Ex-vivo tissue engineering is an emerging medical technology. Its aim is to regenerate tissues and organs and to restore them to full physiological activity. Some clinical trials with human tissue engineered products have been conducted and others will follow. These trials not only have to confirm the therapeutic value of the HTEP, they also have to provide insight in its regenerative activity, its safety and long-term effects. The development of these trials is aggravated by the complexity of the tissue engineering (...) process and product. This paper investigates how this complexity influences the ethical conduct of clinical trials with HTEPs. We focus on the value and validity of the trial, the risk-benefit ratio and the protection of the trial participant. We argue that trials with HTEPs need a robust methodology. The risk-benefit ratio of a new HTEP must be determined and compared with available efficacious therapies. This requires the identification and minimisation of risks associated with tissue engineering. Finally a process as complex as tissue engineering presents serious challenges for the informed consent process, and for the protection of the trial participant during and after the trial. (shrink)

Ex-vivo tissue engineering is a quickly developing medical technology aiming to regenerate tissue through the introduction of an ex-vivo created tissue construct instead of restoring the damaged tissue to some level of functionality. Tissue engineering is considered by some as a new medical paradigm. We analyse this claim and identify tissue engineering’s fundamental characteristics, focusing on the aim of the intervention and on the complexity and continuity of the process. We inquire how these features have an impact not only on (...) the scientific research itself but also on the ethical evaluation of this research. We suggest that viewing tissue engineering as a new medical paradigm allows us to develop a wider perspective for successful investigation instead of focusing on isolated steps of the tissue engineering process in an anecdotal way, which may lead to an inadequate ethical evaluation. We argue that the concept of tissue engineering as a paradigm may benefit the way we address the ethical challenges presented by tissue engineering. (shrink)

There are at least three objections that are commonly made against personalist ethics. Two of those objections which I will not deal with here are that personalism has a tendency to become individualism, a view that stems from a too narrow concept of the person, and that personalism pays insufficient attention to individual, `objective' acts viewed apart from the persons who perform them. While each of these objections deserves separate treatment, I believe that they are easily resolvable on the basis (...) of an adequate and integrated exposition of personalist ethics itself.A third objection against personalist ethics, increasingly heard from specialists in the field of environmental ethics is that personalism is, or at least has a tendency to become, `anthropocentric' and is therefore ill suited to deal with environmental issues. This is based upon the suggestion that personalists automatically presume that the environment exists solely for the purpose and convenience of serving humankind and individuals. Thus, all other creatures are subordinated to human needs and desires. By corollary, something like `rights' will belong exclusively to human beings, and any notion of animal rights or the rights of the environment or a pre-existing eco-system will be categorically denied.The logical starting point for responding to a criticism of any form of ethics would be to determine what that particular form of ethics stands for. Such a determination will sometimes refer to the content of an ethic, while at other times the primary concern will be turned toward method. Thus, the description of a `natural law ethics' would highlight content, in the form of some concept of nature, be this the so-called natural world or human nature, and would emphasize the need to respect the givens of such a system to act ethically. The determination of what constitutes a `consequentialist ethics' would concentrate on method, asking how one isolates and evaluates the consequences of human activity. It is therefore immediately evident that the determination of one `ethics' as opposed to another does not necessarily address the same types of questions. (shrink)

The Concept of Intrinsic Evil and Catholic Theological Ethics examines the origin and meaning of the concept of intrinsic evil and its use in sexual ethics in the teachings of the Catholic Church, and in the construction of a systematic approach to theological ethics. It concludes with a suggestion of how the concept might be used in future ethical discourse.

Ethical questions rarely present themselves in an abstract manner. Situations we encounter in our daily personal and professional lives sometimes cause us to hesitate, to reflect, even for a moment, about the ethical quality of possible modes of acting or withholding action . These situations can be relatively trivial, encountered with such frequency that we do not give them much thought . However, they can also be the origin of major questions that propose clear ethical issues, but that do not (...) immediately include any indication of how we should deal with them .In some cases we can consult existing guidelines, either those which are specifically enumerated, for example by an ethics committee or an existing statement of policy, or those guidelines which are ‘commonly known’, often referred to as ‘common sense’, ‘rules of behavior’, or simply, ‘the way things are done’. Where we get the tools to evaluate ethical issues is only infrequently discussed or raised to the conscious level. And yet it is the tools that we use, the manner of approaching an ethical question, that will most likely influence the kind of response we will tend to give for an ethical dilemma.As already stated, most ethical questions arise in a context, in a situation. As a result, one can easily get the impression that the issue at hand is unique, that this ethical question is one that belongs to a particular area of life, and therefore that only an understanding that is firmly based in this specialized area is capable of responding adequately to the problem. Thus we see the growth of a number of specialized ‘ethics’ — medical ethics, business ethics, political ethics, the ethics of journalism, etc. — frequently accompanied by a specific ‘ethical code’.To the extent that the analysis of any issue, question or ethical dilemma demands that one have control of the facts of the case presenting itself, it is true that specific questions need to be approached with an adequate amount of specific competence . However, the common ground of these types of issues is their ethical nature. The question might realistically be put whether there is ‘one’ ethics which can guide us to an adequate response to most any question, or whether there are ‘many’ ethics, each specific to the area in which it is being called forth.The professional, or competent person, in any given field will tend to suggest that the ethical concerns s/he deals with can only be comprehended by someone who is thoroughly versed in that particular field. As far as comprehension of the facts is concerned, there appears to be little ground for arguing the point. Nevertheless, one could still ask about the basis upon which even the professional ethicist will make his/her judgments. Are the rules and structures of ethical codes still so specific that they apply only to one area of human behavior? (shrink)

The Second Vatican Council called for a fundamental renewal of Catholic theological ethics. That project, however, has not been realized primarily because of the strong defence of a normative, act-centred understanding of morality defended by Pope Paul VI and his successor, Pope John Paul II. Reframing Theological Ethics aims to overcome that impasse by arguing for a change in the method of ethical reasoning, emphasizing the replacement of the norm of natural law with that of the human person, integrally and (...) adequately considered, and elaborating an innovative theory of virtue. The paradigm of complementary virtues presented in this book is developed for the first time and allows the ethicist to flesh out the meaning and contours of the ends or goals of ethical living and decision-making. The study concludes with suggestions about how this approach may converge with the insights of normative ethics and achieve the renewal called for fifty years ago. (shrink)

When it comes to dealing with population growth, there are a number of misconceptions about the position of the Catholic Church. Official teaching during the twentieth century gradually moved toward the acceptance of limiting family size and endorsed the concept of responsible parenthood during the Second Vatican Council. One cannot, therefore, justifiably claim that the church is against birth control. It is an entirely different matter, however, when it comes to the practical question about how a couple might go about (...) regulating fertility. Since the publication of Pope Paul VI's 1968 encyclical, an intense controversy has taken place within the church about the use of artificial contraception. Behind that controversy lies an important methodological issue. For, the traditional teaching to which Paul VI returned in his letter was based upon the presumption that it is possible to morally judge a physical, material act without any consideration of the persons who performed that act, the circumstances within which it took place, or the reasons why the act was chosen. This behavioural approach to morality stands in some contrast to the way that other moral questions are dealt with. Inflicting pain or even taking a person's life, for instance, can be justified for a good reason when one acts in a virtuous manner to instil discipline or safeguard justice. Until this methodological controversy is addressed, the problem of using artificial means to regulate fertility will not be resolved. A helpful key for solving the methodological ambiguities is to use moral language in a consistent and understandable manner. (shrink)

The Papal Encyclical Veritatis Splendor (1993) proposes a model of moral theology based on the notion of universal and unchanging ethical principles that guide the Christian moral life. It also helps to clarify a number of questions about the moral teachings of the Post-Vatican II Church. But Veritatis Splendor has not been received without some serious criticisms. Among the various reservations about the encyclical are that it misrepresents the current state of the questions in contemporary moral theology, that it parodies (...) the positions of a number of responsible moral theologians, and that it offers a vision of moral-theological issues that does not correspond to the world with which most professional and pastoral workers are familiar. The contributors to this volume - all leading professional Roman Catholic theologians - clearly interpret various key statements made by Veritatis Splendor and assess the overall accuracy of the encyclical's moral vision. In the process these essays also demonstrate the true significance of this important Church document for Christians today. (shrink)

(1982). TWENTY SIGNIFICANT POINTS IN THE THEOLOGY OF MARRIAGE AND THE FAMILY PRESENT IN THE TEACHING OF “GAUDIUM ET SPES”. Bijdragen: Vol. 43, No. 4, pp. 412-441.

Knee proprioception deficits and neuroplasticity have been indicated following injury to the anterior cruciate ligament. Evidence is, however, scarce regarding brain response to knee proprioception tasks and the impact of ACL injury. This study aimed to identify brain regions associated with the proprioceptive sense of joint position at the knee and whether the related brain response of individuals with ACL reconstruction differed from that of asymptomatic controls. Twenty-one persons with unilateral ACL reconstruction of either the right or left knee, as (...) well as 19 controls matched for sex, age, height, weight and current activity level, performed a knee joint position sense test during simultaneous functional magnetic resonance imaging. Integrated motion capture provided real-time knee kinematics to activate test instructions, as well as accurate knee angles for JPS outcomes. Recruited brain regions during knee angle reproduction included somatosensory cortices, prefrontal cortex and insula. Neither brain response nor JPS errors differed between groups, but across groups significant correlations revealed that greater errors were associated with greater ipsilateral response in the anterior cingulate, supramarginal gyrus and insula. This is the first study to capture brain response using fMRI in relation to quantifiable knee JPS. Activated brain regions have previously been associated with sensorimotor processes, body schema and interoception. Our innovative paradigm can help to guide future research investigating brain response to lower limb proprioception. (shrink)