Some ecologists, philosophers, and policy analysts believe that ecosystem health can be defined in a rigorous way and employed as a management goal in environmental policy. The idea of ecosystem health may have something to recommend it as part of a rhetorical strategy, but I am dubious about its utility as a technical term in environmental policy. I develop several objections to this latest version of scientism in environmental policy, and conclude that our environmental problems fundamentally involve problems (...) in our institutions of governance, our systems of value, and our ways of knowing. These are the problems that most need to be addressed. (shrink)

Some writers have suggested that it would be desirable to assess the state of the Earth''senvironments by making use of a concept of ecosystem health. We subject this suggestion toscrutiny first by calling attention to obscurities inthe notion of an ecosystem and then by callingattention to obscurities in and objections to someviews about ecosystem health. Finally, we note, thateven if ecosystem health can be adequately clarified, there are reasons for saying that whetherwe are morally obligated to (...) protect the health ofsome ecosystem depends on other circumstances. In many possible circumstances we would not beobligated to protect the health of a particularecosystem. (shrink)

For Van Rensselaer Potter (1911–2001), Global Bio-Ethics is about building on the legacy of Aldo Leopold (1887–1948), one of the most notable forest managers of the twentieth century who brought to light the importance of pragmatism in the sciences and showed us a new way to proceed with environmental ethics. Following Richard Huxtable and Jonathan Ives's methodological 'Framework for Empirical Bioethics Research Projects' called 'Mapping, framing, shaping,' published in BMC Medicine Ethics (2019)), we propose operationalizing a framework for Global (...) Bio-Ethics by hybridizing approaches in empirical bioethics and ecosystem management. We explain this framework using the metaphor of forest management. This mixed approach is articulated through three phases: (1) mapping the “landscape” to build a working theory, (2) framing the “scene” to prepare the fieldwork, and (3) shaping bioethics “tools” to stimulate cooperation. Applying this methodology, an adaptive management cycle is outlined to help ensure that political processes are sustainable and socially acceptable, still based on strategic and ethical thinking, but also capable of reshaping failing policies. (shrink)

Precision medicine is an emerging approach to individualized care. It aims to help physicians better comprehend and predict the needs of their patients while effectively adopting in a timely manner the most suitable treatment by promoting the sharing of health data and the implementation of learning healthcare systems. Alongside its promises, PM also entails the risk of exacerbating healthcare inequalities, in particular between ethnoracial groups. One often-neglected underlying reason why this might happen is the impact of structural racism on (...) PM initiatives. Raising awareness as to how structural racism can influence PM initiatives is paramount to avoid that PM ends up reproducing the pre-existing health inequalities between different ethnoracial groups and contributing to the loss of trust in healthcare by minority groups. We analyse three nodes of a process flow where structural racism can affect PM’s implementation. These are: the collection of biased health data during the initial encounter of minority groups with the healthcare system and researchers, the integration of biased health data for minority groups in PM initiatives and the influence of structural racism on the deliverables of PM initiatives for minority groups. We underscore that underappreciation of structural racism by stakeholders involved in the PM ecosystem can be at odds with the ambition of ensuring social and racial justice. Potential specific actions related to the analysed nodes are then formulated to help ensure that PM truly adheres to the goal of leaving no one behind, as endorsed by member states of the United Nations for the 2030 Agenda for Sustainable Development. Structural racism has been entrenched in our societies for centuries and it would be naïve to believe that its impacts will not spill over in the era of PM. PM initiatives need to pay special attention to the discriminatory and harmful impacts that structural racism could have on minority groups involved in their respective projects. It is only by acknowledging and discussing the existence of implicit racial biases and trust issues in healthcare and research domains that proper interventions to remedy them can be implemented. (shrink)

This paper primarily argues that Epidemiology is Ecosystem Science. It will not only explore this notion in detail but will also relate it to the argument that Classical Chinese Medicine was/is Ecosystem Science. Ecosystem Science and Ecosystem Science share these characteristics: they do not subscribe to the monogenic conception of disease; they involve multi variables; the model of causality presupposed is multi-factorial as well as non-linear.

Ecosystem health, as James Nelson argues, must be understood as having both descriptive and normative content; it is in this sense a 'morally thick' concept. The health analogy refers (a) at the similarities between conservation ecology and medicine or plant pathology as normative sciences, and (b) to the ability of ecosystems to 'heal' themselves in the face of disturbances. Nelson, however, goes beyond these two aspects and argues that judgements of illness in ecosystems only support moral obligations to (...) protect them if they are attributed a 'good of their own'. But this latter extension of the analogy flies in the face of ecological science, which has been forced to abandon organicism. If one separates the question of the warranted assertibility of environmentalists' goals from the question of where values in nature are located, the search for an objective realm of value realism can be seen to be unnecessary. (shrink)

Integral Science provides the empirical rigor needed to shift medicine's worldview. The shift in science will give rise to Integral Medicine, which will emerge from the integration and transformational change of biomedicine, psychosocial approaches, Complementary and Alternative Medicine, and other reform movements. The root metaphor of Integral Medicine is a healthy and sustainable ecosystem. At its heart are mind-body holism and collaborative learning. Healing and the creation of health will emphasize educational, self-care, and community support (...) models. Implications are discussed for practice, research, and education. (shrink)

In light of the central role that medications play in medical progress, the declining rate of new drug development over the past decade is cause for concern . Without important breakthroughs in drug discovery, the future will not be auspicious for the many people suffering from chronic and incurable illnesses. The sluggish pace of pharmaceutical innovation has been particularly characteristic of the largest drug manufacturers, which have generally focused their energies on potential blockbuster medications, those that can generate over $1 (...) billion in annual revenue . Given Pharma’s struggles, the success of the country’s largest drug manufacturer in bringing the .. (shrink)

The United States has pursued policies of urban upheaval that have undermined social organization, dispersed people, particularly African Americans, and increased rates of disease and disorder. Healthcare institutions have been, and can be, a part of this problem or a part of the solution. This essay addresses two tools that healthcare providers can use to repair the urban ecosystem—perspective and solidarity. Perspective addresses both our ability to envision solutions and our ability to see in the space in which we (...) move. Solidarity is our ability to appreciate our fellowship with other people, a mindset that is at the heart of medical practice. These two tools lay the foundation for structurally competent healthcare providers to act in a restorative manner to create a health-giving built environment. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

Ethics of Everyday Medicine: Explorations of Justice examines and analyses the relatively unexplored domain of ethics involved in the everyday practice of medicine. From the author's clinical experience, virtually every decision made in the day-to-day practice of medicine is fundamentally an ethical question, as virtually every decision hinge on some value judgment that goes beyond the medical facts of the matter. The first part of the book is devoted to medical decision cases in several areas of (...) class='Hi'>medicine. These cases highlight elements of the current healthcare ecosystem, involving players other than the physician and patient. Insurers (private, commercial, and governmental), administrators, and regulators' perspectives are surfaced in point of care case analysis. Part two contributes to the development of actionable tools to develop better ethical systems for the everyday practice of medicine by providing a critical analysis of Reflective Equilibrium and ethical induction from the perspective of logic and statistics. The chapter on Justice discusses the neurophysiological representations of just and unjust behaviours. The chapter on Ethical Theories follows, describing the epistemic conundrum, principlism, reproducibility, abstraction, chaos and complexity. The following chapter approaches ethical decisions from the logic and statistic perspectives. The following chapter, The Patient as Parenthetical, the author discusses patient-centric ethics, and the rise of business- and government-cetric ethics. The final chapter, A Framework to Frame the Questions for Explore Further, proposes a working framework to deal with current ethical issues. (shrink)

The advancement of science requires the publication of research results so other scientists may examine, confirm, and build upon them, and the publishing ecosystem that mediates this process has undergone dramatic change over recent decades. This article takes a broad view of the biomedical research publishing system from its origins in the 17th century to the present day. It begins with a story from the author’s lab that illustrates a scientist’s complex interactions with the publishing system and then reviews (...) the history, growth, and evolution of scientific publishing, including several recent disruptive developments: the digital transformation, the open access (OA) movement, the creation of “predatory journals,” and the emergence of preprint archives. Each has influenced scientific peer review and editorial decision-making, two processes critical to the conduct of medical and scientific research and culture. After briefly discussing concerns about the impact of politics on editorial decision-making, the article closes with thoughts on the future evolution of this publishing ecosystem, which will impact the biomedical research ecosystem that depends upon it. Beyond accelerated speed and improved access to publications, the community should prioritize research aimed at further enhancing the quality and impact of published research, the core goal of the scientific enterprise. [End Page 358]. (shrink)

The inclusion of antimicrobial resistance (AMR) and increased research and development (R&D) capabilities in the most recent outline of the World Health Organization’s (WHO’s) international pandemic instrument signals an opportunity to reshape pharmaceutical R&D system in favour of antimicrobial product development. This article explains why the current innovation ecosystem has disadvantaged the creation of antimicrobial products for human use. It also highlights how the COVID-19 pandemic experience can inform and stimulate international cooperation to implement innovative R&D incentives to bring (...) new, life-saving antimicrobial products to the market. (shrink)

Finland has aimed to make itself an international leader in genomic research and related business and, in working towards that goal, has enacted biobank legislation. The Biobank Act requires biobanks to gain approval, be supervised, and register at the national level. Numerous other laws may also apply in any given research setting, such as the Personal Data Act, the Medical Research Act, and the Act on Medical Use of Human Organs and Tissues. In terms of privacy protection, anonymization is generally (...) not permitted under Finnish law and therefore most biobanks pseudonomize data and samples. However, the broad understanding of what is identifiable data in Finland has created difficulties in sharing with non-EU countries. Furthermore, consent to biobank research is only applicable to the sample and related data, not to data stored in other health-related registries, and consent is only to the field of research for that particular biobank. These restrictions impede the sharing of samples and data for research. (shrink)

The problem of harmful, unnecessary and neglected pain has been studied extensively in many health care settings over the past decade. Research has documented the incidence of untreated pain, and scholars and advocates have given the problem several names: “public health crisis,” “oligoanalgesia, and “moral failing,” among them. Articles have identified a litany of now familiar “obstacles” or “barriers” to effective pain relief. Each of these individual obstacles or barriers has been the subject of targeted remedial action in at least (...) some context.The checklist approach to improving care for patients in pain, however, is likely to have only limited effect. What really appears to be operating is a complex ecosystem that supports ambivalence, denial, and even suspicion of the circumstance of patients in pain and efforts to treat them. Pain relief in emergency medicine, a relatively new setting for the study of challenges to treating pain, provides a revealing context for viewing discrete obstacles to effective pain management in medicine as part of an integrated environment into which patients with pain enter for treatment. (shrink)

The problem of harmful, unnecessary and neglected pain has been studied extensively in many health care settings over the past decade. Research has documented the incidence of untreated pain, and scholars and advocates have given the problem several names: “public health crisis,” “oligoanalgesia, and “moral failing,” among them. Articles have identified a litany of now familiar “obstacles” or “barriers” to effective pain relief. Each of these individual obstacles or barriers has been the subject of targeted remedial action in at least (...) some context.The checklist approach to improving care for patients in pain, however, is likely to have only limited effect. What really appears to be operating is a complex ecosystem that supports ambivalence, denial, and even suspicion of the circumstance of patients in pain and efforts to treat them. Pain relief in emergency medicine, a relatively new setting for the study of challenges to treating pain, provides a revealing context for viewing discrete obstacles to effective pain management in medicine as part of an integrated environment into which patients with pain enter for treatment. (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

Good People, by Singaporean playwright Haresh Sharma, unmasks racial and religious tensions between Singapore’s increasingly diverse racial groups and the attendant ramifications on the healthcare ecosystem and the doctor-patient relationship. Drawing upon Michel Foucault’s notion of heterotopia, this paper argues that, in Good People, Sharma employs theater as a site of resistance by calling into question state and medical authority. First, state authority is challenged through the play’s scrutiny of the ideological principle of multiculturalism and its usefulness in fostering (...) meaningful cross-cultural exchanges and acceptance of different cultural and religious beliefs in the clinic. Second, the play destabilizes medical authority by surfacing the complex relationship between the doctor’s unconscious biases, racial and religious prejudice, and clinical judgment, thereby casting doubt on medicine’s claims of objectivity. In doing so, this paper argues, the play resists simplistic binary categorizations of the behaviors and motivations of the characters into good/bad or right/wrong, instead raising questions about power, knowledge, and contesting truths within the confines of the cultural space of a hospice. (shrink)

Agriculture and medicine palpably manifest a culture's world view. Correspondingly, changes in agriculture and medicine may be barometers of change in a culture's overall outlook. Conventional industrial agriculture and modern surgical/chemical medicine clearly express the Newtonian mechanical model of nature. The modern classical world view represents nature to be an externally related, atomic, reductive, material, and mechanical aggregate. Modern medicine, correspondingly, treats the body as an elaborate mechanism and industrial agriculture regards soil as a substratum for (...) monocultures assembled from fossil fuels, synthetic fertilizers, and chemical pesticides. The nascent agroecology and wellness movements each express and reflect the new paradigm variously emerging from ecology and quantum physics. Ecology and the new physics, each in its own way, represent nature to be an internally related, systemic, integrated, organic whole. Agroecology translates this abstract new vision into a concrete agricultural vocabulary: The farmstead is regarded as an artificial ecosystem with a multiplicity of diverse plant and animal constituents interacting with one another and with environing natural ecosystems in complex and mutually supporting ways. (shrink)

Recently, several studies have demonstrated that tetracyclines, the antibiotics most intensively used in livestock and that are also widely applied in biomedical research, interrupt mitochondrial proteostasis and physiology in animals ranging from round worms, fruit flies, and mice to human cell lines. Importantly, plant chloroplasts, like their mitochondria, are also under certain conditions vulnerable to these and other antibiotics that are leached into our environment. Together these endosymbiotic organelles are not only essential for cellular and organismal homeostasis stricto sensu, but (...) also have an important role to play in the sustainability of our ecosystem as they maintain the delicate balance between autotrophs and heterotrophs, which fix and utilize energy, respectively. Therefore, stricter policies on antibiotic usage are absolutely required as their use in research confounds experimental outcomes, and their uncontrolled applications in medicine and agriculture pose a significant threat to a balanced ecosystem and the well‐being of these endosymbionts that are essential to sustain health.Also watch the Video Abstract. (shrink)

While holist views such as ecocentrism have considerable intuitive appeal, arguing for the moral considerability of ecological wholes such as ecosystems has turned out to be a very difficult task. In the environmental ethics literature, individualist biocentrists have persuasively argued that individual organisms—but not ecological wholes—are properly regarded as having a good of their own . In this paper, I revisit those arguments and contend that they are fatally flawed. The paper proceeds in five parts. First, I consider some problems (...) brought about by climate change for environmental conservation strategies and argue that these problems give us good pragmatic reasons to want a better account of the welfare of ecological wholes. Second, I describe the theoretical assumptions from normative ethics that form the background of the arguments against holism. Third, I review the arguments given by individualist biocentrists in favour of individualism over holism. Fourth, I review recent work in the philosophy of biology on the units of selection problem, work in medicine on the human biome, and work in evolutionary biology on epigenetics and endogenous viral elements. I show how these developments undermine both the individualist arguments described above as well as the distinction between individuals and wholes as it has been understood by individualists. Finally, I consider five possible theoretical responses to these problems. (shrink)

This paper investigates the ethical implications of research at the interface between biodiversity and both human and animal health. Health and sanitary crises often lead to ethical debates, especially when it comes to disruptive interventions such as forced vaccinations, quarantine, or mass culling of domestic or wild animals. In such debates, the emergence of a “Planetary health ethics” can be highlighted. Ethics and accountability principles apply to all aspects of scientific research including its technological and engineering applications, regardless of whether (...) they are considered “hard sciences”, such as state-of-the-art technology in the fields of medicine, veterinary medicine, agronomy, or environment, or “soft”, such as local or global governance, health, socio-ecosystems, and the environment. Ethical reflection in the interdisciplinary field of biodiversity and health requires the examination of relevant scientific domains, such as biology, ecology, evolution, human medicine, animal medicine, anthropology, and law, and their epistemology and representation as well as scientific pluralism, which is crucial to establish genuine interdisciplinarity. Navigating the ethics-scape necessitates going beyond the hierarchy of science by recognising that scientific knowledge has implications for both scientific and non-scientific perspectives on the study of nature. The example of a Nipah virus outbreak is used to illustrate how the so-called “modern epidemiological” approach often focuses on risk factors associated with individual behavioural characteristics or collective practices, whereas the so-called “eco-social” approach focuses on global, socio-economic, and environmental factors that are the contextual causes of the health problem affecting the community. “Modern epidemiologists” aim to “correct” individual or practice factors using a “minimal set” of ethics, whereas “eco-social” scientists have to act systemically, which requires integrated research that acknowledges scientific pluralism, avoids the hierarchy of sciences, but accepts the pluralism of ethics and values. (shrink)

This book shows how environmental decline relates to human health and to health care practices in the U.S. and other industrialized countries. It outlines the environmental trends that will strongly affect health, and challenges us to see the connections between ways of practicing medicine and the very environmental problems that damage ecosystems and make people sick. In addition to philosophical analysis of the converging values of bioethics and envrionmental ethics, the book offers case studies as well as a number (...) of practical suggestions for moving health care toward sustainability. (shrink)

The dual role of microbial communities as either beneficial/functional or harmful/pathogenic involves two issues concerning causality in physiology and medicine, etiology of disease, and the notion of function in biology. Causal explanation formulated by the germ theory of disease and the Koch postulates connects the existence of a specifically identified microbe to disease by the isolation and identification of a pathogen from an organism with the disease and the successful infection of a healthy individual. Similarly, microbiome research in (...) class='Hi'>medicine centers on taxonomic composition in correlation with physiological conditions and germ-free mice experimentations to establish causal connections. However, because the microbiome is an ecological community, it lacks the specificity of identification assumed in the germ theory. Furthermore, the ecological aspects within and between microbiomes such as background conditions, microbial interactions, and interdependence, are treated as confounding. Looking at ecological studies, the causal explanations are less specific regarding complex systems with their processes of interactions. This article makes the following two points: One is that microbiome causality in the host should be understood similarly to the microbiome causality in an ecosystem. The second is that if considering a microbiome’s causality in the host as an ecosystem, its etiological explanation needs to be revisited to include a heterogeneous and mutual notion of interactions. Finally, according to the second point, the notion of function in ecology with its relevant notion of causality should be considered accordingly. (shrink)

The paper adopts an inter-theoretical socio-cultural and -material perspective on the relationship between human + machine learning to propose a new way to investigate the human + machine assistive assemblages emerging in professional work (e.g. medicine, architecture, design and engineering). Its starting point is Hutchins’s (1995a) concept of ‘distributed cognition’ and his argument that his concept of ‘cultural ecosystems’ constitutes a unit of analysis to investigate collective human + machine working and learning (Hutchins, Philos Psychol 27:39–49, 2013). It argues (...) that: (i) the former offers a way to reveal the cultural constitution of and enactment of human + machine cognition and, in the process, the limitations of the computational and connectionist assumptions about learning that underpin, respectively, good old-fashioned AI and deep learning; and (2) the latter offers a way to identify, when amplified with insights from Socio-Materialism and Cultural-Historical Activity Theory, how ML is further rearranging and reorganising the distributed basis of cognition in assistive assemblages. The paper concludes by outlining a set of conjectures researchers that could use to guide their investigations into the ongoing design and deployment of HL + ML assemblages and challenges associated with the interaction between HL + ML. (shrink)

The widespread adoption of radioisotopes as tools in biomedical research and therapy became one of the major consequences of the "physicists' war" for postwar life science. Scientists in the Manhattan Project, as part of their efforts to advocate for civilian uses of atomic energy after the war, proposed using infrastructure from the wartime bomb project to develop a government-run radioisotope distribution program. After the Atomic Energy Bill was passed and before the Atomic Energy Commission was formally established, the Manhattan Project (...) began shipping isotopes from Oak Ridge. Scientists and physicians put these reactor-produced isotopes to many of the same uses that had been pioneered with cyclotron-generated radioisotopes in the 1930s and early 1940s. The majority of early AEC shipments were radioiodine and radiophosphorus, employed to evaluate thyroid function, diagnose medical disorders, and irradiate tumors. Both researchers and politicians lauded radioisotopes publicly for their potential in curing diseases, particularly cancer. However, isotopes proved less successful than anticipated in treating cancer and more successful in medical diagnostics. On the research side, reactor-generated radioisotopes equipped biologists with new tools to trace molecular transformations from metabolic pathways to ecosystems. The U.S. government's production and promotion of isotopes stimulated their consumption by scientists and physicians, such that in the postwar period isotopes became routine elements of laboratory and clinical use. In the early postwar years, radioisotopes signified the government's commitment to harness the atom for peace, particularly through contributions to biology, medicine, and agriculture. (shrink)

Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.

Background In 1926, Fritz Jahr described bio-ethics (German: bio-ethik) as “the assumption of moral obligations not only towards humans, but towards all forms of life.” Jahr summarized his philosophy by declaring, “Respect every living being on principle as an end in itself and treat it, if possible, as such!.” Bioethics was thus originally an ethical system concerned with the “problems of interference with other living beings… and generally everything related to the balance of the ecosystem” according to the 1978 (...) Encyclopedia of Bioethics. This definition was predicated on the work of Fritz Jahr, Menico Torchio, and Van Rensselaer Potter. Methods In order to proceed with depthful analysis of the origin and major bioethical flare up, we will use critical analysis of existing literature, followed by a study trip to relevant bioethical localities (collecting photo and other documentations regarding Menico Torchio). Results While Jahr and Potter are typically given intellectual credit for developing the field of bioethics, the eco-ethical contributions of Menico Torchio have been forgotten.This article will first trace the origins of “bioethics” – now commonly bifurcated into “biomedical ethics” and “environmental bioethics.” The former was developed by Tom Beauchamp from the Philosophy Department and James Childress of the Religious Studies department at Georgetown University and is based on principlism, with a narrow focus on medical settings. The latter addresses the environmental impact of the medical industry and climate change health hazards. Second, we will present a panorama of Torchio’s significant intellectual contribution to bioethics. Menico Torchio’s concept of bioethics synthesized work of both Jahr and Potter, advocating “the need to expand our ethical obligations and embrace the most developed groups of animals, not only physically but also psychologically.” Third, we will reflect on the lasting legacy of “bioethics” on biomedical and environmental bioethics today. Thematic elements such as interconnectedness of planetary health and human health, dedication to living in harmony with nature, and emphasis on systems and symbiosis remain unchanged from the legacy of Tochio onward. Conclusion Our conclusion will underscore the necessity of understanding the connections between planetary, environmental, and human health. (shrink)

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such (...) innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter’s conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance. (shrink)

COVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global (...) ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sustains and even worsens injustice, including health injustice, and that has profound consequences for global health, a global ecological ethic would have us see health as interdependent and aim at “ethical place-making” across health ecosystems to enable people everywhere to have the capability to be healthy. (shrink)

The past few years have witnessed several media-covered cases involving citizens actively engaging in the pursuit of experimental treatments for their medical conditions—or those of their loved ones—in the absence of established standards of therapy. This phenomenon is particularly observable in patients with rare genetic diseases, as the development of effective therapies for these disorders is hindered by the limited profitability and market value of pharmaceutical research. Sociotechnical trends at the cross-section of medicine and society are facilitating the involvement (...) of patients and creating the digital infrastructure necessary to its sustainment. Such participant-led research has the potential to promote the autonomy of research participants as drivers of discovery and to open novel non-canonical avenues of scientific research. At the same time, however, the extra-institutional, self-appointed, and, often, oversight-free nature of PLR raises ethical concern. This paper explores the complex ethical entanglement of PLR by critically appraising case studies and discussing the conditions for its moral justification. Furthermore, we propose a path forward to ensure the safe and effective implementation of PLR within the current research ecosystem in a manner that maximizes the benefits for both individual participants and society at large, while minimizing the risks. (shrink)

This essay proposes African-based ethical solutions to profound human problems and a working African model to address those problems. The model promotes sustainability through advanced agroecological and information communication technologies. The essay’s first section reviews the ethical ground of that model in the work of the Senegalese scholar, Cheikh Anta Diop. The essay’s second section examines an applied African model for translating African ethical speculation into practice. Deeply immersed in European and African ethics, Godfrey Nzamujo developed the Songhaï Centers to (...) solve the problem of rural poverty in seventeen African countries. Harnessing advanced technologies within a holistic agroecological ecosystem, Nzamujo’s villages furnish education spanning the fields of ethics, information communication technology, microbiology, international development, and mechanical, electrical, civil and biological engineering in a community-based and centered development enterprise. The essay proposes a global consortium of ecovillages based on Nzamujo’s model. The final section explores funding methods for the consortium. The conclusion contemplates a return to Africa to supplement environmental ethics that enhance life’s future on earth. (shrink)

Despite the burgeoning interest in new and more complex accounts of the organism-environment dyad by biologists and philosophers, little attention has been paid in the resulting discussions to the history of these ideas and to their deployment in disciplines outside biology—especially in the social sciences. Even in biology and philosophy, there is a lack of detailed conceptual models of the organism-environment relationship. This volume is designed to fill these lacunae by providing the first multidisciplinary discussion of the topic of organism-environment (...) interaction. It brings together scholars from history, philosophy, psychology, anthropology, medicine, and biology to discuss the common focus of their work: entangled life, or the complex interaction of organisms and environments. (shrink)

The ethical value—and to some scholars, necessity—of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the (...) nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association’s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem. (shrink)

Without trust there is no credible human health research (HHR). This article accepts this truism and addresses a crucial question that arises: how can trust continually be promoted in an ever-changing and uncertain HHR environment? The article analyses long-standing mechanisms that are designed to elicit trust—such as consent, anonymization, and transparency—and argues that these are best understood as trust represented by proxies of trustworthiness, i.e., regulatory attempts to convey the trustworthiness of the HHR system and/or its actors. Often, such proxies (...) are assumed to operate as markers that trust exists or, at least, has not been lost. But, since trust can neither be “built” nor “secured,” this is a precarious assumption. Worryingly, there is no existing theoretical account of how to understand and evaluate these proxies of trustworthiness as part of a trusted HHR ecosystem. To remedy this, the paper argues for a radical reimagining of trust and trustworthiness as performative acts that ought to be understood in relation to each other and by reference to the common values at stake. It is shown that proxies of trustworthiness are the operational tools used to perform trustworthiness. It advocates for a values-based approach to understanding the relationship between trust and trustworthiness. This establishes a strong basis for an evaluative framework for proxies of trustworthiness, i.e., to determine how to perform trustworthiness well. Five common proxies in HHR are scrutinized from a values perspective. The contribution is to provide a far-reaching normative and practical framework by which existing and future proxies of trustworthiness can be identified, assessed, maintained, or replaced in rapidly changing HHR regulatory ecosystems where trust itself is crucial to the success of the entire HHR enterprise. (shrink)

The One Health approach is a prominent paradigm for research and healthcare practice and increasingly applied in various fields. Theoretical and normative implications of the approach, however, remain underexposed so far, leading to conceptual incoherencies and uncertainties in the application of the concept. This article sheds light on two particularly influential theoretical flaws inherent to the One Health approach. The first difficulty relates to the question of whose health is considered in the One Health paradigm: humans and animals are obviously (...) situated on a different level than the environment, so that the individual, population, and ecosystem dimensions need to be considered. The second theoretical flaw is related to the question of which concept of health can be meaningfully referred to when speaking of One Health. This problem is addressed by analyzing four key theoretical conceptions of health from the philosophy of medicine (well‐being, natural functioning, capacity of achieving vital goals, and homeostasis and resilience) regarding their suitability for the aims of One Health initiatives. It appears that none of the concepts analyzed fully meets the demands of an equitable consideration of human, animal, and environmental health. Potential solutions lie in accepting that one concept of health is more appropriate for some entities than for others and/or forgoing the idea of a uniform conception of health. As a result of the analysis, the authors conclude that theoretical and normative assumptions underlying concrete One Health initiatives should be made more explicit. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 8.1 (2003) 22-36 [Access article in PDF] Art or Nature?Aristotle, Restoration Ecology, and Flowforms Trish Glazebrook He to whom nature begins to reveal her open secrets will feel an irresistible yearning for her most worthy interpreter: Art. 1Aristotle believed strongly in a distinction between artifact (technê) and nature (physis). He intended by "technê" more than is generally understood by the contemporary term "art," for he (...) meant anything produced by human intention. For example, for Aristotle medicine was technê in that the doctor produces health. The key point in distinguishing art from nature for him was that things in nature grow and develop on the basis of an internal principle of change, whereas artistic production requires an outside agent. There are some complications with the Aristotelian account: are the spider's web and the bird's nest art or nature? Aristotle can respond to this problem easily enough by arguing that spiders and birds create on the basis of instinct, while reason is requisite for artistic production. Yet some art may not meet this definition: artists may not always have a full conception of the work to be produced prior to its execution. Creativity can be emergent rather than intentional during the productive process, and may arise, for example, from the artist's interaction with the chosen material. [End Page 22]Despite these objections to the Aristotelian distinction, however, his analysis of the differences between art and nature can be usefully applied to recent debates in restoration ecology in order to argue that the human capacity to restore nature does not justify its destruction. Nature cannot be "faked," that is, recreated through art. Furthermore, the Aristotelian analysis has been influential historically by providing a conceptual basis for the technological domination of nature, as if nature were nothing more than matter upon which form can be imposed. Yet there are alternative possibilities in Aristotle's account that ecologically-minded art can bring to fruition. I will use Aristotle's analysis to suggest a potential resolution of the "faking nature" debate, and accordingly to show how contemporary, ecologically-minded art can promote an ideology of production that works with rather than against nature.Robert Elliot argues that restoration ecology does not justify environmental destruction, because faked nature (that is, nature re-created by human artifice) is not as valuable as the original. 2 I will call this claim, which is based on the idea that restoration is analogous to artistic production, "the Elliot view." I will first assess the Elliot view, and give reasons why I sympathize with his conclusions, yet find his arguments unconvincing. Second, I will present Aristotle's distinction between nature and art, with emphasis on his arguments that nature is goal-directed, in order to give content to the claim that nature has intrinsic value. Third, I will look at restoration policies and practices in the oil industry in Alberta, Canada, to establish a praxical notion of restoration, and to support Elliot's claim that nature cannot be faked. I have chosen oilfield restoration as a working example for the sake of the general methodological principle that praxes without reflections are blind, while reflections that transcend the lifeworld are empty; and specifically because Alberta leads the industry in restoration standards and practices. Finally, I will use Flowforms to argue that ecologically-minded art can demonstrate how production of artifacts need not affirm a logic of domination, but rather can open a space for an alternative conception of the human relation to nature. The Elliot View Elliot's view depends on distinguishing nature from art, and attributing a greater value to the natural. On what basis should we accept this value-hierarchy? The reasons Elliot gives are less than convincing. Ultimately his arguments rest on two points: that copies are not as good as [End Page 23] originals; and that even if an ecosystem's value could be fully restored, the value lost in the time between despoilation and restoration is irrecoverable. He simply finds "naturalness" to be more valuable than artifice. But he is not alone in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 8.1 (2003) 22-36 [Access article in PDF] Art or Nature?Aristotle, Restoration Ecology, and Flowforms Trish Glazebrook He to whom nature begins to reveal her open secrets will feel an irresistible yearning for her most worthy interpreter: Art. 1Aristotle believed strongly in a distinction between artifact (technê) and nature (physis). He intended by "technê" more than is generally understood by the contemporary term "art," for he (...) meant anything produced by human intention. For example, for Aristotle medicine was technê in that the doctor produces health. The key point in distinguishing art from nature for him was that things in nature grow and develop on the basis of an internal principle of change, whereas artistic production requires an outside agent. There are some complications with the Aristotelian account: are the spider's web and the bird's nest art or nature? Aristotle can respond to this problem easily enough by arguing that spiders and birds create on the basis of instinct, while reason is requisite for artistic production. Yet some art may not meet this definition: artists may not always have a full conception of the work to be produced prior to its execution. Creativity can be emergent rather than intentional during the productive process, and may arise, for example, from the artist's interaction with the chosen material. [End Page 22]Despite these objections to the Aristotelian distinction, however, his analysis of the differences between art and nature can be usefully applied to recent debates in restoration ecology in order to argue that the human capacity to restore nature does not justify its destruction. Nature cannot be "faked," that is, recreated through art. Furthermore, the Aristotelian analysis has been influential historically by providing a conceptual basis for the technological domination of nature, as if nature were nothing more than matter upon which form can be imposed. Yet there are alternative possibilities in Aristotle's account that ecologically-minded art can bring to fruition. I will use Aristotle's analysis to suggest a potential resolution of the "faking nature" debate, and accordingly to show how contemporary, ecologically-minded art can promote an ideology of production that works with rather than against nature.Robert Elliot argues that restoration ecology does not justify environmental destruction, because faked nature (that is, nature re-created by human artifice) is not as valuable as the original. 2 I will call this claim, which is based on the idea that restoration is analogous to artistic production, "the Elliot view." I will first assess the Elliot view, and give reasons why I sympathize with his conclusions, yet find his arguments unconvincing. Second, I will present Aristotle's distinction between nature and art, with emphasis on his arguments that nature is goal-directed, in order to give content to the claim that nature has intrinsic value. Third, I will look at restoration policies and practices in the oil industry in Alberta, Canada, to establish a praxical notion of restoration, and to support Elliot's claim that nature cannot be faked. I have chosen oilfield restoration as a working example for the sake of the general methodological principle that praxes without reflections are blind, while reflections that transcend the lifeworld are empty; and specifically because Alberta leads the industry in restoration standards and practices. Finally, I will use Flowforms to argue that ecologically-minded art can demonstrate how production of artifacts need not affirm a logic of domination, but rather can open a space for an alternative conception of the human relation to nature. The Elliot View Elliot's view depends on distinguishing nature from art, and attributing a greater value to the natural. On what basis should we accept this value-hierarchy? The reasons Elliot gives are less than convincing. Ultimately his arguments rest on two points: that copies are not as good as [End Page 23] originals; and that even if an ecosystem's value could be fully restored, the value lost in the time between despoilation and restoration is irrecoverable. He simply finds "naturalness" to be more valuable than artifice. But he is not alone in... (shrink)

This paper develops the outlines of a pragmatic, adaptive management-based approach toward the control of invasive nonnative species (INS) through a case study of Kings Bay/crystal River, a large artesian springs ecosystem that is one of Florida’s most important habitats for endangered West Indian manatees (Trichechus manatus). Building upon recent critiques of invasion biology, principles of adaptive management, and our own interview and participant–observer research, we argue that this case study represents an example in which rigid application of invasion (...) biology’s a␣priori imperative to minimize INS has produced counterproductive results from both an ecological and social standpoint. As such, we recommend that INS control in Kings Bay should be relaxed in conjunction with an overall program of adaptive ecosystem management that includes meaningful participation and input from non-institutional stakeholders. However, we also note that adaptive management and INS control are by no means mutually exclusive, in Kings Bay or elsewhere. Instead, we suggest that adaptive management offers a means by which INS control efforts can emerge from—and be evaluated through—ongoing scientific research and participatory dialogue about the condition of specific places, rather than non-contextual assumptions about the harmfulness of INS as a general class. (shrink)

Wildlife Ethics A systematic account of the ethical issues related to wildlife management and conservation Wildlife Ethics is the first systematic, book-length discussion of the ethics of wildlife conservation and management, and examines the key ethical questions and controversies. Tackling both theory and practice, the text is divided into two parts. The first describes key concepts, ethical theories, and management models relating to wildlife; the second puts these concepts, theories, and models to work, illustrating their significance through detailed case studies (...) on controversies in wildlife management and conservation. The book explores pressing topics including human responsibilities due to climate change, tradeoffs when managing zoonotic disease risks, the ethics of the wildlife trade, culling non-native species, indigenous wildlife use, and zoo-based conservation programs. Readers are encouraged to explore different ways of valuing wild animals and their practical implications. This essential text: Explains and explores relationships between valuing biodiversity, human utility, ecosystems, species, and animal welfare Describes established approaches to wildlife management, such as sustainable use, and emerging concepts, such as compassionate conservation Discusses key ethical theories, including utilitarianism, ecocentrism, and animal rights Offers a practical model of how to analyze ethical issues in wildlife management and conservation Wildlife Ethics: The Ethics of Wildlife Management and Conservation is an accessible introduction to complex ethical issues, making the book an important resource for students in fields such as conservation biology, ecology, environmental science and policy, game management, public health and veterinary medicine. It will also be an invaluable tool for wildlife managers, conservationists, One Health practitioners, practicing veterinarians and animal rehabilitation staff, contemporary wildlife professionals and other stakeholders. (shrink)

The term “Anthropocene” is frequently used to refer to the present planetary epoch, characterized by a geological signature of human activities, which have led to global ecological crises. This paper probes at what it means to be human on earth now, using healing as a concept to orient humanity in relation to other species, and particularly medicinal plants. Donna Haraway’s concept of the “Chthulucene” is used as an alternate lens to the Anthropocene, which highlights the inextricable linkages between humans and (...) other-than-human species. Healing can be viewed as a type of embodied orientation or engagement with the world, which has the potential to reach across boundaries of the skin, blur distinctions between self and other, and allow for both transpersonal and trans-species reconciliation. I focus my attention on Indigenous Shipibo healing rituals, and Shipibo concepts of healing that integrate humans within the ecosystem, and traverse species boundaries through communication with and embodiment of plant spirits. These healing rituals offer ways of coming into being within an ecology of selves—both internal and external, human and non-human—through listening and lending voice. I explore the potential for healing and ritual to work as a form of porous resistance through the internal blurring of binaries and hierarchical structures. (shrink)

James V. Neel, one of the leading human geneticists of the 21st Century, has long been concerned about the consequences of human overpopulation and the accompanying destruction of the earth's ecosystem. His point of view, summarized in this paper, is contrasted with some recent optimistic projections presented by demographers and population biologists who believe the population bomb has been defused by evidence of a decrease in worldwide fertility along with a significant increase in food production. The authors of this (...) paper are not so optimistic and see a continuing need for concern rather than complacency based on ever increasing human wants and aspirations together with the minimal results of recent environmental summits. The case of HIV/aids is used to illustrate the evolutionary implications of the interaction between population dynamics and genetic change based on the concepts of population bottlenecks, genetic drift and founder effects. What becomes evident from this illustration is that epidemics by viral and other pathogens in the 21st Century can affect the size of human populations and thereby the course of the species' evolutionary makeup. The potential of evolutionary medicine and in particular molecular biology to improve our prediction capabilities and modulate some of the possible consequences is discussed. (shrink)

The man is shaped by nature and hence he is organically tied to it. He will develop properly both physically and psychically, when there is harmony and balance in nature. All the symptoms of destroying this balance lead to disturbances in our organisms’, resulting in pathological changes — diseases as well as harmful and irreversible changes in our environment. And this is why recently more attention has been paid to ecology — the knowledge of the natural economics, of the interdependences (...) between organisms as well as between organisms and the environment, so that the values suggested by ecologists could become basic assumptions in economy.The necessity of ecological research in the environment protection has been seen in various levels of the biosphere organisation, i.e. on the levels of organism, population, biocoenosis and ecosystem.The first sign of understanding these difficult and complicated arrangements in nature is the infiltration of the ecological thought into other branches of knowledge, like medicine man’s health in connection with its ecological conditionongs, agriculture (rational productivity of agrocoenoses), forestry (biological fight against pests) etc. (shrink)