The current SARS-CoV-2 pandemic has killed thousands across the world. SARS-CoV-2 is the latest but surely not the last such global pandemic we will face. The biomedical response to such pandemics includes treatment, vaccination, and so on. In this paper, though, we argue that it is time to consider an additional strategy: the somatic enhancement of human immunity. We argue for this approach and consider bioethics objections we believe can be overcome.

Feelings of guilt are human emotions that may arise if a person committed an action that contradicts basic moral mores or failed to commit an action that is considered moral according to their ethical standards and values. Psychological scholarship distinguishes between altruistic guilt (AG) and deontological guilt (DG). AG results from having caused harm to an innocent victim, either by acting or failing to act, whereas DG is caused by violating a moral principle. Although physicians may be expected to experience (...) frequent feelings of guilt in their demanding and intensive work, it is surprising to find that this issue has not been explored in the professional literature on medical ethics. To that end, we conducted a qualitative study that included personal in-depth interviews with Sunni Muslim gynaecologists. These doctors provide underground infertility care and perform religiously forbidden treatments involving sex selection and gamete donation. They opened their hearts and spoke about the emotionally taxing pangs of conscience they suffer. Analysing their narratives led us to characterize their feelings of guilt as DG. We discuss the causes for their plight and the way they cope with it, compare DG to the concept of moral distress, and call for future research on clinicians’ feelings of guilt and pangs of conscience. (shrink)

This essay discusses the new report, Heritable Human Genome Editing, by the National Academy of Medicine, the National Academy of Sciences, and the Royal Society. After summarizing the report, we argue that the report takes four quite bold steps away from prior reports, namely (1) rejecting an omnibus approach to heritable human genome editing (HHGE) in favor of a case‐by‐case analysis of possible uses of HHGE, accepting that HHGE is acceptable in some cases; (2) recognizing that the interest in having (...) children who are genetically related to both would‐be rearing parents is one that the regulation of HHGE should honor; (3) patterning a regulatory model for HHGE on the United Kingdom's approach to regulating mitochondrial replacement techniques; and (4) conveying skepticism that international regulation is possible while showing a strong preference for a default into national regulatory regimes for HHGE. (shrink)

This essay discusses the new report, Heritable Human Genome Editing, by the National Academy of Medicine, the National Academy of Sciences, and the Royal Society. After summarizing the report, we argue that the report takes four quite bold steps away from prior reports, namely (1) rejecting an omnibus approach to heritable human genome editing (HHGE) in favor of a case‐by‐case analysis of possible uses of HHGE, accepting that HHGE is acceptable in some cases; (2) recognizing that the interest in having (...) children who are genetically related to both would‐be rearing parents is one that the regulation of HHGE should honor; (3) patterning a regulatory model for HHGE on the United Kingdom's approach to regulating mitochondrial replacement techniques; and (4) conveying skepticism that international regulation is possible while showing a strong preference for a default into national regulatory regimes for HHGE. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 10-14, March‐April 2022.

Are mechanisms for social attention influenced by culture? Evidence that social attention is triggered automatically by bottom-up gaze cues and is uninfluenced by top-down verbal instructions may suggest it operates in the same way everywhere. Yet considerations from evolutionary and cultural psychology suggest that specific aspects of one's cultural background may have consequence for the way mechanisms for social attention develop and operate. In more interdependent cultures, the scope of social attention may be broader, focusing on more individuals and relations (...) between those individuals. We administered a multi-gaze cueing task requiring participants to fixate a foreground face flanked by background faces and measured shifts in attention using eye tracking. For European Americans, gaze cueing did not depend on the direction of background gaze cues, suggesting foreground gaze alone drives automatic attention shifting; for East Asians, cueing patterns differed depending on whether the foreground cue matched or mismatched background cues, suggesting foreground and background gaze information were integrated. These results demonstrate that cultural background influences the social attention system by shifting it into a narrow or broad mode of operation and, importantly, provides evidence challenging the assumption that mechanisms underlying automatic social attention are necessarily rigid and impenetrable to culture. (shrink)

When prospective parents use in vitro fertilization, many of them hope to generate more embryos than they intend to implant immediately. The technology often requires multiple attempts to reach a successful pregnancy, and couples can cryopreserve any excess embryos so that they have them on hand for later attempts. As part of obtaining informed consent for IVF or cryopreservation, clinics typically ask patients to specify their preferences for the embryos in the event of divorce or death, offering options such as (...) use of the embryos by a specified partner, donation to research, or discarding the remaining embryos. Still, many courts face a recurring problem: the partners dissolve their relationship, and one party wants to use the frozen embryos over the objections of the other. Courts and legislatures have struggled with how to handle these cases, which seem to pit one partner's right to procreate against the other's right not to procreate. In this essay, we use one of the most recent decisions in this line of cases—the Appellate Court of Illinois's decision in Szafranski v. Dunston—to explain the current state of the law and make recommendations for changes. The issue is ripe for revisiting because in the last year, embryo disputes have become a battlefront for larger conflagrations over the moral status of embryos. (shrink)

Professor Sparrow’s (2022) Target Article helpfully elucidates the question of when the ordinary person-affecting conception of harm and benefit should apply to discussions of germline genome editi...

Background Most jurisdictions that allow euthanasia and assisted suicide (AS) regulate it through the medical profession. However, the extent and nature of how medicine should be involved are debated. Swiss AS practice is unusual in that it is managed by lay AS organizations that rely on a law that permits AS when done for nonselfish reasons. Physicians are not mentioned in the law but are usually called upon to prescribe the lethal medications and perform capacity evaluations.Methods We analyzed in-depth interviews (...) of 23 Swiss AS experts including ethicists, lawyers, medical practitioners, and senior officials of AS organizations for their views on AS.Results Although there was agreement on some issues (e.g., need for better end-of-life care), the interviewees’ preferred model for AS, and the nature of preferred medical involvement, varied, which we categorized into five types: preference for AS practice as it occurred prior to lay AS organizations; preference for the current lay model; preference for a modified lay model to increase autonomy protections while limiting medical AS normalization; preference for various types of more medicalized models of AS; and, ambivalence about any specific model of medical involvement. The rationales given for each type of model reflected varying opinions on how medicine’s role would likely impact AS practice and demonstrated the experts’ attitudes toward those impacts.Conclusion The dynamics within the Swiss AS regime, as reflected in the varying views of Swiss AS experts, shed light on the dilemmas inherent to medical scope and involvement in AS, which may have implications for debates in other jurisdictions. (shrink)

Professional, Ethical, Legal, and Educational Lessons in Medicine: A Problem Based Approach provides a comprehensive review of the complex and challenging field of professional medical practice. Its problem-based format incorporates a vast pool of practical, board-exam-style multiple-choice questions for self-assessment, and is an ideal resource for exam preparation as well as ongoing clinical education among trainees and clinicians The practice of medicine is not only about clinical care of patients. Physicians must navigate ethical conundrums, legal pitfalls, and quality improvement issues (...) while maintaining scrupulous professionalism and being exemplary educators. This volume addresses common issues in the realm of professional medical practice not typically covered in other texts. Each of the 73 chapters presents a problem-based case that branches out into an oral board examination type stem questions. A discussion section with brief review articles summarizes the most recent literature. Multiple-choice questions with answers allows for comprehensive self-assessment or interactive group quizzes. This book will appeal to medical and allied health professionals in all specialties of medicine. It is an excellent and hands-on reference for the related but diverse domains associated with professional healthcare practice by students, physicians, and other healthcare providers compacted into one volume. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Background: While religious faith remains one of the most significant features of human life, little is known about its relationship to ordinary belief at the level of the brain. Nor is it known whether religious believers and nonbelievers differ in how they evaluate statements of fact. Our lab previously has used functional neuroimaging to study belief as a general mode of cognition, and others have looked specifically at religious belief. However, no research has compared these two states of mind directly. (...) Methodology/Principal Findings: We used functional magnetic resonance imaging to measure signal changes in the brains of thirty subjects - fifteen committed Christians and fifteen nonbelievers - as they evaluated the truth and falsity of religious and nonreligious propositions. For both groups, and in both categories of stimuli, belief was associated with greater signal in the ventromedial prefrontal cortex, an area important for self-representation, emotional associations, reward, and goal-driven behavior. This region showed greater signal whether subjects believed statements about God, the Virgin Birth, etc. or statements about ordinary facts. A comparison of both stimulus categories suggests that religious thinking is more associated with brain regions that govern emotion, self-representation, and cognitive conflict, while thinking about ordinary facts is more reliant upon memory retrieval networks. Conclusions/Significance: While religious and nonreligious thinking differentially engage broad regions of the frontal, parietal, and medial temporal lobes, the difference between belief and disbelief appears to be content-independent. Our study compares religious thinking with ordinary cognition and, as such, constitutes a step toward developing a neuropsychology of religion. However, these findings may also further our understanding of how the brain accepts statements of all kinds to be valid descriptions of the world. © 2009 Harris et al. (shrink)

Le mouvement général des sciences est de fournir les moyens théoriques d'une reconstruction des phénomènes, en élaborant des lois explicitant leurs régularités sous-jacentes. Aujourd'hui, l'attitude générale en sciences repose sur l'a priori des déterminismes, quelle que soit leur forme. La pensée humaine, dans ses rapports au monde, est une confrontation permanente aux systèmes complexes qui nous habitent et dans lesquels nous habitons. Chacun des systèmes possède une histoire propre qui le rend singulier et source continue de surprises. On se prend (...) à le penser comme système autonome avec ses lois et ses degrés de liberté interne. Quand il s'agit de penser l'être humain, la tentation est encore plus forte de lui prêter un libre arbitre. La question fondamentale est donc celle de la compatibilité entre la pensée scientifique en quête de déterminismes, et la compréhension des complexités, génératrice d'indéterminismes. Comment obtenir une conciliation quand, de la physique à l'éthique, en passant par la cellule biologique, les êtres multicellulaires et les sociétés, on remonte les niveaux d'organisation? Peut-on y parvenir quant à l'être humain et la société sans remettre en question certains aspects cruciaux comme la responsabilité et l'éthique? Ce livre a pour but de revisiter ce débat fondamental, auquel fleuri Atlan a consacré une grande partie de son œuvre, en s'appuyant, d'une part, sur les approches récentes de la modélisation des systèmes complexes et, d'autre part, sur la tradition philosophique multimillénaire. (shrink)

This chapter contains section titled: Discussion.

Tw‌o books, each of them entitled The State and Revolution, were published forty years apart from one another, with the first one written in 1877 by French Communard Arthur Arnould and the other one in 1917 by Lenin, although unaware of Arnould’s work. Their confrontation is arranged and orchestrated in an anachronical way, in conformity with the method of "plagiarism in advance," in order for us to take the full measure of Arnould's resistance to Lenin's recuperation of the Paris Commune (...) and to grasp the unbreachable discrepancy between these two revolutionaries as well as their respective views of the State’s power and of its destruction. (shrink)

En el presente trabajo se pone de relieve una tesis del último Kuhn que ha sido, y aún es, desatendida: el carácter no universal del lenguaje. Luego de ubicarla en los textos y contextos teóricos donde aparece, se intenta aclararla a partir de algunos de sus textos posteriores. En este afán, el trabajo presente en primer lugar muestra, cómo, deben ser modificadas algunas de las propuestas filosóficas atribuidas al Kuhn clásico para poder comprender esta tesis y en segundo lugar, intenta (...) dar cuenta muy brevemente de ciertas innovaciones filosóficas del último Kuhn. Además, se comparan algunas de esas nuevas tesis de Kuhn con sus posibles -aunque nunca explicitados- interlocutores, a saber: N. Chomsky y J. Fodor. This paper draws attention to one of the theses of the Later Kuhn, which has been ignored: the non-universal character of language. After locating the thesis in the texts and theoretical contexts in which it appears, it is attempted to be clarified in view of some of his later texts. In regard of this, the paper firstly shows, how some of the philosophical proposals attributed to the Early Kuhn must be modified in order to understand it. Secondly, a very brief account for certain philosophical innovations in the Later Kuhn is attempted to be given. In addition, some of Kuhn's new theses are compared with his most likely, even if never explicit, interlocutors, namely N. Chomsky and J. Fodor. (shrink)

Zealous nudging can deteriorate into paternalistic bullshitting. To the extent that William Simkulet’s paper is a reminder against that danger, it does us good service.1 Simkulet, however, makes the far bolder claims that nudging just is bullshitting and that—since bullshitting deviates from truthfulness, and truthful disclosure is essential for valid consent—nudging invalidates informed consent. These bolder claims involve a set of errors. The problem starts with Simkulet’s formal definition of ‘bullshit’, which says that conveying x while intending one’s audience to (...) believe y is sufficient for bullshit. This, however, is not true since the bullshitter’s not caring whether x is true is constitutive of bullshitting, and hence a necessary condition. Why, we then ask, must such lack of care be the case with the doctor who nudges? It is at least prima facie easy and intuitive to think of scenarios in which the ethical doctor is staunchly committed to telling the truth while simultaneously acting on additional motives regarding the expected effects of what is said. If the doctor cares about saying only truths, he is not a bullshitter. Having communicative motivations that transcend the trivial motive of transmitting the truth of the literal content of what is said is normal and indeed normative in conversations of regular people.2 …. (shrink)

El presente ensayo sostiene que los principios de justicia de Rawls proporcionan una fundamentación normativa para la teoría de los stakeholders. Los principios articulan (en un nivel abstracto) los derechos de los ciudadanos; estos derechos crean intereses en todos los aspectos de la sociedad, incluyendo el ámbito de la actividad económica; y, por lo tanto, los stakeholders –en calidad de ciudadanos–tienen intereses legítimos en dicho ámbito. Así, la obra de Rawls nos obliga a fundamentar cuestiones de la ética de la (...) empresa en la filosofía política: los derechos e intereses de los stakeholders (que son los derechos e intereses de los ciudadanos en la esfera económica) están protegidos en el nivel institucional, por lo que no pueden venir determinados por los directivos ni las corporaciones. (shrink)

Aristotle's claim in Metaphysics Z.6 that "each substance is the same as its essence" has long puzzled commentators. For it seems to conflict with two other Aristotelian theses: (1) primary substances are individuals (e.g., Socrates and Callias), and (2) essences are universals (e.g., Man and Horse). Three traditional solutions to this difficulty are considered and rejected. Instead, to make the Z.6 equation consistent with (1) and (2), I propose that it be interpreted to be making something other than a straightforward (...) identity claim. Callias is the same as his essence in the sense that to be identical to Callias is to be the same man as Callias (where Man is the essence of Callias). In general, x is identical to y if, and only if, x and y are the same E (where E specifies the "what it is to be" for x, i.e., the essence of x). So each of Socrates and Callias is the same as his essence, and Man is that essence, but Socrates and Callias are not identical, for they are not the same man. (shrink)