Die Behandlung von einwilligungsunfähigen psychisch kranken Menschen mit neuen Therapiemethoden ist insbesondere im Kontext des „individuellen Heilversuchs“, der als Anwendung wenig erprobter Therapieansätze im Rahmen von „ultima ratio“-Entscheidungen charakterisiert ist, mit ethischen Abwägungsproblemen verbunden. Diese bestehen aufgrund von Einschränkungen in der Handlungs- und Entscheidungsautonomie der betroffenen Patienten und, aufgrund eigen- oder fremdgefährdender Symptome der psychischen Krankheit selbst, insbesondere in der praktischen Umsetzung ethisch akzeptierter Modelle stellvertretender Entscheidung sowie in der Wahl des Bezugspunkts der Nutzen-Risiko-Analyse des intendierten Therapieverfahrens. Der Artikel untersucht (...) den ethischen Konflikt zwischen gerechtfertigter Hilfeleistung und Instrumentalisierungsrisiko psychisch kranker Menschen zu Fremdzwecken am historischen Beispiel der „Rindenexcisionen“ des Psychiaters Gottlieb Burckhardt (1836–1907). Als Lösungsmöglichkeit dieses ethischen Konflikts wird das „Konzept des kontrollierten individuellen Heilversuchs“ diskutiert. (shrink)

There is a “revolving door” between federal agencies and the industries regulated by them. Often, at the end of their industry tenure, key industry personnel seek employment in government regulatory entities and vice versa. The flow of workers between the two sectors could bring about good. Industry veterans might have specialized knowledge that could be useful to regulatory bodies and former government employees could help businesses become and remain compliant with regulations. But the “revolving door” also poses at least three (...) ethical and policy challenges that have to do with public trust and fair representation. First, the presence of former key industry personnel on review boards could adversely impact the public’s confidence in regulatory decisions about new technology products, including agrifood biotechnologies. Second, the ‘‘revolving door’’ may result in policy decisions about technologies that are biased in favor of industry interests. And third, the ‘‘revolving door’’ virtually guarantees industry a voice in the policy-making process, even though other stakeholders have no assurance that their concerns will be addressed by regulatory agencies. We believe these three problems indicate a failure of regulatory review for new technologies. The review process lacks credibility because, at the very least, it is procedurally biased in favor of industry interests. We argue that prohibiting the flow of personnel between regulatory agencies and industry would not be a satisfactory solution to the three problems of public trust and just representation. To address them, regulatory entities must reject the traditional notion of objectivity. Instead they should adopt the conception of objectivity developed by Sandra Harding and re-configure their regulatory review on the basis of it. That will ensure that a heterogeneous group of stakeholders is at the decision-making table. The fair representation of interests of different constituencies in the review process could do much to inspire warranted public confidence in regulatory protocols and decisions. (shrink)

In Australia and other countries, certain groups of women have traditionally been denied access to assisted reproductive technologies . These typically are single heterosexual women, lesbians, poor women, and those whose ability to rear children is questioned, particularly women with certain disabilities or who are older. The arguments used to justify selection of women for ARTs are most often based on issues such as scarcity of resources, and absence of infertility , or on social concerns: that it “goes against nature”; (...) particular women might not make good mothers; unconventional families are not socially acceptable; or that children of older mothers might be orphaned at an early age. The social, medical, legal, and ethical reasoning that has traditionally promoted this lack of equity in access to ARTs, and whether the criteria used for client deselection are ethically appropriate in any particular case, are explored by this review. In addition, the issues of distribution and just “gatekeeping” practices associated with these sensitive medical services are examined. (shrink)

Risk analysis and regulatory systems are usually evaluated according to utilitarian frameworks, as they are viewed to operate “objectively” by considering the health, environmental, and economic impacts of technological applications. Yet, the estimation of impacts during risk analysis and the decisions in regulatory review are affected by value choices of actors and stakeholders; attention to principles such as autonomy, justice, and integrity; and power relationships. In this article, case studies of biotechnology are used to illustrate how non-utilitarian principles are prominent (...) in risk analysis and regulatory review and to argue that these relationships should be carefully considered as we consider nanotechnology oversight systems for its products. We argue that there are not distinct separations between “science-based” review systems, in which evaluations of the consequences of technological products are primarily considered, and principles of integrity, justice, non-maleficence, and autonomy. It should further be expected that, given research into fair treatment during decision-making processes, attention to ethics will affect how citizens assess emerging technologies. Finally, a more holistic approach for evaluating oversight systems for the products of nanotechnology is suggested, one which does not draw a sharp distinction between risk analysis, regulation, and respect for non-utilitarian values. (shrink)

Three widely accepted principles – autonomy, beneficence and justice – provide a useful analytic framework for considering controversies and conflicts in bioethics. Since these principles capture key concepts found in diverse normative theories they provide a starting point from which consistent ethical analysis and comparison can begin. While justice is commonly discussed in the business ethics literature, the other two principles are not widely discussed. This paper investigates whether the principles of autonomy and beneficence provide a framework that is equally (...) useful for framing issues in business ethics. It is argued that they do. First, the principle of autonomy, with its associated notions of informed consent, privacy, confidentiality, voluntariness, self-mastery, and so on, provides a consistent approach to the analysis of diverse issues that arise in business ethics from market research to recruitment practices. Second, it is argued that the relationships between a business and its stakeholders ground duties of beneficence. The principle of beneficence provides a framework for considering the issues that arise in these relationships. (shrink)

This paper aims to contribute to a deeper reflection on intercultural conflicts within the scope of bioethics, and to point out the problem of using human rights as a theoretical normative mediator of the conflicts in bioethics that bear elements of interculturalism. The methodological steps adopted in this inquiry were the analysis of the concept of intercultural conflict in bioethics, from the perception developed by Colectivo Amani; the study of human rights as tools of the culture of human beings, based (...) on Bauman's theories; and the investigation of the tools that human rights offer so as to solve intercultural conflicts in bioethics. I conclude that intercultural bioethics must incorporate in its prescriptive and descriptive tasks, norms and institutions of human rights that ensure the participation and social integration of individuals from communities that are in cultural conflict. Such measures will act as instruments for the solution of intercultural conflicts. (shrink)

Two key themes structure the work of French philosopher of science Gilbert Simondon: the processes of individuation and the nature of technical objects. Moreover, these two themes are also at the heart of contemporary debates within Ethics and Bioethics. Indeed, the question of the individual is a key concern in both Virtue Ethics and Feminist Ethics of Care, while the hyper-technical reality of the present stage of medical technology is a key reason for both the urgency for and the success (...) of the field of Bioethics. And yet, despite its potential for thinking about these issues, Simondon’s philosophy remains largely unknown. Rather than exploring Simondon’s complex ontology for itself, the aim of this paper is to establish what contribution his work can make in Ethics and Bioethics on two essential questions: the relational structure of the self and the nature of the human-technology relation. I argue that Simondon’s re-conceptualization of the individual harmonizes with perspectives in Feminist Bioethics (particularly the Ethics of Care) and points toward what I call an “open” Virtue Ethics that takes relations to be essential. In order to establish this connection, I explore at length the relational approach to Feminist Bioethics offered by Susan Sherwin’s work. I argue that a Simondonian account of technology and of the individual furthers the relational understanding of the self, offers a characterization of Virtue Ethics that is in harmony with the Ethics of Care, and clarifies a notion of responsibility that is implicated in the complex reality of the modern technological milieu. (shrink)

This article examines one of the relevant concepts in the current debate on home birth—autonomy in place of birth—and its uses in general language, ethics, and childbirth health care literature. International discussion on childbirth services. A concept analysis guided by the model of Walker and Avant. The authors suggest that autonomy in the context of choosing place of birth is defined by three main attributes: information, capacity and freedom; given the antecedent of not harming others, and the consequences of accountability (...) for the outcome. Model, borderline and contrary cases of autonomy in place of birth are presented. A woman choosing place of birth is autonomous if she receives all relevant information on available choices, risks and benefits, is capable of understanding and processing the information and choosing place of birth in the absence of coercion, provided she intends no harm to others and is accountable for the outcome. The attributes of the definition can serve as a useful tool for pregnant women, midwives, and other health professionals in contemplating their moral status and discussing place of birth. (shrink)