Love enhancement can give us as a say on whom we love and thus ‘free’ us from our brain chemistry, which is mostly out of our control. In that way, we become more autonomous in love and in our life in general, as long as love enhancement is a free, voluntary choice. So goes the argument in favour of this addition to medical interventions of relationships. In this paper, I show that proponents of love enhancement have overlooked, or at least (...) underestimated, the fact that love itself impacts people’s choices. Since this could include the choice for love or anti-love drugs, I call for a re-formulation of the underlying view on autonomy before this medical intervention is made available to the public. (shrink)

While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as being in (...) good standing with a professional body. Rather, reputation is treated in the sense that a craftsman might wish to be known for providing a specific type, quality, and style of service. Professionalism is understood as acting according to the philosophical and scientific principles that are the basis of healthcare (such as acting for the benefit of the patient’s health and following well- evidenced treatment pathways). (shrink)

The US Food and Drug Administration (FDA) is fraught with controversies over the role of values and politics in regulatory science, especially with drugs in the realm of reproductive health. Philosophers and science studies scholars have investigated the ways in which social context shapes medical knowledge through value judgments, and feminist scholars and activists have criticized sexism and injustice in reproductive medicine. Nonetheless, there has been no systematic study of values and gender norms in FDA drug regulation. I focus on (...) three questions about values in regulatory science. First, how have societal values and gender norms shaped the way that the FDA regulates drugs in the realm of reproductive health, specifically with drug labels? Second, what are the ethical, epistemic, and social consequences of these influences on regulation for women and other marginalized groups? Third, which societal values and gender norms ought to influence drug regulation about reproductive health, and how ought this happen? Integrating philosophical analysis with historical archival research and in-depth interviews, I conduct three case studies of drug labeling about reproductive health: (1) the “drug fact” about the mechanism of the morning-after pill; (2) the package inserts for patients about the health risks of oral contraceptives; and (3) the special physician labels made for prescribing drugs to pregnant women. I identify three challenges for the FDA and suggest ways to reduce the influence of sexist values and facilitate feminist alternatives. First, across these cases, I have found that there are many ways in which other concerns in reproductive medicine (such as zygotic life, fetal health, and population control) have devalued women’s health. Second, both knowledge and ignorance xvi about their reproductive health have contributed to women’s oppression, especially poor women and women of color. Finally, by avoiding the epistemic dimensions of ethics, powerful, mostly male parties in medicine (such as doctors, pharmaceutical companies, and religious institutions) have misused “informed consent,” “religious freedom,” and “paternalism” for unethical purposes. For improvement, I suggest extracting sexist values and gender norms from regulatory science that cause epistemic injustices, and I point to success stories for reforming sexism with feminism at the FDA. (shrink)

Healthcare professionals face dilemmas regarding maintaining and breaching confidentiality while dealing with victims of sexual violence. The sensitivity of the cases of violence and the aim to prevent harm generates ambiguity for sound ethical and legal decision making. In Pakistan, maintaining silence is often preferred over breaking the silence. Thus, it is essential to view the risks and benefits of the conflicting positions keeping in mind the diverse perspectives and the bigger picture. Organizations, community and government can plan different strategies (...) to put an end to this obscene game of “silence in violence”. (shrink)

Human Security may mean “the right of all people to live in freedom and dignity, free from poverty and despair and all individuals, in particular vulnerable people, are entitled to freedom from fear and freedom from want, with an equal opportunity to enjoy all their rights and fully develop their human potential” ). HS is at great risk in modern times. It may look outwardly that external wars and cause insecurity to the people; but a deeper study on the socio-economic (...) and environmental conditions of the people prove that they cause more danger and insecurity not only to the people but to the nation itself.. Human security brings together the ‘human elements’ of security, rights and development. It is mainly people centred. Millions of people are threatened by poverty, climate-related disasters, organised crime, human trafficking, health hazards and sudden economic depression and financial downturns. There are different types of HS and the threats and solutions. (shrink)

Part I of the dissertation examines the cognitive aspects of autonomy. The central question concerns what kind of cognitive capacity autonomy is. It will be argued that the concept of autonomy is best understood in terms of a metacognitive capacity of the individual. It is argued that metacognition has two components: procedural reflexivity and metarepresentation. Metarepresentation in turn can be divided into inferential reflexivity and other-attributiveness. These two components are essential for autonomy. Particular emphasis is put on procedural reflexivity. Further, (...) since the essential function of metacognition is control, it is argued that the concept of autonomy, understood as a metacognitive capacity, can be interpreted in terms of control. Issues arising from empirical data from neuroscience on functional, as well as impaired, metacognition, and on undermined autonomy, are dealt with. It is argued that autonomy cannot be determined with respect to subjective conditions. Neurological impairments, like Anton’s Syndrome, dementia, and thought insertion in schizophrenia, are put forward in support of this claim. To determine autonomy we require external conditions. In order to determine whether an individual is autonomous, both the metacognitive status of the individual and the external setting must be considered, since they are in interplay and consequently influence each other. In Part II, the analysis put forward in Part I is applied to Swedish healthcare. It is argued that the distinction between autonomy as a right and as a capacity must be explicit in order to understand what autonomy means and to deal with it effectively in healthcare practice. A discussion about whether or not the patient’s right to autonomy sometimes tends to be over-emphasized in healthcare is put forward. Special emphasis is placed on psychitaric issues such as deinstitutionalization and participation. Following the closure of the mental hospitals, deinstitutionalization and community-based care have become central topics in psychiatry. At the same time, the implementation of such care can be demanding for patients suffering from a persistent mental disorder. In part II it is also suggested that the metacognitive account of the concept of autonomy might help clarify the criteria governing coercive care. Finally, some suggestions concerning developments and improvements in Swedish healthcare, especially in psychiatry, where the concept of autonomy is important but problematic, are put forward. (shrink)

Brian Leiter throws down two gauntlets to philosophers engaged in dialogue with the broader public. If, with the first, public philosophers recognize that they cannot offer substantive answers but only sophisticated method, they nevertheless fail to realize that said method does not resonate with the very public whom they purport to help. For, with the second, that method does not engage the emotivist and tribalist cast of contemporary public discourse: emotivist because a person’s moral and political beliefs are a function (...) of emotional attitudes or affective responses for which she adduces reasons post hoc; tribalist because the person tracks not the inferential relation between beliefs but her similarity with interlocutors. In order to understand the full extent of this critique, it is necessary, first, to parse strands of public philosophy, distinct discursive sites, and pictures of philosophical practice and, then, to probe the critique’s empirical groundedness and intended scope. These elements in place, it is then possible to sketch public philosophy reconceived along Leiter’s lines as equal part rigor and rhetoric. That sketch may be somewhat filled out through two tactics employed in Jeffrey Stout’s work. These form part of a toolkit for philosophical dialogue whereby philosophers get a discursive grip on non-discursive factors underlying public discourse and push back on Leiter's dilemma. (shrink)

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins with a critical interpretive review of (...) the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

Drawing on empirical evidence in medicine, economics, law, and anthropology, I argue that a market is uniquely capable of meeting the demand for transplantable kidneys, and that it may be arranged so as to operate safely. The welfare gains, expected to accrue to both vendors and recipients, are sufficient to justify sales. Having spelled out the considerations recommending a kidney market, I address the most forceful objections facing the proposal. Despite its currency, the claim that incentives will crowd out altruistic (...) donors and result in a decrease in supply is empirically unsupported and predicated on an implausible view of donorsâ motives. A host of objections claim vendorsâ will not give informed consent. Many such objections identify easily remediable problems, or impose unreasonable standards â standards that would rule out morally permissible kidney donation. And all presuppose a model of morally transformative consent that, I argue, is deficient. Two further challenges point to harms inflicted on those who do not participate in the market. Some claim that those in poverty will be subject to harmful social and legal pressure to vend. This objection fails to distinguish between being pressured to perform a specific act, and being under general economic pressure and having the option to perform an act. It, moreover, presupposes vending more common than is possible. Others worry that the market will give rise to unfair pecuniary externalities. This objection also presupposes that kidney sales will occur more often than is possible. But more importantly, the normative consideration that is supposed to make such externalities especially objectionable, in fact, recommends allowing sales. I also make a political case for kidney sales. I offer an account of the stateâs proper role in the market. I begin with a conception of democratic equality according to which the state is responsible to secure for its citizens the preconditions for democratic participation. I then show that this end would be promoted were the state to end the current prohibition on sales. (shrink)

Public health ethics is a subfield of bioethics that focuses on population health. This study aims to conform the principles of biomedical ethics to Islamic values in the context of public health. It culturally helps to optimize health care delivery. The approach is based on the method of immanent critique. The principle of the common good in Islam has a rational justification to draw public interests and ward off harms. The rule of “no harm”, with an emphasis on the preferability (...) of preventing harm to increase benefits, is consistent with the principle of utility, intending to produce a maximum balance of benefit over harm in the context of public health. Thus, on the one hand, the government is obliged to prevent harm and improve public benefits and, on the other hand, as a steward of health and with reference to the article “limitation of the ownership dominance”, it has the right to protect public health with the least justifiable harm. Islam attention to human dignity, individual justice and good will in the rule of goodness implies that Islam, beyond distributive justice, knows that human flourishing and the cultivation of moral virtues are a requisite for the realization of social justice. The present study discusses about the adjustment of the principles of PHE to the principles of the Islamic jurisprudence and, at the same time, it explains why the optimal PH in Muslim societies requires research in order to define accurate indicators of benefit and harm based on the teachings of revelation and reason. (shrink)

This dissertation discusses several ethical and moral issues which arise from the cryonics movement. Within each section, the question is posed: how does that problem impact on how we should think about cryonics? Is cryonics morally permissible and/or morally obligatory? Issues include a consideration of economic resource allocation, bodily ownership and identity.

Humanitarian emergencies and natural disasters can overwhelm the capacity of local and national agencies to respond to the needs of affected populations. In such cases, international relief organizations are frequently involved in the provision of emergency assistance. Health care professionals play a key role in these interventions. This practice environment is significantly different from the context of health care delivery in the home countries of expatriate health care professionals. Clinicians who travel from a developed nation to a resource-poor setting where (...) a humanitarian crisis has occurred experience a shift of professional, social, cultural and regulatory environments. In this dissertation I examine the ethics of health care practice in humanitarian work. I evaluate the literature of global bioethics, global health ethics and the ethics of humanitarian assistance, and consider the contributions of various ethics frameworks and normative approaches. I also develop a set of questions to guide health care professionals as they address ethically complex issues arising in clinical practice during humanitarian crises. In the empirical component of this research program I use Interpretive Description methodology to examine the moral experience of health care professionals in humanitarian relief work, and clinician experiences of resources and constraints for addressing ethical issues in humanitarian settings. Building upon the inductively derived findings, I argue for strategies and approaches that humanitarian organizations, project teams, and health care professionals can adopt to respond to the ethics of this field of practice. I also provide a critical review of Interpretive Description methodology. The research presented in this dissertation makes an important contribution to the ethical analysis of health care practice in humanitarian work. (shrink)

Any ethical argument involving the problems of access to assisted reproductive technologies should entail the discussion of the decision protocol and consider the individual deliberating on the appropriateness of these remedies from the point of view of self and community. Yet, arguments based on patients' own moral calculations are rare in the bioethics literature. The moral voice behind most discourses concerning ARTs is that of an outwardly independent spectator, who nonetheless proceeds to justify a personally significant worldview in the utilization (...) of these resources. Investigators grounded in social and legal sciences have offered relevant arguments in this regard, but because their discourses are derived from research protocols specific to their respective disciplines, they fail to provide a general rationale applicable to moral deliberation. (shrink)

some 20 years. Yet the ethical issues surrounding the disclosure of positive HIV status have not been examined comprehensively. This report examines the ethics behind the disclosure of HIV-positive status primarily or individuals to their sex partners, and for health care practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant rights and ethical principles are analysed, including the rights to: self-preservation; privacy and confidentiality; and the bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice. (...) Historic and contemporary individual rights that people living with HIV have regarding disclosure are emphasised, especially in adverse circumstances, where ethics can support non-disclosure based on the right to self-preservation. Rights declarations and current disclosure guidelines for health care practitioners from several international and South African medical organisations also are reviewed. Of key importance to disclosure decisions are the specific situations of individuals in climates rife with stigma toward, and discrimination against, PLHIV, existing more or less worldwide. The potential negative impacts of disclosure are the basis for disclosure decisions of PLHIV. Research study results show that the negative impacts of disclosure can be severe for individuals, ranging from divorce or abandonment to community ostracism and even to murder. Relevant current theories of social justice related to HIV disclosure also are discussed. A conclusion is reached that, by decreasing stigma and discrimination against PLHIV and protecting individual rights related to HIV disclosure, prevention behaviours will be practised more widely, including ‘positive prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the long-term public health goal of decreased spread of HIV. (shrink)

This paper addresses the topic of bioethics in reproductive medicine from the perspective of the religious implications for the field. The assumption underlying the approach is that religion remains a factor that influences the field of bioethics even in a secularized postmodern society. The first part of the paper analyses the main bioethical issues which mark obstetrics and gynecology, uttering that the four basic principles of bioethics are available both in obstetrics and gynecology and must be applied in association with (...) the practitioner’s virtues. The second part of the paper focuses on the main directions that guide the debate on the presence of religion in the field of bioethics, with a special interest in their relevance for reproductive medicine. Despite the difficulties implied by the task of advocating for the place of religion at the secular table of deliberation in medical ethics, the relevance of religion for bioethics cannot be ignored. (shrink)

In this paper, we analyse the Wittgensteinian critique of the orthodoxy in animal ethics that has been championed by Cora Diamond and Alice Crary. While Crary frames it as a critique of “moral individualism”, we show that their criticism applies most prominently to certain forms of moral individualism (namely, those that follow hedonistic or preference-satisfaction axiologies), and not to moral individualism in itself. Indeed, there is a concrete sense in which the moral individualistic stance cannot be escaped, and we believe (...) that it is this particular limitation that justified Crary’s later move to a qualified version of moral individualism. At the same time, we also argue that there are significant merits to the Wittgensteinian critique of moral individualism, which pertain to its attack on the rationalism, naturalism, and reductionism that characterise orthodox approaches to animal ethics. We show that there is much of value in the Wittgensteinians’ call for an ethics that is more human; an ethics that fully embraces the capacities we are endowed with and one that pays heed to the richness and complexity of our moral lives. (shrink)

The paper discusses the role of anthropological arguments in contemporary ethics as exemplified in the current debate about biotechnological human enhancement interventions. Anthropological arguments refer to a normative conception of what it means to be a human being and are highly contested in contemporary moral philosophy. Most often they are promoted to constrain the ethically acceptable use of enhancement technologies. I argue that anthropological arguments can play a fundamental and important role in assessing the moral qualities of enhancement interventions, but (...) only if their normative justification and their specific content are properly determined. I offer an account how to do so, based on the contractualist and pragmatist ideal that all those who are affected by a decision of normative relevance should be included in what I call a “quasi-democratic deliberative process”. However, given that they stand in need of wide agreement, anthropological arguments resulting from such a process will be be rather minimal in content. In the exemplary debate about human enhancements they hence turn out to be widely – though not fully – permissive and unable to justify a restrictive stance towards enhancement interventions. (shrink)

Moral considerations do not appear to play a large role in discussions of the DSM-IV personality disorders and debates about their empirical validity. Yet philosophical analysis reveals that the Cluster B personality disorders, in particular, may in fact be moral rather than clinical conditions. This finding has serious consequences for how they should be treated and by whom.

This dissertation consists of three parts. Part I is a defense of an artificial language methodology in philosophy and a historical and systematic defense of the logical empiricists' application of an artificial language methodology to scientific theories. These defenses provide a justification for the presumptions of a host of criteria of empirical significance, which I analyze, compare, and develop in part II. On the basis of this analysis, in part III I use a variety of criteria to evaluate the scientific (...) status of intelligent design, and further discuss confirmation, reduction, and concept formation. (shrink)

This study is a contribution to the bioethical debate about new and possibly emerging reproductive technologies. Its point of departure is the intuition, which many people seem to share, that using such technologies to select non-disease traits – like sex and emotional stability - in yet unborn children is morally problematic, at least more so than using the technologies to avoid giving birth to children with severe genetic diseases, or attempting to shape the non-disease traits of already existing children by (...) environmental means, like education. The study employs philosophical analysis for the purpose of making this intuition intelligible and judging whether it is justified. Different ways in which the moral problems posed by reproductive technologies are often framed in bioethical debates are criticised as inadequate for this task. In particular, it is argued that the intuition cannot fully be made sense of in terms of harm to the children that such technologies help create. The study attempts to elaborate an alternative to that broadly consequentialist approach, by drawing on Martin Heidegger’s philosophy of technology, Hans Jonas’s ethics, and Aristotle’s practical philosophy, as it has been received and developed in the hermeneutical tradition. It is suggested that reproductive choices, unlike decisions for already born children, are characterised by a peculiar one-sidedness: the future child appears to the parents as something wholly theirs to decide about, not as a concrete other with whom they must interact in a responsive and attuned way. This is problematic because it means that such choices cannot call upon the particularised moral understanding only gained in interpersonal encounters. In particular, it makes them easily shaped by various tendencies, to which parents are always susceptible, to relate to children in instrumentalising ways, and at risk of reinforcing such tendencies. However, this does not mean that all uses of reproductive technologies are equally troubling. When selecting against severe disease the parents can rely on a widely shared illness experience to escape the dangers that one-sidedness involves. It is concluded that the intuition under discussion, thus explicated and in some ways qualified, makes sense morally. (shrink)

In the following text, medical, anthropological and ethical issues of deep brain stimulation, a medical technology in which electrodes implanted in the human brain electrically influence specified brain regions, will be discussed. After a brief account of the deep brain stimulation procedure and its chances and risks, anthropological and ethical aspects of the approach will be discussed. These relate to the reversibility of the procedure and to the patient’s capacity to control the effects it exerts in the brain, to modifications (...) and fluctuations in a person’s character traits and individuality brought about by neurostimulation, and to the range of legitimate, adequate uses of the deep brain stimulation approach. The paper concludes that deep brain stimulation should be confined to therapeutic contexts and to severe, otherwise treatment-refractory disorders in which the aim is to normalize brain functioning. Apart from this, it should not be used to modify a person’s individual character traits and behaviour or to enhance human traits. (shrink)

This thesis is a contribution to the ethical justification for clinical research with children. A research subject’s participation in a trial is usually justified, in part, by informed consent. Informed consent helps to uphold the moral principle of respect for persons. But children’s limited ability to make informed choices gives rise to a problem. It is unclear what, if anything, justifies their participation in research. Some research ethicists propose to resolve this problem by appealing to social utility, proxy consent, arguments (...) explaining why it is permissible to expose children to some harm, and an argument concerning the appropriate balance between research harms and benefits. I argue that each of these is a necessary part of the justification for research with children, but that the argument concerning harms and benefits is under-developed. It relies on the concept of minimal risk, but minimal risk is inadequately justified. I propose an interpretation of minimal risk. I defend the idea that minimal risk should be interpreted according to the risks of daily life. I reject the most prominent defense of daily life, which claims that daily risks are morally relevant because they replace, rather than add to, the risks a child would ordinarily face. Instead, I propose that these risks are part of a reasonable trade-off between personal safety and our ability to pursue meaningful lives. I then examine whose daily life should be captured in the concept of minimal risk. I reject arguments that minimal risk should refer to healthy children or the subjects of the research and propose instead that the referent should be children who are not unduly burdened by their lives. I argue that children are not unduly burdened when they fare well and defend the idea that children fare well when they possess sufficiently high degrees of the substantive goods of childhood. I conclude by analyzing a controversial case study using my interpretation of minimal risk. I draw on this case to argue that my interpretation offers clear guidance for research ethics review and contributes to a determination that is more plausible than its rivals. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 hours. Tests (...) given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)

Ethical concerns surrounding medical research in resource-poor settings. including the 'pharming' out or outsourcing or ‘offshoring’ of clinical trials, and how these relate to the economic, historical and political dimensions of the global scientific field, are a recurrent theme across the different social science disciplines.

Chemical brain preservation allows the brain to be preserved for millennia. In the coming decades; the information in a chemically preserved brain may be able to be decoded and emulated in a computer. I first examine the history of brain preservation and recent advances that indicate this may soon be a real possibility. I then argue that chemical brain preservation should be viewed as a life-saving medical procedure. Any technology that significantly extends the human life span faces many potential criticisms. (...) However; standard medical ethics entails that individuals should have the autonomy to choose chemical brain preservation. Only if the harm to society caused by brain preservation and future emulation greatly outweighed any potential benefit would it be ethically acceptable to refuse individuals this medical intervention. Since no such harm exists; it is ethical for individuals to choose chemical brain preservation. (shrink)

Topicality of the research topic. As a result of the COVID-19 pandemic, there is an increase in the instability of the structure of ecosocial systems. Technological innovations have led to a sharp deterioration in natural social ecodynamics. The aim of the research is the conceptual modeling of the proliferation of biopolitics from the social sphere to the field of international relations with the subsequent transformation into a systemic factor of the global evolutionary process. Research methods and results. The model is (...) based on our previously proposed concept of a three-module stable evolutionary strategy of technogenic civilization. In relation to the triple spiral of anthropo-socio-technogenesis, i.e., the historical development of the cultural-ecological niche of Homo sapiens, constructed by him, this means the following. Periods of stable progressive growth of evolutionary and civilizational success are replaced by periods of various scales crisis, up to civilizational or even biological-evolutionary singularity. During the crisis, the importance of the political factor increases sharply, and over the past 50 years, this primarily relates to the field of biopolitics. The regional differentiation of the biopolitical sphere reconstruction during the fight against the pandemic will inevitably complicate international relations not only between regions that belong to different cultural and civilizational types. Probably less so, the same problems will affect the reconciliation of differences caused by geopolitical, interethnic, religious and even economic (competition) reasons. The first phase of the adaptive civilizational response is to reduce the degree of connection between the individual socio-cultural elements of modern civilization, i.e., slowing down the globalization process and intensifying interregional conflicts of various contents. In particular, such contradictions will be most acute in the post-Soviet geopolitical space, where the conditions of the civilizational rift are imposed on the conflicts of the transition period. Due to the specifics of modern high technologies, the process will enter the phase of global socio-techno-ecological self-developing systems reconstruction, which includes man as its element. And the obvious conclusion will be the transition of the development of biopolitical issues to a new, no longer international, but global-evolutionary level. In our understanding, transbiopolitics is a political issue related to the rationalization of the global evolutionary process. The latter will become a bearing element of the global process of evolution of the noosphere with the subsequent complication and increase of cohesion between separate sociocultural types which are a part of system of the modern globalizing civilization. (shrink)

In debates about animal sentience, the precautionary principle is often invoked. The idea is that when the evidence of sentience is inconclusive, we should “give the animal the benefit of the doubt” or “err on the side of caution” in formulating animal protection legislation. Yet there remains confusion as to whether it is appropriate to apply the precautionary principle in this context, and, if so, what “applying the precautionary principle” means in practice regarding the burden of proof for animal sentience. (...) Here I construct a version of the precautionary principle tailored to the question of animal sentience together with a practical framework for implementing it. I explain and defend the key features of this framework, argue that it is well-aligned with current practice in animal welfare science, and consider and reject a number of influential counterarguments to the use of precautionary reasoning in this area. (shrink)

This chapter addresses ethical issues for informed consent when recruiting autistic participants for research. The process of informed consent for participation in research involves some abilities, such as dialogue and understanding the intentions of the researchers, that can be especially challenging when autistic individuals are being asked to participate. This chapter reviews these abilities, and suggests ways to provide meaningful support to promote autonomy and help researchers meet their responsibilities. Beyond these more general challenges, it explores Hans Jonas’s suggestion that (...) true informed consent for research requires that participants identify with the goals of the researchers. Given the plurality of perspectives on how to respond to autism, Jonas’s ideas point to additional ethical concerns that can arise when autistic people are recruited for research on autism. (shrink)

The article construes a modern concept of human dignity and factors influencing it. On the grounds of the Antique Greek-Roman notion of a human being as in-dividuus (Lat. not divisible, integral) and per-sona (Lat. mask, role played by an actor), the ambiguity of the human dignity is revealed: on one hand, every human being enjoys an unchangeable and non-deprivable dignity of the human being, on the other hand, the human being, as a creature and participant of social relations, himself/herself creates (...) the dignity of a person. On the grounds of the hermeneutical attitude, it is shown that that human dignity (within the meaning of individuum) may be protected only by means of the guarantees of particular human rights and, vice versa, only by ensuring particular human rights one may also guarantee the protection of human dignity. (shrink)

MA Thesis. Biomedical ethics does not lend itself to easy categorisation as either a 'theoretical' or a 'practical' enterprise because inquiry into the quandaries of morality requires both situational and 'translocal' perspectives. These types of investigation bring into question the legitimacy of the theory/practice divide that has dominated intellectual thought since antiquity. This division hinders the development of bioethics by fostering internal dispute within the discipline regarding appropriate methodology and the practice of clinical ethics. In this thesis, I argue that (...) much of these disciplinary disjunctions are due to an undue labeling of bioethics as either 'applied ethics' or 'practical ethics', and a failure to recognise the intricate way in which theory and practice inform each other and are integral and interrelated parts of moral deliberation. I argue for an integration of the theory and practice of bioethics. (shrink)

This paper provides an analysis of the way in which two foundational principles of medical ethics–the trusted doctor and patient autonomy–can be undermined by the use of machine learning (ML) algorithms and addresses its legal significance. This paper can be a guide to both health care providers and other stakeholders about how to anticipate and in some cases mitigate ethical conflicts caused by the use of ML in healthcare. It can also be read as a road map as to what (...) needs to be done to achieve an acceptable level of explainability in an ML algorithm when it is used in a healthcare context. (shrink)

Medical tourism is a form of medical travel wherein patients move across borders from their home country to another for the purpose of seeking medical trea tmen t tha t is unavailable or unaffordable at home, for the privacy of a transnational location, or for the tourist destination attractions. Medical tourist may seek procedures not approved at home, such as stem cell treatments, or physician assisted suicide. International travel for procedures legal at home and in the destination c oun t (...) r y a re p red omina tely m o tiva ted by affordability and shorter wait-time. In the U.S. some insurance agencies offer reimbursement if a patient goes abroad and has a procedure that is drastically cheaper. Globalization of health care is becoming a fact of life and medical tourism is only one facet of the picture. This paper will examine what we know about medical tourism from a literature survey and evaluate ethical concerns including welfare of pa tien ts, impact on healthcare systems in destination countries, and effect of medical travel on public health. (shrink)

This article explores the viability of life after ‘the end of nature’ – as Žižek reports – in the Anthropocene. Humans can no longer consistently rely on their persistent interventions to nature as its source. The end of nature, however, does not only mean that the problem is solely ecological. Instead, it points to the original chaos of catastrophes that disturb the link of man’s relationship to nature. In short, the current predicament of the times not only exposes problems of (...) ecology per se but also of economy, biology, and society. So, what comes next? Taking off from Heidegger and Leibniz, ethical prospects after this four-fold end should reopen the task of thinking the Anthropocene in various independent but coalescing fronts. (shrink)

La Ética es la parte de la filosofía práctica que se ocupa del hecho moral y de los problemas filosóficos que nacen de la conducta humana, la bioética resulta la rama de la ética que se dedica a proveer los principios para la correcta conducta humana; respecto a la vida. En el proceso de atención a los pacientes con enfermedades reumáticas se emplean variados procedimientos. Las nuevas tecnologías han mejorado notablemente su tratamiento integral; estos adelantos científicos deben ser empleados con (...) la intención fundamental de no producir daño y previo consentimiento informado; por lo que resulta necesario argumentar acerca de las implicaciones bioéticas que resultan del empleo de los avances científico-tecnológicos en el tratamiento a los pacientes con enfermedades reumáticas. Ethics is the part of Practical Philosophy that deals with moral facts and philosophical problems that have their roots in human behavior. Bioethics is the branch of Ethics devoted to providing the principles for correct human behavior, with respect to life. Various procedures are used when treating patients with rheumatic diseases. New technologies have considerably improved their integral treatment; these scientific advances must be used with the main purpose of causing no harm and with prior informed consent. Therefore, it is necessary to argue on the bioethical implications that turn out from the use of scientific-technological advances in the treatment of patients with rheumatic diseases. (shrink)

The current health legislation recognizes minors’ capacity to make decisions or, at least, to take part in those that affect them, according to their age and maturity. But this capacity is not promoted. Capacitating minors to make their own decisions is still a challenge, because it requires something that today is not happening: autonomy has to be understood not as a state, but as a process that needs support. Our proposal is that this support should be based on recognizing minors (...) as vulnerable persons, that is to say, as persons with emotional needs, who are the subjects of rights and duties, and who have social needs of self-fulfillment. All in all, autonomy has to be understood as a process based on recognizing minors’ dignity as a previous condition to help them acquire those typical capabilities of autonomous persons. This concept of support requires, in the first place, a change of the social view of minors. (shrink)

The fourth amendment to the German Medicinal Products Act (Arzneimittelgesetz) states that nontherapeutic research in incompetent populations is permissible under the condition that potential research participants expressly declare their wish to participate in scientific research in an advance research directive. This article explores the implementation of advance research directives in Germany against the background of the international legal and ethical framework for biomedical research. In particular, it addresses a practical problem that arises from the disclosure requirement for advance research directives. (...) We show that, if the disclosure standard for advance research directives is set at a token level, nontherapeutic research in incompetent populations becomes practically impossible. To resolve this issue, we suggest the disclosure standard be set at a type level. (shrink)

Respect for autonomy and beneficence are frequently regarded as the two essential principles of medical ethics, and the potential for these two principles to come into conflict is often emphasised as a fundamental problem. On the one hand, we have the value of beneficence, the driving force of medicine, which demands that medical professionals act to protect or promote the wellbeing of patients or research subjects. On the other, we have a principle of respect for autonomy, which demands that we (...) respect the self-regarding decisions of individuals. As well as routinely coming into opposition with the demands of beneficence in medicine, the principle of respect for autonomy in medical ethics is often seen as providing protection against beneficial coercion (i.e. paternalism) in medicine. However, these two values are not as straightforwardly opposed as they may appear on the surface. In fact, the way that we understand autonomy can lead us to implicitly sanction a great deal of paternalistic action, or can smuggle in paternalistic elements under the guise of respect for autonomy. -/- This paper is dedicated to outlining three ways in which the principle of respect for autonomy, depending on how we understand the concept of autonomy, can sanction or smuggle in paternalistic elements. As the specific relationship between respect for autonomy and beneficence will depend on how we conceive of autonomy, I begin by outlining two dominant conceptions of autonomy, both of which have great influence in medical ethics. I then turn to the three ways in which how we understand or employ autonomy can increase or support paternalism: firstly, when we equate respect for autonomy with respect for persons; secondly, when our judgements about what qualifies as an autonomous action contain intersubjective elements; and thirdly, when we expect autonomy to play an instrumental role, that is, when we expect people, when they are acting autonomously, to act in a way that promotes or protects their own wellbeing. I then provide a proposal for how we might work to avoid this. I will suggest that it may be impossible to fully separate paternalistic elements out from judgements about autonomy. Instead, we are better off looking at why we are motivated to use judgements about autonomy as a means of restricting the actions of patients or research subjects. I will argue that this is a result of discomfort about speaking directly about our beneficent motivations in medical ethics. Perhaps we can reduce the incentive to smuggle in these beneficent motivations under the guise of autonomy by talking directly about beneficent motivations in medicine. This will also force us to recognise paternalistic motivations in medicine when they appear, and to justify paternalism where it occurs. (shrink)

Protocols for evaluating social services consider several variables to measure the quality of their services, but not always attaches importance to intercultural competences of social service professionals. Focusing research in the area of residences for seniors this study analyzes the imagery of cultural otherness present in patients and workers, and tries to identify the significant variables that determine and/or influence coexistence and the appearance of conflicts arising from cultural diversity communication.

This study was designed to explore the concept of witnessed resuscitation. This was achieved through a serial approach to conceptually based research that systematically and incrementally developed understanding of the meaning of witnessed resuscitation in the context of emergency resuscitative care for adult victims of cardiorespiratory arrest. Theoretical investigation provided a strong conceptual foundation of existing knowledge and gave direction for further inquiry. Existential investigation comprised a hermeneuticphenomenological study to explore the phenomenon of lay presence during an adult cardiopulmonary resuscitation (...) attempt. Lived-experience material was subjected to thematic analysis and was revealing of five concepts that represented the essential nature of the lived experience. The concept of exposure emerged as the essence of this phenomenon. Research findings derived during theoretical and existential investigation were compared by adapting a method of template comparison. This process culminated in a synthesised conceptualisation of the meaning of witnessed resuscitation of a higher level of abstraction. Ongoing research is needed to determine whether this ‘state of the art’ conceptualisation of witnessed resuscitation holds its boundaries when applied to alternative phenomena, contexts and disciplines. Priority should be given to exploring the application of this concept in the context of patient and family-centred end-of-life care. (shrink)

Since time immemorial, poverty reduction interventions in Sub‐Saharan Africa like everywhere in the South, have focused on the individual as the basic ingredient of a moral society (ethical individualism). According to this perspective, in order to lift human persons out of poverty, it is imperative to integrate poor persons into poverty eradication interventions irrespective of sex, social status and gender. Scholars and institutions that subscribed to this conception of poverty thought that individuals were poor because of personal weaknesses (case poverty).This (...) perspective has been greatly challenged due to the upsurge of gender and human rights scholarship in the 20th century. Gender scholars have painstakingly argued that in order to understand poverty, we need to look at society (ethical collectivism). They have rejected the Women in Development(WID) discourse that aims at integrating women into the development process in favour of the Gender and Development(GAD) approach to development and poverty reduction that aims at confronting power relations between men and women (empowerment).This GAD perspective looks at poverty in terms of the powerlessness speared head by prevailing structures in society (structural poverty) and hence the need to empower vulnerable persons such as women to challenge structures and strictures of oppression. The International Monetary fund (IMF) and World Bank as vehement promoters of economism in Sub‐Saharan Africa for decades have urged governments to include the perspectives of the poor in poverty polices through what they call participatory poverty assessments (PPAs). Despite its deceptive appearance, this PPAs stance of the IMF and World Bank tacitly looks at poverty as a case and not structural issue and that is why Uganda’s ambitious poverty reduction policy though greatly informed by Participatory Poverty Assessments greatly ignores structures and strictures that render women vulnerable to poverty. This paper critically assesses the obliviousness of Uganda’s Agricultural poverty policy to structures and how this has militated on the gender poverty production in Uganda. The paper contends that in order to realise engendered poverty eradication in Uganda, it is pertinent for the agricultural policy to ultimately make paradigm shift from focusing on the individual as the basic ingredient of a moral society (ethical individualism) to confronting structures and strictures that disempower and vulnerablelise individual moral agents (ethical collectivism). (shrink)

Extreme human enhancement could result in “posthuman” modes of being. After offering some definitions and conceptual clarification, I argue for two theses. First, some posthuman modes of being would be very worthwhile. Second, it could be very good for human beings to become posthuman.

My aim in this paper is to analyze the way in which Edmund Husserl deals with the problem of the constitution of image in his writings. The difference between a common thing and a work of art lies in the fact that the ‘thing’ is submitted as an object to perception, while the work of art is the product of the human capacity called imagination or fantasy (Phantasie). Therefore, the difference between perception (which is an objectifying act) and imagination (which (...) refers to a mental representation) is the fundamental difference Husserl operates with in his analysis of the phenomenological problem of the image building. I also want to show that Husserl’s analysis of the constitution of the image is fundamental in the understanding of the work of art (aesthetic phenomena including) and of its difference from a common thing. From the point of view of the History of Philosophy, the Husserlian analysis presupposes the overcoming of the classical opposition between subject and object, and the aesthetic experience is one of the (privileged) ways through which this overcoming can be achieved. (shrink)