Para Unamuno, que concibe al catedrático como un “fraguador de doctrinas”, la asignatura universitaria, ubicada en las antípodas de su concepción en la enseñanza secundaria, debería ser una expresión de una “ciencia viva” o in fieri, y no un repositorio de conocimientos. Con dicha toma de posición, el rector salmantino terminó por oponerse a la ciencia oficial y al dogma científico a favor de una enseñanza de procedimientos. El presente trabajo procura recuperar dicha concepción de asignatura, intentando desvelarla en sus (...) varias dimensiones con vistas a aportar al espacio de la reflexión pedagógica contemporánea las sui generis ideas educativas unamunianas que, por su densidad y sentido, permiten enfocar la asignatura académica no como un espacio de mera instrucción, sino como un momento de investigación de “hipótesis y utopías”. Utilizaremos como metodología de investigación la lectura, el análisis y el comentario del texto unamuniano, cuya contextualización filosófica, educativa e histórica se hace a partir de la oposición que el autor mantiene, dentro de su obra, hacia la pedagogía escolástica, presente en la universidad de su época en la figura del profesor/lector. La gran propuesta unamuniana es, pues, la de que docente y estudiante pierdan sus características clásicas, que les definen como un “templo del saber” y un “botijo vacío”, respectivamente, a favor de una concepción más adaptada a los nuevos tiempos académicos, en que el perenne desarrollo científico y cultural hace obsoletos los contenidos asimilados ayer. (shrink)

Unamuno fue un pensador comprometido con la realidad educativa de su España de finales del siglo XIX y principios del XX. De sus preocupaciones pedagógicas, se destacan sus reflexiones a propósito de la gramática, del latín y del griego. El presente estudio procurará desvelar el leitmotiv de la crítica unamuniana a la forma como dichas asignaturas eran impartidas en su época histórica con vistas a aclarar el alcance teórico de sus propuestas educativas.

Este estudio pretende determinar los tres principios elementales de la ontología filosófica de M. de unamuno, que se podrían cristalizar en los axiomas que presentamos a continuación: (1) “todo el ser se esfuerza indefinidamente por perseverar en ser”; (2) “ser es obrar, y sólo existe lo que obra en cuanto obra”; y (3) “ser es querer ser”. En nuestros análisis enfatizaremos de forma especial los estudios realizados por Mariano Álvarez Gómez, cuya línea de interpretación hemos adoptado en nuestra aproximación al (...) pensamiento del autor. (shrink)

En este estudio, nos proponemos determinar el ideal ético-normativo de la παιδεια unamuniana. Para el rector salmantino, la libertad debería constituir el principio y el fin de todos los esfuerzos educativos, ya sea de los padres, de la Iglesia o del propio Estado. Para concretar dicho ideal creyó necesario, en un primer momento, defender la libertad de enseñanza, que, en su pensamiento, adquiere dos posturas bien distintas si se considera el antes y el después de la Constitución española del 1931, (...) concernientes a su defensa del Estado docente y del Estado organizador de la enseñanza. Una vez asegurado este requisito, de carácter político, creyó que una enseñanza para la libertad, de matriz ético-normativa, debería estructurarse a partir de la afirmación absoluta del libre examen, la conciencia de la ley y la cultura, ya que sólo a través de una libertad así concebida podría asegurarse la autodeterminación profesional, intelectual y espiritual de las jóvenes generaciones. (shrink)

El presente estudio intenta poner de relieve la posición filosófica de don Miguel frente a la “ciencia” y la “religión”. El insigne rector salmantino, al partir del hecho de que la “ciencia” no puede satisfacer las últimas inquietudes y aspiraciones vitales de la existencia humana, presentó la “religión” como único movimiento espiritual capaz de otorgar un sentido ultraterreno al hombre, irremediablemente abocado a la muerte terrenal. Su tesis podría ser condensada en la siguiente proposición: ninguna “sociedad perfecta”, sea entendida como (...) la de Bebel o la de Kropotkine, puede ser una medicina para la muerte. Precisamente, por ello, justificó la existencia y sentido de la “religión” como respuesta más anhelada al tremendo problema de la precariedad y de la finitud de la existencia humana. (shrink)

La misión educativa del maestro, del profesor de primeras letras, fue uno de los temas pedagógicos al que Unamuno, el insigne rector de la Universidad de Salamanca, más páginas de análisis y reflexión dedicó a lo largo de su producción ensayística. El presente artículo, centrado en dicho tema, procura desvelar la concepción unamuniana del maestro, en cuanto a su misión de promover la formación de una concepción unitaria del saber en sus alumnos. Para nuestro autor, la fragmentación del saber era (...) un grave error educativo al que había que combatir con vehemencia. En contra de dicha fragmentación, propuso, inspirado en su formación romántica, una visión holista e integrada de los saberes impartidos en clase a partir de la cosmovisión étnica del pueblo español (intrahistoria). No pudiendo haber educaciones ideológicamente neutrales, sólo el trasfondo espiritual de la comunidad patria a la que el alumno pertenece podría unificar el saber escolar que tendría siempre que ser consustancial al espíritu del propio pueblo (Volksgeist) en cuanto expresión individualizada del alma de la propia humanidad (Allgeist). Y es aquí donde se hace sentir la educación de talante nacionalista propuesta por Unamuno, siendo cierto que lo nacional en el autor es siempre concebido como puerta para lo universal. (shrink)

En este estudio, que intenta analizar la relación que Unamuno mantuvo con las pedagogías vigentes en España a finales del siglo XIX y principios del XX, procuraremos determinar los aspectos que han alejado al insigne rector salmantino de los métodos pedagógicos de los jesuitas (emulación), de la escolástica (retórica) y de las Escuelas del Avemaría (juego), que, como es bien sabido, han estructurado la enseñanza en España durante el susodicho período. Pero, más allá de su enfoque histórico, este estudio permitirá (...) también la comprensión filosófica de lo que es la educación, y la tarea de educar, que, según su peculiar visión pedagógica, debe estructurarse bajo un horizonte espiritual, donde profesor y alumno se han de concebir como padre e hijo en espíritu. Unamuno, al definir de este modo los agentes del acto educativo, terminó por determinar la formación ético normativa de la persona como telos pedagógico por excelencia de la escuela. No nos extraña, pues, que don Miguel se haya alejado del ideal educativo alemán (Fachmann), el del doctor especialista, a favor del ideal educativo inglés (Gentleman), que ha aceptado sin reservas como eje filosófico de su pensamiento educativo. (shrink)

Los principios ontológicos de la unidad y continuidad del ser constituyen los dos rasgos fundamentales de la categoría de la identidad dentro del pensamiento filosófico del autor. La importancia de los mismos se manifiesta, desde el primer momento, en el hecho de que su antropología filosófica esté polarizada a partir de las categorías de la identidad, alteridad y diferencia ontológicas. Dado que la complejidad del pensamiento unamuniano no nos permite, en un único estudio, el análisis conjunto de las tres categorías, (...) optamos por centrarnos en la categoría de la identidad y en sus principios de unidad y continuidad del ser que constituyen la dimensión más positiva de su proyecto antropológico. (shrink)

En el presente estudio procuraremos determinar los dos ejes de la ética unamuniana, que, al estar vinculados con el dualismo antropológico “yo-íntimo” y “yo-público”, podríamos condensar en los conceptos de “bondad” y “obra”. Unamuno, en cuanto heredero del romanticismo y del existencialismo, consideró que lo fundamental, en términos axiológicos, era que los individuos aprendiesen a “ser buenos” y no a “hacer [meramente] el bien”, ya que solo a través de la pureza del sentir, es decir, de la “bondad ética”, el (...) “sujeto moral” podría constituirse como una “persona” a través de sus “obras”. En este aspecto, la relación de la ética unamuniana con los “oficios” es decisiva, ya que cada “individuo” a través de su “profesión” está llamado a formar su “persona”. (shrink)

Este estudio constituye un intento hermenéutico de lectura de la doctrina darwiniana de la evolución, de sus implicaciones filosóficas y de sus interpretaciones en el contexto español de finales del siglo XIX y principios del siglo XX, según la perspectiva del rector unamuno. Se trata, pues, de analizar la interpretación que el autor realiza de la figura y de la obra del naturalista inglés a partir de los textos que tratan el tema de forma explícita y que se ubican entre (...) los años 1882 y 1912. (shrink)

En este artículo nos proponemos exponer los rasgos esenciales de la poiesis educativa de Unamuno, en su aspecto demagógico* o demopédico*. Por cuestiones metodológicas, expondremos, en primer lugar, las razones que nuestro autor ha sostenido para legitimar la necesidad de dicha educación, que debería alejarse del especialismo* germánico (Fachmann), con vistas a determinar las técnicas de enseñanza de su labor educativa popular, que, en su pensamiento, asume rasgos esencialmente ético-normativos (Gentleman).

En este artículo, intentamos recuperar los aspectos de la reflexión unamuniana acerca del tema educativo que fueron olvidados por el grueso de sus comentaristas. Unamuno, en cuanto pensador, no quiso proponer una teoría educativa. Sin embargo, al reflexionar autobiográficamente sobre los demás aspectos de su vida, en cuanto persona, estudiante, profesor, catedrático y rector, se detuvo sobre una infinidad de temas pedagógicos que, leídos en su conjunto, nos ponen en contacto con un pensamiento bastante desarrollado en sus aspectos teórico-conceptuales. Aquí, (...) daremos voz a algunos aspectos de su pensamiento antropagógico, que el autor cristalizó en sus escritos autobiográficos; nos referimos en concreto a las bibliotecas, a las academias de arte, a las asociaciones infantiles y a los movimientos religiosos en cuanto instancias educativas. (shrink)

Comprehensive in scope and research, this book will be a crucial resource for researchers in the medical sciences, as well as teachers and students alike.

INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...

Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

All investigators funded by the National Institutes of Health are now required to receive training about the ethics of clinical research. Based on a course taught by the editors at NIH, Ethical and Regulatory Aspects of Clinical Research is the first book designed to help investigators meet this new requirement. The book begins with the history of human subjects research and guidelines instituted since World War II. It then covers various stages and components of the clinical trial process: designing the (...) trial, recruiting participants, ensuring informed consent, studying special populations, and conducting international research. Concluding chapters address conflicts of interest, scientific misconduct, and challenges to the IRB system. The appendix provides sample informed consent forms. This book will be used in undergraduate courses on research ethics and in schools of medicine and public health by students who are or will be carrying out clinical research. Professionals in need of such training and bioethicists also will be interested. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

1. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, Department of Health and Human Services, or any of the authors affiliated organizations.

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...) disadvantage, equal moral concern, reciprocity, and instrumental value. These values are universal. None of the values are sufficient alone, and their relative weight and application will vary by context. In addition, there are procedural principles such as transparency, engagement, and evidence-responsiveness. Prioritising instrumental value and minimising harms during the COVID-19 pandemic led to widespread agreement on priority tiers to include health-care workers, first responders, people living in congregate housing, and people with an increased risk of death, such as older adults and individuals with medical conditions. However, the pandemic also revealed problems with the implementation of these values and priority tiers, such as allocation on the basis of population rather than COVID-19 burden, and passive allocation that exacerbated disparities by requiring recipients to spend time booking and travelling to appointments. This ethical framework should be the starting point for the allocation of scarce medical resources in future pandemics and other public health conditions. For instance, allocation of the new malaria vaccine among sub-Saharan African countries should be based not on reciprocity to countries that participated in research, but on maximally reducing serious illness and deaths, especially among infants and children. (shrink)

We argue that charging people to participate in research is likely to undermine the fundamental ethical bases of clinical research, especially the principles of social value, scientific validity, and fair subject selection.

This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...) "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. -/- "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University . (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...) disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles. (shrink)

Our Viewpoint argues that expanding access to less effective or more toxic treatments is supported not only by utilitarian ethical reasoning but also by two other ethical frameworks: those that emphasise equality and those that emphasise giving priority to the patients who are worst off. The inadequate resources available for global health reflect not only natural constraints but also unwise social and political choices. However, pitting efforts to reduce inequality and better fund global health against efforts to put available resources (...) to their best use mistakes complementary objectives for conflicting ones. (shrink)

The understanding of appropriate ethical protections for participants of biomedical research has not been static. It has evolved over time, with the evolution of biomedical research as well as social values. Since World War II, there have been four major paradigms of research and research oversight operative in the United States. These paradigms incorporate different values and provide different approaches to research oversight and the protection of research participants.