Volume 19, Issue 7, July 2019, Page 30-32.

Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns. While these challenges have been studied from a wide range of perspectives, the problems prevail. This article adds value to previous analyses by identifying how the moral imperative of medicine has expanded (...) in three ways: (1) from targeting experienced phenomena, such as pain and suffering, to non-experienced phenomena (paraclinical signs and indicators); (2) from addressing present pain to potential future suffering; and (3) from reducing negative wellbeing (pain and suffering) to promoting positive wellbeing. These expansions create and aggravate problems in medicine: medicalization, overdiagnosis, overtreatment, risk aversion, stigmatization, and healthism. Moreover, they threaten to infringe ethical principles, to distract attention and responsibility from other competent agents and institutions, to enhance the power and responsibility of professionals, and to change the professional-beneficiary relationship. In order to find ways to manage the moral expansion of medicine, four traditional ways of setting limits are analyzed and dismissed. However, basic asymmetries in ethics suggest that it is more justified to address people’s negative wellbeing (pain and suffering) than their positive wellbeing. Moreover, differences in epistemology, indicate that it is less uncertain to address present pain and suffering than future wellbeing and happiness. Based on these insights the article concludes that the moral imperative of medicine has a gradient from pain and suffering to wellbeing and happiness, and from the present to the future. Hence, in general present pain and suffering have normative priority over future positive wellbeing. (shrink)

The current ban on certain performance enhancing substances in sport such as erythropoietin faces a line-drawing problem: what is the moral difference between taking an EPO injection to incre...

Volume 19, Issue 7, July 2019, Page 32-34.

The monograph is an English, expanded and revised version of the book Cheshko, V. T., Ivanitskaya, L.V., & Glazko, V.I. (2018). Anthropocene. Philosophy of Biotechnology. Moscow, Course. The manuscript was completed by me on November 15, 2019. It is a study devoted to the development of the concept of a stable evolutionary human strategy as a unique phenomenon of global evolution. The name “An Evolutionary Metaphysics (Cheshko, 2012; Glazko et al., 2016). With equal rights, this study could be entitled “Biotechnology (...) as a result and factor of the evolutionary processˮ. The choice in favor of used “The Evolutionary Metaphysics of Human Enhancement Technologiesˮ was made in accordance with the basic principle of modern post-academician and human-sized science, a classic example of which is biotechnology. The “Metaphysics of Evolution” and “Evolutionary Metaphysics” concepts are used in several ways in modern philosophical discourse. In any case, the values contain a logical or associative reference to the teleological nature of the evolutionary process (Hull, 1967, 1989; Apel, 1995; Faye, 2016; Dupre, 2017; Rose, 2018, etc). In our study, the “evolutionary metaphysics” serves to denote the thesis of the rationalization and technologization of global evolution and anthropogenesis, in particular. At the same time, the postulate of an open future remains relevant in relation to the results of the evolutionary process. The theory of evolution of complex, including the humans system and algorithm for its constructing are а synthesis of evolutionary epistemology, philosophical anthropology and concrete scientific empirical basis in modern science. ln other words, natural philosophy is regaining the status bar element theoretical science in the era of technology-driven evolution. The co-evolutionary concept of 3-modal stable evolutionary strategy of Homo sapiens is developed. The concept based оn the principle of evolutionary complementarity of anthropogenesis: value of evolutionary risk and evolutionary path of human evolution are defined bу descriptive (evolutionary efficiency) and creative-teleological (evolutionary correctness) parameters simultaneously, that cannot bе instrumental reduced to others ones. Resulting volume of both parameters define the vectors of blological, social, cultural and techno-rationalistic human evolution Ьу two gear mechanism genetic and cultural co-evolution and techno-humanitarian balance. The resultant each of them сап estimated Ьу the ratio of socio-psychological predispositions of humanization / dehumanization in mentality. Explanatory model and methodology of evaluation of creatively teleological evolutionary risk component of NBIC technological complex is proposed. Integral part of the model is evolutionary semantics (time-varying semantic code, the compliance of the blological, socio-cultural and techno-rationalist adaptive modules of human stable evolutionary strategy). It is seem necessary to make three clarifications. First, logical construct, “evolutionary metaphysics” contains an internal contradiction, because it unites two alternative explanatory models. “Metaphysics”, as a subject, implies deducibility of the process from the initial general abstract principle, and, consequently, the outcome of the development of the object is uniquely determined by the initial conditions. Predicate, “evolutionary”, means stochastic mechanism of realizing the same principle by memorizing and replicating random choices in all variants of the post-Darwin paradigm. In philosophy, random choice corresponds to the category of “free will” of a reasonable agent. In evolutionary theory, the same phenomenon is reflected in the concept of “covariant replication”. Authors will attempt to synthesize both of these models in a single transdisciplinary theoretical framework. Secondly, the interpretation of the term “evolutionary (adaptive) strategyˮ is different from the classical definition. The difference is that the adaptive strategy in this context is equivalent to the survival, i.e. it includes the adaptation to the environment and the transformation (construction) of the medium in accordance with the objectives of survival. To emphasize this difference authors used verbal construction “adaptiveˮ (rather than “evolutionaryˮ) strategy as more adequate. In all other cases, the two terms may be regarded as synonymous. Thirdly, the initial two essays of this series were published in one book in 2012. Their main goal was the development of the logically consistent methodological concept of stable adaptive (evolutionary) strategy of hominines and the argumentation of its heuristic possibilities as a transdisciplinary scientific paradigm of modern anthropology. The task was to demonstrate the possibilities of the SESH concept in describing and explaining the evolutionary prospects for the interaction of social organization and technology (techno-humanitarian balance) and the associated biological and cultural mechanisms of the genesis of religion (gene-cultural co-evolution). In other words, it was related to the sphere of cultural and philosophical anthropology, i.e. to the axiological component of any theoretical constructions describing the behavior of self-organizing systems with human participation. In contrast, the present work is an attempt to introduce this concept into the sphere of biological anthropology and, consequently, its main goal is to demonstrate the possibility of verification of its main provisions by means of procedures developed by natural science, i.e. refers to the descriptive component of the same theoretical constructions. The result of this in the future should be methods for assessing, calculating and predicting the risk of loss of biological and cultural identity of a person, associated with a permanent and continuously deepening process of development of science and technology. (shrink)