This chapter contains sections titled: References Further reading.

BackgroundThis paper highlights the issues that one of the 90 Italian Research Ethics Committees (RECs) might encounter during the approval phase of a clinical trial to identify corrective and preventive actions for promoting a more efficient review process and ensuring review quality. Publications on the subject from Italy and the rest of Europe are limited; encouraging constructive debate can improve RECs’ service to the subject of the clinical trial.MethodsWe retrospectively reviewed a cohort of 822 clinical trial protocols, initially (...) reviewed by REC, from June 2014 to December 2018. Data collected for each protocol were type of trial, sample size, use of placebo, number and kind of revisions requested by the REC before approval, and time taken for approval. Data for each protocol were collected by a trained clinical research assistant using the REC’s files and electronic archives.ResultsAlmost 45% of the reviewed studies (374/822) required clarifications, significant changes to the documentation, or minor changes before final approval.ConclusionsPreventive measures are needed to reduce the number of requested corrections and thus also the time required for approval, while maintaining review quality. All critical points and proposals presented in this paper require harmonization through updates to European regulations, as regulatory harmonization produces better compliance with rules and reduces the number of changes required before the trials’ final approval. Such updates include the development of standardized formats for informed consent, the verification of any evidence in favor of using off-label treatments over placebo as comparators, using multidisciplinary staff in clinical trials with children and adolescents, improving the legal definition of RECs to assign responsibilities and ensure independence, and providing guidance for RECs to engage clinical research assistants in internal audits. (shrink)

Rowan Williams's theological-moral reasoning regarding the formation of personal identities in relation to gender, familial and communal ties is analysed in an article review of his book Lost Icons. This is his most sustained essay in theological social criticism, and was intended for the general public beyond academic theology. Williams exposes Christian moral reasoning on these issues to forms of secular critique whilst simultaneously using theological and historical strategies from liberal Anglo-Catholicism. His argumentation is subjected to theological (...) and social-scientific scrutiny. The article calls for closer attention to debates within secular feminism and social research concerning the formation of adult men and women in relation to the wider post-Christian society. Links are made from Williams's thought in Lost Icons to underlying patterns in his academic theological output. (shrink)

The World Health Organisation's programme for the eradication of poliomyelitis as currently practised in India raises many ethical issues. In this paper we concentrate on just two. The first is the balance to be struck between the risks and benefits generated by the eradication programme itself. The issue of risks and benefits arises in relation to the choice between two different vaccine types available for polio programmes: oral polio vaccine (OPV) and inactivated polio vaccine (IPV). OPV is the (...) vaccine currently used in the eradication campaign in India. We argue that given the current risks/benefits profile of this vaccine, there is an urgent need to review the programme and take remedial action to address existing problems (at least in India). The second issue we discuss is the fact that there is little effort to gain the informed consent of the parents of vaccinated children, as they are not currently told about the potential limitations of OPV or the possibility of vaccine-induced harm. We suggest that such a policy might be justifiable, given the importance of polio eradication, but only if there is a system of compensation for vaccine-induced harm as part of the eradication programme itself. There is a real danger that if these issues are not addressed then public trust in the eradication programme and vaccination programmes as a whole will be lost. (shrink)

Wearable and mobile technology has advanced in leaps and bounds in the last decade with technological advances creating a role from enhancing healthy living to monitoring and treating disease. However, the discussion about the ethical use of such commercial technology in the community, especially in minors, is lacking behind. In this paper, we first summarize the major ethical concerns that arise from the usage of commercially available wearable technology in children, with a focus on smart watches, (...) highlighting issues around the consent process, mitigation of risk and potential confidentiality and privacy issues, as well as the potential for therapeutic misconceptions when used without medical advice. Then through a relevant thought experiment we move on to outline some further ethical concerns that are connected to the use of wearables by minors, to wit the issue of informed consent in the case of minors, forcing them to live in the spotlight, and compromising their right to an open future. We conclude with the view that mitigating potential pitfalls and enhancing the benefits of wearable technology especially for minors requires brave and comprehensive moral debates. (shrink)

This article concerns the ways in which authors from various fields conceptualise the ethical issues arising in the conduct of research. We reviewed critically and systematically the literature concerning the ethics of conducting research in order to engage in a reflection about the vocabulary and conceptual categories used in the publications reviewed. To understand better how the ethical issues involved in conducting research are conceptualised in the publications reviewed, we 1) established an inventory of (...) the conceptualisations reviewed, and 2) we critically assessed them. We found that the publications reviewed mostly showed examples of descriptive ethics, in that most authors describe ethical issues without reflecting much on them, which could be explained both by 1) a lack of ethical education in research contexts, and 2) by the fact that we do not know what researchers know (or do not) about ethical issues. Additionally, the definitions identified in the publications are scarce and at times imprecise, but this seems more to point out the ethical vocabulary’s difficulties in certain contexts. Further, very few authors offer proper conceptualisations of the ethical issues arising in conducting research. When dealing with vast arrays of ethical issues to conceptualise, perhaps one ought to remember that some typologies already exist that could guide further reflection and help understand other realities for which the current ethical vocabulary may be lacking. We believe that combining the reviewed typologies, both with other well-developed typologies and critical reflection, could help support better ethical practice in conducting research. (shrink)

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans (...) and possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics. (shrink)

The paper questions current assumptions about the benefits of corporate social responsibility and the claims that corporations make on behalf of their corporate social responsibility programmes. In particular, the paper suggests that the use of corporate social responsibility for public relations ends raises moral problems over the motivation of corporations. The paper cautions that the justifications which corporations employ may either be immoral or inaccurate with regard to the empirical evidence gained from a small-scale qualitative study carried out (...) in the UK at a time when the practice of corporate social responsibility was expanding quickly (1989). It is noticeable, in retrospect, that great emphasis is placed upon environmental rather than social responsibility. This implies that organisations are primarily reactive in their development of corporate social responsibility programmes and that they respond to external pressures rather than working out the nature of their corporate responsibilities. It might suggest that corporations only take such actions when they feel compelled to do so by consumerist and environmentalist lobbies. The paper argues that corporations do need to find moral justifications for their moral activities and to ensure that corporate social responsibility practice lives up to the claims made by public relations practitioners. The paper explores the nature of public relations and illustrates how its responsibility for corporate social responsibility extends beyond truthfulness in publicity. (shrink)

The use of genetically modified plants in agriculture (GM crops) is controversially discussed in academic publications. Important issues are whether the release of GM crops is beneficial or harmful for the environment and therefore acceptable, and whether the modification of plants is ethically permissible per se . This study provides a comprehensive overview of the moral reasoning on the use of GM crops expressed in academic publications from 1975 to 2008. Environmental ethical aspects in the publications were (...) investigated. Overall, 113 articles from 15 ecology, environmental ethics, and multidisciplinary science journals were systematically reviewed. Three types of moral concerns were used to structure the normative statements, moral notions, and moral issues found in the articles: concerns addressing consequences of the use of GM crops, concerns addressing the act (the technique itself), and concerns addressing the virtues of an actor. Articles addressing consequences (84%) dealt with general ecological and risk concerns or discussed specific ecological issues about the use of GM crops. Articles addressing the act (57%) dealt with the value of naturalness, the value of biotic entities, and conceptual reductionism, whereas articles addressing the actor (43%) dealt with virtues related to the handling of risks and the application of GM crops. The results of this study may help to structure the academic debate and contribute to a better understanding of moral concerns that are associated with the key aspects of the ethical theories of consequentialism, deontology, and virtue ethics. (shrink)

A lot of interest has been generated by the possibility of deriving gametes from embryonic stem cells and bone marrow stem cells. These stem cell derived gametes may become useful for research and for the treatment of infertility. In this article we consider prospectively the ethical issues that will arise if stem cell derived gametes are used in the clinic, making a distinction between concerns that only apply to embryonic stem cell derived gametes and concerns that are (...) also relevant for gametes derived from adult stem cells. At present, it appears preferable to use non-embryonic stem cells for the derivation of gametes. Adult stem cell derived gametes do not present any problems with regard to the moral status of the human embryo, bypass the safety risks linked to SCNT and do not present any ambiguity or novel problems with regard to informed consent, psychological consequences for the child or genetic parenthood. A remaining ethical concern, however, regards the safety of the procedure in terms of the welfare of the resulting children. This should spark a thorough reflection on how far one must go to accommodate a person’s wish to have a genetically related child. (shrink)

In the early 2000s, several states legalized marijuana for medicinal uses. Since then, more and more states have either decriminalized or legalized marijuana use for medical or recreational purposes. Federal law has remained unchanged. The state-level decriminalization of marijuana and the concomitant de-stigmatizing and mainstreaming is likely to lead to greater use among the general population, including among nursing mothers. Marijuana is already one of the most widely used illicit substances among lactating women. There exist few studies demonstrating the effects (...) of marijuana in breast milk on nursing babies. In the present context of a changing legal landscape, shifting cultural beliefs, and the absence of clear professional guidelines, healthcare professionals are faced with ethical questions around how best to support nursing mothers and their babies when marijuana use is a factor. This paper first presents an overview of the law, science, and professional guidelines as they relate to marijuana and breastfeeding. Then, I offer an assessment of the relevant ethical issues providers and their patients may need to navigate. (shrink)

The geographically inequitable distribution of physicians has long posed a serious social problem in Japan. The government tackled this problem by establishing and managing Jichi Medical University (JMU) and regional quotas (RQs) for medical schools. JMU/RQs recruit local students who hope to work as physicians in rural areas, educate them for 6 years without tuition (JMU) or with scholarship (RQs), and after graduation, assign them to their home prefectures for 9 years, including 4–6 years of rural service. JMU/RQs entrants now (...) occupy 11.6% of all medical school entrants. While JMU/RQs have been shown to be highly effective in securing physicians for rural areas, ethical issues related to these policies have been raised, such as whether the government truly needs to implement these policies using tax money, and whether it is acceptable to limit the personal freedoms of the physicians. In this paper, we discuss these issues from the perspectives of social justice, utilitarianism, luck egalitarianism, liberty, medical professionalism and consistency with national health insurance and the Japanese Constitution. We conclude that JMU/RQs are necessary and ethically valid policies, and also propose some institutional improvements to better secure the integrity and maturity of these systems. (shrink)

Simona Giordano investigates the moral concerns raised by current clinical options available for transgender and gender diverse children and adolescents. From the time young children express gender incongruent preferences and attitudes, up to the time in which older adolescents might apply for medical or surgical treatment, moral questions are likely to be asked: should children be enabled to express themselves freely inside and outside the domestic environment? What are the implications of the choices that parents might make early on? (...) How should clinicians respond to distress around sexual anatomy? Is it ethical to suspend pubertal development? What level of evidence should we seek for medications to be used in paediatric care? What are the risks and benefits of various forms of hormonal treatment? Is it ethical to defer surgical interventions till adulthood? Giordano provides a detailed ethical analysis of these and many other questions that are likely to arise at various stages of a person's life and proposes a moral formula to answer these questions, as well as others, that are likely to arise in a fast-changing landscape. Children and Gender combines a detailed ethical analysis with an accurate clinical description of gender development and available clinical pathways. (shrink)

BackgroundUmbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico.DiscussionA number of experts have stated that the use of umbilical cord (...) goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord.SummaryConflicts between moral principles and economic interests (non-moral principles) cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks' performance. (shrink)

This chapter examines some of the ethical issues associated with the persistent use of animals in the fashion and cosmetic industries. There are some cultural differences in the construction of what is considered a human need and what is luxury or simply a desire. Fashion and cosmetics are examples of self-determination, and people may also express their membership of a particular gender, indigenous or ethnicity through their fashion. There is discussion of opposition to the killing of animals for (...) fur clothing, and consideration of both the fur trapping industry and factory farm production. Particular issues are also raised through the killing of endangered animals and environmental pollution from tanning industry. There are also animals used for research aimed at increasing the productivity and efficiency of animals to produce fibre and safe ingredients for the cosmetic industry. The desire to dress attractively, and fashionably, is universal and applauded in most cultures, but our use of animals also shapes our moral community, and may also lead to legal reform. (shrink)

Bioethics today has become a subject of wide public concern. Almost every one of its tenets is being seriously questioned and likely to be reformulated. Moreover, the pressure on bioethics continues to mount as the number of moral conflicts that buffet our society increases. What, then, will bioethics look like a decade from now? In the variety of approaches that have been employed in the practice of bioethics, one has dominated in the United States in the last decade (...) and a half. That approach is "principlism", the use of moral principles to address theoretical issues and to resolve conflicts at the bedside. Recently, however, bioethicists and others increasingly have realized the limitations of principlism and are calling for the development of alternative approaches such as phenomenology, hermeneutics, narrative ethics, casuistry, and virtue ethics. This book maps the debate over principlism and the future direction of U.S. bioethics. Part One consists of a sociological description of U.S. bioethics at the beginning of the 1990s, along with a defense of principlism by one of its major proponents. Part Two maps cross-cultural critiques of principlism, while Part Three covers five alternatives to it. Three essays in Part Four - by a bioethicist, a physician, and a theologian - reflect on the future of U.S. bioethics, principlism, and its alternatives. The Afterword emphasizes the place of religion and theological discourse in the alternative approaches and in the future of bioethics. (shrink)

Given the evolution of the public health (PH) and the changes from the phenomenon of globalization, this area has encountered new ethical challenges. In order to find a coherent approach to address ethical issues in PH policy, this study aimed to identify the evolution of public health ethics (PHE) frameworks and the main moral values and norms in PH practice and policy. According to the research questions, a systematic search of the literature, in English, (...) with no time limit was performed using the main keywords in databases Web of Science (ISI) and PubMed. Finally, the full text of 56 papers was analyzed. Most of the frameworks have common underpinning assumptions and beliefs, and the need to balance PH moral obligation to prevent harm and health promotion with respect for individual autonomy has been specified. As such, a clear shift from liberal values in biomedical ethics is seen toward the community’s collective values in PHE. The main moral norms in PH practice and policy included protecting the population against harm and improving PH benefits, utility and evidenced-based effectiveness, distributive justice and fairness, respect for all, privacy and confidentiality, solidarity, social responsibility, community empowerment and participation, transparency, accountability and trust. Systematic review of PHE frameworks indicates utilization of the aforementioned moral norms through an practical framework as an ethical guide for action in the PH policy. The validity of this process requires a systematic approach including procedural conditions. (shrink)

Social experimental research commonly employs media to elicit responses from research subjects. This use of media is broadly protected under fair use exemptions to copyright, and creators of content used in experiments are generally not afforded any formal consideration or protections in existing research ethics frameworks. Online social networking sites are an emerging and important setting for social experiments, and in this context the material used to elicit responses is often content produced by other users. This article argues that (...) users may have a reasonable interest in controlling the use of their content in experiments conducted in online social networks. Matters of risk and autonomy in research ethics are explored by analogy to active debates in law over adhesion contracts, moral rights, and the right to be forgotten. The article concludes by considering practical difficulties in identifying and protecting the interests of creators. (shrink)

ObjectiveTo present the ethical issues, moral arguments, and reasons found in the ethical literature on organoid models.DesignIn this systematic review of reasons in ethical literature, we selected sources based on predefined criteria: The publication mentions moral reasons or arguments directly relating to the creation and/or use of organoid models in biomedical research; These moral reasons and arguments are significantly addressed, not as mere passing mentions, or comprise a large portion of the body of work; The publication (...) is peer-reviewed and published in an academic article, book, national-level report, working paper, or Ph.D. thesis; The publications collected are in English.AnalysisEach article was read in-depth for identifiable moral reasons, arguments, and concerns. These were then inductively classified and synthesized to create broader categories of reasons, and eventually an overarching conceptual scheme was created.ResultsA total of twenty-three sources were included and analyzed out of an initial 266 collected sources. Five themes of ethical issues and arguments were found: Animal Experimentation; Clinical Applications and Experiments; Commercialization and Consent; Organoid Ontology and Moral Status; and Research Ethics and Research Integrity. These themes are then further broken down into sub-themes and topics. Given the extensive nature of the topics found, we will focus on describing the topics that comprised of more in-depth reasons and arguments rather than few, passing mentions or concerns.ConclusionsThe ethics of organoids requires further deliberation in multiple areas, as much of the discussions are not presented as in-depth arguments. Such sentiments are also echoed throughout the organoid ethics literature. (shrink)

The term "false memories" has been used to refer to suggestibility experiments in which whole events are apparently confabulated and in media accounts of contested memories of childhood abuse. Since 1992 psychologists have increasingly used the term "false memory" when discussing memory errors for details, such as specific words within word lists. Use of the term to refer to errors in details is a shift in language away from other terms used historically (e.g., "memory intrusions"). We empirically examine this (...) shift in language and discuss implications of the new use of the term "false memories." Use of the term presents serious ethical challenges to the data-interpretation process by encouraging over-generalization and misapplication of research findings on word memory to social issues. (shrink)

The aim of this article is to argue, by example, for neuroethics as a new way of doing ethics. Rather than simply giving us a new subject matter—the ethical issues arising from neuroscience—to attend to, neuroethics offers us the opportunity to refine the tools we use. Ethicists often need to appeal to the intuitions provoked by consideration of cases to evaluate the permissibility of types of actions; data from the sciences of the mind give (...) us reason to believe that some of these intuitions are less reliable than others. I focus on the doctrine of double effect to illustrate my case, arguing that experimental results suggest that appeal to it might be question-begging. The doctrine of double effect is supposed to show that there is a moral difference between effects that are brought about intentionally and those that are merely foreseen; I argue that the data suggest that we regard some effects as merely foreseen only because we regard bringing them about as permissible. Appeal to the doctrine of double effect therefore cannot establish that there are such moral differences. (shrink)

Digitization of a health record changes its accessibility. An electronic health record (EHR) can be accessed by multiple authorized users. Health information from EHRs contributes to learning healthcare systems’ development. The objective of this systematic review is to answer a question: What are ethical issues concerning research using EHRs in the literature? We searched Medline Ovid, Embase and Scopus for publications concerning ethical issues of research use of EHRs. We employed the constant comparative method to (...) retrieve common ethical themes. We descriptively summarized empirical studies. The study reveals the breadth, depth, and complexity of ethical problems associated with research use of EHRs. The central ethical question that emerges from the review is how to manage access to EHRs. Managing accessibility consists of interconnected and overlapping issues: streamlining research access to EHRs, minimizing risk, engaging and educating patients, as well as ensuring trustworthy governance of EHR data. Most of the ethical problems concerning EHR-based research arise from rapid cultural change. The framing of concepts of privacy, as well as individual and public dimensions of beneficence, are changing. We are currently living in the middle of this transition period. Human emotions and mental habits, as well as laws, are lagging behind technological developments. In the medical tradition, individual patient’s health has always been in the center. Transformation of healthcare care, its digitalization, seems to have some impacts on our perspective of health care ethics, research ethics and public health ethics. (shrink)

The emergence of implantable drug delivery systems will allow us to produce the effects of psychosurgery and surgical sterilization without their irreversible invasions of bodily integrity. However, this clinical advantage does not resolve the most important ethical problems these surgeries face, and may even obscure them when they arise in the practice of drug implantation.

: Common morality theory must confront apparent counterexamples from the history of morality, such as the widespread acceptance of slavery in prior eras, that suggest core norms have changed over time. A recent defense of common morality theory addresses this problem by drawing a distinction between the content of the norms of the common morality and the range of individuals to whom these norms apply. This distinction is successful in reconciling common morality theory with (...) practices such as slavery, but only at the cost of underscoring the limits of common morality theory, in particular its inability to resolve disputes about the moral status of entities. Given that many controversies in bioethics center on the disputed status of various entities, such as embryos and nonhuman animals, this is an important limitation. Nonetheless, common morality theory still can be a useful resource in diminishing moral conflict on issues that do not involve disputes over moral status. (shrink)

BackgroundHIV molecular epidemiology is increasingly recognized as a vital source of information for understanding HIV transmission dynamics. Despite extensive use of these data-intensive techniques in both research and public health settings, the ethical issues associated with this science have received minimal attention. As the discipline evolves, there is reasonable concern that existing ethical and legal frameworks and standards might lag behind the rapid methodological developments in this field. This is a follow-up on our earlier work that (...) applied a predetermined analytical framework to examine the perspectives of a sample of scientists from the fields of epidemiology, public health, virology and bioethics on key ethical issues associated with HIV molecular epidemiology in HIV network research.MethodsFourteen in-depth interviews were conducted with scientists from the fields of molecular epidemiology, public health, virology and bioethics. Inductive analytical approaches were applied to identify key themes that emerged from the data.ResultsOur interviewees acknowledged the potential positive impact of molecular epidemiology in the fight against HIV. However, they were concerned that HIV phylogenetics research messages may be incorrectly interpreted if not presented at the appropriate level. There was consensus that HIV phylogenetics research presents a potential risk to privacy, but the probability and magnitude of this risk was less obvious. Although participants acknowledged the social value that could be realized from the analysis of HIV genetic sequences, there was a perceived fear that the boundaries for use of HIV sequence data were not clearly defined.ConclusionsOur findings highlight distinct ethical issues arising from HIV molecular epidemiology. As the discipline evolves and HIV sequence data become increasingly available, it is critical to ensure that ethical standards keep pace with biomedical advancements. We argue that the ethical issues raised in this study, whether real or perceived, require further conceptual and empirical examination. (shrink)

“Ethics” is used as a label for a new kind of expertise in the field of science and technology. At the same time, it is not clear what ethical expertise consists in and what its political status in modern democracies can be. Starting from the “participatory turn” in recent social research and policy, we will argue that bioethical reasoning has to include public views of and attitudes towards biomedicine. We will sketch the outlines of a bioethical conception (...) of “public understanding of ethics,” addressing three different issues: the methodological relevance of moral questions and problems raised by lay persons in everyday life regarding biomedicine and technology, the normative relevance of such lay moralities for the justification of ethical decisions, and the necessity of public deliberation in this context. Finally, we draw conclusions in view of the concepts and methods such a conception of “public understanding of ethics” should employ. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.1 (2004) 47-54 [Access article in PDF] Ethical Guidelines for Human Embryonic Stem Cell Research*(A Recommended Manuscript) Adopted on 16 October 2001Revised on 20 August 2002 Ethics Committee of the Chinese National Human Genome Center at Shanghai, Shanghai 201203 Human embryonic stem cell (ES) research is a great project in the frontier of biomedical science for the twenty-first century. Be- cause the research (...) involves the use of human embryos, it triggers serious debate on ethical issues. Opponents consider the embryo to be an early form of human life that should be respected and not destroyed. However, the majority of scientists support embryonic stem cell research, believing that it offers good prospects for the treatment of diseases that have remained incurable until now and so will benefit humankind. The Ethics Committee of the Department of Ethical, Legal, and Social Implications of the Chinese National Human Genome Center at Shanghai seriously discussed the ethical debate initiated by embryonic stem cell research. We concluded that we should support the scientists of our country in actively carrying out human embryonic stem cell research for the noble cause of "medicine being a beneficent art." For the healthy and orderly development of human embryonic stem cell research in our country, we put forward the following recommended Ethical Guidelines for Human Embryonic Stem Cell Research as a reference for leaders, administrative departments, and related scientists. Preface Article 1. Human embryonic stem cells are the primitive cells that play the main role in the growth and development of a human body. These [End Page 47] primitive cells have the potential for infinite proliferation, self-renewal, and multi-directional differentiation. If scientists can discover the mechanism of differentiation of human embryonic stem cells, it will be possible to induce differentiation of human embryonic stem cells to form various types of human cells for clinical cell therapy. If human embryonic stem cell research can be integrated with modern biomedical engineering techniques, it also will be possible to make repair and replacement of human tissues and organs a reality. Article 2. There are two ways to classify human embryonic stem cells. One way is to classify them according to their potential for differentiation. There could be three kinds of stem cells: totipotent stem cells, pluripotent stem cells, and unipotent stem cells.A totipotent stem cell has the potential to develop into a whole individual. It can differentiate into the more than 200 cell types in the whole body, construct any tissue or organ of the body, and finally develop into a whole individual. The fertilized egg and the cleavage cells at the very early stage of embryonic development are totipotent stem cells.A pluripotent stem cell has the potential to differentiate into many cell types derived from the three embryonic layers. However, it has lost the capacity to develop into a complete organism.A unipotent stem cell is derived from the further differentiation of the pluripotent stem cell. It can differentiate only into one cell type such as a hematopoietic stem cell, neural stem cell, and others.The other way is to classify human stem cells according to their source. There could be two kinds of human stem cells: embryonic stem cells and tissue stem cells (also called adult stem cells). The former involves experimentation with embryos, which has serious ethical implications. Ethical issues associated with the latter are mainly expressed in the various opinions regarding the allocation of health resources. Article 3. Human embryonic stem cells are the group of cells called the blastocyst inner cell mass during the early stage of embryonic development. They are the main source of totipotent stem cells, and hence the focal and hot point in stem cell research. Studies on the clinical application of embryonic stem cells probably will involve use of the somatic cell nucleus transfer (SCNT) technique, which destroys the early human embryo. At present, the ethical and moral debate is very serious in human embryonic stem cell research regarding whether the research will develop... (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and (...) medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns between individuals with more certainty brings a new sense (...) of urgency to already difficult ethical issues associated with privacy, consent and a moral obligation to avoid spreading a disease. It is therefore important that professionals reflect on the ethical implications of using these techniques in outbreak management, in order to be able to formulate the conditions under which they may be applied in public health practice. (shrink)

The outsourcing of medical research has become a strategic imperative in the global pharmaceutical industry. Spurred by the challenges of competition, the need for speed in drug development, and increasing domestic costs, pharmaceutical companies across the globe continue to outsource critical parts of their value chain activities, namely contract clinical research and drug testing, to sponsors across the globe, typically into emerging markets. While it is clear that important ethical issues arise with this practice, unraveling moral responsibility and (...) the allocation of responsibility is not so clear, considering that contracts, by their very definition transfer responsibility from the principal to the agent. This research provides a framework for exploring some of the ethical issues, including attributions of moral responsibility associated with Contract Medical Research. Using a theory of strategic and moral behavior, the research shows that both clients and sponsors in contract research have individual and collective responsibility to ensure that due care and diligence is exercised in the performance of clinical research. The research suggests some guidelines for stakeholder action. (shrink)

The advent and growth of bioethics in the United States in the late 1960s and early 1970s precipitated an era of public moral discourse, that is, the deliberate attempt to analyze and formulate moral argument for use in public policy. The language for rational discussion of moral matters evolved from the parent disciplines of moral philosophy and theological ethics, as well as from the idioms of a secular, pluralistic world that was searching for policy answers to (...) difficult bioethical questions. This article explores the basis and content of the unique contributions of both theological and philosophical ethics to the development of public moral discourse. (shrink)

This paper examines the ethical issues of the inclusion of workers with disabilities in the workplace with a cross-fertilization approach between organization studies, the ethics of care, and a movement from the field of architecture and design that is called Universal Design (UD). It explores how organizations can use UD to develop more inclusive workplaces, first by applying UD principles to workspaces and second by showing how UD implies an integrative understanding of inclusion from the workspace (...) to the workplace. Moreover, this paper discusses the ethical challenges and complexities that this design practice faces in regard to its applicability to diverse organizations and industries. Finally, this paper demonstrates that inclusion requires abandoning any notion of a perfect, productive body and, therefore, recognizing our shared vulnerability and fundamental interdependence in the workplace. (shrink)

Background At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response. This ‘resetting’ of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into routine healthcare practices. We draw on data collected as part of the ‘NHS Reset Ethics’ (...) project, which explored the everyday ethical challenges of resetting England’s NHS maternity and paediatrics services during the pandemic. Methods Healthcare professionals and members of the public participated in interviews and focus group discussions. The qualitative methods are reported in detail elsewhere. The focus of this article is our use of Frith’s symbiotic empirical ethics methodology to work from our empirical findings towards the normative suggestion that clinical ethics should explicitly attend to the importance of relationships in clinical practice. This methodology uses a five-step approach to refine and develop ethical theory based on a naturalist account of ethics that sees practice and theory as symbiotically related. Results The Reset project data showed that changed working practices caused ethical challenges for healthcare professionals, and that infection prevention and control measures represented harmful barriers to the experience of receiving and offering care. For healthcare professionals, offering care as part of a relational interaction was an ethically important dimension of healthcare delivery. Conclusions Our findings suggest that foregrounding the importance of relationships across a hospital community will better promote the ethically important multi-directional expression of caring between healthcare professionals, patients, and their families. We offer two suggestions for making progress towards such a relational approach. First, that there is a change of emphasis in clinical ethics practice to explicitly acknowledge the importance of the relationships (including with their healthcare team) within which the patient is held. Second, that organisational decision-making should take into account the moral significance afforded to caring relationships by healthcare professionals, and the role such relationships can play in the negotiation of ethical challenges. (shrink)

A comprehensive study of the ethics of killing in cases in which the metaphysical or moral status of the individual killed is uncertain or controversial. Among those beings whose status is questionable or marginal in this way are human embryos and fetuses, newborn infants, animals, anencephalic infants, human beings with severe congenital and cognitive impairments, and human beings who have become severely demented or irreversibly comatose. In an effort to understand the moral status of these beings, this book develops and (...) defends distinctive accounts of the nature of personal identity, the evaluation of death, and the wrongness of killing. The central metaphysical claim of the book is that we are neither nonmaterial souls nor human organisms but are instead embodied minds. In ethical theory, one of the central claims is that the morality of killing is not unitary; rather, the principles that determine the morality of killing in marginal cases are different from those that govern the killing of persons who are self‐conscious and rational. Another important theme is that killing in marginal cases should be evaluated in terms of the impact it would have on the victim at the time rather than on the value of the victim's life as a whole. What primarily matters is how killing would affect that which would be rational for the victim to care about at the time of death. By appealing to various foundational claims about identity, death, and the morality of killing, this book yields novel conclusions about such issues as abortion, prenatal injury, infanticide, the killing of animals, the significance of brain death, the termination of life support in cases of persistent vegetative state, the use of anencephalic infants as sources of organs for transplantation, euthanasia, assisted suicide, and advance directives in cases of dementia. In particular, the book defends the moral permissibility of abortion, infanticide, and euthanasia in certain cases and argues that brain death is not the appropriate criterion of death either for a person or a human organism. (shrink)

As a result of the increase in genetic testing and the fear of discrimination by insurance companies, employers, and society as a result of genetic testing, the disciplines of ethics, public health, and genetics have converged. Whether relatives of someone with a positive predictive genetic test should be notified of the results and risks is a matter urgently in need of debate. Such a debate must encompass the moral and ethical obligations of the diagnosing physician and the (...) patient. The decision to inform or not will vary depending on what moral theory is used. Utilising the utilitarian and libertarian theories produces different outcomes. The principles of justice and non-maleficence will also play an important role in the decision. (shrink)

"Many of today's moral conflicts concerning family values and medical ethics have their basis in different conceptions of man and the nature and purpose of human life. Fr Bristow argues that contemporary utilitarianism and the various forms of permissive morality are insufficient for dealing with these matters and that only a natural law morality is adequate to the needs and dignity of the human person. He goes on to apply its principles to the issues that derive (...) class='Hi'>from advancing technology, such as genetic engineering, in vitrio fertilization, embryo research, drugs and painkillers and ecology."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Advances in transplantation have extended the life and relieved the suffering of thousands of individuals. The prospect of being able to use tissues from embryos, as well as from anencephalic newborns, offers the promise of further relief of suffering. However, these possibilities raise significant moral and public policy issues. The question arises of the extent to which those who disapprove of abortion may make use of tissues derived from abortion in order to treat serious diseases. (...) This essay argues that, with proper safeguards, such tissue can be used without cooperating in abortion. That is, even those who oppose abortion can benefit from the use of tissue procured during abortion. Questions also arise regarding the probity of maintaining a pregnancy in order to produce an anencephalic newborn whose biological existence will be maintained so as better to secure organs once death is declared. It is argued that, since no harm can be done to a being that has neither a sense of self or the capacity to feel pain, and since women have a right to forego abortions, there is no legitimate ground for opposing women's seeking meaning in their pregnancy through maximizing the opportunity of others to use the organs of their anencephalic newborn once death has been declared. Finally, it is argued that, since the capacities for sentience, a minimal condition for personhood, are never realized by an anencephalic, the entity has never been alive as a person. Therefore, there should be no opposition in principle to aborting anencephalics nor, after proper declaration, to making their organs available as one would after whole-brain death, despite the continued functioning of the brain stem. (shrink)

Debates concerning mask wearing continue in Japan. Here we critically examine the reasons for relaxing these regulations from a public health ethics perspective. We focus on three issues: government responsibility, political motivation, and cultural orientation, also discussing how these issues might have broader application in other parts of the world.

Food production, water management, land use, and animal and public health are all topics of extensive public debate. These themes are linked to the core activities of the agricultural sector, and more specifically to the work of farmers. Nonetheless, the ethical discussions are mostly initiated by interest groups in society rather than by farmers. At least in Europe, consumer organizations and animal welfare and environmental organizations are more present in the public debate than farmers. This is (...) not how it should be. First, because consumers often cannot but rely on agriculture. Second, because recent research shows that farmers have moral beliefs and convictions that appear to be broader than economic considerations and that are—to a certain extent—specific to their profession. This raises the question how to make input from farmers operational in the public debates on the future of farming. We discuss one option: entrusting farmers with professional autonomy concerning moral matters related to farming. We sketch the historical background of the current situation in which farmers are relatively silent on moral matters and we present some clear indications that farmers have values and moral beliefs that are relevant for the public debate. Next the concepts of professionalism and professional autonomy are discussed and applied to the practice of farming. Finally, we discuss the relevance and limits of professional moral autonomy for the agricultural profession. We close with an overview of what this moral autonomy implies for and requires from farmers in practice. We conclude that if some preconditions are met by farmers, then this type of moral autonomy can be relevant for farmers and for society, and contributes to the quality of the public debate on the future of farming. (shrink)

Currently whole world is facing immense crisis caused by the unprecedented pandemic coronavirus disease 2019 (COVID-19). This pandemic with its unique features has raised distinct ethical issues and the whole scenario has altered according to its pressing novel features. This paper aims to analyze the emerging ethical issues raised by the recent worldwide pandemic outbreak of SARS-COV-2. I have differentiated and analyzed the unprecedented emerging ethical issues from three aspects. First, there are (...) class='Hi'>ethical issues which arise due to the sudden imposition of preventive measures such as isolation, quarantine, and social distancing by public health authorities. It is indeed problematic to suddenly adopt the ‘new normal’ in our usual social life. Secondly, there are moral dilemmas which occur when physicians and health care workers try to maintain just allocation of the limited medications to treat large number of patients. Finally, the challenge of policy makers on the effective implementation of the policies that gain trust from people. Here, the role of administrative policy makers is to recognize the moral values in decision-making within the ethically challenging situations when the usual approved behaviors are dangerous to others. I analyze the importance of the virtue of solidarity, benevolence, honesty, and equity to deal with this crisis. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, (...) were addressed.Results: Non-maleficence was the most frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

“Ethics” is used as a label for a new kind of expertise in the field of science and technology. At the same time, it is not clear what ethical expertise consists in and what its political status in modern democracies can be. Starting from the “participatory turn” in recent social research and policy, we will argue that bioethical reasoning has to include public views of and attitudes towards biomedicine. We will sketch the outlines of a bioethical conception (...) of “public understanding of ethics,” addressing three different issues: (a) the methodological relevance of moral questions and problems raised by lay persons in everyday life regarding biomedicine and technology, (b) the normative relevance of such lay moralities for the justification of ethical decisions, and (c) the necessity of public deliberation in this context. Finally, we draw conclusions in view of the concepts and methods such a conception of “public understanding of ethics” should employ. (shrink)

The Ethics of Governance: Moral Limits of Policy Decisions offers a toolbox drawn from normative ethics which finds applications in public governance, primarily focusing on policy making and executive action. It includes ethical concepts and principles culled from different philosophical traditions, ranging from more familiar Western theories to non-Western ethical perspectives, thereby providing a truly global, decolonized and expanded normative lens on issues of governance. The book takes a unique and original approach; it (...) demonstrates the use of the ethical toolbox in the context of actual examples of governance challenges. Taking three major case studies each representing an aspect of human-human and/or human-nature and/or human-animal relationship, the book attempts to show the significance of public practical reasoning in policy decisions with the aim of arriving at reasonable responses. Acknowledging the challenges that policy makers often face, the book highlights the fact that policy making is hardly an exercise yielding a black-or-white solution; rather it involves finding the most reasonable normative outcome in a given situation, especially employing an expanded understanding of values including well-being, sustainability, interdependence and community. This effort that helps bridge the gap between ethical theorists and policy practitioners exemplifies the necessary role of ‘engaged philosophy’ in public governance. In the major case studies, Boxes offer facts and figures along with pertinent ethical questions that have been raised and discussed. Aiming to aid the engagement of a diverse audience including non-philosophy readers, each chapter also includes Boxes containing examples, shorter case studies, at-a-glance charts, and tables with comprehensive ethical tools for a quick recap. (shrink)

Moral status is the moral value that something has in its own right, independently of the interests or concerns of others. Research using human embryonic stem cells implicates issues about moral status because the current method of extracting hESCs involves the destruction of a human embryo, the moral status of which is contested. Moral status issues can also arise, however, when hESCs are transplanted into embryonic or fetal animals, thereby creating human/ nonhuman stem cell chimeras. In particular, one (...) concern about chimera research is that it could confer upon an animal the moral status of a normal human adult, but then impermissibly fail to accord the animal the protections it merits in virtue of its enhanced status. Understanding the public policy implications of this ethical conclusion is complicated by the fact that certain views about the moral status of the embryo cannot legitimately be used to justify public policy decisions. Arguments like those employed in the abortion debate for the conclusion that abortion should be legally permissible even if abortion is not morally permissible also support, to a more limited degree, a liberal policy on hESC research involving the creation of chimeras. (shrink)

BackgroundHuman embryonic stem cells are currently used for developing treatment against Parkinson’s disease (PD). However, the use of ES cells is surrounded with moral concerns. Research regarding the public's attitudes can form an important basis for policymaking. The aim was to explore the perceptions of the public on using donated human embryos for developing treatment of Parkinson’s Disease.MethodsSemi-structured individual qualitative interviews were conducted with 11 members of the general population in Sweden. Interviews were analyzed with thematic content analyses.ResultsFour (...) categories and additional sub-categories; Different views on the embryo requires delicacy, Using embryos to treat Parkinson’s disease, Doing things in the right way, and Communication, media, and public opinion. In general, respondents were positive towards the usage of embryotic stem cells to treat PD, but the usage were conditioned and specific terms were demanded. Informed consent from both donors were required and delicacy and sensitivity when working with embryos were needed.ConclusionsIt was perceived better to use surplus embryos to treat PD increase is than to discard them, also among those who perceived the embryo as “a potential life.” The participants raised several conditions under usage for treatment should be allowed. Even if the embryos otherwise are going to be discarded, usage requires informed consent from the donating couples. (shrink)

The study of social, ethical, and political issues from a naturalistic perspective has been pervasive in social sciences and the humanities in the last decades. This articulation of empirical research with philosophical and normative reflection is increasingly getting attention in academic circles and the public spheres, given the prevalence of urgent needs and challenges that society is facing on a global scale. The contemporary world is full of challenges or what some philosophers have called ‘existential risks’ (...) to humanity. Nuclear wars, natural and/or engineered pandemics, climate change, global totalitarianism, and emergent technologies, are some of the challenges mentioned by many authors devoted to the study of long-term potential risks for the survival of the human species. However, while there are many reasons to be a pessimist about the future of humanity, there is also a lot of ink wasted in showing that the world today is far better than we had in the past and also that there have been many instances of social and moral progress in the last centuries. Some authors have even claimed that “we have made more progress over the last 100 years than in the first 100,000”. According to ‘our world in data’, some of the most relevant advances of humanity in the last centuries have to do with the reduction of poverty and/or inequality, better health and security, the decline of violence and war, and the development of democracy and institutional mechanisms to guarantee individual freedom and rights. Yet, there is a more concrete concern that our world faces nowadays, and requires a particularly detailed analysis. In a few words, the advance in information and communication technologies, the huge volume of people migration because of prevalent instances of global inequality, and the reality of an interconnected world that just mirrors an extensive history of massive human intergroup relations open the question about the feasibility of social and moral progress in the contexts of diverse, multicultural, and unequal societies. This makes it crucial to reflect not only on whether human societies may keep advancing on a path of social progress, but how this can be achieved by addressing the challenges of inequality and potential intergroup conflict. This concern closely relates to the further consolidation of democratic values and the achievement of a more generalized consideration of the equal moral value of human individuals far from group, ethnic, or collective distinctions. This vision of progress follows the moral convictions that have been considered right and worthy to be pursued by most ethical theories explored by philosophers and social scientists so far. This work aims to contribute to the study of the mechanisms and feasibility of social and moral progress grounded on the precept of human equality and is guided by the idea that social and moral progress in a plural world requires the accomplishment of a more democratic and tolerant society. These forms of progress have already been defined by philosophers Allen Buchanan and Russel Powell as inclusivist forms of moral progress. According to these authors, inclusivist moral progress is featured by the transformation of moral judgments, motivations, and norms guided by the rejection of “group-based restrictions on moral standing and moral status” (2018). The work of Buchanan and Powell is fundamental for the argumentation developed in this work since they have pioneered a more complex debate in the field of evolutionary social sciences and philosophical anthropology. In brief, these authors have inquired how human nature, conceptualized by the advances in evolutionary thinking and the empirical sciences, is related to our moral convictions and the possibilities that we have to establish certain forms of social and moral progress. The work of Buchanan and Powell contributes to the debate on moral progress by incorporating empirically-informed concepts and arguments. With this objective in mind, they develop their discussion around a generalized tension between exclusivist and inclusivist forms of moral progress. This tension revolves around the question of whether and to what extent human moral concerns, motivations, and norms, are limited or bounded by social identities, group thinking, or collective values. This question is at the center of this work. In other words, I aim to answer whether and to what extent the nature of our social and moral cognition hinders or enables the development of inclusivist forms of morality and moral progress. As I mentioned so far, the distinction between exclusivist and inclusivist forms of morality has a practical implication and facilitates the reflection on the mechanisms and feasibility of concrete forms of progress based on the precept of human equality, which is the road to progress that we should follow according to most ethical theories. The distinction between exclusivist and inclusivist morality is not used here as a form of summarizing highly divergent descriptive approaches to morality, but as a way to address the practical implications of morality research, particularly around the question of the feasibility of social forms of progress based on the precept of equality and tolerance. My objective then has less to do with offering a conceptualization of human morality or with the proposition of a new ethical perspective. Instead, I aim to identify, from an empirically informed perspective, what enables the achievement of egalitarian forms of social progress, to subsequently offer a normative reflection about what we should do if we want to accomplish such inclusivist forms of progress. This task is of great relevance, having in mind that some theoretical proposals on the matter have claimed that human prosocial behavior and morality are constrained by exclusivist fixed tendencies as a product of our evolutionary history. According to these views, human morality is a group-centered cognitive and behavioral expression that has severe limits in its scope and extent, which hinders in the end the emergence of inclusivist forms of moral concerns and behaviors. These claims align with the philosophical intuition about the ‘dissociation of empathy’, or the fact that human individuals tend to express empathy and sympathy preferably for members of their group whereas their empathic and moral concern and recognition for outgroup individuals tend to be reduced or eliminated in real-life social interactions. Multiple theorists have expressed, however, that these assumptions are wrong for empirical and philosophical reasons, which results in a serious challenge to the conception of human morality as exclusivist by nature. Furthermore, simple intuition and practical experience constantly show us that human individuals can develop and endorse a broad spectrum of moral considerations and adopt an arguably inclusivist stance concerning the kind of persons or agents that deserve moral concern. Moreover, and adopting a historical perspective, the expansion of cultural and commercial exchanges, the consolidation of democracy, the development of welfare states, or the emergence of institutions based on the concept of universal human rights, have partially driven human progress based on the impartial concern for the well-being of persons. These historical instances of cultural evolution and institutional design have shown that it is feasible to promote behaviors and attitudes grounded in impersonal prosocial and inclusivist principles. This optimistic perspective, however, still begs the question of the exact relationship between social, cultural, and historical contexts, and the emergence of certain behavioral expressions of inclusivist morality. This is crucial since a great number of human individuals around the world still do not make part of these instances of social progress, and some authors have suggested that such instances of social and moral progress are particularly favored by the contexts of the WEIRD world, that is the world of Western, Educated, Industrialized, Rich, and Democratic societies. Some of these approaches consider moral inclusivity a ‘luxury good’ and follow the ‘dependency thesis’ according to which the expression of moral inclusivity depends on the presence of very concrete material conditions that trigger inclusivist and impersonal prosocial tendencies that human beings are not able to express in threatening contexts without physical security. This thesis is problematic for various reasons and has led to incomplete explanations about the enabling and causal factors of inclusivist moral progress, as well as unsatisfactory suggestions about what we should do to foster the accomplishment of more generalized instances of progress based on inclusivist concerns. In an attempt to contribute to this debate, the main objective of this thesis is to offer an alternative proposal about the nature of human morality and a more detailed reflection on what we should do if we want to further accomplish such instances of progress. More precisely, this work adopts a particular developmental and constructivist vision of human morality to answer the question of how feasible it is to reach generalized forms of social progress based on the precepts of moral inclusivity. Furthermore, it offers some ideas about what are the most adequate and favorable conditions to foster such progress both at the individual and the collective level. At this point, a preliminary clarification of some starting points is necessary. In the first place, and contrary to what other authors have proposed when debating moral progress from an empirically-based approach, my perspective adopts a radical developmental and constructivist perspective, following particularly the conceptual and empirical ideas of the social-domain theory in moral psychology. From this perspective, morality is a domain of normative and social knowledge that develops and emerges in human interactions. Moral concerns, judgments, and norms are not only the result of the expression of innate adaptive intuitions, nor the product of social conformity and a simple process of mirroring the normativity that communities have established to organize their social life. Human individuals, instead, construct moral concerns and judgments during their situated interactions. More specifically, the constructivist tradition claims that we need to research how moral concerns, judgments, and reasons emerge in social interactions and how human beings construct the content of their moral knowledge in the first place. Based on these ideas, morality is defined here as the result of a constructive process through which human individuals, by the means of constant interactions on a background of mutual respect and recognition, develop evaluative concerns about how we ought to treat others, and how to ‘care’ and ‘respect’ others’ well-being, needs, and vulnerabilities. This developmental-constructivist theory of human psychology contributes to an alternative understanding of the origins of moral variability and informs a very particular normative stance about the most desirable contexts needed for the urgent accomplishment of inclusivist forms of morality in contemporary societies. This is so given that the very same definition of morality adopted presupposes the feature of inclusivity. The main objective of this work is then to argue, based on a developmental perspective, what are the most favorable conditions to foster the development of moral inclusivity and what we should do to accomplish concrete instances of moral progress that truly help us to overcome our most urgent moral challenges. The whole thesis is organized as follows. In part I, I show how received visions about human social evolution have informed conceptions of morality as an adaptive function evolved to solve the challenges of cooperative life. Based on these assumptions, some theories argue that human morality is limited by the boundaries of group thinking, and always obeys the mandates of collective interests and the will of the majority. However, this conception has problematic implications from a normative and ethical perspective. The aim of Chapter 1 is to present this introductory debate in detail. In chapter 2, I consider a relevant amount of scientific evidence that helps to consolidate a more optimistic and inclusivist perspective about the starting conditions of human prosocial behavior. Later, I will summarize some ideas offered to explain the possible evolutionary mechanisms that led to the consolidation of these inclusivist capacities. However, I will also show how evolutionary theories that share the same adaptationist foundations but initially seem relevant to explain the feasibility of moral inclusivity, result incomplete when considering the complexity of moral behavior and its ethical implications. Part II is devoted to presenting a developmental alternative to the adaptationist versions around the starting conditions of morality. In this section, I first summarize the epistemological, conceptual, and empirical basis of a constructivist perspective already proposed by several authors in the last decades. This is the goal of chapter 3. More precisely, I adopt the conceptualization of morality established by the social-domain theory school and clarify its conception of the situated development of moral concerns, motivations, and norms. All these ideas are essential for my argumentation on the feasibility of inclusivist moral progress offered later. Chapter 4 provides a more detailed idea of constructivist thinking about moral development, by analyzing one particular dimension: the development of moral concerns for fairness and the sense of justice in distributive dilemmas. In Part III, I assume a constructivist perspective on morality to contribute to the philosophy of moral progress. In particular, I discuss the implications of such a perspective for the conceptualization of human moral nature and discuss what are the most favorable conditions for moral inclusivity to emerge. Answering that question is of enormous relevance since favoring the transition of human societies towards more inclusivist forms of moral concern and behavior supposes a more generalized accomplishment of our most urgent moral convictions. Previous developmental or culturally-sensible attempts to explore this issue are already on the market. As mentioned before, most authors have approached the topic by situating the cultural evolution and development of (inclusivist) moral progress in the WEIRD world. For instance, some of these authors claim that very concrete material conditions (mostly present in the Western World) have been necessary for triggering inclusivist and impersonal prosocial tendencies that human beings are not able to express in threatening contexts without physical security. Despite their interest in explaining inclusivist morality and the feasibility of inclusivist forms of progress following a naturalistic and culturally situated approach, these theories are problematic for two main reasons. In the first place, most of the authors that explain moral progress tend to focus exclusively on the consolidation of liberal values in the Western world and the underlying adoption of laws, social-epistemic practices, and public narratives about tolerance and inclusivity, as unequivocal signs of inclusivist morality. Nevertheless, there is an enormous distance between the institutional and public support of inclusivist moral values or the construction of public images of tolerance and inclusivity, and the real materialization of impersonal moralities in situated social interactions. Secondly, the variability of human moral behavior is far bigger than most of the theories in moral psychology and moral progress tend to assume. Accordingly, inclusivist and exclusivist forms of morality may develop simultaneously in similar or divergent geographical and socio-ecological environments, including those with harsh conditions such as competition for scarce resources, potential intergroup conflict, and risks of disease transmission. In addition, harsh environmental conditions are usually present in almost all societies around the globe, and the presence of socio-ecological conditions such as physical security and prosperity, predominant in highly resourced populations, do not prevent the existence of exclusivist moral tendencies. My model explores a different perspective on the relationships between cultural, institutional, and historical factors, and the situated development of human morality. This supposes a clear distinction from previous approaches to the matter since it offers a different view on what we should do to pursue further instances of inclusivist social progress. In the fifth chapter, I first analyze the proposals of some defenders of the ‘dependency’ theory. The attention is focused on the ‘Evolutionary Developmental Model’ proposed by Buchanan and Powell (2018). Based on a critique of this approach, I will argue that to explain the evolution and development of human morality in its multiple manifestations, it is essential to put focus on social interactions. This also involves a different perspective on human-environment relations that in line with a constructivist worldview makes an innovative contribution to the philosophy of moral behavior and moral progress. Later, in the sixth chapter, I will define my alternative relational view of inclusivist morality and I will offer my view on how to establish favorable conditions that make inclusivist morality possible. Complementing the constructivist approach, my conception is based on the essential role of equality and individuality and on how moral inclusivity is favored if moral concerns do not develop driven by the accomplishment of group-centered, binding, and communitarian concerns and values. In brief, my relational model suggests that the accomplishment of moral inclusivity not only depends on the overall achievement of certain levels of physical security or economic prosperity. Instead, its development is favored by transforming the interactional contexts in which moral concerns towards autonomy and individuality emerge. In arguing so, I will need to start with a critique of contemporary situated and embodied approaches in ethics. Then, I will show how societies guided by the accomplishment of group-centered values of power, dominance, and relational inequality tend to express exclusivist moral behaviors, while individualistic societies tend to be more inclusivist. Starting from this diagnosis, my final attempt is then to reflect on which are the best conditions for the moral valuation of individuality to emerge and what we should do to promote the accomplishment of moral inclusivity at the societal level. (shrink)

The literature concerning ethical issues associated with nanotechnologies has become prolific. However, it has been claimed that ethical problems are only at stake with rather sophisticated nanotechnologies such as active nanostructures, integrated nanosystems and heterogeneous molecular nanosystems, whereas more basic nanotechnologies such as passive nanostructures mainly pose technical difficulties. In this paper I argue that fundamental ethical issues are already at stake with this more basic kind of nanotechnologies and that ethics impacts every kind of (...) nanotechnologies, already from the simplest kind of engineered nanoproducts. These ethical issues are mainly associated with the social desirability of nanotechnologies, with the difficulties to define nanotechnologies properly, with the important uncertainties surrounding nanotechnologies, with the threat of ‘nano-divide’, and with nanotechnology as ‘dual-use technology’. (shrink)

The scientific evidence and understanding underpinning societal responsibility for the accelerating pace of climate change has become increasingly strong over the past hundred years. Although many nations have begun to take actions that have the potential to eventually slow the pace of change, contention over the issue continues in the United States, particularly in the nation's capital. A major cause appears to arise from different interpretations of the evidence arising from different perspectives on the issue, including those (...) of the scientific, environmental, fossil-fuel generating, technological, economic and ethical communities. In addition, the public encounters a cacophony of intermixed perspectives from the media and elected officials. While each perspective provides some useful insights, each alone contributes to inhibiting development of the national political consensus needed to responsibly address climate change. Without leadership that balances and reconciles competing perspectives, it is unlikely that a sufficient limiting of emissions will be enacted to prevent significant changes in climate that will impose increasing challenges for those in both developing and developed nations. (shrink)

The Heart of What Matters shows that literature has a powerful and unique role to play in understanding life's deepest ethical problems. Anthony Cunningham provides a rigorous critique of Kantian ethics, which has enjoyed a preeminent place in moral philosophy in the United States, arguing that it does not do justice to the reality of our lives. He demonstrates how fine literature can play an important role in honing our capacity to see clearly and choose wisely as he develops (...) a moral philosophy that engages with our intimate emotional concerns. Written in an accessible style and drawing from a provocative body of contemporary literature, this book shows how moral philosophy can reach a far wider audience than it has. -/- In part one of this book, Cunningham sketches out the theoretical basis for a redefined conception of moral philosophy. In part two, he engages in extended analyses of novels that address significant life and character issues, specifically Kazuo Ishiguro's The Remains of the Day, Toni Morrison's Beloved, and Zora Neale Hurston's Their Eyes Were Watching God and Seraph on the Suwanee. Cunningham shows exactly how works like these can inform moral philosophy. Drawing from film, history, psychology, and other social sciences in addition to literature, this book adds to the growing number of works that use literature for ethical analysis and to the growing controversy over Kantian ethics. (shrink)

During the last decade neurotransplantation has developed into a technique with the possible potential to repair damaged or degenerating human brain. Effective neurotransplantation has so far been based on the use of fetal brain tissue derived from aborted embryos or fetuses. The ethical issues related to this new therapeutic approach therefore not only concern the possible adverse side effects for a neural graft-receiving patient, but also the relationship between the requirements for fetal tissue and the decision-making process (...) for induced abortion. Although for decades human embryos and fetuses have been the subject of biomedical studies, and, in principle, their use has therefore not been seen as ethically objectionable, the above points made it necessary to reconsider the moral issues. The present paper points out several of these issues, both from the donor and acceptor (patient) point of view. The conclusion is that under a series of restrictions intended to prevent the use of grafts from encouraging induced abortions and to maintain high standards of respect for life and human dignity, neurotransplantation using embryonic or fetal brain tissue parts cannot be rejected on moral grounds. (shrink)