Titel oversat: Islamisk, medicinsk etik i det tyvende århundrede.

Contains twenty-one of the papers presented at the 3rd Islam and Bioethics International Conference held April 14-16, 2010, in Manavgat, Antalya, Turkey.

Selecting the sex of a fetus has been a desire of parents in many different cultures. Modern Muslim religious scholars have identified advantages and disadvantages of this practice, permitting it in certain cases while forbidding it in others. In general, they do not appear to desire that selection of sex become a common practice, yet they are willing to allow it for personal reasons. This case-by-case approach exemplifies a key aspect of Muslim ethical discourse. After an overview of justifications for (...) fetal sex selection in different cultures, I turn to a discussion of authoritative Islamic sources. I then analyze the reasoning of several modern authorities who deal with the issue. In the absence of a clear religious text on the subject, scholars seem inclined to legitimize sex selection, and in so doing they appear strongly influenced by social attitudes. (shrink)

Difference and Disability in the Medieval Islamic World: Blighted Bodies. By Kristina L. Richardson. Edinburgh: Edinburgh University Press, 2012. Pp. ix + 158. $110, £65 ; $40, £24.99.

The ArgumentMuslims share with others both the interest in and the concern about genetic engineering. Naturally their reactions and views stem from general Islamic dogma and from Islamic medical ethics, but they are not unaware of Western scientific data. Particularly relevant is the Islamic religious prohibition against “changing what Allah has created.” Muslim muftis try to offer practical solutions for individuals. Islamic law is concerned about maintaining pure lineage. Consanguineous matings are very common, but induced abortions are usually ruled out. (...) Cloning has reawakened among Muslims an old debate over the positive as well as hazardous aspects of genetic engineering. (shrink)

Postmortem examinations have recently become common practice in Western medicine: they are used to verify the cause of death and to obtain additional scientific information on certain diseases, as well as to train medical students. For religious people of the monotheistic faiths postmortems present several ethical questions even though the advantages attributed to postmortems in the West are also acknowledged by Jews, Christians and Muslims. The Islamic way of dealing with such questions will be surveyed via contemporary fatawa (legal opinions) (...) issued primarily by Egyptian scholars; Islamic law, which was formulated in the eighth to ninth centuries, did not speak of postmortems. I will therefore depict the means whereby contemporary scholars approach postmortems in the absence of clear legal reference. The difficulties that postmortems create for Muslims at present will be weighed against some shar i instructions which may help circumvent them. While the ethical and religious debate continues, postmortems seem to be accepted but not, however, without certain reservations. (shrink)

While the practice of Western medicine is known today to doctors of all ethnic and religious groups, its standards are subject to the availability of resources. The medical ethics guiding each doctor is influenced by his/her religious or cultural background or affiliation, and that is where diversity exists. Much has been written about Jewish and Christian medical ethics. Islamic medical ethics has never been discussed as an independent field of ethics, although several selected topics, especially those concerning sexuality, birth control (...) and abortions, have been more discussed than others. Islamic medical ethics in the 20th century will be characterised on the basis of Egyptian fatawa (legal opinions) issued by famous Muslim scholars and several doctors. Some of the issues discussed by Islamic medical ethics are universal: abortions, organ transplants, artificial insemination, cosmetic surgery, doctor-patient relations, etc. Other issues are typically Islamic, such as impediments to fasting in Ramadan, diseases and physical conditions that cause infringement of the state of purity, medicines containing alcohol, etc. Muslims' attitudes to both types of ethical issues often prove that pragmatism prevails and the aim is to seek a compromise between Islamic heritage and the achievements of modern medicine, as long as basic Islamic dogma is not violated. (shrink)

This book comprises a series of studies devoted to an analytic examination of reasoning in the field of conduct. The first is analysis of the idea of justice undertaken in a spirit of positivism; the series continues in a different vein necessitated by compelling obligation the author found himself under to work out a logic of value judgments. This logic is in fact the Rhetoric and Topics of antiquity: the author's "Traité de l' Argumentation gave this new life, and the (...) present work demonstrates its philosophical importance. (shrink)

This book discusses the justifications and limits of cultural nationalism from a liberal perspective. Chaim Gans presents a normative typology of nationalist ideologies, distinguishing between cultural liberal nationalism and statist liberal nationalism. Statist nationalisms argue that states have an interest in the cultural homogeneity of their citizenries. Cultural nationalisms argue that people have interests in adhering to their cultures and in sustaining these cultures for generations. Gans argues that freedom- and identity-based justifications for cultural nationalism common in literature can (...) only support the adherence thesis, while the historical thesis could only be justified by the interest people have in the long-term endurance of their personal and group endeavors. The Limits of Nationalism examines demands often made in the name of cultural nationalism, such as claims for national self-determination, historical rights claims to territories and demands entailed by cultural particularism as opposed to cultural cosmopolitanism. (shrink)

Combining ethnographic, semiotic, and performative approaches, this book examines texts and accompanying acts of writing of national commemoration. The commemorative visitor book is viewed as a mobilized stage, a communication medium, where visitors' public performances are presented, and where acts of participation are authored and composed. The study contextualizes the visitor book within the material and ideological environment where it is positioned and where it functions. The semiotics of commemoration are mirrored in the visitor book, which functions as a participatory (...) platform that becomes an extension of the commemorative spaces in the museum. The study addresses tourists' and visitors' texts, i.e. the commemorative entries in the book, which are succinct dialogical utterances. Through these public performances, individuals and groups of visitors align and affiliate with a larger imagined national community. Reading the entries allows a unique perspective on communication practices and processes, and vividly illustrates such concepts as genre, voice, addressivity, indexicality, and the very acts of writing and reading. The book's many entries tell stories of affirming, but also resisting the narrative tenets of Zionist national identity, and they illustrate the politics of gender and ethnicity in Israel society. The book presents many ethnographic observations and interviews, which were done both with the management of the site, and with the visitors themselves. The observations shed light on processes and practices involved in writing and reading, and on how visitors decide on what to write and how they collaborate on drafting their entries. The interviews with the site's management also illuminate the commemoration projects, and how museums and exhibitions are staged and managed. (shrink)

Substantial research demonstrates that ethical leaders improve a broad range of outcomes for their employees, but considerably less attention has been devoted to the performance and success of the leaders themselves. The present study explores the extent to which being ethical relates to leaders’ performance and promotability. We address this question by examining ethical leadership from the two ethical perspectives most common in Western traditions—i.e., the “right” and the “good”—and whether one might be more closely associated than the other with (...) performance and promotability evaluations. Results from 117 employee-supervisor-manager triads show that supervisors with a deontological outlook are more likely to be seen as ethical leaders and that utilitarian leaders are more likely to earn higher performance evaluations. We discuss the implications of these findings for research on ethical leadership. (shrink)

The legitimacy of the Zionist project--establishing a Jewish homeland in Palestine--has been questioned since its inception. In recent years, the voices challenging the legitimacy of the State of Israel have become even louder. Chaim Gans examines these doubts and presents an in-depth, evenhanded philosophical analysis of the justice of Zionism.

The New Rhetoric is founded on the idea that since “argumentation aims at securing the adherence of those to whom it is addressed, it is, in its entirety, relative to the audience to be influenced,” says Chaïm Perelman and L. Olbrechts-Tyteca, and they rely, in particular, for their theory of argumentation on the twin concepts of universal and particular audiences: while every argument is directed to a specific individual or group, the orator decides what information and what approaches will achieve (...) the greatest adherence according to an ideal audience. This ideal, Perelman explains, can be embodied, for example, "in God, in all reasonable and competent men, in the man deliberating or in an elite.” Like particular audiences, then, the universal audience is never fixed or absolute but depends on the orator, the content and goals of the argument, and the particular audience to whom the argument is addressed. These considerations determine what information constitutes "facts" and "reasonableness" and thus help to determine the universal audience that, in turn, shapes the orator's approach. /// The adherence of an audience is also determined by the orator's use of values, a further key concept of the New Rhetoric. Perelman's treatment of value and his view of epideictic rhetoric sets his approach apart from that of the ancients and of Aristotle in particular. Aristotle's division of rhetoric into three genres–forensic, deliberative, and epideictic–is largely motivated by the judgments required for each: forensic or legal arguments require verdicts on past action, deliberative or political rhetoric seeks judgment on future action, and epideictic or ceremonial rhetoric concerns values associated with praise or blame and seeks no specific decisions. For Aristotle, the epideictic genre was of limited importance in the civic realm since it did not concern facts or policies. Perelman, in contrast, believes not only that epideictic rhetoric warrants more attention, but that the values normally limited to that genre are in fact central to all argumentation. "Epideictic oratory," Perelman argues, "has significant and important argumentation for strengthening the disposition toward action by increasing adherence to the values it lauds.” These values are central to the persuasiveness of arguments in all rhetorical genres since the orator always attempts to "establish a sense of communion centered around particular values recognized by the audience.”. (shrink)

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics’ (IAB’s) selection of Qatar to host the 2024 World Congress of Bioethics. IAB’s choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets (...) forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles.One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? (shrink)

Investigators and institutional review boards should integrate plans about the appropriate disclosure of individual genetic results when designing research studies. The ethical principles of beneficence, respect, reciprocity, and justice provide justification for routinely offering certain results to research participants. We propose a result-evaluation approach that assesses the expected information and the context of the study in order to decide whether results should be offered. According to this approach, the analytic validity and the clinical utility of a specific result determine whether (...) it should be offered routinely. Different results may therefore require different decisions even within the same study. We argue that the threshold of clinical utility for disclosing a result in a research study should be lower than the threshold used for clinical use of the same result. The personal meaning of a result provides additional criteria for evaluation. Finally, the context of the study allows for a more nuanced analysis by addressing the investigators' capabilities for appropriate disclosure, participants' alternative access to the result, and their relationship with the investigators. This analysis shows that the same result may require different decisions in different contexts. (shrink)

Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...) fetal genome. The benefits of this screening tool are generally framed, by both providers and commercial laboratories, as enhancing reproductive autonomy and choice by providing an earlier, simpler, and more accurate screening while potentially reducing the need for invasive follow-up testing. The majority of the literature has explored these issues empirically or conceptually from a European or North American vantage point, one that assumes normative priorities such as individual reproductive autonomy and the clinical availability of maternal health care or prenatal screening programs within which cell-free DNA screening is offered. While its implementation has raised both challenges and opportunities, very little is known about real-world experiences and the implications of the rapid introduction of cell-free DNA screening outside of North America and Europe, especially in low- and middle-income countries. To begin addressing this gap in knowledge, we organized a four-day international workshop to explore the ethical, legal, social, economic, clinical, and practical implications of the global expansion of cell-free DNA screening. We describe eight key insights that arose from the workshop. (shrink)

In the past generation, restitution law has emerged as a global phenomenon. From its Oxbridge home, restitution migrated to the rest of the Commonwealth, and ongoing Europeanization projects have brought the common law of restitution into contact with the Romanist concept of unjust enrichment, further internationalizing this movement. In contrast, in the United States, scholarly interest in restitution, in terms of books, articles, treatises, symposia and courses on restitution, is meager. Similarly, while restitution, equity and tracing cases receive considerable treatment (...) at the highest levels of the English judiciary, US courts seem uninterested in these issues, rarely producing the theory-laden opinions that have become quite common in the House of Lords. The situation is particularly curious because restitution is generally thought to be the invention of late nineteenth-century American scholars. This article explains this divergence. I argue that the Commonwealth restitution discourse is largely a product of pre- or anti-realist legal thought which generates scepticism within the American academic-legal establishment. The article identifies the two dominant camps in American private law thought—left-leaning redistributionalists and the centre-right legal economists—and shows that neither has any use for the Commonwealth's discourse. I conclude by analysing the emerging drafts of the Restatement of Restitution and forecast the future of American restitution law. (shrink)

Since the 1970s, prenatal testing has been integrated into many health care systems on the basis of two competing and largely irreconcilable rationales. The reproductive autonomy rationale focuses on nondirective counseling and consent as ways to ensure that women's decisions about testing and subsequent care are informed and free of undue pressures. It also represents an easily understandable and ethically convincing basis for widespread access to prenatal testing, since the value of autonomy is well established in Western bioethics and widely (...) recognized by funders of health care. In contrast, the public health rationale approaches prenatal testing as designed to reduce the incidence of certain conditions in the population to reduce the burden of disease. This rationale emphasizes the societal consequences of reproduction and the aggregate impact of women's individual reproductive decisions on the overall health of future populations. In this essay, I argue that, despite what could be seen as a persistent failure to meet the ideals of reproductive autonomy, resisting the public health rationale as a basis for prenatal screening is ethically and pragmatically crucial. I recommend policy mechanisms that can enhance reproductive autonomy at a societal level to support choice at the individual level. (shrink)

One of the most prominent justifications for the use of germline gene editing (GGE) is that it would allow parents to have a “genetically related child” while preventing the transmission of genetic disorders. However, we argue that since future uses of GGE may involve large-scale genetic modifications, they may affect the genetic relatedness between parents and offspring in a meaningful way: Due to certain genetic modifications, children may inherit much less than 50% of their DNA from each parent. We show (...) that the reduction in genetic relatedness between parents and offspring has three important social and legal implications. First, the desire for a genetically related child may end up not being the strong justification it is currently thought to be for the use of GGE. Second, prospective parents may be reluctant to use GGE because of a potential loss of genetic relatedness. Third, in some jurisdictions, parents who would not pass on “enough” DNA to their child may not be recognized as the child's legal parents. We further argue that the reduction in genetic relatedness challenges current conceptions of genetic parenthood that rely on the quantity of DNA shared with the child or on whether the child was directly derived from the parent's genes. We suggest that genetic parenthood should instead be determined based on the nature of the genetic modifications and whether the child's numerical identity has been preserved after the editing process. (shrink)

Current advances in assisted reproductive technologies aim to promote the health and well-being of future children. They offer the possibility to select embryos with the greatest potential of being born healthy (eg, preimplantation genetic testing) and may someday correct faulty genes responsible for heritable diseases in the embryo (eg, human germline genome modification (HGGM)). Most laws and policy statements surrounding HGGM refer to the notion of ‘serious’ as a core criterion in determining what genetic diseases should be targeted by these (...) technologies. Yet, this notion remains vague and poorly defined, rendering its application challenging and decision making subjective and arbitrary. By way of background, we begin by briefly presenting two conceptual approaches to ‘health’ and ‘disease’: objectivism (ie, based on biological facts) and constructivism (ie, based on human values). The basic challenge under both is sorting out whether and to what extent social and environmental factors have a role in helping to define what qualifies as a ‘serious’ disease beyond the medical criteria. We then focus on how a human rights framework (eg, right to science and right to the highest attainable health) could integrate the concepts of objectivism and constructivism so as to provide guidance for a more actionable consideration of ‘serious’. Ultimately, it could be argued that a human rights framework, by way of its legally binding nature and its globally accepted norms and values, provides a more universal foundation for discussions of the ethical, legal and social implications of emerging or disruptive technologies. (shrink)

This book examines the central questions concerning the duty to obey the law: the meaning of this duty; whether and where it should be acknowledged; and whether and when it should be disregarded. Many contemporary philosophers deny the very existence of this duty, but take a cautious stance toward political disobedience. This 'toothless anarchism', Professor Gans argues, should be discarded in favour of a converse position confirming the existence of a duty to obey the law which can be outweighed by (...) values and principles of political morality. Informed by the Israeli experience of political disobedience motivated by radically differing moral outlooks, the author sets out the principles which should guide our attitude to law and political authority even amidst clashing ideologies and irreconcilable moralities. This book will be of interest to students and scholars of law, philosophy and politics, and anyone concerned with the individual's responsibilties toward his or her political community. (shrink)

This book will also inform the general public, patients, and family members as they seek answers to the bioethical issues of the day.

Unlike most Western nations, Israel does not recognize full separation of church and state but seeks instead a gentle fusion of Jewish and democratic values. Inasmuch as important religious norms such as sanctity of life may clash with dignity, privacy, and self-determination, conflicts frequently arise as Israeli lawmakers, ethicists, and healthcare professionals attempt to give substance to the idea of a Jewish-democratic state. Emerging issues in Israeli bioethics—end-of-life treatment, fertility, genetic research, and medical ethics during armed conflict—highlight this conflict vividly.

Bayefsky and Berkman argue in favor of evidence-based policy development for expanded prenatal genetic testing. They propose to identify what kinds of information pregnant persons, their par...

Effective July 22, 2011, a new law in the state of Washington requires any donor of sperm or eggs to provide a medical history and identifying information to fertility clinics. It also allows donor‐conceived individuals to request this information from clinics once they reach the age of eighteen. This is a significant legislative milestone and a promising development in a country that has consistently shied away from regulating the infertility industry in any way. What do we as a society owe (...) donor‐conceived individuals in terms of obtaining access to information about their genetic origins? This essay addresses just one of this set of issues: the regulatory changes required to address the medical interests of donor‐conceived individuals, regardless of whether a human right to know one's genetic origins is acknowledged. (shrink)

Background Noninvasive prenatal testing (NIPT) provides important benefits yet raises ethical concerns. We surveyed Canadian pregnant women and their partners to explore their views regarding pressure to test and terminate a pregnancy, as well as other societal impacts that may result from the routinization of NIPT.Methods A questionnaire was offered (March 2015 to July 2016) to pregnant women and their partners at five healthcare facilities in four Canadian provinces.Results 882 pregnant women and 395 partners completed the survey. 64% of women (...) anticipated feeling no pressure to take the test if it were offered routinely, and 39% were not concerned about routinization leading to increased pressure to terminate a pregnancy of a fetus with Down Syndrome. Regarding other social concerns possibly resulting from routinization, pregnant women were most concerned regarding a reduction in resources available for people with Down Syndrome and their families and least concerned regarding a decrease in the population of people with Down Syndrome.Conclusions Our findings reflect the concerns expressed by pregnant women and their partners, both personal (pressure to test, pressure to terminate) and societal (e.g., regarding potential negative impact on people with disabilities and their families). Even if most women were not concerned about feeling pressured to test due to NIPT routinization, a large minority express concerns that should not be taken lightly. Moreover, a majority of respondents were concerned regarding pressure to terminate pregnancies due to NIPT routinization as well as regarding most societal impacts they were queried on, especially the possible future reduction in resources available for people with DS and their families. Canadian policy-makers should consider these potential negative ramifications of NIPT and ensure that appropriate social policies accompany its implementation. (shrink)

Ancient Greek philosophers claimed that the adequate understanding of a particular subject can be achieved only when its nature, or essence, is properly defined. This view furnished the core teachings of late medieval natural philosophers, and was often reaffirmed by early modern philosophers such as Bacon and Descartes. Yet during the second half of the seventeenth century, a radical transformation was to take place that led a to the emergence of a recognisably modern cultures of empirical research.Experimental Philosophy and the (...) Birth of Empirical Science focuses on the works of Robert Boyle, John Locke, and Isaac Newton, the most notable exponents of the experimental philosophy in the late seventeenth century, and explores this transformation to a modern viewpoint that seeks to understand phenomena by seeking explanatory correlations between the empirical properties of the universe.Experimental Philosophy and the Birth of Empirical Science offers a novel solution to one of the major problems in the history of early modern science and philosophy, while addressing received views concerning these problems. It provides a new perspective on the Scientific Revolution and the rise of modern science and offers new tools for science studies in general, by showing how the problem of human understanding and the problem of explanation are central to the evolution of science, and how we can combine historical and sociological approaches to study modern science from this perspective. (shrink)

The concept of electrical conductivity, or, as initially coined by Stephen Gray , ‘electrical communication’, has always been assigned an important role in the history of electrical research. Some thirty-five years after Gray's ‘electrical communication’ acquired wide attention, Priestley employed the concept of conductivity to define physical reality, thus giving a privileged position to the science he himself endeavoured to cultivate. As he argued in the introduction to The History and Present State of Electricity , ‘the electrical fluid is no (...) local, or occasional agent in the theatre of the world. Late discoveries show that its presence and effects are every where … It is not, like magnetism, confined to one kind of bodies, but every thing we know is a conductor or nonconductor of electricity’. Contemporary historians, for example, Heilbron, Home and Hackmann, link the concept of conductivity to a radical transformation of electrical research which pertained to its mode of organization and the definition of its subject-matter, and which culminated in its emergence as a distinctive branch of eighteenth-century ‘experimental philosophy’. (shrink)

IntroductionResponsive neurostimulation is an evolving therapeutic option for patients with treatment-refractory epilepsy. Open-loop, continuous stimulation of the anterior thalamic nuclei is the only approved modality, yet chronic stimulation rarely induces complete seizure remission and is associated with neuropsychiatric adverse effects. Accounts of off-label responsive stimulation in thalamic nuclei describe significant improvements in patients who have failed multiple drug regimens, vagal nerve stimulation, and other invasive measures. This systematic review surveys the currently available data supporting the use of responsive thalamic neurostimulation (...) in primary and secondary generalized, treatment-refractory epilepsy.Materials and MethodsA systematic review was performed using the following combination of keywords and controlled vocabulary: OR ) OR [responsive neurostimulation AND thalamus AND ]. In addition, a search of the publications listed under the PubMed “cited by” tab was performed for all publications that passed title/abstract screening in addition to manually searching their reference lists.ResultsTen publications were identified describing a total of 29 subjects with a broad range of epilepsy disorders treated with closed-loop thalamic neurostimulation. The median age of subjects was 31 years old. Of the 29 subjects, 15 were stimulated in the anterior, 11 in the centromedian, and 3 in the pulvinar nuclei. Excluding 5 subjects who were treated for 1 month or less, median time on stimulation was 19 months. Of these subjects, 17/24 experienced greater than or equal to 50%, 11/24 least 75%, and 9/24 at least 90% reduction in seizures. Although a minority of patients did not exhibit significant clinical improvement by follow-up, there was a general trend of increasing treatment efficacy with longer periods on closed-loop thalamic stimulation.ConclusionThe data supporting off-label closed-loop thalamic stimulation for refractory epilepsy is limited to 29 adult and pediatric patients, many of whom experienced significant improvement in seizure duration and frequency. This encouraging progress must be verified in larger studies. (shrink)

According to cultural nationalism, members of groups sharing a common history and societal culture have a fundamental, morally significant interest in adhering to their culture and in sustaining it for generations. Moreover, this interest should be protected by states. I shall examine three theses included in this statement. The first, theadherence thesis,relates to the basic interest people have in adhering to their national culture. The second thesis ishistorical.It concerns the basic interest people have in recognizing and protecting the multigenerational dimension (...) of their culture. The third thesis, apoliticalone, holds that the interests people have in living their lives within their culture and in sustaining this culture for generations should be protected politically. Some contemporary writers who support a liberal version of cultural nationalism do so by arguing that people have an interest in culture mainly because it is a prerequisite for their freedom and also because it is a component of their identity. (shrink)