Syltern et al. (2022) propose a new approach to decision-making at the limit of viability: by default, intensive care will be initiated for every infant born in “the gray zone” of viability. This w...

Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to initiate at least one egg freezing cycle in Belgium. Our findings, facilitated by a ‘symbiotic empirical ethics’ approach, shed light on the concerns and perceptions that accompany women's (...) decisions while supporting a more context-sensitive reading of the ethical debate. We identified three key themes: feeling overwhelmed with uncertainty and a threatening future, bodily discomfort and distress during the medical process, and the endless pursuit of peace of mind. One of the issues that emerges from these findings is the risk ritual function of social egg freezing, referring to routine actions of risk anticipation that mitigate uncertainty and express a sense of individual responsibility. While more research is needed, this conceptualisation provides a starting point to flesh out the wider context of this moral practice and its symbolic meaning for women. (shrink)

Recently, Petersen provided in this journal a critical discussion of individualisation arguments in the context of social egg freezing. This argument underlines the idea that it is morally problematic to use individual technological solutions to solve societal challenges that women face. So far, however, there is a lack of empirical data to contextualise his central normative claim that individualisation arguments are implausible. This article discusses an empirical study that supports a contextualised reading of the normative work of Petersen. Based on (...) a qualitative interview study, we found that most women could make sense of this argument but addressed other concerns that are overlooked in the premises of moral individualisation arguments, for instance, the influence of relationship formation on the demand of egg freezing. Furthermore, women did not experience social egg freezing as morally problematic. Nonetheless, the interviewees pointed to a need of more societal solutions and even actively advocated for efforts to increase accessibility such as a partial reimbursement and better quality of information. The implications of these findings for empirical bioethics are discussed. While more research is needed, we argue that, in order to better address individualisation arguments and related ethical concerns, we need to contextualise normative evaluations within women’s moral reasoning. (shrink)

In their article, Sedlakova and Trachsel (2023) propose a holistic, ethical, and epistemic analysis of conversational artificial intelligence (CAI) in psychotherapeutic settings. They mainly descri...

Male fertility–related mHealth (MFmHealth), including smartphone applications that allow men to test their fertility at home, is getting some attention now and then. In this commentary, I argue that MFmHealth technology has the potential to undermine established norms around male reproduction but cannot be examined using traditional individualist frameworks in bioethics. Instead, theoretical literature on the concept of vulnerability in feminist bioethics allow a theoretical alliance with critical studies of men and masculinities. Proposed benefits like empowerment, shared responsibility, and democratization (...) may justify disruptive innovation but may also obscure more fundamental ethical concerns about vulnerability and social justice. (shrink)

AbstractWhile the literature on oncofertility decision-making was central to the bioethics debate on social egg freezing when the practice emerged in the late 2000s, there has been little discussion juxtaposing the two forms of egg freezing since. This article offers a new perspective on this debate by comparing empirical qualitative data of two previously conducted studies on medical and social egg freezing. We re-analysed the interview data of the two studies and did a thematic analysis combined with interdisciplinary collaborative auditing (...) for empirical ethics projects. Despite their different contexts, major similarities in women’s decision-making and reasoning were found. We developed two main common themes. Firstly, women felt a clear need to plan for future options. Secondly, they manipulated decision-times by postponing definitive decisions and making micro-decisions. The comparison highlights that the passage of time and the preservation of future choice seems to permeate all aspects of the patient experiences in both studies. As a result of considering real-world lived experiences, we suggest that there are many overlaps in women’s reasoning about egg freezing regardless of why they are making a decision to freeze. These overlaps are morally relevant and thus need to be further integrated into the existing arguments that have been canvassed in the flourishing egg freezing and fertility preservation debates across the field, and in policy and practice globally. (shrink)

Freezing Fertility: Oocyte Cryopreservation and the Gender Politics of Aging is the fourth path-breaking monography in the flourishing literature on egg freezing in just a few years. In April 2019, The Oocyte Economy: The Changing Meaning of Human Eggs by the renowned Australian social scientist Catherine Waldby, was published, the first book to examine the emergence of a global market for eggs through biomedical innovation. In September 2019, sociologist Kylie Baldwin of De Montfort University published Egg Freezing, Fertility and Reproductive (...) Choice: Negotiating Responsibility, Hope and Modern Motherhood, in which she explores the experiences of some pioneering women who are having eggs frozen in the United... (shrink)

This article examines the ethical validity of using viability as the cutoff point for abortion in the Netherlands, in view of potential changes to the Dutch perinatal care guideline. According to the Dutch Penal Code, abortion is permitted until viability: the point at which a fetus can survive outside the womb with technological assistance. Since the law was enacted in 1984, viability has been set at 24 weeks gestational age. Currently, in the Netherlands, the treatment limit for extreme prematurity is (...) also set at 24 weeks. The potential revision of the guideline could lower this threshold. Such a change could have implications for abortion in the Netherlands. We critically evaluate the use of viability within the Dutch context and offer recommendations for modifying the legal framework concerning abortion. We conclude that relying on any interpretation of viability is morally problematic for abortion regulation, as it is too indeterminate a concept to establish a threshold in a morally relevant way. (shrink)

Recent discussion on artificial womb technology (AWT) has given rise to a proliferation of terms to denote the subject of AWT. De Bie et al. opt for “fetal neonate” or “fetonate’ as “the best way t...

Cho and Martinez-Martin (2023) discuss the ethical challenges associated with the use of digital simulacra (also known as digital twins) in biomedicine, specifically focusing on the issue of episte...

Pozzi1 has thoroughly analysed testimonial injustices in the automated Prediction Drug Monitoring Programmes (PDMPs) case. Although Pozzi1 suggests that ‘the shift from an interpersonal to a structural dimension … bears a significant moral component’, her topical investigation does not further conceptualise the type of collective knowledge practices necessary to achieve epistemic justice. As Pozzi1 concludes: ‘this paper shows the limitations of systems such as automated PDMPs, it does not provide possible solutions’. In this commentary, we propose that an Ubuntu perspective—which, (...) so far, has received little attention in connection with epistemic injustice in medical machine learning (MML)—can fill this gap. This perspective can be used to mitigate some of the harmful effects of epistemic injustices by encouraging community involvement and forward-looking responsibility. It may be instructive to note first and foremost that the debate on epistemic justice and artificial intelligence in medicine has mostly been restricted to the Western World, that is, Europe and North America. There has been very little insight or accommodation of insights from the Global South. Ubuntu is a concept originating from Southern Africa that focuses on the close connections and mutual …. (shrink)

Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’ 1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics for healthcare’s contribution to climate change. Recent research analyses, for instance, the ‘greening’ of informed consent and related bioethical principles. 2 3 (...) It is unclear what the duty of practising sustainable healthcare means at the level of doctor–patient interaction. Parsa-Parsi _et al_ flag the potential conflict in the ICoME’s provisions if ‘the actions of physicians are influenced by environmental considerations to the detriment of patients’ (p. 2), noting that the ICoME does not provide a handhold to improve understanding of such tensions. The code ‘does not... (shrink)

This perspective article explores the use of digital twins (DTs) in medicine, highlighting its capacity to simulate risks and personalize treatments while examining the emerging bioethical concerns. Central concerns include power dynamics, exclusion, and misrepresentation. We propose adopting a relational bioethical approach that advocates for a comprehensive assessment of DTs in medicine, extending beyond individual interactions to consider broader structural relations and varying levels of access to power. This can be achieved through two key relational recommendations: acknowledging the impact of (...) uneven relational structures on access to medical care and promoting social justice by evaluating resource allocation. While DTs in medicine offer promising advancements, a relational bioethical lens may provide a nuanced understanding, fostering equitable, inclusive and responsible integration of DTs into medical practice. (shrink)

Recent medical innovations like ‘omics’ technologies, mobile health (mHealth) applications or telemedicine are perceived as part of a shift towards a more preventive, participatory and affordable healthcare model. These innovations are often regarded as ‘disruptive technologies’. It is a topic of debate to what extent these technologies may transform the medical enterprise, and relatedly, what this means for medical ethics. The question of whether these developments disrupt established ethical principles like respect for autonomy has indeed received increasing normative attention during (...) the past years. Yet, more fundamental ethical considerations of a possible disruption of the concept of ‘medical necessity’ (and the potential ensuing clinical ramifications) have been limited if not absent. It is our modest – though morally and practically relevant – aim to address this objective in this article, by exploring how the current wave of allegedly disruptive innovation is invoking a resurgence of this concept and related debates on ‘the’ goal(s) of medicine. (shrink)

Genetic relatedness figures heavily in contemporary ethical debates on egg freezing, although the arguments lack empirical‐based evidence. Rather than adding another theoretical view on the moral relevance of genetic connections, this paper instead proposes an empirically grounded perspective based on two independent qualitative interview‐based studies conducted in Belgium and France. Three themes emerge from our empirical data: (1) prioritizing family building; (2) centering the gestational experience of motherhood; and (3) identifying the complexities and limitations of adoption. These themes suggest that (...) the relationship between egg freezing, genetics, biological motherhood, and adoption is highly complex and less straightforward than what is often assumed in the egg freezing debate. Our study provides more detailed insights into women's ambivalent experiences regarding those reproductive options. We discuss the ethical implications of our empirical findings and hold that pursuing genetic desire is not necessarily the main moral reason why women freeze their eggs. (shrink)

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How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

Practical deliberation often involves conditional judgements about what will (likely) happen if certain alternatives are pursued. It is widely assumed that the conditionals useful in deliberation are counterfactual or subjunctive conditionals. Against this, I argue that the conditionals of deliberation are indicatives. Key to the argument is an account of the relation between 'straightforward' future-directed conditionals like ' If the house is not painted, it will soon look quite shabby' and * "w e r e ' ' e d F (...) D C s like ' If the house were not to be painted, it would soon look quite shabby': an account on which both of these types of FDCs are grouped with the indicatives for semantic treatment and on which, while conditionals of both types are properly used in means/ends deliberations, those of the ' were'ed-up variety are especially well suited for that purpose. (shrink)

'Pataphysics: The Poetics of an Imaginary Science is a survey that attempts to describe a hypothetic philosophy--the avant-garde pseudo-science imagined by Alfred Jarry. 'Pataphysics is a supplement to metaphysics, accenting it, then replacing it, in order to create a philosophic alternative, whose discipline can study cases, not of conception, but of exception: variance , alliance , and deviance . 'Pataphysics synthesizes the romantic schism between a literal, scientized discourse and a figural, poeticized discourse, and my thesis suggests that this revision (...) of the signifier "science" by 'pataphysics is symptomatic of a postmodern transition in science from a paradigm of absolutism to a paralogy of relativism. Structured as a descriptive explication, which emphasizes a theoretical perspective, this survey is divided into five chapters: the first chapter recounts the history of the conflict between science and poetry ; the second chapter examines the avant-garde pseudo-science of 'pataphysics itself ; and finally, the last three chapters discuss the influence of 'pataphysics upon the poetics of its subsequent successors . While my thesis focuses upon theories of textual poetics rather than poetry itself , my thesis does nevertheless strive to be as conceptually encyclopedic as 'pataphysics itself: instead of normalizing 'pataphysics within one theoretical perspective, this survey alludes intermittently to 'pataphysical enterprises that constitute exceptions to such a genealogy of Jarryites. What is at stake is the status of poetry in a world of science. How might poetry reclaim its own viable truth? How might science benefit from its own poetic irony? For the postmodern condition, such questions have already opened up a novel space for speculative imagination; hence, this survey presents itself as a kind of primer for a future of possible research. (shrink)

In this short but meaty book, Peter Unger questions the objective answers that have been given to central problems in philosophy. As Unger hypothesizes, many of these problems are unanswerable, including the problems of knowledge and scepticism, the problems of free will, and problems of causation and explanation. In each case, he argues, we arrive at one answer only relative to an assumption about the meaning of key terms, terms like "know" and like "cause," even while we arrive at an (...) opposite answer relative to quite different assumptions, but equally arbitrary assumptions, about what the key terms mean. (shrink)

This article explores the enduring mysteries of consciousness and the afterlife, two enigmatic topics that have fascinated humanity for ages. Despite extensive scientific efforts, the existence of an afterlife remains unproven, and understanding consciousness remains a significant challenge. The research introduces innovative hypotheses through simple thought experiments with empirical evidence and robust theoretical foundations. It delves into the complexities of consciousness, its relationship with the brain, and the need for interdisciplinary approaches encompassing physics, psychology, and philosophy. Boldly contemplating the probability (...) of a continuous consciousness after death, the study argues that existing evidence strongly supports this idea. Beyond theoretical implications, it envisions practical outcomes, suggesting that insights into these mysteries could enhance human well-being and contribute to a more harmonious world. In summary, this article embarks on a quest to shed light on age-old questions about consciousness and the afterlife. Through fresh methodologies, it aims to provide new perspectives that could reshape our understanding of existence and inspire intellectuals to positive individual and societal advancements. -/- . (shrink)

Neoplatonic allegorical interpretation expounds how literary texts present philosophical ideas in an enigmatic and coded form, offering an alternative path to the divine truths. The Neoplatonist Porphyry’s _On the Cave of the Nymphs_ is one of the most significant allegorical interpretation handed down to us from Antiquity. This monograph, exclusively dedicated to the analysis of _On the Cave of Nymphs_, demonstrates that Porphyry interprets Homer’s verse from Odyssey 13.102-112 to convey his philosophical thoughts, particularly on the material world, relationship between (...) soul and body and the salvation of the soul through the doctrines of Plato and Plotinus. The Homeric cave of the nymphs with two gates is a station where the souls descend into genesis and ascend to the intelligible realm. Porphyry associates Odysseus’ long wanderings with the journey of the soul and its salvation from the irrational to rational through escape from all toils of the material world. (shrink)

are ambiguous. In the mouth of someone who cannot remember whether it was Michael, or rather someone else, who was top scorer, can express the epistemic possibility that Michael led the league in scoring. But from someone who knows that Michael did not even play last season, but is wondering what would have happened if he had, means something quite different. Now where it has this quite different meaning, may still turn out to be the expression of some epistemic possibility. (...) Perhaps where does not express the epistemic possibility of ‘Michael led the league in scoring’, it expresses the epistemic possibility of ‘Michael would have led the league in scoring’. Analysis of this ‘would have’ statement, together with an exploration of the suspicion that the ‘might have’ statement is ambiguous between these two epistemic possibilities, will have to await another occasion. The important point for present purposes is that is ambiguous between an expression of the epistemic possibility of ‘Michael led the league in scoring’ and some quite different reading. (shrink)

What are the criteria for reasonable clinical judgements? The reasonableness of macro-level decision-making has been much discussed, but little attention has been paid to the reasonableness of applying guidelines generated at a macro-level to individual cases. This paper considers a framework for reasonable clinical decision-making that will capture cases where relevant guidelines cannot reasonably be followed. There are three main sections. (1) Individual claims on healthcare from the point of view of concerns about equity are analysed. (2) The demands of (...) responsibility and equity on professional clinical performance are discussed, and how the combination of these demands emerges into seven requirements that constitute the framework is explored. Since this framework is developed to assist in reasonable clinical decision-making, practical implications of all these requirements are also suggested. (3) Challenges concerning the framework are discussed. First, a crucial presumption that the framework relies upon is considered—namely, clinicians’ willingness to justify their decisions as requested. Then how public deliberation may influence clinical decision-making is discussed. Next is a consideration of how clinicians’ need to have confidence in their own judgements in order to perform in a manner worthy of trust would be compatible with adherence to the framework supported by public deliberation. It is concluded that fair distribution in the interplay between macro- and micro-level considerations can be secured by legitimising procedures on each level, by ensuring well-organised and continuing public debate and by basing individual clinical judgements upon well-justified and principled normative bases. (shrink)

It is only when mixing two or more pure substances along a reversible path that the entropy of the mixing can be made physically manifest. It is not, in this case, a mere mathematical artifact. This mixing requires a process of successive stages. In any finite number of stages, the external manifestation of the entropy change, as a definite and measurable quantity of heat, isa fully continuous function of the relevant variables. It is only at an infinite and unattainable limit (...) thata non-uniform convergence occurs. And this occurs when considered in terms of the number of stages together with a distinguishability parameter appropriate to the particular device which is used to achieve reversibility. These considerations, which are of technological interest to chemical engineers, resolve a paradox derived in chemical theory called Gibbs'' Paradox. (shrink)