In this article I argue for an interpretive approach to bioethics with critically ill children. I begin by highlighting the dominant Anglo-American bioethical framework that defines standards for ethical care in critically ill children and then outline a critique of this framework. Drawing predominantly on the ideas of Charles Taylor, Michael Walzer and Richard Zaner, I call for a reconception of bioethics and propose an interpretive ‘thick’ framework that is centred on culture and context. Finally, I illustrate this interpretive approach (...) through a comparative study of two cases in pediatric intensive care: the narratives of Marc and Larry. These case studies reveal that ethical dilemmas in pediatric critical care can be traced to relational tensions over respect, trust and power rooted in the disparity of moral horizons among the persons involved. (shrink)

Accepted standards of parental decisional autonomy and child best interests do not address adequately the complex moral problems involved in the care of critically ill children. A growing body of moral discourse is calling for the recognition of `tragedy' in selected human problems. A tragic dilemma is an irresolvable dilemma with forced terrible alternatives, where even the virtuous agent inescapably emerges with `dirty hands'. The shift in moral framework described here recognizes that the form of conduct called for by tragic (...) dilemmas is the practice of phronesis. The phronetic agent has acquired a capacity to discern good agency in tragic circumstances. This discernment is practiced through the artful creation of moral narratives: stories that convey that which is morally meaningful in a particular situation; that is, stories that are `meaning making'. The phronetic agent addresses tragic dilemmas involving children as a narrator of contextualized temporal embodied human (counter)stories. (shrink)

Oscar de Beaux was professor of Zoology at Genova University and then director of Civil Museum of Natural History in the same town. The first contributions of de Beaux which included elements of biological ethics concerned the european bison of Bialowieza and the brown bear of the Alps between 1923–1929. In 1930 de Beaux published his most important study called “Biological ethics: an attempt to arouse a naturalistic conscience”, translated also in german (1932) and in english (1933). According to Oscar (...) de Beaux, biological ethics is the study and definition of man's moral position before the living beings which do not belong to the humane race, beginning with the morale premise that man was not able to create the species. With these outlook, man takes on a decisively active and intelligent position regarding the problem of conserving nature and its resources; on the basis of this definition of morality man becomes the wise administrator of life on earth. (shrink)

This article reviews empirical evidence and ethical norms in cross-linguistic nursing. Empirical evidence highlights that linguistic barriers between nurses and patients can perpetuate discrimination and compromise nursing care. There are significant organizational and relational challenges involved in ensuring adequate use of interpreters by nurses. Some evidence suggests that linguistic barriers are particularly problematic for nurses when compared with physicians. A comparative analysis of nursing ethical norms for cross-linguistic nursing was conducted using the codes of ethics of the American Nurses Association, (...) the Canadian Nurses Association, and the International Council of Nurses. Five principal ethical norms for cross-linguistic nursing were identified: (1) respect for the patient as a unique person; (2) respect for the patient’s right to self-determination; (3) respect for patient privacy and confidentiality; (4) responsibility for one’s own competence, judgment, and action; and (5) responsibility to promote action better to meet the needs of patients, families, and groups. (shrink)

The aim of this article is to highlight the under-recognized merits of clinical ethics committees (CECs), to help ensure that the development of roles for clinical ethics consultants do not unwittingly compromise the valuable contributions that CECs can continue to provide. I argue that CECs can offer distinctive contributions to the clinical ethics consultation process that can complement and enrich the input provided by a clinical ethics consultant. These distinctions and complementarities should be further examined and developed. This will help (...) to optimize the synergistic contributions that CECs and clinical ethics consultants can make to promote the ethical treatment of patients and their families. (shrink)

Among Benjamin Libet's experiments on the relationship between consciousness and neural activity, those pointing at a substantive difference between subjective timing of a sensory experience and the experimental measure of the time needed to produce that experience appear particularly interesting. From a subjective standpoint, one is immediately conscious of a sensory experience, whereas, as a result of objective measured time of reaction, unconscious neural activation in the presence of a sensory stimulus begins 500 msec before one being aware of the (...) stimulus. In order to compensate this discrepancy, Libet introduces the notion of antedating. However, there is no fully satisfactory answer to the question about the conditions of possibility for antedating. Therefore, the very notion of antedating is highly problematic, though not infertile: the paradoxes present in this conception foster a profound review of the meaning of our experience of time and of the relationships between objective and subjective time. (shrink)