A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics (...) of health care. The moral status of any system of managed care ought to be judged with respect to its congruence with Gospel teachings about the care of the sick, Papal Encyclicals, and the documents of the Second Vatican Council. In this essay, I look at the important conceptual or definitional issues of managed care, assess these concerns over against the source and content of a Catholic ethic of health care, and outline the necessary moral requirements of any licit system of health care. (shrink)

Following up on a 1989 paper on the subject, this essay revisits the question of ethical expertise in the court room. Informed by recent developments in the use of ethics experts, the authors argue 1) that the adversarial nature of court proceedings challenges the integrity of the ethicist's pedagogical role; 2) that the use of ethics experts as normative authorities remains dubious; 3) that clarification of the State's interest in “protecting the ethical integrity of the medical profession” is urgently required; (...) and 4) that the expertise of the ethicist may be more appropriately used in advising the legislature than in influencing the court. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

In this paper, two different axiologies of pleasure are attributed to Hutcheson and Mill. Hutcheson endorsed a hedonist axiology, where quality of pleasure works as a still quantitative factor, able to counterbalance other quantitative features of pleasurable mental states - such as intensity and duration. By contrast, in Mill's view of value, the quality of pleasures is the only value-making feature, silencing any contribution from other quantitative elements. Therefore, the presence of certain qualitative characteristics - namely, the connection of certain (...) pleasures with human active faculties - becomes a necessary and sufficient condition of value. Due to this unique role of quality, Mill's axiology opens the way to non-pleasurable experiences being valuable - for non-pleasurable exercises of the human active faculties meet the condition to be valuable states. Thus, Mill's theory of value is declared non-hedonistic - against the recent claims to the contrary put forth by W. Donner. (shrink)

The moral authority for professional ethics in medicine customarily rests in some source external to medicine, i.e., a pre-existing philosophical system of ethics or some form of social construction, like consensus or dialogue. Rather, internal morality is grounded in the phenomena of medicine, i.e., in the nature of the clinical encounter between physician and patient. From this, a philosophy of medicine is derived which gives moral force to the duties, virtues and obligations of physicians qua physicians. Similarly, an ethic specific (...) to the other healing professions, law, teaching or ministry, can be derived from the specific ends to telos of each of these professions, which like medicine, are focused on a special type of human relationship. (shrink)

Questo saggio ha come oggetto di riflessione i conflitti ambientali, i nuovi soggetti politici che ne sono protagonisti e le visioni collettive che paiono centrarsi in maniera inedita sulla cattiva gestione delle risorse locali e sui conseguenti rischi per la salute pubblica. Nuovi soggetti politici appunto che operano l'articolazione fra discorsi scientifici e discorsi politici. A partire da alcuni casi di studio l'articolo conduce una breve analisi sulle forme argomentative adottate da questi gruppi, sulle modalitÀ di intendere il rapporto con (...) le istituzioni democratiche e con la scienza, sui processi interni di leadership e sull'idea di ‘rivolta' da condurre. (shrink)

Il saggio introduce le tematiche di questo numero, soffermandosi in particolare sulla rilevanza etica e politica del cambiamento climatico. Dopo una rapida spiegazione dell'effetto serra naturale e artificiale, si ripercorrono le teorie che concepiscono il cambiamento climatico come un problema di giustizia distributiva. Secondo alcuni autori queste teorie non sono sufficienti per dare strumenti adeguati, perché il cambiamento climatico rappresenta un problema etico nuovo, che richiede una strumentazione etica inedita. Il saggio approfondisce alcune delle caratteristiche nuove dell'etica del cambiamento climatico, (...) soprattutto in relazione all'impatto che le scelte presenti avranno sulla qualitÀ della vita delle generazioni future. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

O presente artigo tem como objetivo analisar a cooperação militar entre Brasil e Suriname. Nas últimas décadas a América do Sul tornou-se plataforma estratégica de inserção internacional, modernização da defesa nacional e amadurecimento das relações regionais nos temas de segurança e defesa. Nosso recorte temporal é entre o ano de 1975, ano de independência do Suriname e de inicio de suas relações diplomáticas com o Brasil, até o ano de 2014, final do primeiro mandato da presidente Dilma Rousseff. A metodologia (...) consistiu em análise bibliográfica, levantamento e análise dos acordos de cooperação militar entre o Brasil e Suriname, análise documental e de declarações oficiais, discursos e posicionamentos dos atores sociais e políticos da região sobrea cooperação militar. Nossa análise demonstra que mesmo o Suriname apresentando uma baixa interação diplomática com o Brasil, o país ocupa posição de destaque na cooperação militar. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Origins and Evolution of Bioethics: Some Personal ReflectionsEdmund D. Pellegrino (bio)AbstractBioethics was officially baptized in 1972, but its birth took place a decade or so before that date. Since its birth, what is known today as bioethics has undergone a complex conceptual metamorphosis. This essay loosely divides that metamorphosis into three stages: an educational, an ethical, and a global stage. In the educational era, bioethics focused on (...) a perceived “dehumanization” of medicine by the rising power of science and technology. Remedies were sought by introducing humanities, ethics, and human “values” into the medical curriculum. Ethics was one among the humanistic disciplines, but not the dominant one. In the second era, ethics assumed a dominant role as ever more complex dilemmas emerged from the rapid pace of biological research. As such dilemmas were applied to medical practice, the need for a more rigorous and more formal analysis of their moral status was clear. Philosophically-trained ethicists had an obvious role. They began to teach, write, and profoundly influence medical education and practice. In the third—and present—period, the breadth of problems has become so broad that ethicists must, themselves, draw on disciplines well beyond their expertise—e.g., law, religion, anthropology, economics, political science, psychology, and the like. The era of bioethics as a global enterprise is upon us. The original hope for humanizing medicine has not been overtly successful; however, much has been accomplished of value to patients, the profession, and society. Medical morality has been transformed into a formal, systematic study of a whole range of issues of the greatest significance to humanity. Now the major challenge is one of identity, or inter-relationships and connections between the theoretical and the practical. Bioethics has outgrown its beginnings.I have been invited to give a “personal recollection” of the early development of bioethics. Such invitations are notoriously hard to resist, but also problematic when they are the recollections of a participant [End Page 73] in the events to be described. We need only be reminded of the vagaries common to the plethora of memoirs on the book stands today. Few have escaped the perils of selective memory, self-promotion, or the settling of old scores. Yet their perils notwithstanding, memoirs may serve some useful purpose. They are the raw material—verbal kitchen middens so to speak—out of which historians can later sift fact from fancy. They enable “tribal elders” to give witness to the past from which the present can fashion some sense of continuity.I will organize my reflections around three very arbitrary time periods that represent my own way of thinking about the evolution of bioethics: (1) an era of “proto-bioethics” (1960–1972), (2) an era of philosophical bioethics (1972–1985), and (3) an era of global bioethics (1985-present). Each era, of course, overlaps with the others, and the dominant strand of each runs through the others as well.In the proto-bioethics period, the language of human values predominated; in the era of bioethics philosophically construed, it was the language of philosophical ethics; and in the era of bioethics globally construed, the social and behavioral sciences have gained greater prominence. In each period, interest in the traditional humanities other than philosophy waxed and waned. In the earlier years, religion and theology predominated. Beginning in the 1970s, philosophy took a dominant role. In the last two decades, other disciplines, like law, literature, and the social sciences, have exerted more and more influence (McNeur 1963; Pellegrino 1997; Barker 1987).I make no pretense here of writing any part of the formal “history” of bioethics. Works of this nature are beginning to appear (Rothman 1991; Jonsen 1998 ; Dell’Oro and Viafora 1996). Thomas McElhinney and I are preparing our own account of the work and influence of the Institute on Human Values in Medicine, one of the influential programs of the Society for Health and Human Values (Pellegrino and McElhinney, n.d.). Space limitations as well as prudence preclude any attempt to do justice to all the events, institutions, and people who have made the field of bioethics what it is today. I apologize for these omissions, for any unintentional lapses of... (shrink)

Le projet de recherche collaborative intitulé TRACS ( Transatlantic Cultures. Cultural Histories of the Atlantic World 18th – 21st Centuries ) vise à élaborer une plate-forme numérique encyclopédique afin de mettre en œuvre une histoire des circulations culturelles dans l’espace atlantique à l’époque contemporaine dans une perspective pluridisciplinaire associant historiens, anthropologues, sociologues, géographes, musicologues, spécialistes de littérature, d’arts, de théâtre ou encore de cinéma. Si le premier objectif du projet est de décrypter l’économie complexe des échanges entre l’Europe, l’Afrique et (...) les Amériques entre la fin du XVIII et le début du XXI siècles en partant du postulat selon lequel le monde atlantique a été un laboratoire privilégié de la mondialisation culturelle, il propose également une réflexion sur les processus identitaires et les frontières qui ont contribué à l’établissement et à la reconfiguration des grandes aires culturelles, ainsi que sur les régimes circulatoires des pratiques, des savoirs et des représentations d’une rive à l’autre de l’océan sur le temps long des 250 dernières années. Pour mener à bien notre démonstration, nous aborderons trois aspects essentiels : le premier tient à la définition même de l’espace atlantique, à ses lignes de forces et à ses frontières ; le second concerne les temporalités de son histoire, longtemps restreinte à l’époque moderne ; le troisième relève des objets étudiés et de la spécificité de l’histoire culturelle, conçue comme une histoire sociale des représentations, des pratiques et des productions symboliques, face à des approches de nature géopolitique et aux Cultural Studies. (shrink)

Le projet de recherche collaborative intitulé TRACS ( Transatlantic Cultures. Cultural Histories of the Atlantic World 18th – 21st Centuries ) vise à élaborer une plate-forme numérique encyclopédique afin de mettre en œuvre une histoire des circulations culturelles dans l’espace atlantique à l’époque contemporaine dans une perspective pluridisciplinaire associant historiens, anthropologues, sociologues, géographes, musicologues, spécialistes de littérature, d’arts, de théâtre ou encore de cinéma. Si le premier objectif du projet est de décrypter l’économie complexe des échanges entre l’Europe, l’Afrique et (...) les Amériques entre la fin du XVIII et le début du XXI siècles en partant du postulat selon lequel le monde atlantique a été un laboratoire privilégié de la mondialisation culturelle, il propose également une réflexion sur les processus identitaires et les frontières qui ont contribué à l’établissement et à la reconfiguration des grandes aires culturelles, ainsi que sur les régimes circulatoires des pratiques, des savoirs et des représentations d’une rive à l’autre de l’océan sur le temps long des 250 dernières années. Pour mener à bien notre démonstration, nous aborderons trois aspects essentiels : le premier tient à la définition même de l’espace atlantique, à ses lignes de forces et à ses frontières ; le second concerne les temporalités de son histoire, longtemps restreinte à l’époque moderne ; le troisième relève des objets étudiés et de la spécificité de l’histoire culturelle, conçue comme une histoire sociale des représentations, des pratiques et des productions symboliques, face à des approches de nature géopolitique et aux Cultural Studies. (shrink)

: Artificial intelligences and robots increasingly mimic human mental powers and intelligent behaviour. However, many authors claim that ascribing human mental powers to them is both conceptually mistaken and morally dangerous. This article defends the view that artificial intelligences can have human-like mental powers, by claiming that both human and artificial minds can be seen as extended minds – along the lines of Chalmers and Clark’s view of mind and cognition. The main idea of this article is that the Extended (...) Mind Model is independently plausible and can easily be extended to artificial intelligences, providing a solid base for concluding that artificial intelligences possess minds. This may warrant viewing them as morally responsible agents. Keywords: Artificial Intelligence; Mind; Moral Responsibility; Extended Cognition Intelligenze artificiali come menti estese. Perché no? Riassunto: Intelligenze artificiali e robot simulano in misura sempre crescente le capacità mentali e i comportamenti intelligenti umani. Molti autori, tuttavia, sostengono che attribuire loro capacità mentali umane sia concettualmente errato e moralmente pericoloso. In questo lavoro si difende l’idea per cui le intelligenze artificiali possano avere capacità mentali simili a quelle umane, sostenendo che menti umane e artificiali possano essere considerate come menti estese – sulla scorta della prospettiva di Chalmers e Clark circa la mente e la cognizione. L’idea principale alla base di questo lavoro è che il Modello della Mente Estesa abbia plausibilità a prescindere e che possa essere facilmente esteso alle intelligenze artificiali, fornendo una base solida per concludere che le intelligenze artificiali possiedano delle menti e si possano considerare come agenti moralmente responsabili. Parole chiave: Intelligenza artificiale; Mente; Responsabilità morale; Conoscenza estesa. (shrink)

The study of a middle school social studies and literacy project this paper addresses occurred in the national capital region of the United States, where perceptions of “patriotism” and immigration policies were the subjects of frequent media reports. With this examination the authors considered one overarching research question: how do middle school students describe and illustrate citizenship when given access to multimodal texts and media (e.g., digital photography and slam poetry)? The authors called on young adolescents to create slam poems (...) with incorporated images to address the question “What does it mean to be a ‘citizen’?”. The authors examined products of this project, which included surveys and slam poems, to address this research question, identifying findings that might inform social studies educators’ practices and curricula. Employing alternative and multimodal texts motivated students to engage with this project and to more candidly share expansive perspectives about what they believe makes a “citizen”. (shrink)