The problem of closeness was posed by Philippa Foot in the article “The Problem of Abortion and the Doctrine of Double Effect”. Foot criticizes the classic version of the principle of double effect which distinguishes direct from indirect intention. On this basis, she considers it justified to cause bad effects which were foreseen but not intended. She believes that if we consider causing a bad effect to be justified then the way we do it is irrelevant, while the reference to (...) the direct/indirect distinction may lead to absurd solutions in some cases that allow us to distinguish two events in one action. These constitute, respectively, the object of direct and indirect intention and they are much too close for an application of the principle of double effect, such as when a doctor performs a craniotomy. The root of the problem of closeness is the question about the possible criterion that would allow us to determine which of the effects of an action are intended and which are merely foreseen. The starting point of the analysis of the problem of closeness in this article is the manner in which Foot outlines it in her article. In the second and more extensive part of the article, a number of contemporary attempts to solve the problem of closeness are presented, while the third section is an attempt to answer the question of why the discussion of the problem of closeness seems to remain deadlocked. (shrink)

The following text is a voice in the discussion around normative problems of innovative therapies. It particularly refers to the amendment to the Polish Act on the Professions of Physician and Dentist, also discussed in this issue in the article by Rafał Kubiak "Criminal liability for crimes related to the illegal conduct of a medical experiment.".

The presented article is devoted to the question of whether extended access therapy can or should be accompanied by research activity. It consists of three parts. The first lists the tasks that can be used for medical information regarding extended access programs, which leads to the conclusion that even taking into account the specific limitations of their cognitive value, this type of data can be meaningfully used. The second part is devoted to the limited regulations in European law concerning the (...) discussed issue, and the Polish Act on the Professions of Physician and Dentist which grants physicians/researchers broader powers. In the last part of the article, two arguments are presented to ethically justify the granting of such broad powers to researchers, and thus limiting the autonomy of patients. (shrink)

The subject of this article are the definitional and regulatory aspects of experimental (or innovative) therapies, understood either as new and unproven treatment methods that can be tested – and for this purpose used – also in clinical trials, or as applications of these new and unproven procedures in medical practice. After a short introduction, recalling one of the important sources of the concept of experimental or innovative therapy, which was the Belmont Report, I first discuss the problems related to (...) the definition of experimental therapy (as a new and nonvalidated medical procedure used to improve the patient's health), and then the controversial issues related to its regulation (including in particular the required control to which each such therapeutic intervention should be subject). Finally, I point out the importance of the discussions on experimental therapy reported in this article, conducted in other countries or in international contacts, for the necessary revision or reinterpretation of Polish regulations regarding therapeutic experiments. (shrink)

The following text is a voice in the discussion around normative problems of innovative therapies. It particularly refers to problems related to the contribution of experimental therapies to the development of medical knowledge, also discussed in this issue in the article by Olga Dryla "Expanded access programs as a source of cognitive data.".

In 2021, there was a significant amendment to the legislation on medical experimentation. In particular, Chapter 4 of the Law of December 5, 1996 on the Profession of Physician and Dentist (Journal of Laws 2023, item 1516) was amended, in which the prerequisites of legally relevant consent given by the participant in the experiment or by other entities that express a position on their behalf were specified. In addition, procedures related to the opinion of the research project by the so-called (...) bioethics committee were described. Its members were obliged to maintain confidentiality with regard to information obtained in connection with the fulfilled function. These norms became protected by criminal sanctions, set forth in the amended Article 58 of the law. New generic types of criminal acts were introduced, primarily aimed at protecting the participant's right to self-determination, the voluntariness of participation in the experiment, and the confidentiality of data submitted by the experimenters in their proposals to bioethics committees. These norms fill in the gaps that have existed so far in the criminal law protection of these values. The article systematically discusses the generic types of criminal acts that have been penalized in Article 58 (4) to (6) of the referenced law. Their object of protection, object side, subject, subject side, punishability and potential confluence with other regulations are presented. The historical-dogmatic justification for the introduction of these regulations is also shown. (shrink)

_The dynamic development of medical technologies, i.e. the use of medicinal products and medical procedures, requires reflection on the ways to ensure the safety of patients and people using such methods of treatment (medical professionals) in legal and ethical terms. This applies in particular to the currently observed influence of the media on the actions taken in the health care system in Poland as well as individual decisions of patients on the use of the offered drugs and other medical procedures._ (...) _The article presents selected legal provisions defining the conditions for the use of medicinal products (drugs) and experimental medical procedures. The basic element of the considerations is to indicate the legal conditions for this type of use of medical technologies understood in this way, also in a broader context – with the characteristics of ethical conditions for „the media message”, including ensuring its proper quality for the protection of public health._. (shrink)

The following text is a voice in the discussion around normative problems of innovative therapies. It particularly refers to the meaning of the concept of innovation, also discussed in this issue in the article by Tomasz Rzepiński "Advanced therapy medicinal products (ATMP) as products of innovative biotechnologies.".

The following text is a voice in the discussion around normative problems of innovative therapies. It particularly refers to legal and ethical problems related to the advertisement of experimental medicinal products and medical procedures, also discussed in this issue in the article by Paweł Lipowski "Advertisements of experimental medicinal products and medical procedures in the light of Polish law and media ethics.".

Advanced therapy medicinal products (ATMP) offer hope for health benefits in all situations where traditional methods of therapy fail or cannot be used for various reasons. The main purpose of this article is to analyze the concept of innovation as applied to the biotechnologies employed in ATMP. In the analysis of the concept, five main contexts of meaning that contribute to its understanding will be distinguished: a change in the way of thinking about the available spectrum of medical procedures, the (...) short time of recognition of technologies in the experimental and theoretical models, lack of clinical data in advance of used technologies, increase of technologies’ complexity and diversity of substrates used in them. The conducted analysis indicates the need to adopt an attitude of far-reaching caution in the evaluation of the safety of ATMP therapies in which innovative biotechnologies are used. (shrink)

Abnormal body weight has been subject to varying assessments over time. The stigmatization of obesity for aesthetic reasons only began in the Western world in the second half of the 19th century, and in the 20th century its association with increased mortality was recognized. Body weight is associated with social and cultural meanings that affect human identity, and discussions about it generate considerable emotion. Words used to refer to body weight can influence people's self-perceptions, attitudes and behavior. Experimental studies have (...) shown that even brief exposure to body-related words can trigger automatic judgements and evaluations about body shape and weight. These negative and often implicit associations are symptomatic of a wider social stigma associated with weight. Recent evidence points to globalization and the presence of weight stigma in both developed and developing countries around the world. Numerous studies further indicate that weight shaming does not lead to weight reduction but rather to weight gain. Therefore, from a public health perspective, it is important to develop messages that are at least non-stigmatizing. The aim of this article is to present existing research on stigmatizing content in the media, as well as to analyze three selected social campaigns related to obesity. (shrink)

The aim of the article was to develop the thesis that patient’s decisions about truth and responsibility are central to the process of psychotherapy and yet they are rarely explicitly articulated. In the first part of the text, I outlined the anthropological context of the thesis, according to which human intentionality and psychological mechanisms have the status of domains of objective reality that are ontologically separate, although in the patient’s experience they combine with one another. Next, with reference to the (...) classical opinions of psychotherapy, I identified two aspects of patient decisions related to her/his psychopathology: adaptive (more pronounced in childhood) and moral (more pronounced in adulthood). I went on to isolate groups of psychological operating mechanisms involved in both truth- and responsibility-avoidance choices and, using clinical illustration, showed how the therapist can support alternative decisions. Finally, I further clarified the understanding of the proposed working model by indicating the different therapeutic consequences of revealing psychological mechanisms vs. decision-making based on the type of patient disorder and the anthropological-moral character of his/her choices. (shrink)

Symbiotic associations have been studied extensively in recent years, focusing mainly on the potential benefits to the host. However, understanding the role played by microorganisms in the physiology and fitness of the host, an aspect of the subject that had been neglected for a long time, has now become an important goal of symbiotic studies. Among the interesting philosophical questions are the following: how should we study the impact of symbiosis on the fitness of symbiotic microorganisms? What framework should scientists (...) use, and on what philosophical assumptions should such research be based? In other words, when does comparing fitness make sense? In this paper, I develop such a framework, and argue that these requirements comprise: (i) phenotypically similar individuals put in the same (ii) sub-environment and contrast it with another popular approach. Finally, I apply this to the symbiosis between the Euprymna scolopes squid and Vibrio fischeri bacteria to show how scientists should evaluate the fitness of symbiotic microorganisms. (shrink)

The aim of the article is to explain the relationship between the ethical evaluation of scientific research involving personal data and the assessment of compliance with data protection law. The article presents the mutual relationship between the protection of personal data and scientific activity from a dogmatic perspective, the legal regulation of the processing of personal data in scientific research, and the so-called research exceptions that apply when data are processed for scientific research. It also covers the importance of meeting (...) the ethical requirements of scientific research in order to profit from the indicated exceptions. Finally, it provides a comparison between the ethical and the legal systems of personal data protection in research (objectives, criteria, authorities, and procedures). (shrink)

The purpose of the paper is to present the challenges and difficulties that may be encountered in the process of the evaluation of qualitative research on sex workers by ethics committees. Such research is usually subject to review by ethics committees because of the risk of harm to participants, who are considered “vulnerable”. At the same time, due to the social stigma arising from the provision of sex services, researchers, research participants, and ethics committee members may have their own ideas (...) and expectations about how ethical research in this area should be conducted. Referring to the experience of researchers from common law countries, this paper will discuss how these expectations and the requirements of ethics committees collide, confronting the researcher with the need to meet the divergent or even contradictory expectations of various social actors. I will also propose alternative procedures for Polish ethics committees to ensure that the process of obtaining their approval is more democratic and open to the diverse needs of both researchers and research participants. (shrink)

Ethics committees enjoy both a long history and a strong presence in Anglophone countries, although simultaneously their functioning provokes debate in the social research community. In this paper, I analyse selected contested issues that revolve around three questions: 1) Who do ethics committees protect, and who should they? 2) Should ethics committees protect all research participants in the same way? 3) When can ethics committees intervene in the methodology of the research project under review? Analysing these disputes is important since (...) it may help to improve the functioning of ethics committees for social research in Poland. Their number has increased significantly in the last decade, but this has not been accompanied by a broader reflection on either their functioning or the concerns associated with this kind of control. (shrink)

This article is of both a historical and philosophical nature. It aims to present the intellectual relationship between the Spanish philosopher José Ortega y Gasset and one of the most influential German thinkers of the first half of the twentieth century, Nicolai Hartmann. It is based on hitherto unknown and unpublished correspondence that the philosophers conducted intermittently between 1907 and 1912. The correspondence was found in the archives of the José Ortega y Gasset – Gregorio Marañón Foundation in Madrid along (...) with other letters that show the relationship between the Spanish author and representatives of the neo-Kantian Marburg School, including its founder Hermann Cohen, as well as Paul Natorp, Ernst Cassirer, and Heinz Heimsoeth. (shrink)

Michal Pruski and Richard C. Playford argue that if partial ectogenesis technology becomes available then it would undermine Judith Jarvis Thomson’s defense of abortion. Thomson argues that even if a fetus has a right to life, this is not a positive right to be given whatever one needs to survive; it is not a right to use the mother’s body or to risk her life without her permission. Pruski and Playford argue that when the risks involved in ectogenesis are comparable (...) to those of abortion, then minimal decency requires gestational mothers to opt for ectogenesis over abortion. This argument hinges on egregious misunderstandings of (1) ectogenesis technology, (2) medical and surgical abortion, and (3) medical consent. (shrink)