Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described (...) below recently occurred on a ward in a university hospital in Croatia. An unexpected request from the patient’s parents created a number of issues that needed to be addressed by the medical team, which was made more difficult by the lack of clinical ethics support services. Such cases press the question currently being debated as to what type of ethics support services would be suitable for Croatia and why. (shrink)

In Croatia, the subject of medical ethics, or bioethics, was introduced into the curriculum in the early 1990s at the medical schools of the University of Rijeka and the University of Zagreb. Today, bioethics education has become a basic part of undergraduate medical education not only in Rijeka and Zagreb but also in Osijek.

BackgroundDecisions about limitations of life sustaining treatments are made for end-of-life patients in intensive care units. The aim of this research was to explore the professional and ethical attitudes and experiences of medical professionals on treatment of end-of-life patients in ICUs in the Republic of Croatia.MethodsA cross-sectional study was conducted among physicians and nurses working in surgical, medical, neurological, and multidisciplinary ICUs in the total of 9 hospitals throughout Croatia using a questionnaire with closed and open type questions. Exploratory factor (...) analysis was conducted to reduce data to a smaller set of summary variables. Mann–Whitney U test was used to analyse the differences between two groups and Kruskal–Wallis tests were used to analyse the differences between more than two groups.ResultsLess than third of participants stated they were included in the decision-making process, and physicians are much more included than nurses. Sixty two percent of participants stated that the decision-making process took place between physicians. Eighteen percent of participants stated that ‘do-not-attempt cardiopulmonary resuscitations’ orders were frequently made in their ICUs. A decision to withdraw inotropes and antibiotics was frequently made as stated by 22.4% and 19.9% of participants, respectively. Withholding/withdrawing of LST were ethically acceptable to 64.2% of participants. Thirty seven percent of participants thought there was a significant difference between withholding and withdrawing LST from an ethical standpoint. Seventy-nine percent of participants stated that a verbal or written decision made by a capable patient should be respected. Physicians were more inclined to respect patient’s wishes then nurses with high school education. Nurses were more included in the decision-making process in neurological than in surgical, medical, or multidisciplinary ICUs. Male participants in comparison to female, and physicians in comparison to nurses with high school and college education displayed more liberal attitudes about LST limitation.ConclusionsDNACPR orders are not commonly made in Croatian ICUs, even though limitations of LST were found ethically acceptable by most of the participants. Attitudes of paternalistic and conservative nature were expected considering Croatia’s geographical location in Southern Europe. (shrink)

Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context (...) in which CECs function in Europe focusing on five aspects. We conclude that in Europe clinical ethics committees need to maintain a critical independence while generating acceptance of the CEC and its potential benefit to both individuals and the organization. CECs, perhaps particularly in transitional countries, must counter the charge of “alibi ethics”. CECs must define their contribution to in-house quality management in their respective health care organization, clarifying how ethical reflection on various levels serves the hospital and patient care in general. This last challenge is made more difficult by lack of consensus about appropriate quality outcomes for CECs internationally. These are daunting challenges, but the fact that CECs continue to develop suggests that we should make the effort to overcome them. We believe there is a need for further research that specifically addresses some of the institutional challenges facing CECs. (shrink)

In this article, the question is discussed if and how Healthcare Ethics Committees (HECs) should be regulated. The paper consists of two parts. First, authors from eight EC member countries describe the status quo in their respective countries, and give reasons as to the form of regulation they consider most adequate. In the second part, the country reports are analysed. It is suggested that regulation of HECs should be central and weak. Central regulation is argued to be apt to improve (...) HECs’ accountability, relevance and comparability. To facilitate biomedical citizenship and ethical reflection, regulation should at the same time be weak rather than strict. Independence of HECs to deliberate about ethical questions, and to give solicited and unsolicited advice, should be supported and only interfered with by way of exception. One exception is when circumstances become temporary adversarial to ethical deliberation in healthcare institutions. In view of European unification, steps should be taken to develop consistent policies for both Eastern and Western European countries. (shrink)

As Croatia makes the transition from one political system and type of economy to another, there are inevitable social and political changes that have a profound affect on the healthcare system. This article charts some of the progress of change with respect to patients’ rights and informed consent.

BackgroundThere has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. The aim of this study was to examine these attitudes and their correlation with sociodemographic characteristics, religion, political orientation, tolerance of personal choice, trust in physicians, health status, experiences with death and caring for the seriously ill, and attitudes towards death and dying. MethodsA cross-sectional study was conducted on a three-stage random sample of adult citizens of (...) the Republic of Croatia, stratified by regions, counties, and locations within those counties. In addition to descriptive statistics, ANOVA and Chi-square tests were used to determine differences, and factor analysis, correlation analysis and multiple regression analysis for data analysis.Results38.1% of the respondents agree with granting the wishes of dying people experiencing extreme and unbearable suffering, and withholding life-prolonging treatment, and 37.8% agree with respecting the wishes of such people, and withdrawing life-prolonging treatment. 77% of respondents think that withholding and withdrawing procedures should be regulated by law because of the fear of abuse. Opinions about the practice and regulation of euthanasia are divided. Those who are younger and middle-aged, with higher levels of education, living in big cities, and who have a more liberal worldview are more open to euthanasia. Assisted suicide is not considered to be an acceptable practice, with only 18.6% of respondents agreeing with it. However, 40.1% think that physician assisted suicide should be legalised. 51.6% would support the dying person’s autonomous decisions regarding end-of-life procedures.ConclusionsThe study found low levels of acceptance of withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. In addition, it found evidence that age, level of education, political orientation, and place of residence have an impact on people’s views on euthanasia. There is a need for further research into attitudes on different end-of-life practices in Croatia. (shrink)

Healthcare professionals working in intensive care units are often involved in end-of-life decision-making. No research has been done so far about these processes taking place in Croatian ICUs. The aim of this study was to investigate the perceptions, experiences, and challenges healthcare professionals face when dealing with end-of-life decisions in ICUs in Croatia. A qualitative study was performed using professionally homogenous focus groups of ICU nurses and physicians of diverse professional and clinical backgrounds at three research sites. In total, six (...) institutions at the tertiary level of healthcare were included. The constant comparative analysis method was used in the analysis of the data. Differences were found between the perceptions and experiences of nurses and physicians in relation to end-of-life decisions. Nurses’ perceptions were more focused on the context and features of immediate care, while physicians’ perceptions also included the wider sociocultural context. However, the critical issues these specific professional groups face when dealing with end-of-life decisions seem to overlap. A high variability of practices, both between individual practitioners and between different organizational units, was omnipresent. The lack of adequate legal, professional, and clinical guidelines was commonly expressed as one of the most critical source of difficulties. (shrink)

Background Past studies emphasized the possible cultural influence on attitudes regarding reprogenetics and reproductive risks among medical students who are taken to be “future physicians.” These studies were crafted in order to enhance the knowledge and expand the boundaries of cultural competence. Yet such studies were focused on MS from relatively marginalized cultures, namely either from non-Western developing countries or minority groups in developed countries. The current study sheds light on possible cultural influences of the dominant culture on medical students (...) in two developed countries, potentially with different dominant cultures regarding reprogenetics and reproductive risks: Israel and Croatia. Methods Quantitative-statistical analyses were employed, based on anonymous questionnaires completed by 150 first year medical students in Israel and Croatia. The questionnaires pertained to the knowledge and attitudes regarding genetics, reproduction and reproductive risks. These questionnaires were completed before the students were engaged in learning about these topics as part of the curriculum in their medical school. Results Substantial differences were revealed between the two groups of medical students. Israeli medical students were less tolerant regarding reproductive risks and more knowledgeable about genetics and reproductive risks than Croatian medical students. For example, while nearly all Israeli medical students disagreed with the idea that “Screening for reproductive risks in prospective parents is wrong,” less than 40% of their Croatian counterparts shared a similar stance. Similarly, all Israeli medical students correctly observed that “A carrier of a recessive genetic disease actually has the disease” was wrong, as opposed to only 82% of Croatian students. Conclusions By linking applicable theoretical literature to these findings, we suggest that they may reflect the hidden influence of the dominant culture in each country, disguised as part of the “culture of medicine.” Acknowledging and learning about such influence of the dominant culture, may be an important addition to the training of medical students in cultural competence, and specifically their cultural awareness. Such an acknowledgement may also pave the road to drawing the attention of existing physicians regarding a less known yet an important aspect of their cultural competence, insofar as the cultural awareness component is concerned. (shrink)

Objectives: To study knowledge and attitudes of hospital ethics committee members at the first workshop for ethics committees in Croatia.Design: Before/after cross-sectional study using a self administered questionnaire.Setting: Educational workshop for members of hospital ethics committees, Zagreb, 2003.Main outcome measurements: Knowledge and attitudes of participants before and after the workshop; everyday functioning of hospital ethics committees.Results: The majority of the respondents came from committees with at least five members. The majority of ethics committees were appointed by the governing bodies of (...) their hospitals. Most committees were founded after the implementation of the law on health protection in 1997. Membership structure and functions were established on the basis of that law. Analysis of research protocols was the main part of their work. Other important functions—education, case analysis, guidelines formation—were neglected. Members’ level of knowledge was not sufficient for the complicated tasks they were supposed to perform. However, it was significantly higher after the workshop. Most respondents felt their knowledge should be improved by additional education. Their views on certain issues and bioethical dilemmas displayed a high level of paternalism and over protectiveness, which did not change after the workshop.Conclusions: The committees developed according to bureaucratic requirements. Furthermore, there are concerns about members’ knowledge levels. More efforts need to be made to use education to improve the quality of the work. Additional research is necessary to explore ethics committees’ work in Croatia especially in the hospital setting. (shrink)

After the events of 11 September 2001 and the anthrax letters, terrorism and bioterrorism have become the number one issue and motivation for all sorts of discussions and actions within the USA and in the rest of the world. Therefore, it is no wonder that bioterrorism and the threat of chemical weapons are prevalent issues in bioethical debates throughout the world and especially in the USA.In the Wake of Terror tries to give an American perspective on the most important bioethical (...) issues connected with terrorism and bioterrorism. The book is from the series Basic Bioethics published by the MIT press. The series editors …. (shrink)

Authentic leadership has become increasingly important in the literature, attracting the attention of many scholars in the last decade. This study adopted an employee-centered perspective to guide its examination of the relationship between authentic leadership and individual performance and investigation of the sequential mediation of employees’ affective commitment and individual creativity. An analysis was conducted of data collected from 214 employees working in different business sectors. The results reveal a statistically significant positive relationship between authentic leadership and employees’ workplace performance, (...) which are both directly connected and indirectly linked through the two proposed psychosocial mechanisms. The findings thus indicate that authentic leadership reinforces workers’ emotional connection with their organizations, thereby increasing their individual creativity and, subsequently, promoting better on-the-job performance. This study presents new and significant results since, on the one hand, it relied on a sequential mediation analysis of variables and, on the other hand, integrated the four main constructs into a single model. The proposed model displays the chain of effects between authentic leadership, affective commitment, individual creativity, and employee workplace performance. Implications for organizational management are discussed. (shrink)

Online education has become an essential component of education. Thus, several factors, such as the student’s learning strategy and motivation, generally contribute to their academic success. This study investigates the relationship between learning strategies, motivation, and online learning environment among 150 first-year college students. Employing correlational design, the statistical findings of the study reveal that the r coefficient of 0.59 indicates a moderate positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision (...) to reject the null hypothesis. Hence, a significant relationship exists between learning strategies, motivation, and the online learning environment. (shrink)

In this essay I present some of my thoughts on the issue of boundaries in the professional relationship between service users and social workers. As a graduate student of social work, I had an opportunity to discuss ethical dilemmas in an international perspective in one of my courses. A guest professor, who provided international perspectives, was Prof. Kim Strom from UNC at Chapel Hill in North Carolina, USA. The lectures offered a fresh perspective that raised many questions about thick and (...) thin boundaries in social work – especially when approaching social work by following prevailing guidelines for social work in Slovenia requiring us to co-create solutions through dialogue with service users, keeping in mind that service users are actually the ones who are the experts from experience. In this way, the working relationship seeks to foster a sense of partnership between social workers and service users. In this essay I would like to challenge the idea of rigid boundaries in social work and explore the possibility of fluid boundaries, keeping in mind that boundaries should reflect their main purpose, which I believe is to protect human dignity. (shrink)

The purpose of this article is to investigate human spatiality and perception in general, with the experience of adventure sports as its background. These activities highlight especially our strong relationship with the world when we consider the specific way in which the environment participates in the development of human potential. We first analyse the notions of risk and instability as important elements in adventure sports. Then we explore the notion of experience and spatiality, considering the way in which we establish (...) our relationship with the world. The theoretical background is found in the phenomenology of Merleau-Ponty and Bachelard’s phenomenology of imagination to investigate perspectives of space among adventurers. We hold that more than a different range of corporeal techniques, adventure sports can teach us a way of interrogating and looking at the world. They require a peculiar sensibility that allows our body to experience the environment in favour of a corporeal wisdom. Alternative sports indicate the possibility that we have to build up different ways of inhabiting the world and comprehending it. (shrink)

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies’ vulnerability to new pathogens and the critical role of vaccines in containing this and future pandemics. It has also put science at the forefront of (...) the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity. (shrink)

Aggregating snippets from the semantic memories of many individuals may not yield a good map of an individual’s semantic memory. The authors analyze the structure of semantic networks that they sampled from individuals through a new snowball sampling paradigm during approximately 6 weeks of 1-hr daily sessions. The semantic networks of individuals have a small-world structure with short distances between words and high clustering. The distribution of links follows a power law truncated by an exponential cutoff, meaning that most words (...) are poorly connected and a minority of words has a high, although bounded, number of connections. Existing aggregate networks mirror the individual link distributions, and so they are not scale-free, as has been previously assumed; still, there are properties of individual structure that the aggregate networks do not reflect. A simulation of the new sampling process suggests that it can uncover the true structure of an individual’s semantic memory. (shrink)

Flexibility in conceptual projection constitutes one of the most challenging issues in the embodiment and conceptual metaphor literatures. We sketch a theoretical proposal that places the burden of the explanation on attentional dynamics in interaction with mental models in working memory that are constrained to be maximally coherent. A test of this theory is provided in the context of the conceptual projection of time onto the domain of space. Participants categorized words presented at different spatial locations (back–front, left–right) as referring (...) to the past or to the future. Responses were faster when the irrelevant word location was congruent with the back–past, front–future metaphoric mapping. Moreover, when a new highly task-relevant spatial frame of reference was introduced, it changed the projection of past and future onto space in a way that was congruent with the new frame (past was now projected to left space and future to right space), as predicted by the theory. This study shows that there is substantial flexibility in conceptual projection and opens a venue to study metaphoric variation across tasks, individuals, and cultures as the result of attentional dynamics. (shrink)

Body ecology by cosmosis refers to the experience of immersion, or the incorporation of the elements of nature through a body practice, leisure or sport. In this article, we propose comprehensive u...

U ovom članku raspravljamo o hipotezi proširenog jastva Andyja Clarka i Davida Chalmersa, a osobito o prigovoru prema kojemu proširenom jastvu nedostaje stabilnost i kontinuitet koji su potrebni da bismo ga smatrali identičnim kroz vrijeme. Pokušavamo pokazati da je taj prigovor neodrživ. Raspravljamo i o gledištu prema kojemu se drugi tip jastva, to jest narativno jastvo, također može shvatiti kao prošireno, i tvrdimo da stabilnost i kontinuitet toga tipa jastva također nisu ugroženi ako ga proširimo izvan granica čovjekova tijela. Stoga, (...) barem što se tiče tih tipova jastva, kada razmišljamo o problemima osobnog identiteta, nije potrebno ograničiti se na internalizirano jastvo. (shrink)

The language of ethics expertise has become particularly important in bioethics in light of efforts to establish the value of the clinical ethics consultation, to specify who is qualified to function as a clinical ethics consultant, and to characterize how one should evaluate whether or not a person is so qualified. Supporters and skeptics about the possibility of ethics expertise use the language of ethics expertise in ways that reflect competing views about what ethics expertise entails. We argue for clarity (...) in understanding the nature of expertise and ethics expertise. To be an ethics expert, we argue, is to be an expert in knowing what ought to be done. Any attempt to articulate expertise with respect to knowing what ought to be done must include an account of ethics that specifies the nature of moral truth and the means by which we access this truth or a theoretical account of ethics such that expertise in another domain is linked to knowing or being better at judging what ought to be done and the standards by which this “knowing” or “being better at judging” is determined. We conclude with a discussion of the implications of our analysis for the literature on ethics expertise in CEC. We do think that there are clear domains in which a clinical ethics consultant might be expert but we are skeptical about the possibility that this includes ethics expertise. Clinical ethics consultants should not be referred to as ethics experts. (shrink)

Citizenship is no longer an exclusive relationship. Many people today are citizens of multiple countries, whether by birth, naturalization, or even through monetary means, with schemes fast-tracking citizenship applications from foreigners making large investments in the state. Moral problems surround each of those ways of acquiring a second citizenship, while retaining one's original citizenship. Multiple citizenship can also have morally problematic consequences for the coherence of collective decisions, for the constitution of the demos, and for global inequality. The phenomenon of (...) multiple citizenship and its ramifications remains understudied, despite its magnitude and political importance. In this innovative book, Ana Tanasoca explores these issues and shows how they could be avoided by unbundling the rights that currently come with citizenship and allocating them separately. It will appeal to scholars and students of normative political theory, citizenship, global justice, and migration in political science, law, and sociology. (shrink)

Fencing for the blind and visually impaired is an emerging sub-discipline of fencing that creates unusual conditions for meaning-making through interaction between embodied endowments and worldly affordances. With the rules of fencing slightly adjusted to the needs of the blindfolded participants – regardless of their sightedness – the discipline requires the fencers to engage in a duel by relying on other than visual cues. This article explores what an autoethnographic account of experiences of participation in fencing for the blind and (...) visually impaired brings to debates on the embodied, and specifically sensory difference. The discussion of these experiences intersects with debates on affect, affordance, and habit, with all three having important roles in related semiotic processes. Presented vignettes draw upon the author’s lived experiences of participation in fencing for the blind and visually impaired and are analyzed as part of a mixed-method autoethnographic study, accompanied by sensory methodologies, with a focus on an inquiry beyond the visual. The vignettes elucidate how we make sense of our surroundings through a complex engagement with the ecology of sensory and affective processes. In addition to exploring the role of affective and pre-conceptual aspects of our experiences, the article seeks to understand how semiosis occurs through both exposure to as well as the active pursuit of specific environmental signs available to us. The article also derives from biosemiotics to examine the complex relationship between meaning-making processes and habits. Finally, the autoethnographic account provides an insight into how we habituate the world and our embodied differences and thus enable meaning-making processes. (shrink)

In her recent book Gillian Brock argues that states’ legitimacy depends on their being part of a just state system that protects human rights. Here I discuss some practical limitations raised by Brock’s legitimacy framework: mainly, (1) the problematic real-world implications of such an account, and (2) the epistemic challenges that judgements inspired by this account would have to face, were we to proceed solely on the basis of it.

Studies of creative industries typically contend that creative work is profoundly precarious, taking place on a freelance basis in highly competitive, individualized and contingent labour markets. Such studies depict creative workers as correspondingly self-enterprising, self-reliant, self-interested and calculative agents who valorise care-free independence. In contrast, we adopt the ‘ethics of care’ approach to explore, recognize and appreciate the communitarian, relational and moral considerations as well as interpersonal connectedness and interdependencies that underpin creative work. Drawing on in-depth interviews with creative workers (...) in a range of marginal socio-cultural contexts, we argue that creative workers cultivate and sustain a diverse array of practices of care arising from an affective concern with the well-being of others. Far from being merely individualistic and crudely competitive actors, creative workers enact practical ethical responsibilities and affectivities towards a range of human and non-human others, including families, local communities and neighbourhoods, colleagues, artistic scenes and their adjacent genres, and surrounding national and linguistic cultures. In emphasizing the fundamental and structuring role of care in contingent labour markets our approach accords with recent trends in the social sciences that ‘affirmatively’—as opposed to ‘negatively’ and ‘suspiciously’—recognize that mutuality, solidarity and affectivity are powerful drivers of action on a par with or even exceeding market-driven self-centredness. (shrink)

Despite its potential implications for the objectivity of scientific knowledge, the claim that “scientific instruments are perspectival” has received little critical attention. I show that this claim is best understood as highlighting the dependence of instruments on different perspectives. When closely analyzed, instead of constituting a novel epistemic challenge, this dependence can be exploited to mount novel strategies for resolving two old epistemic problems: conceptual relativism and theory-ladeness. The novel content of this article consists in articulating and developing these strategies (...) by introducing two fine-grained notions of perspectives as the key units of analysis: “broad perspectives” and “narrow perspectives.”. (shrink)

The theory of mental models postulates that meaning and knowledge can modulate the interpretation of conditionals. The theory's computer implementation implied that certain conditionals should be true or false without the need for evidence. Three experiments corroborated this prediction. In Experiment 1, nearly 500 participants evaluated 24 conditionals as true or false, and they justified their judgments by completing sentences of the form, It is impossible that A and ___ appropriately. In Experiment 2, participants evaluated 16 conditionals and provided their (...) own justifications, which tended to be explanations rather than logical justifications. In Experiment 3, the participants also evaluated as possible or impossible each of the four cases in the partitions of 16 conditionals: A and C, A and not-C, not-A and C, not-A and not-C. These evaluations corroborated the model theory. We consider the implications of these results for theories of reasoning based on logic, probabilistic logic, and suppositions. (shrink)

This book advances a 'naturalized' normative theory of deliberative democracy; one that is informed by an empirically-grounded analysis of public deliberation in naturalistic settings and in unadulterated form, and goes on to provide institutional design proposals for how to improve it.

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB community (...) to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

The nature, possibility, and implications of ethics expertise in general and of bioethics expertise in particular has been the focus of extensive debate for over thirty years. What is ethics expertise and what does it enable experts to do? Knowing what ethics expertise is can help answer another important question: What, if anything, makes a claim of expertise legitimate? In other words, how does someone earn the appellation “ethics expert?” There remains deep disagreement on whether ethics expertise is possible, and (...) if so, what constitutes such expertise and what it entails and legitimates. Discussion of bioethics expertise has become particularly important given the growing presence of bioethicists in the clinical setting as well as efforts to professionalize bioethics through codes of ethics and certification efforts. Unlike in the law or in engineering, where there may be a body of knowledge that professional organizations or others have articulated as important for education and training of experts, ethics expertise admits of no such body of knowledge or required experience. Nor is there an entity seen as having the authority to articulate the necessary scope of knowledge. Questions about whether there is such a body of knowledge for particular areas within bioethics have emerged and played a central role in professionalization efforts in recent years, especially in the area of clinical ethics. (shrink)

Analytic study of ethical conviction and beliefs with reference to the Advaitavada of Śaṅkarācārya and Śuddhādvaitavāda of Vallabhachars.

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

En el presente artículo se pretende hacer un recorrido por aquellas herramientas metodológicas utilizadas por Foucault para el estudio de la institución educativa disciplinaria y su posible aplicación al nuevo panorama educativo en las sociedades de control. Foucault analiza los discursos y prácticas como formas de poder en la sociedad disciplinaria, los cuales configuran una individualidad determinada: el cuerpo dócil. Tras la Segunda Guerra Mundial, nuevas modalidades de poder dan lugar a la sociedad de control, conformando una individualidad autogobernada. En (...) la educación secundaria actual aparecen tanto formas del régimen disciplinario como del régimen de control. (shrink)