From this followed the characteristic paternalism of traditional medical practice: if physicians were experts in moral matters as well, if they knew what the right course of action to choose was, then they had a right to benevolently force this course of action on their patients. The remnants of this doctrine, although rarely stated explicitly, still can often be seen in clinical practice. The whole bioethics movement can be seen as a radical denial of the doctrine of physician's hard expertise in moral matters. Bioethics, however, represents a type of soft ethics expertise (mainly value sensitivity). Hence follows the seeming paradox of bioethics expertise: bioethics is both a denial of ethics expertise (in its hard form) as well as a type of (soft) ethics expertise.
Keenan, James F
Orthodox bioethics is distinctive in how it reflects on issues in bioethics. This distinctiveness is found in the relationship of spirituality and liturgy to ethics. Eber's essay, however, treats the distinctiveness as absolute uniqueness. In so focusing on the incommensurability of Orthodox bioethics Eber fails to tell his reader what Orthodox bioethics is about. Furthermore, his description of Western Christian ethics is seriously inaccurate.
Full Text Available This article aims to contribute to a deeper reflection on intercultural conflicts within the bioethics scope, and to point out the problem of using human rights as a theoretical normative mediator of the conflicts in bioethics that bear elements of interculturalism. The methodological steps adopted in this inquiry were: analysis of the concept of intercultural conflict in bioethics, from the perception developed by Colectivo Amani; study of human rights as tools of the culture of human beings, based on Bauman’s and Beauchamp’s theories; investigation of the toolsthat human rights offer so as to solve intercultural conflicts in bioethics. It was concluded that intercultural bioethics must incorporate to its prescriptive and descriptive tasks norms and institutions of human rights that ensure the participation and social integration of the individuals from communities that are in cultural conflict. Such measure will act as instrumentsfor the solution of intercultural conflicts.
Carr, Mark F; Bergman, Brett A
: Numerous medical schools currently offer a master of arts (MA) in bioethics dual degree for physicians. A degree in bioethics enhances the care physicians provide to patients and prepares physicians to serve on ethics committees and consult services. Additionally, they may work on institutional and public policy issues related to ethics. Several physician assistant (PA) programs currently offer a master of public health (MPH) dual degree for PAs. A degree in public health prepares PAs for leadership roles in meeting community health needs. With the success of PA/MPH dual degree programs, we argue here that a PA/bioethics dual degree would be another opportunity to advance the PA profession and consider how such a program might be implemented. The article includes the individual perspectives of the authors, one of whom completed a graduate-level certificate in bioethics concurrently with his 2-year PA program, while the other served as a bioethics program director.
Marin, Ana; Bouffard, Chantal
At a time in which the ethical awareness towards socio-cultural diversity is a necessity, it seems of paramount importance to explore what is meant by bioethics. Without being exhaustive, this paper suggests to scrutinize the key defnitions of bioethics, considering their evolution over time as well as their convergence with anthropology. Starting with its global and its restricted definitions, this article examines certain differences or definitional imprecisions in the light of the concepts used by bioethicists and anthropologists in their conception of bioethics. While this exercise shows the pertinence of the conceptual tools proposed by anthropology to facilitate the cultural diversity's integration into bioethics, it ultimately challenges an anthropological approach that has been unable to mainstream this knowledge into the definition of bioethics.
The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics scholarship. Then, drawing on Dixon-Wood's concept of critical interpretive synthesis, I put forward six features of a good critical interpretive literature review in bioethics: answering a research question, capturing the key ideas relevant to the research question, analysing the literature as a whole, generating theory, not excluding papers based on rigid quality assessment criteria, and reporting the search strategy. © 2015 John Wiley & Sons Ltd.
Faunce, T A
The International Bioethics Committee (IBC) of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) is currently drafting a Universal Bioethics Declaration ("the declaration"). The content and even the name of the declaration has yet to be finalized, but it is expected to range widely over human and non-human bioethics. It appears likely to include many articles directly related to medical ethics. The declaration may well evolve, like the Universal Declaration of Human Rights, into a component of international customary law, or be the precursor to an International Convention on Bioethics. This article discusses whether this process will facilitate bioethics and, in particular, medical ethics, being subsumed by the normative system of international human rights.
The first of two articles analyzing the justifiability of international bioethical codes and of cross-cultural moral judgments reviews "moral fundamentalism," the theory that cross-cultural moral judgments and international bioethical codes are justified by certain "basic" or "fundamental" moral priniciples that are universally accepted in all cultures and eras. Initially propounded by the judges at the 1947 Nuremberg Tribunal, moral fundamentalism has become the received justification of international bioethics, and of cross-temporal and cross-cultural moral judgments. Yet today we are said to live in a multicultural and postmodern world. This article assesses the challenges that multiculturalism and postmodernism pose to fundamentalism and concludes that these challenges render the position philosophically untenable, thereby undermining the received conception of the foundations of international bioethics. The second article, which follows, offers an alternative model -- a model of negotiated moral order -- as a viable justification for international bioethics and for transcultural and transtemporal moral judgments.
The discussion of the nature and value of dignity in and for bioethics concerns not only the importance of the concept but also the aims of bioethics itself. Here, I challenge the claim that the concept of dignity is useless by challenging the implicit conception of usefulness involved. I argue that the conception of usefulness that both opponents and proponents of dignity in bioethics adopt is rooted in a narrow understanding of the role of normative theory in practical ethical thinking. I then offer an alternate understanding of the nature and value of dignity. I begin by recognizing that claims that one's dignity has been violated point to an important difference between "respect for autonomy" and "respect for persons." I then suggest three different conceptions of how dignity can be normatively guiding for bioethics, and conclude that, ultimately, understanding dignity as the cornerstone of a reflective perspective that frames moral reflection and deliberation is valuable for doing bioethics well.
Hunt, Adrienne; Banner, Natalie; Littler, Katherine
Research during pregnancy is affected by multiple ethical challenges which have not received sufficient international attention and consideration from the bioethics, clinical, and policymaking communities working together. Unresolved ethical questions about research in pregnancy have significant detrimental impacts on maternal and newborn health, in part because they inhibit an evidence base being developed on the efficacy and safety of medicines and health interventions for pregnant women. These problems are compounded in low- and middle-income country (LMIC) settings due to variability in regulatory provisions, the burden of maternal morbidity and mortality, and many social and cultural conventions that impact on pregnant women's ability to participate in research. Research in pregnancy was chosen as a topic for the 2016 Global Forum on Bioethics in Research (GFBR) meeting, and its timeliness was all the more apparent given the 2016 Zika outbreak, which has deeply affected the Latin American region. The meeting's emerging consensus themes and outputs epitomized the core aims of the GFBR-to give voice to LMIC perspectives as a priority in dialogue about global health research ethics and to promote collaboration. In this instance, the GFBR meeting catalyzed a strong, unified drive to push researchers and policymakers to include pregnant women in research by default: given the complex nature of the topic, this is a significant achievement in addressing an important question of social justice.
Aleksandrova-Yankulovska, Silviya S
Bioethics and clinical ethics emerged from the classical medical ethics in the 1970s of the 20th century. Both fields are new for the Bulgarian academic tradition. The aims of this paper were to demarcate the subject fields of medical ethics, bioethics, and clinical ethics, to present the developments in the field of medical ethics in Bulgaria, to delineate the obstacles to effective ethics education of medical professionals, and to present the results of the application of an adapted bottom-up methodology for clinical ethics consultation in several clinical units in Bulgaria. Extended literature review and application of an adapted METAP methodology for clinical ethics consultation in six clinical units in the Northern Bulgaria between May 2013 and December 2014. Teaching of medical ethics in Bulgaria was introduced in the 1990s and still stands mainly as theoretical expertise without sufficient dilemma training in clinical settings. Earlier studies revealed need of clinical ethics consultation services in our country. METAP methodology was applied in 69 ethics meetings. In 31.9% of them non-medical considerations affected the choice of treatment and 34.8% resulted in reaching consensus between the team and the patient. Participants' opinion about the meetings was highly positive with 87.7% overall satisfaction. Development of bioethics in Bulgaria follows recent worldwide trends. Several ideas could be applied towards increasing the effectiveness of ethics education. Results of the ethics meetings lead to the conclusion that it is a successful and well accepted approach for clinical ethics consultation with a potential for wider introduction in our medical practice.
This paper explores complementarities between bioethics and human rights in the ethical analysis of early childhood development (ECD) policies. It is argued that conceptual synergies arising from the integration of these fields are considerable, if underexplored, and best illumined through application to specific domains of health policy. ECD represents an especially germane case study: it is characterized by rapidly evolving science whose normative implications are complex, emergent, and understudied, yet whose societal impacts are wide-ranging. The paper first charts the disciplinary evolution of bioethics, demonstrating its gradual social turn: from the individual to collective, from the medical to the societal. It then reviews points of theoretical confluence between bioethics and human rights, to assess the value and feasibility of their joint application to health policy analysis. Finally, it maps these complementarities onto issues provoked by the epigenetics of ECD, in the hopes that both the policy domain and the analysis of theoretical synergies are enriched. It finds that the distinctly relational and emergent nature of ECD science and policy demands novel forms of normative inquiry. Only an ethical approach supple enough to adapt to emergent questions, examine issues from varied theoretical perspectives, and assimilate insights across traditional disciplinary bounds will prove sufficient to the task. Copyright 2015 Denburg. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.
This Bioethics and Biopolitics: Presents and Futures of Reproduction symposium draws together a series of articles that were each submitted independently by their authors to the JBI and which explore the biopower axis in the externalization of reproduction in four contexts: artificial gestation (ectogenesis), PGD for sex selection, women's (reproductive) rights, and testicular cryopreservation (TCCP). While one contribution explores a "future" of reproduction, the other three explore a "present," or better, explore different "presents." What may counts as "present," and what may count as "future," has dramatically different connotations depending on the geographical declination of the tense.
Full Text Available The article presents an integrated empirical ethics research project that used the moral deliberation, according to the theoretical and philosophical conception, and methodical proposal of Diego Gracia, as a theoretical and methodological framework. The application showed the potential to realize the dynamics of the studied object in real life, making it possible, from the situation presented in the vignettes, for participants to include what they considered for dealing with the conflict of values. It also made the integration of philosophical and empirical approaches in bioethics research possible. The analytical category of prudence allowed the results to be assessed in a critical and comprehensive way.
Full Text Available En Occident, on semble généralement persuadé que ce qui y est appelé la bioéthique peut s’exporter mondialement. En fait les excellentes études qui ont été consacrées aux indiens Hopi montrent que notre bioéthique y serait totalement incompréhensible. Et l’enquête faite chez les Hopis donnerait des résultats très semblables dans d’autres sociétés dites « traditionnelles », dénomination qui signale l’autre aspect du problème. L’Occident, qui prétend étendre la bioéthique, en plus de ce qu’il appelle le droit, la démocratie et d’autres valeurs qui sont en fait une façon d’afficher sa supériorité et sa stratégie de conquête, cet Occident dissimule derrière son discours civilisateur la réalité d’une pensée sauvage qui se perçoit fort bien lorsque le prêche bioéthique dissimule mal les interdits des sacralités primitives.The Western world seems generally convinced that what is labelled as bioethics can be exported throughout the world. In fact the excellent research devoted to Hopi indians shows that our bioethics would be there totally impossible for them to understand. And the study carried out among the Hopis would produce very similar results in other so-called « traditional » societies. When the West claims the extension of bioethics in addition to law, democracy and other values, this may in fact be analyzed as a way of displaying its superiority and its strategy of conquest. It conceals behind its civilizing discourse the reality of a savage mind which is clearly perceptible, for its bioethical sermonising barely hides the taboos of its primitive sacrednesses .
In 1969, the field of human genetics was in its infancy. Amniocentesis was a new technique for prenatal diagnosis, and a newborn genetic screening program had been established in one state. There were also concerns about the potential hazards of genetic engineering. A research group at the Hastings Center and Paul Ramsey pioneered in the discussion of genetics and bioethics. Two principal techniques have emerged as being of enduring importance: human gene transfer research and genetic testing and screening. This essay tracks the development and use of these techniques and considers the ethical issues that they raise.
In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an 'abstract' philosophical analysis. Bioethics has (arguably) always been an interdisciplinary field, and the rise of 'empirical' (bio)ethics need not be seen as an attempt to give a new name to the longstanding practice of interdisciplinary collaboration, but can perhaps best be understood as a substantive attempt to engage with the nature of that interdisciplinarity and to articulate the relationship between the many different disciplines (some of them empirical) that contribute to the field. It can also be described as an endeavour to explain how different disciplinary approaches can be integrated to effectively answer normative questions in bioethics, and fundamental to that endeavour is the need to think about how a robust methodology can be articulated that successfully marries apparently divergent epistemological and metaethical perspectives with method. This paper proposes 'Reflexive Bioethics' (RB) as a methodology for interdisciplinary and empirical bioethics, which utilizes a method of 'Reflexive Balancing' (RBL). RBL has been developed in response to criticisms of various forms of reflective equilibrium, and is built upon a pragmatic characterization of Bioethics and a 'quasi-moral foundationalism', which allows RBL to avoid some of the difficulties associated with RE and yet retain the flexible egalitarianism that makes it intuitively appealing to many. © 2013 John Wiley & Sons Ltd.
Data collectors play a vital role in producing scientific knowledge. They are also an important component in understanding the practice of bioethics. Yet, very little attention has been given to their everyday experiences or the context in which they are expected to undertake these tasks. This paper argues that while there has been extensive philosophical attention given to 'the what' and 'the why' in bioethics - what action is taken place and why - these should be considered along 'the who' - who are the individuals tasked with bioethics and what can their insights bring to macro-level and abstract discussions of bioethics. This paper will draw on the philosophical theories of Paul Ricoeur which compliments a sociological examination of data collectors experiences and use of their agency coupled with a concern for contextual and institutional factors in which they worked. In emphasising everyday experiences and contexts, I will argue that data collectors' practice of bioethics was shaped by their position at the frontline of face-to-face interactions with medical research participants and community members, alongside their own personal ethical values and motivations. Institutional interpretations of bioethics also imposed certain parameters on their bioethical practice but these were generally peripheral to their sense of obligation and the expectations conferred in witnessing the needs and suffering of those they encountered during their quotidian research duties. This paper will demonstrate that although the principle of autonomy has dominated discussions of bioethics and gaining informed consent seen as a central facet of ethical research by many research institutions, for data collectors this principle was seldom the most important marker of their ethical practice. Instead, data collectors were concerned with remedying the dilemmas they encountered through enacting their own interpretations of justice and beneficence and imposing their own agency on the
Choe, Kwisoon; Park, Sunghee; Yoo, So Yeon
In order to help nurses advocate for the patient's human rights and ensure respect for life in clinical situations, it is of utmost importance to improve nursing students' capacity to make ethical decisions. This study compares the effects of two constructivist teaching strategies (action learning and cross-examination debate) on nursing students' recognition of bioethical issues, experience of bioethical issues, and attainment of ethical competence. This study used a quasi-experimental (two-group pretest-posttest) design. A nursing college in South Korea. A total of 93 Korean nursing students participated in the study (46 in the action learning group and 47 in the cross-examination debate group). Participants took a bioethics class employing one or the other of the strategies mentioned, 2h a week for 15 weeks. All participants responded twice to a set of questionnaires, at the beginning of the first session and at the end of the last session. After their bioethics education, the students' recognition of bioethical issues improved for both classes; however, the knowledge of students who had participated in action learning improved more than that of the students in the debate-based class. Students in both groups reported more experience of bioethics and exposure to better-quality instruction in bioethics after their classes than previously. Students in both groups also reported improved ethical competency after this education. Positive effects of action learning and cross-examination debate implemented as teaching strategies on nursing students' understanding of bioethical issues and their ethical competency were identified; these findings will be important in the essential task of teaching bioethics to nursing students in order to foster more ethical decision-making and other ethical behavior. © 2013.
Hiemke Katharina Schmidt
Full Text Available Prior knowledge is known to facilitate learning new information. Normally in studies confirming this outcome the relationship between prior knowledge and the topic to be learned is obvious: the information to be acquired is part of the domain or topic to which the prior knowledge belongs. This raises the question as to whether prior knowledge of various domains facilitates recalling information. In this study 79 eleventh-grade students completed a questionnaire on their prior knowledge of seven different domains related to the bioethical dilemma of prenatal diagnostics. The students read a text containing arguments for and arguments against prenatal diagnostics. After one week and again 12 weeks later they were asked to write down all the arguments they remembered. Prior knowledge helped them recall the arguments one week (r = .350 and 12 weeks (r = .316 later. Prior knowledge of three of the seven domains significantly helped them recall the arguments one week later (correlations between r = .194 to r = .394. Partial correlations with interest as a control item revealed that interest did not explain the relationship between prior knowledge and recall. Prior knowledge of different domains jointly supports the recall of arguments related to bioethical topics.
Full Text Available This study explains the appearance of a new ethical branch and practice called Bioethics, which task is life defense and development of human appearances and functions. In compliance with Bioethics, the concept of Special needs Education and Rehabilitation as a science and activity is investigated.Special needs Education and Rehabilitation is considered as a top of contemporary human ethics. The paper exposes the basic meanings professional ethics in Special Education and Rehabilitation. Many new phenomena determine the essence of the contemporary world. The most significant among them are the development of ethical awareness about doing people good and paying attention to all aspects of life in the world. The social sensitivity for young and weak people has developed. The philanthropic spirit for necessary charity among people has appeared. Especially significant appearances of this kind are the development of special education and rehabilitation as a special science and practice to help people with developmental disabilities and the occurrence of ecology as a specific awareness about protection of life natural conditions. These special moral knowledge and activities are fundamental elements for the new type of philosophy of living called “bioethics”.
María Natalia Zavadivker
Full Text Available This article seeks to investigate to what extent the resulting empirical data from various experiments in Moral Psychology (some behavioral, others based on evidence from neuroimaging and in patients with brain lesions associated with moral competence areas , can contribute to a better understanding of the psychological processes (cognitive and emotional underlying to our moral practical judgments, helping us to understand the mechanisms that influence our assessment of moral dilemmas in general and bioethics in particular. Various experiments are discussed (and the theoretical models that are supported that reveal aspects such as the role of disgust or repugnance in the production of moral judgments, the competitive or cooperative role of emotions and cognitions in impersonal and personal moral dilemmas -and between the above mentioned, easy and difficult-, the neurophysiological bases of deontologist and consequentialist, the value attributed to the intent and the results of action, etc. The relevance of these experiments are analyzed to understand the evaluative and deliberative processes concerning various bioethical dilemmas, for which appeals to examples of conflict situations involved and our emotional resources (that activate immediate assessment and our higher cortical areas interact (cognitive processes responsible for slower deliberative and reflexive.
There has been considerable work in bioethics addressing injustice and gender oppression in the provision of healthcare services, in the interaction between client and healthcare professional, and in allocation of healthcare services within a particular hospital or health service. There remain several sites of continued injustice that can only be addressed adequately from a broader analytical perspective, one that attends to the social and political contexts framing healthcare policy and practice. Feminist bioethicists have a strong track record in providing this kind of analysis. Using current Australian aged care and welfare policy this paper demonstrates some of the ways in which issues of gender, age, and social inequity shape bioethical debate, policy, and practice in the areas of aged care and welfare provision. The author develops an argument that demonstrates the gender injustice underlying health care and welfare policy. This argument recognises the inevitability of human dependency relations, and questions the adequacy of current political theories to address the requirements for full and equal citizenship. The author shows that an adequate analysis of the ethics of aged healthcare depends on sufficient consideration of the social and political context within which healthcare policy is framed and an adequate understanding of human dependency.
The Thai concern for bioethics has been stimulated by the departure of Thai medicine from its long tradition through the introduction of Western medical models. Bioethics is now being taught to Thai medical students emphasizing moral insights and principles found within Thai culture. These are to a large extent Buddhist themes. Veracity is always a duty for people in general and medical personnel in particular. Falsehoods and deception cannot be morally justified simply on the grounds that we think it is good for another. Buddhism also prohibits killing. The doctrine of kamma holds that joys and sorrows are the result of one's own past actions. Kamma must run its course or will be manifest in a future life. Mercy-killing also violates the Buddhist psychology. A physician who kills subconsciously transfers his aversion to suffering to the one who embodies the suffering. Buddhist justice is understood in terms of impartiality and equal treatment. Compassion goes beyond justice to self-giving and self-denial. It is central to the path to the attainment of highest human fulfillment.
I reflect on the past, present, and future of the field of bioethics. In so doing, I offer a very situated overview of where bioethics has been, where it now is, where it seems to be going, where I think we could do better, and where I dearly hope the field will be heading. I also propose three ways of re-orienting our theoretic tools to guide us in a new direction: (1) adopt an ethics of responsibility; (2) explore the responsibilities of various kinds of actors and relationships among them; (3) expand the types of participants engaged in bioethics. © 2010 Blackwell Publishing Ltd.
ten Have, Henk
Vulnerability has become a popular though controversial topic in bioethics, notably since 2000. As a result, a common body of knowledge has emerged (1) distinguishing between different types of vulnerability, (2) criticizing the categorization of populations as vulnerable, and (3) questioning the practical implications. It is argued that two perspectives on vulnerability, i.e., the philosophical and political, pose challenges to contemporary bioethics discourse: they re-examine the significance of human agency, the primacy of the individual person, and the negativity of vulnerability. As a phenomenon of globalization, vulnerability can only be properly addressed in a global bioethics that takes the social dimension of human existence seriously.
Schonfeld, Toby; Stoddard, Hugh; Labrecque, Cory Andrew
Assessing mastery of bioethics in a graduate program requires careful attention not simply to the content knowledge and skill development of students but also to the principles of sound assessment processes. In this article, we describe the rationale, development process, and features of the comprehensive exam we created as a culminating experience of a master's program in bioethics. The exam became the students' opportunity to demonstrate the way they were able to integrate course, textual, and practical knowledge gained throughout the experience of the program. Additionally, the exam assessed students' proficiency in the field of bioethics and their ability to critically and constructively analyze bioethical issues. In this article, we offer tips to other exam creators regarding our experiences with question and answer development, scoring of the exam, and relationships between coursework and exam preparation and completion. We also include a sample rubric for others to see how we determined which student answers were satisfactory.
Bloom, Arthur; Constan, Phyllis
A bioethics unit aimed at taking biology out of the laboratory and classroom and into the world. An experience in which students not only begin to understand reasons for making decisions, but also understand how values change. (Author/EB)
Hussain, Zeenat; Kuzian, Edyta; Hussain, Naveed
Gender representation in Islamic bioethics research in the twenty-first century has not been studied. To study temporal trends in representation of female subjects in Islamic bioethics research, PubMed-listed publications on Islamic bioethics from years 2000 to 2014 were reviewed for gender participation in human subjects' research. There were temporal trends of increasing publications of Islamic bioethics-related human subjects' research (64 papers over 15 years; R 2 = 0.72; p < 0.0004). Female subjects were well represented with a trend toward increasing participation. This was true for women from Muslim-majority countries even in non-gender-focused studies over the past 15 years.
An introduction to aspects of health law: bioethical principles, human rights and the law · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. D McQuoid-Mason, 7-10 ...
Full Text Available This brief essay proposes to reflect on what could be Latin American bioethics, speculating about possible identity characteristics and operational limits of the idea of what constitutes Latin America, outlined conceptually by geographical, historical and cultural aspects. This attempt does not assume the task of defining exactly or definitively what Latin American bioethics is, but rather limits itself to the purpose of causing controversy in order to stimulate reflection on this topic to assess its usefulness.
Meagher, Karen M; Lee, Lisa M
Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.
Faunce, Thomas Alured; Nasu, Hitoshi
The United Nations Scientific, Education, and Cultural Organization Universal Declaration on Bioethics and Human Rights (UDBHR) expresses in its title and substance a controversial linkage of two normative systems: international human rights law and bioethics. The UDBHR has the status of what is known as a "nonbinding" declaration under public international law. The UDBHR's foundation within bioethics (and association, e.g., with virtue-based or principlist bioethical theories) is more problematic. Nonetheless, the UDBHR contains socially important principles of technology transfer and transnational benefit (articles 14, 15, and 21). This paper is one of the first to explore how the disciplines of bioethics and international human rights law may interact in the UDBHR to advance the policy relevance and health impact of such principles. It investigates their normative ancestry in the UDBHR, as well as relevant conceptual differences between bioethics and public international law in this respect, and how these may be relevant to their conceptual evolution and application.
Bioethical norms that had constituted only a rather short chapter in the medical curricula are now integrated into universal human rights. This paper seeks to demonstrate the normative convergence between the fields of bioethics and human rights by discussing the recently adopted relevant international documents and some applicable cases from international law. Human rights case law relevant in this emerging legal domain is analyzed with the aim to tackle changes that have occurred in the fields of human rights and bioethics due to the convergence and interdependence between them. Bioethics and human rights are two different systems of norms but bioethics can enrich human rights by extending the traditional catalogue of rights in certain new fields. The theory of human rights nevertheless dictates some discipline in formulating new and new rights. Therefore it offers to bioethics, as an exchange, a more sufficient enforcement mechanism and international recognition.
Pandya, Radhika H; Shukla, Radha; Gor, Alpa P; Ganguly, Barna
The principles of bioethics have been identified as important requirements for training basic medical doctors. Till now, various modalities have been used for teaching bioethics, such as lectures, followed by a small case-based discussion, case vignettes or debates among students. For effective teaching-learning of bioethics, it is necessary to integrate theory and practice rather than merely teach theoretical constructs without helping the students translate those constructs into practice. Classroom teaching can focus on the theoretical knowledge of professional relationships, patient-doctor relationships, issues at the beginning and end of life, reproductive technologies, etc. However, a better learning environment can be created through an experiencebased approach to complement lectures and facilitate successful teaching. Engaging students in reflective dialogue with their peers would allow them to refine their ideas with respect to learning ethics. It can help in the development both of the cognitive and affective domains of the teaching of bioethics. Real-life narratives by the interns, when used as case or situation analysis models for a particular ethical issue, can enhance other students' insight and give them a moral boost. Doing this can change the classroom atmosphere, enhance motivation, improve the students' aptitude and improve their attitude towards learning bioethics. Involving the students in this manner can prove to be a sustainable way of achieving the goal of deep reflective learning of bioethics and can serve as a new technique for maintaining the interest of students as well as teachers.
The paper explores the backward and forward linkage between HCL and bioethics. Indeed, the relationship between the two is so close that it can be considered one of symbiosis. This is particularly the case when an account is taken of how HCL and bioethics positively benefitted from each other in diverse ways during their development into their present status as discrete disciplines. In the first place, the aftermath of the Second World War, such as the Nuremberg trial and unprecedented medical experiment scandals in the 1960s/70s fuelled the increasing participation of lay scholars in exploring and critiquing medical ethics which culminated in the emergence ofbioethics.2 This in turn facilitated the evolution of HCL as a discipline, since academic lawyers involved in early bioethical discourse developed interest in exploring the interface between law and bioethics at the same time that society was waking up to the ethical implications of medical advances. As HCL emerged as a discrete discipline, it consolidated the status of bioethics as a field of inquiry by projecting the relevance of the latter in adjudication of novel cases with significant slippery moral undertones. Thus, the chicken and egg paradox finds a perfect reflection in the emergence of health care law and bioethics in England and Wales.
Ribeiro, Carlos Dimas Martins; Maksud, Ivia; Claro, Lenita Barreto Lorena; Un, Julio Wong
This article discusses the character and use of qualitative research methods in the field of bioethics. A systematic review of articles published in Latin American countries and selected from the SciELO database was conducted, with special emphasis on articles that employed qualitative research methodology. The set of articles reveals a field of bioethics composed of three distinct vectors. The first refers to the dual characterization of bioethics that can be defined as a social movement or as a discipline; the second differentiates bioethics from other fields of ethics, especially from predominantly deontology-based professional ethics; and the third is related to ethical approaches adopted in the analyses conducted in the research. A relatively insignificant part of these texts result from qualitative research and they can be divided into four categories according to their themes and guidelines: bioethics as a field and/or discourse; training in health; ethics, care, and clinical practice; formulation of health policy. The production shows, on the one hand, a relatively timid approach of social science researchers to the field of bioethics and, on the other hand, little use of qualitative methodologies in research in the field and, in some cases, a certain lack of precision regarding use of the methods.
Harrell, Reginal M
Normative ethical considerations of growth of the marine biotechnology and aquaculture disciplines in biopharming, food production, and marine products commercialization from a bioethical perspective have been limited. This paucity of information begs the question of what constitutes a bioethical approach (i.e., respect for individuals or autonomy; beneficence, nonmaleficence, and justice) to marine biotechnology and aquaculture, and whether it is one that is appropriate for consideration. Currently, thoughtful discussion on the bioethical implications of use, development, and commercialization of marine organisms or their products, as well as potential environmental effects, defaults to human biomedicine as a model. One must question the validity of using human bioethical principlism moral norms for appropriating a responsible marine biotechnology and aquaculture ethic. When considering potential impacts within these disciplines, deference must be given to differing value systems in order to find common ground to advance knowledge and avoid emotive impasses that can hinder the science and its application. The import of bioethical considerations when conducting research and/or production is discussed. This discussion is directed toward applying bioethical principles toward technology used for food, biomedical development (e.g., biopharming), or as model species for advancement of knowledge for human diseases.
This article discusses the notion of social responsibility for personal health and well-being in bioethics. Although social responsibility is an intrinsic aspect of bioethics, and its role is increasingly recognized in certain areas, it can still be claimed that bioethics in general is committed to an individualistic theoretical framework that disregards the social context in which decisions, health, and well-being are situated. The philosophical premises of this framework regard individuals as rational decisionmakers who can be held accountable for their health conditions and who should be the primary objects of intervention in attempts to reduce lifestyle-associated chronic diseases. There are, however, social determinants of health that challenge this conclusion. Because their impact can be controlled, to a certain extent, by social and public policy decisions, their existence shows the inadequacy of the purely individualistic approach. I suggest, accordingly, that bioethics would benefit, both academically and societally, from a more social perspective. Bioethical studies that acknowledge, from the start, the social determinants of health would be more amenable to constructive multi- and interdisciplinarity, and a more balanced account of responsibility would further the contribution of sound bioethical work to sensible public policies.
Nythamar de Oliveira
Full Text Available http://dx.doi.org/10.5007/1677-2954.2016v15n3p343 In this article, I argue that the neuroethics of cognitive enhancement can help us bridge the explanatory gap between metaethics and bioethics (qua normative, applied ethics and throw light on the classic gap between moral beliefs and neural correlates of brain processes. Insofar as it unveils the irreducibility of first-person propositional attitudes (esp. moral beliefs and judgments, neuroethics allows for justifying cosmetic, pharmacological interventions so as to bring about human enhancement, regardless of descriptive accounts of its neural correlates and independently of the cognitivist, noncognitivist or hybrid inputs of metanormative theories. Precisely because it cannot provide the ultimate grounds for any conservative, libertarian or liberal attitudes towards cognitive enhancement, neuroethics is better conceived in terms of a Rawlsian-like wide reflective equilibrium, procedurally and without any specific substantive commitment to any moral or comprehensive doctrine of sorts.
Elizabeth J. Donaldson
Full Text Available This essay focuses on specific teaching assignments, strategies, and resources designed to help undergraduate students think critically about key concepts in bioethics—such as autonomy, paternalism, informed consent, and competency—using examples and case studies involving people diagnosed with schizophrenia. The assignments described below are disability-rights inspired interventions into the students' career-focused mindsets and training; one of my main strategies is social decentering, or having students examine a situation from a variety of theoretical and subjective perspectives. Exposing students to online talks by people diagnosed with schizophrenia and similar primary sources helps those students without first-hand experience to better understand these different points of view. While these assignments are primarily geared toward bioethics classes, they include resources and ideas for class activities that might be useful in other courses within disability studies, mad studies, psychiatry, literature, or film.
John Christopher Sikorski
Full Text Available Dominant trends within the philosophical debate over personhood and identity tend to discount the significance and meaning of the human body and often slip into dualistic conceptions. I will argue that a Catholic theology of the body challenges many of the prevalent understandings in bioethics today. Such a notion takes Christ’s Incarnation as its foundation and seeks to develop an account of the human body in the context of the call to communion imprinted on humanity as made in the image of the Trinitarian communion of love. Such a conception counteracts forms of utilitarian or technological reductionism of the person. While Catholic bioethicists will need to consider how such an account will have practical applicability to cases, the call to communion ought to be fostered through the liturgical life of the Church, which enables Catholic bioethicists to develop a liturgical worldview that guards against devaluations of the dignity of the human person.
Ramos-Rocha de Viesca, Mariablanca
Cosmetic surgery is one of the best examples of the current health empowerment. Aesthetic surgical interventions have been criticized because they expose the healthy individual to an unnecessary risk. In modern society the body has turned into a beauty depository with a commercial value. In published bioethics papers, analyses of the cosmetic problem pointed their attention on the freedom, autonomy and distributive justice. Mexico occupies fifth place in the world of cosmetic surgeries. Vulnerability is an inherent condition of man's existence and marks the limit of human dignity. UNESCO agrees that some populations are more inclined to vulnerability. The aim of this work is to demonstrate that those who wish to make a physical change had given up to social coercion and psychological problems.
Fitzpatrick, Scott J; Kerridge, Ian H; Jordens, Christopher F C; Zoloth, Laurie; Tollefsen, Christopher; Tsomo, Karma Lekshe; Jensen, Michael P; Sachedina, Abdulaziz; Sarma, Deepak
The prevention and relief of suffering has long been a core medical concern. But while this is a laudable goal, some question whether medicine can, or should, aim for a world without pain, sadness, anxiety, despair or uncertainty. To explore these issues, we invited experts from six of the world's major faith traditions to address the following question. Is there value in suffering? And is something lost in the prevention and/or relief of suffering? While each of the perspectives provided maintains that suffering should be alleviated and that medicine's proper role is to prevent and relieve suffering by ethical means, it is also apparent that questions regarding the meaning and value of suffering are beyond the realm of medicine. These perspectives suggest that medicine and bioethics have much to gain from respectful consideration of religious discourse surrounding suffering.
Thomas Hobbes is one of the most ardent and thoroughgoing opponents of participatory democracy among Western political philosophers. Though Hobbes's alternative to participatory democracy-assent by subjects to rule by an absolute sovereign-no longer constitutes a viable political alternative for Westerners, his critique of participatory democracy is a potentially valuable source of insight about its liabilities. This essay elaborates five theses from Hobbes that stand as cogent warnings to those who embrace participatory democracy, especially those (such as most bioethicists) advocating for deliberative democracy based on a rational consensus model. In light of these warnings, the author suggests an alternative, modus vivendi approach to deliberative democracy that would radically alter the current practice of bioethics.
Singer, G R; Koch, K A
Listening, teaching, understanding, exploring, explaining: these are the foundations of a sound patient-physician relationship. From these skills, we can then proceed to discussions on difficult topics such as preferences for end-of-life care. We can share bad news without destroying hope. We can show what makes the medical profession unlike any other. This issue of The Journal addresses the handling of medical errors, the termination of mechanical ventilatory support, ethical problems in managed care, and confidentiality issues in the computer era. Guidelines for institutional ethics committees also are presented. These are only a sampling of topics that cut to the heart of bioethics, patient communication, and contemporary medical practice. The more that we study such issues, the more we understand the contributions of medical ethics to medical practice, and the better we serve our patients.
Solomon, Mildred Z; Jennings, Bruce
Across the world, an authoritarian and exclusionary form of populism is gaining political traction. Historically, some populist movements have been democratic and based on a sense of inclusive justice and the common good. But the populism on the rise at present speaks and acts otherwise. It is challenging constitutional democracies. The polarization seen in authoritarian populism goes beyond the familiar left-right political spectrum and generates disturbing forms of extremism, including the so-called alternative right in the United States and similar ethnic and nationalistic political movements in other countries. The field of bioethics will be profoundly affected if authoritarian populism displaces constitutional democracy. But the field has a significant contribution to make to rebuilding the communal and civic foundations upon which constitutional democracy rests. © 2017 The Hastings Center.
Kass, Nancy E; Ali, Joseph; Hallez, Kristina; Hyder, Adnan A
Our primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments. We surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre-post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables. 10 different FBTPs that trained individuals from Africa from 2000 to 2011. Of 253 eligible respondents, 171 completed the survey (response rate 67.6%). Pre-post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes. Post-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles. African
Lolas, Fernando; Rodriguez, Eduardo
This paper reviews the experience in training Latin American professionals and scientists in the ethics of biomedical and psychosocial research at the Interdisciplinary Center for Studies in Bioethics (CIEB) of the University of Chile, aided by a grant from Fogarty International Center (FIC) – National Institutes of Health from 2002 to 2011. In these 10 years of experience, 50 trainees have completed a 12-month training combining on-line and in-person teaching and learning activities, with further support for maintaining contact via webmail and personal meetings. The network formed by faculty and former trainees has published extensively on issues relevant in the continent and has been instrumental in promoting new master level courses at different universities, drafting regulations and norms, and promoting the use of bioethical discourse in health care and research. Evaluation meetings have shown that while most trainees did benefit from the experience and contributed highly to developments at their home institutions and countries, some degree of structuring of demand for qualified personnel is needed in order to better utilize the human resources created by the program. Publications and other deliverables of trainees and faculty are presented. PMID:22754084
Bioethics is ethics applied to the field of the bios, of life. As such, bioethics addresses morally relevant human actions and related moral judgments which obtain throughout the phenomenon of human life...
Leandro Correa Figueiredo
Full Text Available Introduction: Currently, conflicts found in the health field bring new discussions on ethical and bioethical issues also in the Occupational Therapy domain. As noted in previous studies, the codes of professional ethics are not sufficient to face the current challenges daily experienced during professional practice. Objective: The present study aimed to find documental evidence of deontological and bioethical approaches in the new Brazilian code for Occupational Therapists through content analysis compared with the same analysis conducted in the preceding code. Method: Content analysis methods were applied to written documents to reveal deontological and bioethical approaches among textual fragments obtained from the new code of ethics. Results: The bioethical approaches found in the totality of the new code were increased in content and number (53.6% proportionally compared with those found in the former code. It seems that this increase was a result of the number of fragments classified in the justice-related category (22.6% - one of the most evident differences observed. Considering the ratio between the total number of fragments classified as professional autonomy and client autonomy in the new code - although the number of professional-related fragments have remained higher in comparison with client-related fragments - a significant decrease in the percentages of this ratio was detected. Conclusion: In conclusion, comparison between the codes revealed a bioethical embedding accompanied by a more client-centered practice, which reflects the way professionals have always conducted Occupational Therapy practice.
In France, bioethics norms have emerged in close interaction with medical practices. The first bioethics laws were adopted in 1994, with provisions for updates in 2004 and most recently, in 2011. As in other countries, bioethics laws indirectly refer to certain fundamental values. The purpose of this paper is threefold. First, I shall briefly describe the construction of the French bioethics laws and the values they are meant to protect. Secondly, I will show that the practice of clinical ethics, as reported in a few studies on ART, living organ donation and PGD, challenge the role attributed to doctors as "gatekeepers" of those fundamental values. Thirdly, I will suggest that the quality of medical practices would improve if the law focused on strengthening the tacit pact between doctors and patients, rather than putting doctors in charge of enforcing societal values. Doctors, for their part, would limit their role to what they can do best: provide sufficient patient support and safe care. Against those who argue that we should dispense with bioethics laws altogether, I hold that the laws are useful in order to limit the development of abusive practices. However, a new legislative approach should be adopted which would a positive presumption in favor of patients' requests.
Pereira Rates, Camila Maria; Maciel Silva, Larriny; Moura Pereira, Lívia; Reis Pessalacia, Juliana Dias
Identifying the contribution of using films in the process of teaching-learning in bioethics and verifying the facilities and difficulties in using this teaching resource. A qualitative study analyzed from the Bardin referential. Semi-structured interviews were carried out, recorded, and transcribed in full. For definition of the sample was used the criteria of repetition. In total, participated in the study 21 students of Nursing and Biochemistry, members of a Center for Teaching and Research in Bioethics of a public federal university in the city of Divinópolis, Minas Gerais, Brazil. During the analysis of interviews, two thematic categories and two subcategories emerged. In their responses, students indicated the importance of viewing the bioethical problem for the reflection and decision-making in professional practice. Many reported that from the experience in discussions of the films showed, were made changes in the ethical position. The use of films as a teaching resource contributes to the process of teaching-learning in bioethics for undergraduate students. The discussions of the films are stimulating and provide a space for reflection and dialogue on bioethical problems that students may encounter in their professional practice.
Recent work done at the intersection of classical American pragmatism and bioethics promises much: a clarified self-understanding for bioethics, a modus vivendi for progress, and liberation from misguided and misguiding theories and principles. The revival of pragmatism outside bioethics in the past twenty years, however, has been of a distinctly anti-realist orientation. Richard Rorty, for example, has urged that there is no objective truth or good for philosophy to be concerned with. I ask whether the work in Pragmatic Bioethics follows this perilous Rortyan trend. It will move towards anti-realism if its account of the good abandons any notion of truth or objectivity, and if, in its discussion of specific problems, it divides these problems into public and the private, urging consensus as the goal of the one, and an unconstrained notion of happiness as the goal of the other. In a final section, I suggest that bioethics done in the spirit of Royce's Philosophy of Loyalty might have much to offer to those dissatisfied with anti-realism.
Camila Maria Pereira Rates
Full Text Available Objective. Identifying the contribution of using films in the process of teaching-learning in bioethics and verifying the facilities and difficulties in using this teaching resource. Methodology. A qualitative study analyzed from the Bardin referential. Semi-structured interviews were carried out, recorded, and transcribed in full. For definition of the sample was used the criteria of repetition. In total, participated in the study 21 students of Nursing and Biochemistry, members of a Center for Teaching and Research in Bioethics of a public federal university in the city of Divinópolis, Minas Gerais, Brazil. During the analysis of interviews, two thematic categories and two subcategories emerged. Results. In their responses, students indicated the importance of viewing the bioethical problem for the reflection and decision-making in professional practice. Many reported that from the experience in discussions of the films showed, were made changes in the ethical position. Conclusion: The use of films as a teaching resource contributes to the process of teaching-learning in bioethics for undergraduate students. The discussions of the films are stimulating and provide a space for reflection and dialogue on bioethical problems that students may encounter in their professional practice.
Justyna A. Kaczmarczyk
Full Text Available The rapid development of medicine that has taken place in the last 10 years confronts personnel with new challenges that extend beyond life-saving treatments; they include moral, legal, and deontological dilemmas, which can be recognised as bioethical ones. The new discourse of patient’s participation in planning their treatment makes it impossible to remain indifferent to their expectations and will, the patient’s approval, and declaration of intent on the healing process, and at the same time not to respect their basic privileges guaranteed by law and those arising from the codes of ethics. Humans are a bio-psychophysical unity, and therefore should be perceived from a holistic perspective. This article presents the different dilemmas concerning the treatment of patients in the terminal stage of disease, including minors. It indicates the assessment and the prospect of death, from the child and adult perspective. It recognises patient’s rights, his/her autonomy, dignity, subjectivity, but also the responsibilities and duties of health care personnel, taking into account respect for the patient, his/her independence, the adequacy of activities, and reference to the principle of double effect.
Valles, Sean A
Cheryl Cox Macpherson recently argued, in an article for this journal, that 'Climate Change is a Bioethics Problem'. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields. © 2014 John Wiley & Sons Ltd.
Mariluci Alves Maftum
Full Text Available ABSTRACT: One is about a reflection on some recurrent controversial subjects of the present time of the advances of the biotechnology, as the attended reproduction, the cloning human being, the production of transgênicos products and others that not rare are part of day-by-day of the health professionals. Subjects for which answers in Laws and Professional Codes of Ethics are not found, with also not have a consensus in a plural society, some time that involve divergent beliefs and cultural values. However the health professionals that have in the exercise of the profession the responsibility to clarify even though to safeguard the right of the patient in the taking of decisions or the times have the paper to decide and to make choices for it, becomes necessary this knowledge as base of one practical professional, in which the respect and dignity human being is the mark of the quality. KEY WORDS: Bioethics; Assisted reproduction; cloning; Human being cloning.
Ibrahim, Abdul Halim; Rahman, Noor Naemah Abdul; Saifuddeen, Shaikh Mohd
Rapid development in the area of assisted reproductive technology (ART), has benefited mankind by addressing reproductive problems. However, the emergence of new technologies and techniques raises various issues and discussions among physicians and the masses, especially on issues related to bioethics. Apart from solutions provided using conventional bioethics framework, solutions can also be derived via a complementary framework of bioethics based on the Higher Objectives of the Divine Law (Maqasid al-Shariah) in tackling these problems. This approach in the Islamic World has been applied and localised in the Malaysian context. Thus, this paper highlights a conceptual theoretical framework for solving current bioethical issues, with a special focus on ART in the Malaysian context, and compares this theory with conventional theories of bioethics.
Mendelevich, Vladimir D
This article provides an overview of a sociological study of the views of 338 drug addiction treatment professionals. A comparison is drawn between the bioethical approaches of Russian and foreign experts from 18 countries. It is concluded that the bioethical priorities of Russian and foreign experts differ significantly. Differences involve attitudes toward confidentiality, informed consent, compulsory treatment, opioid agonist therapy, mandatory testing of students for psychoactive substances, the prevention of mental patients from having children, harm reduction programs (needle and syringe exchange), euthanasia, and abortion. It is proposed that the cardinal dissimilarity between models for providing drug treatment in the Russian Federation versus the majority of the countries of the world stems from differing bioethical attitudes among drug addiction treatment experts.
Mendelevich Vladimir D
Full Text Available Abstract This article provides an overview of a sociological study of the views of 338 drug addiction treatment professionals. A comparison is drawn between the bioethical approaches of Russian and foreign experts from 18 countries. It is concluded that the bioethical priorities of Russian and foreign experts differ significantly. Differences involve attitudes toward confidentiality, informed consent, compulsory treatment, opioid agonist therapy, mandatory testing of students for psychoactive substances, the prevention of mental patients from having children, harm reduction programs (needle and syringe exchange, euthanasia, and abortion. It is proposed that the cardinal dissimilarity between models for providing drug treatment in the Russian Federation versus the majority of the countries of the world stems from differing bioethical attitudes among drug addiction treatment experts.
Kotalik, Jaro; Martin, Gerry
Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge. As an example of an element of traditional knowledge that contains strong ethical guidance, we present the story of the Gifts of the Seven Grandfathers. We note a resemblance of this Ojibway teaching to virtue ethics in European traditions, but we suggest that there are also important differences in how these two traditions are currently presented. We hope that further engagement with a variety of indigenous moral teachings and traditions could improve health care involving Aboriginal patients and communities, and enrich the discipline of bioethics.
In this paper I argue that bioethics is in crisis and that it will not have a future unless it begins to embrace a more Socratic approach to its leading assumptions. The absence of a critical and sceptical spirit has resulted in little more than a dominant ideology. I focus on three key issues. First, that too often bioethics collapses into medical ethics. Second, that medical ethics itself is beset by a lack of self-reflection that I characterize here as a commitment to three dogmas. Third, I offer a more positive perspective by suggesting how bioethics may benefit from looking towards public health ethics as a new source of inspiration and direction.
Full Text Available The main objective of this work is to expand the bioethics notion expressed in the Article 17th of the Universal Declaration on Bioethics and Human Rights, concerning the interconnections between human beings and other life forms. For this purpose, it is combined the transdisciplinary methodology with the theoretical framework of the “Big History” to approach the co-evolutionary phenomena that life is developing on Earth for some 3.8 billion years. As a result, the study introduces us to the unification, integration and inclusion of the history of the universe, the solar system, Earth, and life with the history of human beings. In conclusion, I consider to safeguard the cosmic miracle that represents the emergence of life we must adopt new transdisciplinary perspectives into bioethics to address the ecosystem complexity of co-evolutionary processes of life on Gaia as a whole.
Only recently, bioethics has crystallized into a full-fledged discipline. The aim of this article is to analyze whether Freud is competent to deal with bioethics. Freudian psychoanalysis is reviewed as a global theory that touches culture as a totality. And it is by way of a global theory of culture that Freud takes up the phenomenon of morality. Freud gives not an alternative answer to unchanged questions in bioethics, but delivers a new manner of asking moral questions. The ground rule establishes the conditions for treatment. And secondly, it is a radical elimination of any position of moral existence. Ethics is simply bracketed (put in parenthesis) in the sense that in its regard no position is taken either for or against. What is at stake is self-recognition and Freudian itinerary runs from misunderstanding to recognition. If Freud offers a technique, it is not included in the cycle of techniques of domination; it is a technique of veracity.
It is increasingly common for universities to provide cross-curricular education in bioethics as part of contemporary attempts to produce 'global citizens.' In this article I examine three perspectives drawn from research into pedagogy that has been conducted from the perspective of cognitive anthropology and consider its relevance to bioethics education. I focus on: two metaphors of learning, participation and acquisition, identified by Sfard; the psychological notion of moral development; and the distinction between socialization and enculturation. Two of these perspectives have been particularly fruitful in understanding the processes of teaching and learning in a variety of domains. The third perspective has been developed in relation to the formal ethical education of medical students. I examine their relevance for 'non-professional' bioethics education suggesting that if we take seriously the idea that it is part of 'educating for citizenship' then the distinction between 'ethics' and 'politics' is blurred as such programmes aim at the development of student's political subjectivity.
VUGAR, MAMMADOV; KERIM, MUNIR; LALA, JAFAROVA
Azerbaijan is a modern, rapidly developing democratic country at the crossroads of Europe and Asia. The country is currently harmonizing its national legislation with international norms, and reforming its national scientific and medical. Higher standards of medical research and education will enhance public health and protect human rights to life and health that are specified in Azerbaijan Constitution. In order to raise its medical research and education to international standards, Azerbaijani scientists and authorities are studying the experience of other countries and taking measures to implement international standards and norms in the country’s national legislation. Cooperation with the WHO, UNESCO and other international and foreign organizations, both on regional and global level is creating steps to achieve this goal. These steps include, for example, creation of the Azerbaijan unit of the UNESCO Chair in Bioethics and teaching bioethics based on UNESCO’s Bioethics Core Curriculum. Another step is providing research fellowship for young Azerbaijani professionals to study at leading medical research and educational centers around the world including Harvard Medical School and Boston Children’s Hospital in the USA, and Koc University in Turkey. A complementary step is the development of local bioethical research, including its legal, ethical and scientific foundations. Adherence to ethical principles in different spheres of life is currently one of the most challenging social and professional issues, especially, this is true with the development of new medical technologies in recent decades and the development of new ethical and legal standards, issues involving different areas of health and medicine and their relation to human rights. Bioethics in Azerbaijan is developing as an important field that deals with universal moral principles within the context of both national laws and the UNESCO Universal Declaration on Bioethics and Human Rights. PMID
Hart, Curtis W
This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in psychosomatic medicine and clinical pragmatism in bioethics, and illustrates the breadth of influence of the school of philosophical thought known as pragmatism with which Dewey's name and those of William James and Charles Sanders Pierce are most often identified.
Siqueira-Batista, Rodrigo; Schramm, Fermin Roland
This article discusses bioethical aspects of medical futility, focusing on some of its intersections in public health. Starting from a demarcation of finitude in the core of the philosophical and bioethical debate on the end of life, we confront the contemporary criticism regarding medical futility with the ideas of Plato (427-347 B.C.), a philosopher who proposed significant considerations on numerous features of the medicine of his time. We thus explore novel theoretic references to guide the disputes related to this essential problem, the implications of which are decisive to health and life.
Filc, Dani; Davidovich, Nadav; Gottlieb, Nora
This article argues that current, mainstream, liberal approaches to the right to health and to bioethics are not adequately aware of the structural and political character of health and illness. We propose a radical egalitarian definition of the right to health as the basis for the discussion of a republican egalitarian perspective on bioethics that redefines autonomy and stresses the importance of equality, political participation, and the common good. The violations of the right to health in unrecognized Bedouin villages in Israel are analyzed to exemplify the possibilities opened by the republican egalitarian approach. © The Author(s) 2015.
Faunce, Thomas Alured
The United Nations Scientific, Education and Cultural Organisation (UNESCO) has commenced drafting a Universal Bioethics Declaration. Some in the relevant UNESCO drafting committee have previously desired to restrict its content to general principles concerning the application (but not necessarily the goals) of science and technology. As potentially a crucial agenda-setting statement of global bioethics, however, it is arguable important the Universal Bioethics Declaration transparently address major bioethical dilemmas in the field of public health, such as universal access to affordable, essential medicines. Article 13 (Social Responsibility) of the Preliminary Draft Universal Bioethics Declaration states: 'Any decision or practice shall ensure that progress in science and technology contributes, wherever possible, to the common good, including the achievement of goals such as: (i) access to quality health care and essential medicines, including for reproductive health and health of children.' Cost effectiveness pricing systems, such as that most notably used in Australia's Pharmaceutical Benefits Scheme (PBS), arguably represent one of the most scientifically effective mechanisms whereby public monies may be utilised to assist in the provision of medicines for the common good. They contain two essential elements: first, a process of scientific evaluation of objectively demonstrated therapeutic significance, and then, a fiscal lever (the government reimbursement price) attached to that evaluation. It is now well established that the US Pharmaceutical Research and Manufacturers Association (Pharma), through the assistance of the US Trade Representative (USTR), saw the Australia United States Free Trade Agreement (AUSFTA) as an opportunity to fulfill a legislative mandate to 'eliminate' the cost-effectiveness pricing system in Australia's PBS. One of the most remarkable features of the arguments raised against the PBS in this context was the fact that they made
Bergman, Edward J
Bioethics mediators manage a wide range of clinical conflict emanating from diverse sources. Parties to clinical conflict are often not fully aware of, nor willing to express, the true nature and scope of their conflict. As such, a significant task of the bioethics mediator is to help define that conflict. The ability to assess and apply the tools necessary for an effective mediation process can be facilitated by each mediator's creation of a personal compendium of sources that generate clinical conflict, to provide an orientation for the successful management of complex dilemmatic cases. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
Bioethics in a globalized world is meeting a number of challenges - fundamentalism in its different forms, and a focus on economic growth neglecting issues such as equity and sustainability, being prominent among them. How well are we as bioethicists equipped to make meaningful contributions in these times? The paper identifies a number of restraints and proceeds to probe potential resources such as the capability approach, care ethics, cosmopolitanism, and pragmatism. These elements serve to outline a perspective that focuses on the preconditions for flourishing human relationships as a way to address bioethical challenges in a globalized world. © 2011 Blackwell Publishing Ltd.
Goodwin Frederick K
Full Text Available Abstract Objective To assess the scientific and ethical basis for clinical innovation in psychopharmacology. Methods We conducted a literature review, utilizing MEDLINE search and bibliographic cross-referencing, and historical evidence regarding the discovery and development of new medications in psychiatry. Clinical innovation was defined as use of treatments in a clinical setting which have not been well-proven in a research setting. Results Empirical data regarding the impact of clinical innovation in psychopharmacology are lacking. A conceptual and historical assessment of this topic highlights the ethical and scientific importance of clinical innovation. Ethically, it touches a borderline that, in our judgment, is not adequately framed in contemporary mainstream bioethics. Currently, research is viewed as not at all benefiting the patients who participate in it, while clinical care is viewed as being solely for the benefit of patients. Clinical innovation straddles these two worlds, uncomfortably at times. While many argue that clinical innovation should either be avoided or folded into research projects, we argue that clinical innovation is necessary for progress in psychopharmacology research, and that it can prosper best when guided by the following ethical principles: 1. The treatment should be based on a viable hypothesis. 2. Whenever possible, one's clinical observations should be reported so they can be evaluated by the scientific community. 3. One should be willing to report unexpected observations of drug effects. 4. A high standard of informed consent should be maintained. Again, this proposal goes against the standard view among bioethicists that research and clinical care are categorically opposed activities, as made clear by the either-or dichotomy of the Belmont Report on bioethics. This approach has so polarized our profession into clinicians versus researchers, that many clinicians will not apply new knowledge produced by
This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things-bodily pains, inability to carry out everyday actions, and failure to realize core life values-and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about (1) my embodiment, (2) my engagements in the world together with others, and (3) my core life values. Suffering is in essence a feeling (a mood), but as such, it has implications for and involves the person's entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood-as in the cases of pain and other bodily ailments-but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person's identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances.
Jin, Pingyue; Hakkarinen, Mark
The field of bioethics is constantly evolving. To investigate trends in the field of bioethics, we conducted a quantitative analysis of the top-cited articles in bioethical journals over the past 40 years. Retrospective quantitative study of the 20 most cited bioethics articles published each year from 1975 to 2014 were conducted. Article samples were selected from a list of the most relevant 100 journals in the field of bioethics. In total, 800 top-cited articles between 1975 and 2014 in the domain of bioethics were retrieved and analysed. More than half of them were composed by single authors, but multiauthorship became more prevalent with time. The majority (84.5%) of these highly cited articles originated from the USA (65.3%), UK or Canada, though the proportion of other countries increased in recent years. Almost half (44.6%) of the highly cited articles belonged to the subfield of clinical ethics , but other subfields such as research ethics , public health ethics and neuroethics became more prominent. Overall, the distribution of Thesaurus keywords and subfields became more diverse over time, and the number of journals publishing top-cited articles doubled. Furthermore, the empirical ethics approach increased over time in our sample of top-cited articles. In sum, the forefront of bioethics is getting more diversified, collaborative and international. The presumed 'mainstream' becomes less dominant over time, as more highly cited articles come from new subfields, discuss new topics, use more Bioethics Thesaurus keywords, more authors participate and more countries other than the USA contribute to bioethics journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
... approximately 11:30 a.m. ADDRESSES: Emory Conference Center Hotel, 1615 Clifton Road, Atlanta, GA 30329. Phone... Conference Center Hotel, Atlanta, GA. The meeting will be open to the public with attendance limited to space... technological innovation. In undertaking these duties, the Commission will examine specific bioethical, legal...
... approximately 1:15 p.m. ADDRESSES: The Warwick New York Hotel, 65 West 54th Street, New York, NY 10019. Phone... p.m. on Thursday, May 19, 2011, at the Warwick New York Hotel, New York, NY. The meeting will be... will examine specific bioethical, legal, and social issues related to potential scientific and...
... approximately 12:30 p.m. ADDRESSES: The St. Regis Hotel, Washington, DC, 923 16th and K Streets, NW., Washington.... to approximately 12:30 p.m. on Tuesday, March 1, 2011, at the St. Regis Hotel, Washington, DC. The... duties, the Commission will examine specific bioethical, legal, and social issues related to potential...
Downie, Don; Snart, Fern
The paper reviews bioethical positions regarding the "human-ness" of severely handicapped students, notes that the quality of life for many severely handicapped persons is directly threatened by the utilitarian position which questions the personhood of individuals with limited IQ, and asserts that the deontological postition is more aligned with…
Goodwin, Mark; Kramer, Cas; Cashmore, Annette
Bioethics is an increasingly important part of the biosciences curriculum at school and in higher education, but few science teachers have much experience of teaching the subject in an engaging or interactive manner. This article sets out a session that allows students to practise the skills of ethical thinking and ethical debate in a relevant…
Respect for vulnerability is a human right: Article 8 of the UNESCO Declaration on Bioethics and Human Rights, and senior citizens in South Africa · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. R Rheeder, 18-21 ...
Loike, John D.; Rush, Brittany S.; Schweber, Adam; Fischbach, Ruth L.
Columbia University offers two innovative undergraduate science-based bioethics courses for student majoring in biosciences and pre-health studies. The goals of these courses are to introduce future scientists and healthcare professionals to the ethical questions they will confront in their professional lives, thus enabling them to strategically…
Hendrix, Jon R.
Data from questionnaires sent to every college and university in the United States ascertained that 26 percent of the 223 responding major institutions offered a bioethics course, most frequently presented by the biology department to medical students and taught most frequently by professors of ethics and philosophy background. Questionnaire and…
Lora Jean Brake
Full Text Available At first glance the twenty-first century arena of biotechnology and bioethics seems worlds away from the practical concerns of the first century outlook of the New Testament book of James. A closer look, however, reveals that the issues that James addresses have applications to challenges in bioethics. This article will give an overview of James and examine James’ teaching on wealth, poverty, and generosity and its import for the issue of global stewardship in bioethics. Stewardship concerns both a Christian’s care and management of time, talents, and treasures. Faithful use of the resources God has given demonstrates the fruitful faith that James writes of in his epistle. The idea of global stewardship, though “stewardship” is grounded in a distinctly Christian ethic, reflects an emerging discussion in bioethics regarding the need to address the inequities present between the money and time spent on biotechnology in some of the world in proportion to the money spent on meeting the basic healthcare needs of the poor of the entire world. This New Testament epistle gives clear indications of how the Christian is to view wealth and how the Christian is to respond to poverty. James, though a comparatively small book, sends a crucial message across the years that should greatly impact how Christians view stewardship in terms of global healthcare needs.
So far the activities of the Comitato Nazionale per la Bioetica (CNB) have been subject to desultory and fragmentary analyses, stuck to the paradigm (in the way Kuhn means it) which claims the division between the issues of "frontier bioethics" and those of "everyday bioethics" (and between the respective types of communication). According to the above mentioned paradigm, bioethics should just deal with the problems coming from the application of technological progress to extreme cases (which imply a type of communication internal to the scientific communities), and only subordinately with other issues, even if of a more general interest and widespread public involvement. Nonetheless, in the last years another paradigm has come out and it is emphasizing the importance of the interaction between the two models of bioethics and of a type of external communication not just limited to the scientific communities in the strict sense of the word, but based on "open opinions ". The present notes are supposed to be an introduction to a historical comprehension of the CNB activity and of its impact, in the light of the rising of the new paradigm and of the Italian adherence to the Oviedo Convention of the Council of Europe.
Burgos Velasco, Juan Manuel
This article analyses the position of two secularized theories on the role of religious beliefs in bioethical reasoning. The excluding laicism of Sádaba rejects the rationality of religious fact and extend a general suspicion about the bioethical reasoning of believer. Contrary, the open position of Habermas-Rawls considers reasonable religions as one of the typical comprehensive views of liberal State, encourage secularized citizens to value his contributions and urge to secular and, then, neutral, State not to impose to all citizens a secularized cosmo-vision. Only the second perspective put the bases for a fruitful and calm dialogue in the bioethical area.
Van Campen, Luann E; Therasse, Donald G; Klopfenstein, Mitchell; Levine, Robert J
Pharmaceutical human biomedical research is a multi-dimensional endeavor that requires collaboration among many parties, including those who sponsor, conduct, participate in, or stand to benefit from the research. Human subjects' protections have been promulgated to ensure that the benefits of such research are accomplished with respect for and minimal risk to individual research participants, and with an overall sense of fairness. Although these protections are foundational to clinical research, most ethics guidance primarily highlights the responsibilities of investigators and ethics review boards. Currently, there is no published resource that comprehensively addresses bioethical responsibilities of industry sponsors; including their responsibilities to parties who are not research participants, but are, nevertheless key stakeholders in the endeavor. To fill this void, in 2010 Eli Lilly and Company instituted a Bioethics Framework for Human Biomedical Research. This paper describes how the framework was developed and implemented and provides a critique based on four years of experience. A companion article provides the actual document used by Eli Lilly and Company to guide ethical decisions regarding all phases of human clinical trials. While many of the concepts presented in this framework are not novel, compiling them in a manner that articulates the ethical responsibilities of a sponsor is novel. By utilizing this type of bioethics framework, we have been able to develop bioethics positions on various topics, provide research ethics consultations, and integrate bioethics into the daily operations of our human biomedical research. We hope that by sharing these companion papers we will stimulate discussion within and outside the biopharmaceutical industry for the benefit of the multiple parties involved in pharmaceutical human biomedical research.
Harmon, Shawn H E
Complex social and ethical problems are often most effectively solved by engaging them at the messy and uncomfortable intersections of disciplines and practices, a notion that grounds the InVisible Difference project, which seeks to extend thinking and alter practice around the making, status, ownership, and value of work by contemporary dance choreographers by examining choreographic work through the lenses of law, bioethics, dance scholarship, and the practice of dance by differently-abled dancers. This article offers a critical thesis on how bioethics has come to occupy a marginal and marginalizing role in questions about the differently-abled body. In doing so, it has rendered the disabled community largely invisible to and in bioethics. It then defends the claim that bioethics - as a social undertaking pursued collaboratively by individuals from different disciplines - must take much better notice of the body and the embodied individual if it is to better achieve its ends, which include constructing a moral and just society. Finally, this article considers how the arts, and specifically dance (and here dance by differently-abled dancers), provides us with rich evidence about the body and our ability to respond positively to normally 'othered' bodies. It concludes that greater attention to empirical evidence like that being generated in InVisible Difference will help to expand the reach and significance of bioethics, and thereby its relevance to (and consciousness of) important questions about the status of bodies and bodily differences, which must be considered as central to its ambitions. © 2014 John Wiley & Sons Ltd.
Bioethics is not a subject in the French school curriculum but it can be taught in secondary schools. I will first raise the problems I encountered in order to teach it and some possible solutions for teaching it within the French educational system. An experimental approach often appears irrefutable to students and this can be an obstacle or slow down their acceptance of an ethical approach which leads to questioning result sor exploring more than one answer. The study of an ethical problem requires an interdisciplinary approach which is not always easy to put in place in schools, but which has been helped by the latest reform of the lycle curriculum. Nevertheless, who will be responsible for it? And how? The experiment which I have led over the past 9 years in my school, the Lycle International of St. Germain en Laye, has led me to try to work alongside at least one colleague who is a teacher of Philosophy. A group of students made up of volunteers from the classes of lère and Tie (the last two years of high school),from all three options of the baccalauréat (Scientific, Economic and Literary) and from all the international sections to be found in the school (13 in all) was formed. Firstly they became acquainted with ethical questioning and then took greater control by debating these issues after doing individual research. They spoke for themselves and I gained much from their own ideas and reflections. Arranging contacts and debates with specialists in the field and with witnesses with experiences of these situations enabled the students to be confronted with concrete examples and to understand the human dimension and the daily life of those concerned. Giving their thoughts in written form or translating ethical questioning in other ways proceeded the sharing of these ideas and thoughts with others: either in their own school through debates and other media or from French specialists during the days of reflections organized by the CCNE. In my opinion, this
Constuctivism learning theory lays emphasis on the learners' active learning, such as learning initiative, sociality and context. By analyzing the relationship between constructivism learning theory and learner autonomy, this paper explores how to cultivate learners' learner autonomy under the guidance of constructivism learning theory.
Flavia Pedro dos Anjos Santos
underlie health education, on bioethical issues in the school violence field. It consists of a critical-reflexive literature review by accessing the Virtual Health Library (VHL database, using the keywords: "violence and bioethics", and "violence at school", considering the studies published from 2004 to 2009. We also surveyed Paulo Freire's and Pedro Demo's works, theorists of Libertarian Education, which led us define and discuss three thematic areas: 1 bioethics as a reflective instrument for the moral values resumption in the society, 2 school as an ethics and citizenship practice creator, 3 health education as a contributor to coping with violence at school. We believe that school violence involves bioethical issues that should be the target of educational interventions in the liberating perspective, in order to generate reflections on the negative character of school violence, both for teaching and learning, as to the sickening of the actors involved in this issue. Health professionals may establish the intersectoriality with the education and contribute in preventing violence at school, through health education actions, mobilizing citizens for a society committed to promoting life. And the education professionals must be receptive and co-participants in the education and health intersectorial process.
Padela, Aasim I; Furber, Steven W; Kholwadia, Mohammad A; Moosa, Ebrahim
The field of medicine provides an important window through which to examine the encounters between religion and science, and between modernity and tradition. While both religion and science consider health to be a 'good' that is to be preserved, and promoted, religious and science-based teachings may differ in their conception of what constitutes good health, and how that health is to be achieved. This paper analyzes the way the Islamic ethico-legal tradition assesses the permissibility of using vaccines that contain porcine-derived components by referencing opinions of several Islamic authorities. In the Islamic ethico-legal tradition controversy surrounds the use of proteins from an animal (pig) that is considered to be impure by Islamic law. As we discuss the Islamic ethico-legal constructs used to argue for or against the use of porcine-based vaccines we will call attention to areas where modern medical data may make the arguments more precise. By highlighting areas where science can buttress and clarify the ethico-legal arguments we hope to spur an enhanced applied Islamic bioethics discourse where religious scholars and medical experts use modern science in a way that remains faithful to the epistemology of Islamic ethics to clarify what Islam requires of Muslim patients and healthcare workers. © 2013 John Wiley & Sons Ltd.
Bioethics journals have lagged behind medical and science journals in exploring the threat of conflict of interest (COI) to the integrity of publications. Some recent discussions of COI that have occurred in the bioethics literature are reviewed. Discussions of what has been termed the "Healy affair" unintentionally demonstrate that the direct and indirect influence of undisclosed COI may come from those who call for protection from the undue influence of industry. Paradoxically, the nature and tone of current discussions may serve to dull sensitivities to what is indeed a serious set of issues facing bioethics. Some proposals are presented to address COI and other challenges to the integrity of bioethics and its journals. COI is too important a topic to be left to ideologues, and there is no substitute for readers' caution and skepticism as tools in dealing with the full range of biases that exist in published papers.
Akhaladze, V M
The aim of the research was to determine the role of resuscitation science and practice in development of new trends in thanatology; and to determine the significance of integrated interdisciplinary approach to notion "death" as "biological, medical, and bioethical" categories. The author discusses nine distinct concepts of death and concludes that only complex scientific approach can enrich the knowledge about the notion of death. The list of different aspects of interdisciplinary bioethical definition of notion "death" was developed.
Hernández-Marrero, Pablo; Martins Pereira, Sandra; de Sá Brandão, Patrícia Joana; Araújo, Joana; Carvalho, Ana Sofia
Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.
Full Text Available Abstract The anthology, Feminist Bioethics, edited by Jackie Leach Scully, Laurel E. Baldwin-Ragaven, and Petya Fitzpatrick, examines how feminist bioethics theoretically and methodologically challenges mainstream bioethics, and whether these approaches are useful for exploring difference in other contexts. It offers critical conceptual analyses of "autonomy", "universality", and "trust", and covers topics such as testing for hereditary cancer, prenatal selection for sexual orientation, midwifery, public health, disability, Indigenous research reform in Australia, and China's one child policy.
María del Carmen Amaro Cano
social influences take part in it, too. The purpose of this paper is to reflect on the most significant aspects connected with sexuality that increasingly demand a bioethical approach of these matters, that is, to propitiate the analysis of these natural, psychological and social phenomena that link persons, to the light of moral values. The claiming of a systematic and progressive sexual education from puberty to adulthood; the critical analysis of the ethical violations resulting from the disrespect of human dignity in the case of pornography and prostitution, including children in these trade relations related to sex; the intolerance against different sexual options, the limits of sexual liberty based on the respect to others' sexual liberty, the protection of the immature and unable to establish responsible sexual relations; the extramarital sexual relations or the sex had only for pleasure; the critical analysis of the consequences for third persons that cannot give an opinion about their future regarding the adoption of children by homosexual males, or the assisted reproduction in lesbian couples, the rented mothers or substitute or carrier mothers, are some of the topics the author puts into our consideration to be discussed, demanding a thorough analysis and reflection.
Civilian and common law judges differ substantially in their approach to the resolution of issues concerning bioethics and health sciences. Whereas the civilian judge will first take into account the legislative source, his common law counterpart will most probably first look at judicial precedents for guidance. In both systems, however, the legislative drafting technique differs substantially and has a direct impact on judicial interpretation of the law. Both systems also differ in the way that judicial decisions are drafted and rendered. In the common law tradition, judges draft their own opinion, leaving the possibility of dissent which, in turn, helps to better illustrate contentious issues and may have an influence on social awareness of difficult problems. Finally, in bioethics, legislation should be preferred if only for a question of social legitimacy, since decisions are then taken by elected representatives. However, this type of legislation should be subject to periodical review to better adapt its rules to the evolution of science and society.
October 19, 2015, marked the 10th anniversary of the adoption by the General Conference of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) of the "Universal Declaration on Bioethics and Human Rights," which was signed by representatives of the 191 member states of the conference. The declaration is of major importance: it was the first legally binding document approved by a global organization to address the whole range of subjects covered by bioethics. Among the principles laid down in the declaration, those most relevant for the allocation of organs are benefit and harm (Article 4), equality, justice and equity (Article 10), nondiscrimination and nonstigmatization (Article 11), solidarity and cooperation (Article 13), social responsibility and health (including access to quality health care; Article 14), and sharing of benefits (Article 15). Policies concerning the allocation of organs cannot disregard the principles affirmed in the Declaration. Copyright © 2016 Elsevier Inc. All rights reserved.
Salako, Solomon E
The desirability of obtaining freely given consent is universally accepted. The point, however, is that there is no unanimity on the definition of informed consent or its application in bioethics. Whether informed consent is based on principalism or casuistry or the virtue theory, the problem is how to handle the ethically complex situation created in the interface between informed consent and social justice under international biomedical instruments. This article will proceed by offering detailed historical and critical analyses of informed consent under the European Convention on Human Rights and Biomedicine 1997 and The UNESCO Universal Declaration on Bioethics and Human Rights 2005. Three conceptions of justice will be utilised to show that the doctrine of informed consent has driven the ethos of research on human beings and shaped the physician-patient relationship; and that casuistry and virtue theory are consistent with and not rivals of a principle-based account of informed consent.
In a prior issue of Developing World Bioethics, Cheryl Macpherson and Ruth Macklin critically engaged with an article of mine, where I articulated a moral theory grounded on indigenous values salient in the sub-Saharan region, and then applied it to four major issues in bioethics, comparing and contrasting its implications with those of the dominant Western moral theories, utilitarianism and Kantianism. In response to my essay, Macpherson and Macklin have posed questions about: whether philosophical justifications are something with which bioethicists ought to be concerned; why something counts as 'African'; how medicine is a moral enterprise; whether an individual right to informed consent is consistent with sub-Saharan values; and when thought experiments help to establish firm conclusions about moral status. These are important issues for the field, and I use this reply to take discussion of them a step or two farther, defending my initial article from Macpherson's and Macklin's critical questions and objections. © 2010 Blackwell Publishing Ltd.
Mario Orlando Parra-Pineda
Full Text Available Deliberation is a basic rational human activity recognized since ancient times due to its role in decision making during daily life activities and in specialized areas of knowledge such as medicine, politics and ethics. The objective of this reflection paper is to study the contribution of Aristotle to the deliberative process through his work the Nicomachean Ethics, where the following aspects of deliberation were identified for analysis: origin, definition, characteristics, and types and conditions for its development. Bioethics defend these aspects, since it finds in Aristotelian phronesis the fundamental axis to guide its actions in search of human self-realization and the analysis and decision making of the clinical bioethical problems. Twenty-four centuries have passed until the importance of this process and the need to educate about it was finally rediscovered.
Full Text Available “Global health” is an increasingly important area of research and practice, concerned with the profound implications of globalisation for individual and communal health (particularly in developing countries and focused on achieving health equity for all people worldwide. As such, it is often viewed as overlapping with public health and, thus, conceptually distinct from the field of biomedicine and bioethics. Both fields bear an uneasy relationship with the field of human rights, which remains largely unexplored. The paper constructively utilises insight derived from theories of global legal pluralism and global constitutionalism to argue, perhaps controversially, that recent developments in international biomedical law and bioethics, constitute an important phase in the constitutional construction of a global health law system. In doing so, the paper analyses the role of human rights in the growing constitutional autonomy and organization of global health.
Full Text Available Buying and selling human organs for transplants from living donors has been discussed worldwide in the bioethical debate and it is becoming a public health problem. This essay discusses, in light of the Social Bioethics, arguments used to justify such practices, which are related to the common good, moral plurality, autonomy and individual freedom. Such justificatory aspects assume liberal and utilitarian characteristics. They present the possibility of double standard, do not consider social vulnerability, and harm dignity and human rights by evidencing an apology to the market laws. Thus, the justifications for buying and selling human organs for transplantations intervivos eventually turn the body, or part of it, into a commodity.
Riaan A.L. Rheeder
Full Text Available In the development and acceptance of Article 12 of the Universal Declaration of Bioethics and Human Rights, the United Nations Education, Science and Cultural Organization (UNESCO did not involve the Protestant faith tradition in the consultation process (other traditions were indeed consulted. This brings the universality (UNESCO perspective as well as the acceptability of the Declaration and its principles (democratic perspective into question. In order to address this issue, it is necessary to involve the Protestant tradition in the discourse by presenting own reasons that support the universal principles in the Declaration (theological perspective. This discourse has shown that respect for cultural diversity, pluralism and the priority of universal shared values can be grounded from a Trinitarian perspective; therefore, the appeal of the Declaration to consider this principle seriously in the field of bioethics can be supported by the Protestant religious tradition.
Full Text Available Bioethics tends to be dominated by discourses concerned with the ethical dimension of medical practice, the organization of medical care, and the integrity of biomedical research involving human subjects and animal testing. Jacques Derrida has explored the fundamental question of the “limit” that identifies and differentiates the human animal from the nonhuman animal. However, to date his work has not received any reception in the field of biomedical ethics. In this paper, I examine what Derrida’s thought about this limit might mean for the use/misuse/abuse of animals in contemporary biomedical research. For this, I review Derrida’s analysis and examine what it implies for scientific responsibility, introducing what I have coined the “Incompleteness Theorem of Bioethics.”
In the age of globalisation, more and more people who are members of different religions and cultures live in the same society. This situation tends to create many conflicts in different areas of life and not least in the health care system, a fact which raises a number of bioethical issues. The cultural and religious differences between patient and physician can be a cause of bioethical conflicts and therefore represent a challenge for biomedical ethics. The confrontation between Turkish Muslin patients and the German health care system is a convenient example of this situation. The Muslim Turks came to Germany 40 years ago as industrial workers. Their value system had been shaped by traditional and Islamic parameters in Turkey. With this value system, they now found themselves in the German modern health care system. In many fields of modern medicine there are areas of potential conflict of values, where a Muslin patient will argue differently from a secular or Christian person. In an ethical conflict between two individuals who are members of different cultures, it is necessary to make sure that the ethical concept which is to be used for resolving the problem is relevant. In this particular case, both the Islamic legal responses (fatwa) and the classical theories of biomedical ethics are often insufficient. This paper tries to give a brief outline of these bioethical conflicts and discuss these conflicts with regard to the principle of respect for autonomy in the concept of "principilism," as introduced by T.L. Beauchamp and J.F. Childress. The central question is whether this bioethical concept is able to analyse and to help solve the kinds of ethical conflicts which involve transcultural dimensions. This question is discussed with some consideration of the ongoing debate about universalism versus relativism in biomedical ethics.
Full Text Available A more and more obvious gap between the human spiritual development, which mostly stagnates, and often even regresses, and the technological development of society, which intensively and unstoppably grows, has been the initiation of numerous bioethical discussions that cover a wide range of topics, i.e. from a concern for a man and his health to a concern for nature and preservation of life in general. No matter the fact that numerous ethical discussions, which highlighted the last decade, have resulted with commonly accepted principles, several ethical issues were left without clear and unambiguous solutions. Within this context, the legal regulations expected to protect persons from unacceptable and harmful actions, but at the same time not to present an obstacle to scientific and technological development of society, have gained a special meaning. This is a significant challenge due to the fact that through statutory provisions we need to reach a balance between the freedom of scientific research and protection of a man. Although ethical dilemmas follow almost every field of human actions, bioethical contents are especially associated with the unimaginable technological achievements in medicine. Thereby, persons with mental difficulties, as one of the most vulnerable groups of patients, demand a highlighted bioethical sensibility within the meaning of humanity, understanding and enhanced awareness when ethically questionable medical procedures are applied on them, and especially when these patients are included in, sometimes even hazardous, biomedical researches. A basic protective mechanism for this category of persons in the Republic of Croatia is the Law on Protection of Persons with Mental Difficulties. The Law establishes a clear legal framework to proceed with actions designated for persons with mental difficulties, and certain legal provisions embodied within the Law could be considered a quite concrete answer to numerous ethical
Segura Castillo Mario
Full Text Available Resumen:En este ensayo pretendo presentar concepciones a cerca del abordaje de la bioética, desde las teorías del caos y del pensamiento complejo. La bioética es un modo de estar en el dominio del consenso, de coordinaciones de sentires, que requiere de una gran plasticidad, desde lo humano, comprometido con su historia y las futuras generaciones. Además, concibo la aprendiencia como un proceso bioético de vida, en la convivencia, en ese lenguajear perpetúo, que permite la aceptación del otro y la otra. En ese sentido, todos los seres, que crecemos en el lenguaje, somos capaces de aprender y de reconocer nuestros propios errores, como los que hemos cometido con la naturaleza, en todas sus formas. Por lo tanto, una idea personal de la bioética es aprehender los sentires y los pensamientos, con compromiso, en el devenir sostenible de la Tierra.Abstract:In this essay I try to present conceptions which deal with bioethics, from the chaos theories and complex thinking. Bioethics is a mode of being dominated by consensus, the coordination of feelings, which require great flexibility from the human, committed to its history and future generations. Furthermore, I conceive learning as a bioethical process of life, within coexistence, in this perpetual language which permits the acceptation of the other. In this sense, all beings, we who grow up with language, are capable of learning and recognizing our own mistakes, and those which we have committed in nature, and in all forms. Therefore, a personal idea of bioethics is to seize feelings and thoughts, with commitment, in order for earth’s sustainability to come about.
Greenberg, Rebecca A; Kim, Celine; Stolte, Helen; Hellmann, Jonathan; Shaul, Randi Zlotnik; Valani, Rahim; Scolnik, Dennis
The World Health Organization calls for stronger cross-cultural emphasis in medical training. Bioethics education can build such competencies as it involves the conscious exploration and application of values and principles. The International Pediatric Emergency Medicine Elective (IPEME), a novel global health elective, brings together 12 medical students from Canada and the Middle East for a 4-week, living and studying experience. It is based at a Canadian children's hospital and, since its creation in 2004, ethics has informally been part of its curriculum. Our study sought to determine the content and format of an ideal bioethics curriculum for a culturally diverse group of medical students. We conducted semi-structured interviews with students and focus groups with faculty to examine the cultural context and ethical issues of the elective. Three areas were explored: 1) Needs Analysis - students' current understanding of bioethics, prior bioethics education and desire for a formal ethics curriculum, 2) Teaching formats - students' and faculty's preferred teaching formats, and 3) Curriculum Content - students' and faculty's preferred subjects for a curriculum. While only some students had received formal ethics training prior to this program, all understood that it was a necessary and desirable subject for formal training. Interactive teaching formats were the most preferred and truth-telling was considered the most important subject. This study helps inform good practices for ethics education. Although undertaken with a specific cohort of students engaging in a health-for-peace elective, it may be applicable to many medical education settings since diversity of student bodies is increasing world-wide.
Gros Espiell, Héctor
This article deals with the importance that the preamble has in relation with the Declaration. There is an emphasis on the legal nature of such, as well as the characteristics of the preamble as an international instrument, as it shapes the "context of the document". All this is in reference to the Universal Declaration on Bioethics and Human Rights, whose preamble will be the object of a detailed study.
Goldenberg, Maya J
The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable (or at least non-falsifiable) considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. The "empirical turn" in bioethics signals a need for reconsideration of the methods used
In October 2005, UNESCO (the United Nations Educational, Scientific and Cultural Organization) adopted the Universal Declaration on Bioethics and Human Rights. This was the culmination of nearly 2 years of deliberations and negotiations. As a non-binding instrument, the declaration must be incorporated by UNESCO’s member states into their national laws, regulations or policies in order to take effect. Based on documentary evidence and data from interviews, this paper compares the declaration’s universal principles with national bioethics guidelines and practice in Kenya and South Africa. It concentrates on areas of particular relevance to developing countries, such as protection of vulnerable persons and social responsibility. The comparison demonstrates the need for universal principles to be contextualised before they can be applied in a meaningful sense at national level. The paper also assesses the ‘added value’ of the declaration in terms of biomedical research ethics, given that there are already well-established international instruments on bioethics, namely the World Medical Association Declaration of Helsinki and the CIOMS (Council for International Organizations of Medical Sciences) guidelines on biomedical research. It may be that the added value lies as much in the follow-up capacity building activities being initiated by UNESCO as in the document itself. PMID:18240025
Walker, Rebecca L; Morrissey, Clair
While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). © 2013 John Wiley & Sons Ltd.
Walker, Rebecca; Morrissey, Clair
While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003-2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations). PMID:23796275
Ricardo de Amorim Cini
Full Text Available The use of the term vulnerability in the discussion of bioethics, either as a concept or as a reality, has become increasingly recurrent. The first, and also most important use of this term is to protect subjects participating in experiments, but its use has been expanded to other situations. The aim of this research was to identify the subjects or realities that are classified as vulnerable. We used the descriptors “bioethics” and “vulnerability” to search for literature in Scielo.BR, Scielo.ORG and Lilacs, and analyzed 79 articles. Furthermore, in these articles we identified four categories of vulnerability that can be grouped as vulnerability in:  stages of life and gender;  health, disease and research;  socioeconomic and cultural exclusion;  and environment. This categorization demonstrates that the bioethical reflection on the vulnerability of life is still predominantly anthropocentric, which makes the protection of the dignity of life as a whole a challenge that is still to be faced by bioethical discussion.
This article critically examines the development and current state of speculative bioethics (bioethics discourse concerned with future technologies) as reflecting an intensifying science fictionality, a cognitive/perceptual mode in which the imagined future begins to exert increasing degrees of influence on the present, culminating in a collapse of distance between the two. Future technologies thereby come to be viewed as generating practical ethical issues that need to be addressed well in advance of their arrival. Although this appears to be a prudent effort, it actually bypasses the present as a site of moral agency and locates ethics within a simulation of the imagined future. A constructive form of speculative bioethics must be able to critically assess visions of technological futures if it is to function as an ethics that is of and for the present. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
In October 2005, UNESCO (the United Nations Educational, Scientific and Cultural Organization) adopted the Universal Declaration on Bioethics and Human Rights. This was the culmination of nearly 2 years of deliberations and negotiations. As a non-binding instrument, the declaration must be incorporated by UNESCO's member states into their national laws, regulations or policies in order to take effect. Based on documentary evidence and data from interviews, this paper compares the declaration's universal principles with national bioethics guidelines and practice in Kenya and South Africa. It concentrates on areas of particular relevance to developing countries, such as protection of vulnerable persons and social responsibility. The comparison demonstrates the need for universal principles to be contextualised before they can be applied in a meaningful sense at national level. The paper also assesses the 'added value' of the declaration in terms of biomedical research ethics, given that there are already well-established international instruments on bioethics, namely the World Medical Association Declaration of Helsinki and the CIOMS (Council for International Organizations of Medical Sciences) guidelines on biomedical research. It may be that the added value lies as much in the follow-up capacity building activities being initiated by UNESCO as in the document itself.
Magdalena (Leentie C. de Lange
Full Text Available Recent technological advancements in Bioethics have been rapid and incremental, leaving little time for Christian ethicists to reflect or develop a coherent methodological approach. To assess the situation in the Reformed Churches in South Africa (RCSA, a bioethical questionnaire was developed and administered during the synod in 2009. Three practical questions served as point of departure, viz. which bioethical issues confronted ministers in their work environment, which value judgement trends are evident when counselling members of their congregations and what theoretical frameworks or resources do they call upon when reflecting on these difficult situations? The survey consisted of 19 questions with several subquestions that sought demographic information to determine the population and information about bioethical issues confronting them, methodological strategies they apply and how they think they can contribute to the resolution of any such bioethical dilemmas. The results were tabulated and it was concluded that recent advancements in biotechnology cannot be ignored or dealt with in a piecemeal fashion any longer, either by the RCSA or its ministers. The need for clarity and analysis of the principles underlying those theories that guide or should guide their decision-making and pastoral care in dealing with bioethical dilemmas was emphasised. The findings highlighted the need for appropriate courses in Bioethics to be taught during initial theological training, as well as the need to keep the debate alive by offering workshops, seminars and short courses for practicing ministers to enhance awareness and allay fears and uncertainties in this very dynamic and morally challenging field of human and scientific endeavour.
Full Text Available Aim The place of ethics in undergraduate medical curricula is essential but the methods of teaching medical ethics did not show substantial changes. “Basic principles of bioethics” is the best knowledge to develop student’s reasoning analysis in medical ethics In this study, we investigate the effects of an additional small group discussion in basic principles of bioethics conventional lecture methods to cognitive achievement and retention. This study was a randomized controlled trial with parallel design. Cognitive scores of the basic principles of bioethics as a parameter was measured using basic principles of bioethics (Kaidah Dasar Bioetika, KDB test. Both groups were attending conventional lectures, then the intervention group got an additional small group discussion.Result Conventional lectures with or without small group discussion significantly increased cognitive achievement of basic principles of bioethics (P= 0.001 and P= 0.000, respectively, and there were significant differences in cognitive achievement and retention between the 2 groups (P= 0.000 and P= 0.000, respectively.Conclusion Additional small group discussion method improved cognitive achievement and retention of basic principles of bioethics. (Med J Indones 2009; 18: 48-52Keywords: lecture, specification checklist, multiple choice questions
Diana Martín Ross
Full Text Available Una de las investigaciones más fabulosas, sorprendentes y gigantes, comparada por muchos con el Proyecto Apolo o el Proyecto Manhattan, es el Proyecto Genoma Humano (PGH mediante el cual se intenta ubicar y conocer el papel de los genes que constituyen al ser humano. De manera que los genes y el genoma, de forma particular y la Genética en general se han convertido en el “terremoto de la ciencia contemporánea” por ello hemos decidido incursionar en el empeño de conocer mas de cerca lo intrincado y misterioso del “Poder de los Genes” y los dilemas bioéticos que promueven las actuales investigaciones y la aplicación de sus resultados. En esta primera parte de este ensayo exponemos de forma precisa aspectos relacionados con la historia y actualidad del Proyecto Genoma Humano y la Terapia Génica, así como los beneficios y riesgos potenciales que implican, tanto para los países desarrollados como para los países del SurOne of the most fabulous, surprising and enormous investigations, compared by many with the Apollo Project or the Manhattan Project, is the Human Genome Project (HGP by means of which it is intended to locate and to know the role of human genes. In this way, genes and genome, particularly and Genetics in general have become the "earthquake of contemporary science". That's why, we have decided to deepen into people's endeavour of knowing closely the entangled and mysterious world of “Genes' Power", as well as the bioethical dilemmas that the current investigations and the application of their results promote. In this first part of this essay we expose clearly aspects related to the history and novelties of the Human Genome Project and Genic Therapy, and also the benefits and potential risks that they imply, for developed and underdeveloped countries
Hansen, Solveig L
In the traditions of narrative ethics and casuistry, stories have a well-established role. Specifically, illness narratives provide insight into patients' perspectives and histories. However, because they tend to see fiction as an aesthetic endeavour, practitioners in these traditions often do not realize that fictional stories are valuable moral sources of their own. In this paper I employ two arguments to show the mutual relationship between bioethics and fiction, specifically, science fiction. First, both discourses use imagination to set a scene and determine a perspective. Second, bioethics and science fiction share the family resemblance of expressing moral beliefs. I then consider how understanding bioethics and science fiction as interrelated discourses can be the basis of a methodology for inquiry into relational autonomy in the context of biotechnologies and medicine. As an example of this methodology, I analyse Fay Weldon's novel The Cloning of Joanna May (1989).
Grant, Jenna M
Controversies about global clinical trials, particularly HIV trials, tend to be framed in terms of ethics. In this article, I explore debates about ethics in the Cambodia Pre-Exposure Prophylaxis trial, which was designed to test the safety and efficacy of tenofovir as a prevention for HIV infection. Bringing together studies of public participation in science with studies of bioethics, I show how activists around the Cambodian Pre-Exposure Prophylaxis trial circulated and provoked debates about standards of research ethics, as opposed to research methodology. This postcolonial bioethics was configured through the circulation of and debate about ethics guidelines, and historically and culturally specific relations of vulnerability and responsibility between foreigners and Cambodians and between Cambodian leaders and Cambodian subjects. I argue that this shift in the object of ethical concern, from the experimental human subject to the relation between subjects and researchers, illustrates how a postcolonial field of articulation reformulates classical bioethics.
Berger, Zackary; Cahan, Rabbi Joshua
In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge.
Khorfan, Rhami; Padela, Aasim I
Modern secular bioethics has focused on developing a set of universal principles to guide clinical decision making. However, this ignores the important role of religion in resolving bioethical questions. It is imperative that health-care providers understand these belief systems in order to traverse value conflicts and provide the highest quality care to a diverse population. This paper focuses on the process of bioethical deliberation in Judaism, Catholicism, and Islam. Abortion is normatively prohibited in each faith and through examining how each ethical code allows for abortion when the mother's life is in peril due to the fetus, we highlight the value of unborn life in each faith. Orthodox Judaism uses the concept of rodef, or pursuer, to permit abortion in this scenario, Catholicism uses the moral concept of "double effect," while Islamic law cites the maqāṣid, higher objectives of the law, to permit abortion in this scenario.
Kopaladze, R A
Ethic aspects of biomedical experiment evolution from Alkmaion to Pavlov, are analysed. The history of reflexes in the paradigm of mechanitsism and antropomorphism is reinterpreted. It is emphasized that animal life and their behaviour exceed the bounds of mechanitsizm. It is grounded the necessity of humane treating living organisms. The theory of conditioned reflexes and the method of physiological synthesis are considered in the context of bioethics. It is shown that Pavlov's methodological approaches are in correspondence with the modern principles of bioethics of scientific animal experiments.
Gerrits, Trudie; Reis, Ria; Braat, Didi D M; Kremer, Jan A M; Hardon, Anita P
This article provides insight into how ethically sensitive requests for the use of assisted reproductive technologies (ARTs) are dealt within the daily practice of a Dutch fertility clinic. The findings presented are part of an ethnographic study conducted in this clinic from September 2003 until April 2005. Information for this article was gathered by attending the multidisciplinary ethics meetings and conversations with clinic staff. By looking at 'bioethics in practice', this article provides insight into the complex and dynamic interplay between particular couples' situations, contextual features, bioethical principles, doctors' subjective feelings and views, and the employment of medical practices. Our study suggests that personal views to a certain extent inform the agenda of the ethics meetings, but in the end neither these views nor bioethical principles fully determine the decisions made. Clinic staff members employ routine medical practices with the intention to carefully resolve ethically sensitive cases. These practices include: collegial consultation, searching for scientific evidence in the literature, obtaining more medical information, offering medical tests, referring couples to other clinics and ensuring informed consent. Rather than examining hypothetical cases, which evoke principles, observations of practices regarding real life cases of which many details are known, allowed us to identify the influence of routine medical practice on ethical decisions. Despite initial concerns from the side of the medical professionals (some of which might be regarded as paternalistic), at the end the reproductive autonomy of most couples seeking ARTs was not jeopardized. The format of the multidisciplinary ethics meetings seems to be promising as it provides a space for clinic staff members to express and reflect on their subjective views and feelings of unease regarding certain requests for ARTs, while at the same time it diminishes the risk that decision
Transhumanists advance a "posthuman" condition in which technological and genetic enhancements will transform humankind. They are joined in this goal by bioethicists arguing for genetic selection as a means of "enhancing evolution," improving if not also the species then at least the potential lives of future individuals. The argument of both, this paper argues, is a new riff on the old eugenics tune. As ever, it is done in the name of science and its presumed knowledge base. As ever, the result is destructive rather than instructive, bad faith promoted as high ideal. The paper concludes with the argument that species advancement is possible but in a manner thoroughly distinct from that advanced by either of these groups.
Santos, Ana Carolina Clemente Dos; Amorim Neto, Thomaz Pereira de; Goes, Andrea Carla de Souza
The speed with which science generates results in modern society requires reflection on the limits of scientific progress. This is the foundation of Brave New World, a book published by Aldous Huxley in 1932 that portrays a future technological society along the lines of Fordism. This article establishes a relationship between our current technocratic society and that described by Huxley, discussing the viability of the technical and biological aspects of the manipulations narrated in the book in light of current knowledge. Some bioethical considerations with respect to the procedures 'invented' by the author - and which are already or could be developed in modern society - will also be addressed.
Barkhordarian, Andre; Demerjian, Gary; Jan, Allison; Sama, Nateli; Nguyen, Mia; Du, Angela; Chiappelli, Francesco
Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can
Full Text Available The ethics in economy is not only a corrector, but also must be initiator if we want to achieve essence of our existence - the human being as “Homo ethicus”, as well as, which is more important for mankind - to achieve a human being as “Homo homine ethica ethicus est”. This remark points on two things. First: we came to the stage where we become aware about the fact that our economies are dehumanized. The second: that’s the reason why we must return to ethics and pull out from it that universal values which will make the managers of natural recourses more ethically awarded, so they will be able to start managing production without endangering bio potentials anymore. Previous remark lead us to conclusion that, no matter if the idiom “business ethics” is oxymoron or not, the present ethics is more a list of rules of conduction or, more precisely, etiquette. This clearly points that this kind of ethics of economy and in economy is not adoptive to the imperative of Bioethics: Don’t misuse recourses if you want to feed yourself and those for which you create the existence! This is so because always when we talk about ethics and ethicizing of those which managing the base of existence, de facto, are discussions about choosing the appropriate model of capitalism. The problem of these “discussions” is that we almost always forget to explain: is the chosen model of capitalization of society applicable considering the local specifics and needs of community? Therefore, the imperative of Bioethics, in this context, is to teach the ethics how to think about bio resource and bio heritage, even if we stop talk of some kinds of ethics and ethicizing of economies and of those which managing with it, because if we reconsider the reactions of the population, it is clear that they are seek of talking about it. But also, it’s recognizable the fact that they who talks just show that the essential thinking about Bioethics is absent and that the
Buxó, M Jesús; Casado, María
Early diagnosis of Alzheimer disease raises important bioethical issues. In the interval between early disease detection and symptom onset, there is a time in which the patient's autonomy, privacy, and dignity may be undermined by certain healthcare measures or by family care and support. These measures may eventually turn patients into an object of care, preventing them from accepting the disease, developing an identity, and rearranging their living spaces. Every effort should be made to ensure that care does not become compassionate harassment or an invasive act, annulling the patient's autonomy, identity, and self-determination. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Full Text Available Este texto propone una serie de observaciones y argumentos que permiten situar adecuadamente el desafío planteado por la bioética al derecho. El modelo de Kelsen, consistente en identificar los desafíos de la bioética como simples problemas de contenido de normas, es postulado como limitado y reduccionista respecto de las temáticas substanciales que la bioética plantea. El camino propuesto por el autor para evitar convertir la ciencia jurídica en una simple técnica, consistiría en lograr que aquélla reasuma su específica validez antropológica, lo que la alejaría de toda tentación de estéril formalismo, obligándola a trabajar en la perspectiva de las estructuras que caracterizan el ser del hombre, dado que la bioética plantea problemas antropológicos generales, esto es, de estructuraO texto apresenta uma série de observações e argumentos que permitem identificar adequadamente o desafio apresentado pela bioética ao direito. O modelo de Kelsen que consiste em identificar os desafios da bioética como simples problemáticas de normas é limitado e reducionista quando se considera os temas essenciais por ela apresentados. O caminho proposto pelo autor para não converter a ciência jurídica em simples técnica consiste em fazê-la assumir sua expressão antropológica específica, o que a afastaria da tentação do formalismo estéril, obrigando-a a considerar as características fundantes do ser humano, já que a bioética apresenta problemas antropológicos geraisThis text proposes a series of observations and arguments that allow to suitably locate the challenge raised by bioethics to the law. Kelsen's model consisting in identifying the challenges of bioethics as simple problems of norm content, is postulated as a limited and reductionist approach to the substantial issues that bioethics raises. The way proposed by the author to avoid to turn legal science into a simple technique, would consist in reassuming its specific
Itai, K; Asai, A; Tsuchiya, Y; Onishi, M; Kosugi, S
Objective The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them. Methods A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students. Results A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing ethical disagreement in the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators' individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents' individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students' sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators' sense of the purpose of bioethics education. Conclusions This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students. PMID:16648283
Full Text Available Many biobanks were established as biorepositories for biomedical research, and a number of biobanks were founded in the 1990s. The main aim of the biobank is to store and to maintain biomaterials for studying chronic disease, identifying risk factors of specific diseases, and applying personalized drug therapies. This report provides a review of biobanks, including Korean biobanks and an analysis of sample volumes, regulations, policies, and ethical issues of the biobank. Until now, the top 6 countries according to the number of large-scale biobanks are the United Kingdom, United States, Sweden, France, the Netherlands, and Italy, and there is one major National Biobank of Korea (NBK and 17 regional biobanks in Korea. Many countries have regulations and guidelines for the biobanks, and the importance of good management of biobanks is increasing. Meanwhile, according to a first survey of 456 biobank managers in the United States, biobankers are concerned with the underuse of the samples in their repositories, which need to be advertised for researchers. Korea Biobank Network (KBN project phase II (2013-2015 was also planned for the promotion to use biospecimens in the KBN. The KBN is continuously introducing for researchers to use biospecimens in the biobank. An accreditation process can also be introduced for biobanks to harmonize collections and encourage use of biospecimens in the biobanks. KBN is preparing an on-line application system for the distribution of biospecimens and a biobank accreditation program and is trying to harmonize the biobanks.
Park, Jaesun; Cho, Sangyun; Lee, Meehee; Kim, Namhee; Min, Haesook; Lee, Sooyoun; Park, Ok; Han, Bokghee
Many biobanks were established as biorepositories for biomedical research, and a number of biobanks were founded in the 1990s. The main aim of the biobank is to store and to maintain biomaterials for studying chronic disease, identifying risk factors of specific diseases, and applying personalized drug therapies. This report provides a review of biobanks, including Korean biobanks and an analysis of sample volumes, regulations, policies, and ethical issues of the biobank. Until now, the top 6 countries according to the number of large-scale biobanks are the United Kingdom, United States, Sweden, France, the Netherlands, and Italy, and there is one major National Biobank of Korea (NBK) and 17 regional biobanks in Korea. Many countries have regulations and guidelines for the biobanks, and the importance of good management of biobanks is increasing. Meanwhile, according to a first survey of 456 biobank managers in the United States, biobankers are concerned with the underuse of the samples in their repositories, which need to be advertised for researchers. Korea Biobank Network (KBN) project phase II (2013-2015) was also planned for the promotion to use biospecimens in the KBN. The KBN is continuously introducing for researchers to use biospecimens in the biobank. An accreditation process can also be introduced for biobanks to harmonize collections and encourage use of biospecimens in the biobanks. KBN is preparing an on-line application system for the distribution of biospecimens and a biobank accreditation program and is trying to harmonize the biobanks. PMID:24465232
Badulescu, Daniel; Badulescu, Alina
Nowadays, medical tourism reports impressive growth in terms of number of persons, income and number of countries involved in cross-border flows. So this study was undertaken to clarify entrepreneurship opportunities and bio-ethics boundaries in medical tourism. For tourism entrepreneurs, these outgoing flows related to medical procedures and tourism become an opportunity that cannot be ignored, so a wide range of tourist services related to health care are provided on a private, entrepreneurial basis. However, social and economic boundaries are omnipresent (impaired health services in receiving (incoming) countries, the crisis of the health care systems in emitting (outgoing) countries, over-consumption of medical and tourism services), and, not least, ethical considerations. Transforming medical care in a market tool, reducing human attributes to the status of commodity that can be bought, sold or negotiated, seriously challenges contemporary bioethics principles. It is a significant entering in the area (which is essentially un-ethic) of market transactions, where libertarianism and consumer-oriented attitudes dominates the spectrum of rational choice. So tourism comes to provide an organized and comfortable framework for all these choices, but many issues still re-main controversial and may worsen if national health systems and national and international regulations would not identify their problems and would continue to leave medical tourism to market mechanisms. Market will efficiently allocate the resources, but not always in an ethical manner.
Faria, Miguel A
In 2013, U.S. President Barack Obama decreed the creation of the Presidential Commission for the Study of Bioethical Issues, as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. In the wake of the work of this Commission, the purpose, goals, possible shortcomings, and even dangers are discussed, and the possible impact it may have upon neuroscience ethics (Neuroethics) both in clinical practice as well as scientific research. Concerns were expressed that government involvement in bioethics may have unforeseen and possibly dangerous repercussions to neuroscience in particular and to medicine in general. The author emphasizes that the lessons of history chronicle that wherever governments have sought to alter medical ethics and control medical care, the results have frequently been perverse and disastrous, as in the examples of the communist Soviet Union and National Socialist (Nazi) Germany. The Soviet psychiatrists' and the Nazi doctors' dark descent into ghastly experimentation and brutality was a product of convoluted ethics and physicians willingly cooperating with authoritarianism citing utilitarianism in the pursuit of the 'collective' or 'greater good.' Thus in the 20(th) century, as governments infringed on the medical profession, even the Liberal Democracies have not been immune to the corruption of ethics in science and medicine.
Newland, Shelby E
In terms of health care access, bioethics has an important role to inform and shape policy issues and develop interdisciplinary ideas and interventions. The rising price of prescription drugs presents one of the most looming barriers to health care access in the world today. Including both theoretical and practical features of the pharmaceutical industry's behavior is necessary to find ethical solutions towards increasing access. Bioethics can evaluate global justice by weighing human rights theory and future innovation at the macro level, and by addressing market forces and responsibilities at the micro level. Inherent structural features of pharmaceuticals, such as its reliance on research and development, cause the industry to employ pricing strategies that seem counter-intuitive to conventional wisdom, but that result in producing a just allocation as defined by market forces. Parallel trade and drug exportation/reimportation threaten the saliency of the industry's differential pricing scheme; a case-study of a single "Euro-price" within the European Union illustrates how this will actually create harm to the most needy member states. This complex situation requires solutions weighing arguments from human rights theory with those from economic theory to arrive at the most globally just allocation of prescription drugs in the global marketplace, as well as to ensure future innovation and scientific progress. Bioethicists as well as economists need to partake urgently in this discourse for the betterment of the global injustices in the international prescription drug market.
Fausett, Jennifer Kleiner; Gilmore-Szott, Eleanor; Hester, D Micah
Ethics networks have emerged over the last few decades as a mechanism for individuals and institutions over various regions, cities and states to converge on healthcare-related ethical issues. However, little is known about the development and nature of such networks. In an effort to fill the gap in the knowledge about such networks, a survey was conducted that evaluated the organizational structure, missions and functions, as well as the outcomes/products of ethics networks across the country. Eighteen established bioethics networks were identified via consensus of three search processes and were approached for participation. The participants completed a survey developed for the purposes of this study and distributed via SurveyMonkey. Responses were obtained from 10 of the 18 identified and approached networks regarding topic areas of: Network Composition and Catchment Areas; Network Funding and Expenses; Personnel; Services; and Missions and Accomplishments. Bioethics networks are designed primarily to bring ethics education and support to professionals and hospitals. They do so over specifically defined areas-states, regions, or communities-and each is concerned about how to stay financially healthy. At the same time, the networks work off different organizational models, either as stand-alone organizations or as entities within existing organizational structures.
Murphy, Timothy F
In many ways, we live in propitious times for gay and lesbian people. In 1996, the Supreme Court struck down Colorado law prohibiting any kind of protected status based on sexual orientation. In 2003, the Supreme Court held that states may not criminalize sexual conduct between consenting adults of the same sex in private, so long as no money changes hands. In 2010, the Congress repealed the "Don't Ask, Don't Tell" policy that excluded openly gay men and lesbians from military service. In 2013, the Supreme Court struck down key elements of the Defense of Marriage Act that prohibited any federal recognition of same-sex marriage. Most states do not allow same-sex marriage, but more and more states are joining the fold. Likewise, most U.S. states do not forbid discrimination based on sexual orientation, but the number that does is increasing. Arguably, no other social minority has made as much legal progress in so short a time. Despite these advances, the story of gay and lesbian people and the law is not yet finished, and the meaning of homosexuality for bioethics is still being written too. Concerns about gay and lesbian people remain important to bioethics in key domains, especially in seeing to the conferral of optimal health care benefits and in sorting through the priorities and social effects of research. Progress in these domains still involves lifting certain burdens of medical and social misjudgments about same-sex attraction. © 2014 by The Hastings Center.
BADULESCU, Daniel; BADULESCU, Alina
Abstract Nowadays, medical tourism reports impressive growth in terms of number of persons, income and number of countries involved in cross-border flows. So this study was undertaken to clarify entrepreneurship opportunities and bio-ethics boundaries in medical tourism. For tourism entrepreneurs, these outgoing flows related to medical procedures and tourism become an opportunity that cannot be ignored, so a wide range of tourist services related to health care are provided on a private, entrepreneurial basis. However, social and economic boundaries are omnipresent (impaired health services in receiving (incoming) countries, the crisis of the health care systems in emitting (outgoing) countries, over-consumption of medical and tourism services), and, not least, ethical considerations. Transforming medical care in a market tool, reducing human attributes to the status of commodity that can be bought, sold or negotiated, seriously challenges contemporary bioethics principles. It is a significant entering in the area (which is essentially un-ethic) of market transactions, where libertarianism and consumer-oriented attitudes dominates the spectrum of rational choice. So tourism comes to provide an organized and comfortable framework for all these choices, but many issues still re-main controversial and may worsen if national health systems and national and international regulations would not identify their problems and would continue to leave medical tourism to market mechanisms. Market will efficiently allocate the resources, but not always in an ethical manner. PMID:26005650
The need for explicit theoretical reflection on cross-cultural bioethics continues to grow as the spread of communication technologies and increased human migration has made interactions between medical professionals and patients from different cultural backgrounds much more common. I claim that this need presents us with the following dilemma. On the one hand, we do not want to operate according to an imperialist ethical framework that denies and silences the legitimacy of cultural values other than our own. On the other hand, we do not want to backslide into a form of cultural relativism that is unable to critically appraise cultural practices that are harmful, unjust, or oppressive. I examine two prominent attempts - the principlism of Tom Beauchamp and James Childress and the Contractarianism of Robert Baker - to frame cross-cultural bioethics between these two extremes and argue that both approaches have significant flaws. The principlist approach fails to provide a non-question begging way to identify cross-cultural norms that does not already assume the universal legitimacy of moral principles dominant in North American society. Baker's contractarianism cannot grapple with the realities of political power imbalances that often characterize cross-cultural moral disputes. I suggest that a naturalized feminist framework, though not free of its own theoretical difficulties, provides the best alternative for approaching moral diversity respectfully and critically. © 2014 John Wiley & Sons Ltd.
Rodrigo A. Salinas
Full Text Available The reflection on bioethical contents of health policies and their effects on the demands for social justice has been a preferred concern of those who have driven the health reforms that were behind the creation of the National Health Service and, more recently, the regime of health guarantees. In the course of the years, the concern for the vindication of individual rights in the context of health care and research has joined to citizen demands for equitable access to health actions. For this purpose, in 2006 and 2012, specific laws addressing these matters were enacted and in the last year, regulations that make them operative emerged and are being implemented. The wording of the articles of both laws, in the effort to rescue individual rights, raises an imbalance in some respects, with regard to the social impact of their implementation. In certain subjects, its provisions run counter to existing codes of professional ethics in the country and in others; its implementation allows the privatization of the process of ethical review of pharmacological research, which was restricted to public health services. The absence of starting up of the National Bioethics Commission, pending since 2006, has prevented the creation of a pluralistic spaTce for deliberation on these issues and others as provided by law.
Because ethics consults are often more about conflict than moral puzzlement, the skills of conflict resolution and communication facilitation are now deemed a core competency for ethics consultants. Those skills range beyond the traditional ambit of "bioethics mediation," as illustrated here by a recent mediation regarding a difficult discharge. As conflict permeates healthcare, often spawning downstream ethical issues, conflict resolution services might be deemed a genre of preventive ethics suitably offered by ethics committees. If so, a strong distinction must be made. "Bioethics mediation" as historically defined is a curious amalgam between a consultant who recommends, and a mediator who facilitates consensus among the parties at the table. On closer examination this approach is problematic, particularly in the clinical setting. A mediator who acts as consultant, telling parties what they should do or directly circumscribing the limits of an "acceptable" decision, quickly becomes just another pair of fists in the fight. At that point the odds for reaching genuine agreement, as opposed to a transient acquiescence, diminish markedly. Accordingly, those who undertake conflict resolution in the clinical setting need to distinguish quite sharply between facilitative mediation, versus a consultant's role. © 2015 American Society of Law, Medicine & Ethics, Inc.
Full Text Available In an environment which is ethically and from a human rights point of view overly sensitive and in which interculturism is becoming more and more a norm, pastoral care practitioners need to be committed to providing services that are ethical, intercultural and respecting of patients’ rights. This article demonstrates how application of the Symphonology Bioethical Theory (SBT as the framework for practice in pastoral care and counselling can help Pastoral Care Practitioners (PCP to be ethical while upholding patients’ human rights, and it can also help to bridge the intercultural chasm while simultaneously explaining the rationale for the practice. Symphonology is a context-driven, ethical decision- making model guiding holistic interaction between patients and PCPs. The Symphonological decision-making matrix is based on a practitioner-patient agreement for pastoral care that emphasizes patient preferences, pastoral psychological and theological knowledge, the pastoral care content and the context of the situation. The goal of the PCP is to ethically incarnate the divine presence and thus to bring about hope and emancipation to the patient using the bioethical standards of autonomy, freedom, objectivity, self-assertion, benevolence and fidelity.
Full Text Available Carlo Petrini Bioethics Unit, Office of the President, National Institute of Health, Rome, Italy Abstract: A review of the European Union (EU regulations concerning blood, tissues, and cells of human origin is under way in the EU. From the ethical point of view, the non-remuneration of donations and the ban on deriving gain from human biological materials are of particular significance. While the basic ethical principles involved in the procurement, preservation, and use of these materials are the same, their practical application should be adapted to the specific context of each material. In the case of donation and use of blood, in particular, the issue of legitimate reimbursements to donors and for transfusion centers has to be managed in accordance with the principle of non-commercialization. There is also a need for strict rules to avoid possible commercial spillover effects from blood-derived products. The author proposes ethical criteria regarding reimbursements to donors, costs associated with processing, and the development (and possible marketing of products. Keywords: bioethics, blood, legislation, Europe, transfusion
Butler, Catherine R; Mehrotra, Rajnish; Tonelli, Mark R; Lam, Daniel Y
Throughout the history of dialysis, four bioethical principles - beneficence, nonmaleficence, autonomy and justice - have been weighted differently based upon changing forces of technologic innovation, resource limitation, and societal values. In the 1960s, a committee of lay people in Seattle attempted to fairly distribute a limited number of maintenance hemodialysis stations guided by considerations of justice. As technology advanced and dialysis was funded under an amendment to the Social Security Act in 1972, focus shifted to providing dialysis for all in need while balancing the burdens of treatment and quality of life, supported by the concepts of beneficence and nonmaleficence. At the end of the last century, the importance of patient preferences and personal values became paramount in medical decisions, reflecting a focus on the principle of autonomy. More recently, greater recognition that health care financial resources are limited makes fair allocation more pressing, again highlighting the importance of distributive justice. The varying application and prioritization of these four principles to both policy and clinical decisions in the United States over the last 50 years makes the history of hemodialysis an instructive platform for understanding principlist bioethics. As medical technology evolves in a landscape of changing personal and societal values, a comprehensive understanding of an ethical framework for evaluating appropriate use of medical interventions enables the clinician to systematically negotiate and optimize difficult ethical situations. Copyright © 2016 by the American Society of Nephrology.
Rawlinson, Mary C; Donchin, Anne
This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the 'fundamental equality of all human beings in dignity and rights'(1) and insists that 'the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition'(2) yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention.
This paper suggests that many of the pressing dilemmas of bioethics are global and structural in nature. Accordingly, global ethical frameworks are required which recognize the ethically significant factors of all global actors. To this end, ethical frameworks must recognize the rights and interests of both individuals and groups (and the interrelation of these). The paper suggests that the current dominant bioethical framework is inadequate to this task as it is over-individualist and therefore unable to give significant weight to the ethical demands of groups (and by extension communal and public goods). It will explore this theme by considering the inadequacy of informed consent (the 'global standard' of bioethics) to address two pressing global bioethical issues: medical tourism and population genetics. Using these examples it will show why consent is inadequate to address all the significant features of these ethical dilemmas. Four key failures will be explored, namely, • That the rights and interests of those related (and therefore affected) are neglected; • That consent fails to take account of the context and commitments of individuals which may constitute inducement and coercion; • That consent alone does not have the ethical weight to negate exploitation or make an unjust action just ('the fallacy of sufficiency'); • That consent is a single one-off act which is inappropriate for the types of decision being made. It will conclude by suggesting that more appropriate models are emerging, particularly in population genetics, which can supplement consent. © 2010 Blackwell Publishing Ltd.
Jennifer M. Kilty
Full Text Available This article highlights the ethically uncertain and emotionally charged climate that governs the criminalization of HIV nondisclosure in Canada. Focusing on AIDS Service Organizations (ASO, we suggest that interlocutors perform critical work that helps people living with HIV/AIDS make sense of their rights and responsibilities. Semi-structured interviews with 62 ASO staff across Canada revealed this shifting landscape of HIV advocacy in the age of criminalizing HIV nondisclosure. Drawing on a critical bioethics approach that is informed by considering the role of emotion in decision-making, this article critiques the liberal model of the rational actor that is central to traditional discussions of bioethics and law. Our findings suggest that ASO workers have varying degrees of knowledge about the intricacies of legal duties of disclosure, which affect how they balance their own emotions and thoughts about nondisclosure with their professional duties to provide support and counselling. Ultimately, we argue that critical bioethics in the context of criminalization commands us to appreciate the inherently affective nature of the environment in which bioethical decisions are made.
Güvercin, Cemal Huseyin; Munir, Kerim M
The arguments set forth by religious authority are important since they play a crucial role in shaping the social values of the public and influence the decision of individuals in practice pertaining to bioethical issues. The Religious Affairs Administration (RAA) was established at the inception of the Republic of Turkey in 1924 to guide religious considerations moving out of the Ottoman caliphate to a secular bioethical framework. In this article, the bioethical views of the RAA under Islamic tradition is examined and contrasted with those influenced by the Roman Catholic and Orthodox Judaic traditions. On bioethical deliberations related to the beginning and end-of-life, all three religious traditions justify sacredness of life and that of God's will in its preservation it. Assisted reproduction techniques between spouses is considered to be appropriate, although third party involvement is explicitly forbidden. Organ transplantation is approved by all three religious traditions, except uterine transplantation. Contraceptive practices are approved under certain conditions - views differ most on approaches to contraception and the appropriateness of methods. The RAA judgement on cloning is to prohibit it, like Roman Catholicism and Orthodox Judaism. In other topics, cosmetic surgery and gender determination are approved only for treatment.
This article analyses the international governance of human reproductive cloning. Noting that bioethics is a new field of engagement for international lawyers, it recounts some of the institutional developments in bioethical law making. The role of UNESCO and the United Nations General Assembly is scrutinized and the author discusses the relative merits of the institutions' governance of human reproductive cloning. The author suggests that some international institutions and mechanisms are better suited than others for bioethical law making. The 2005 General Assembly resolution on human cloning is analysed in this context.
This paper discusses from a sociological perspective one of Catholicism's fronts of public intervention in the development and enactment of health legislation. In particular we analyze the debate in parliamentary committees on the so-called "death with dignity" law (No. 26742), for which a group of bioethics experts was convened to counsel senators regarding the scope and limits of the law. The majority of the invited experts advocated a personalist bioethics perspective, which is a theological bioethics development of contemporary Catholicism. In the debate no representatives of other faiths were present, reinforcing the widely studied overlap between Catholicism and politics in Argentina.