As the public profile of bioethics rises, and as litigation about issues ranging from assisted reproduction to gene therapy multiplies, the presence of bioethics experts in a litigation context has become more common. Dozens of appellate opinions refer to bioethics testimony in the lower courts. Today's technical advisory services for attorneys advertise bioethics experts along with experts in scientific fields. A single bioethicist has served as an expert in more than fifty cases. In all likelihood, opportunities for bioethicists to fill (...) the role of testifying expert will grow as medicine and biotechnology become more complex. Bioethics experts have also been involved in several other kinds of litigation-related activities, including investigation, consultation with attorneys, preparing reports that express expert opinions, and explaining and defending these opinions by deposition.Despite the growth of these activities by bioethicists, they have never been free of controversy, have recently been received with little enthusiasm by the judiciary, and could become highly problematic in the future. (shrink)

The aim of this study was to assess nurses’ and physicians’ ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N = 364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is (...) limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services. (shrink)

Zadaniem artykułu jest analiza wniosków, płynących z debaty na temat eksperymentów na zarodkowych komórkach macierzystych, dla refleksji bioetycznej. Autorka postawiła sobie trzy cele. Po pierwsze, scharakteryzowanie toczonej w Polsce dyskusji na temat moralnej dopuszczalności prowadzenia eksperymentów na zarodkowych komórkach macierzystych - istoty tego sporu i wysuwanych w nim argumentów. Po drugie, zanalizowanie formy prowadzenia tej dyskusji z punktu widzenia wyróżnionych w literaturze przedmiotu modeli uprawiania bioetyki. Po trzecie, przedstawienie na tym przykładzie pewnych ogólniejszych refleksji filozoficznych i metodologicznych, dotyczących sposobu rozważania (...) problemów bioetycznych i roli bioetyki. W konkluzji Autorka stwierdza, że "bioetyka regulacji", traktowana obecnie jako paradygmat refleksji bioetycznej, nie dysponuje odpowiednimi narzędziami do rozstrzygnięcia pytań etycznych i filozoficznych, wykraczających poza kwestię oceny użyteczności danej techniki dla realizacji postawionego celu medycznego i powinna zostać uzupełniona o "bioetykę kulturową". Zwraca także uwagę na paradoks związany z rozwojem bioetyki, której powstanie wiązano z koniecznością obrony cenionych w danej kulturze wartości przed technologią medyczną. Akceptacja eksperymentów na zarodkowych komórkach macierzystych jest równoznaczna ze złamaniem wypracowanych dotąd zasad prowadzenia badań na człowieku i zmusza do zadania pytania, w jaki sposób powinniśmy bronić istotnych dla naszej kultury wartości przed "bioetyką regulacji". (shrink)

Genome editing, for instance by CRISPR-Cas, is a major advancement of the last 10 years in medicine but questions ethically our practices. In particular, human embryo heritable genome editing is a source of great controversy. We explored how this ethical question was debated in the literature from PubMed database, in a period of 4 years (2016–2020) around the announcement of the ‘CRISPR babies’ Chinese experiment in November 2018. We evaluated the weight of the arguments for and against this topic, through (...) an analysis of reviews published on this question. The most important arguments come from the technical perspective: safety issues and benefits, putative long-term effects on the future generations and the need to assess this aspect. Next, foreseeable clinical benefits and the alternatives to these methods are discussed. The number of people that would benefit from such techniques is also considered. However, social and anthropological issues are addressed in a more disparate way. Parenthood and desire for children are sometimes overlooked. Few authors mention social justice, stigmatisation and equality of access. Consent and information are more clearly addressed, as well as the question of the relationship between generations. Finally, the effects on the nature of humankind or human species are far from being consensual; the risks of enhancement, eugenics and transhumanism are raised. We conclude that the risks associated with the immaturity of the technique were at the forefront of the ethical debate on human embryo heritable genome editing. Their consequences were seen as more immediate and easier to handle than those of sociological or anthropological projections, which are more speculative in nature. (shrink)

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

Some bioethicists have proposed a legalized market in human organs as a solution to transplant waiting lists and global poverty. Solutions to organ procurement problems that are solely market-based would unfairly shift the burdens of medical procedures onto developing nations. Market advocates base their claims on the understanding of organs as property, a position that should be problematized. Instrumentalizing people in this way is part of the broader commodification of animals and the environment. Combating the market mentality requires a return (...) to the holistic view of bioethics that led to the founding of the field. (shrink)

A comprehensive analysis of the evolving conditions that provided for the emergence and autonomization of the field of bioethical inquiry, as well as the social, cultural and political background against which its birth can be set, should enlighten us about the problematic nature that characterises it from its very onset. Those conditions are: abuses in experimentation on human subjects, availability of new biomedical technologies, the challenging of prevalent medical paradigms and the ultimate meaning and purpose of medical care, new scientific (...) and social fields of concern dealing with ecology and environmental health, genetic engineering and biotechnologies, demographics, behavioural manipulation, reproductive medicine, etc., the upsurge of social movements raising issues of medical importance, and the need for an ethics for the technological age. The scope and meaning of bioethics is best defined by the overriding questions that open up the field of both theoretical and practical bioethical inquiry rather than by the individual responses given to such questions by the most prominent spokesmen in bioethics. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 51-53, September‐October 2021.

Medical practitioners have traditionally seen themselves as part of an international community with shared and unifying scientific and ethical goals in the treatment of disease, the promotion of health, and the protection of life. This shared mission is underpinned by explicit acceptance of traditional concepts of medical morality, and by an implied link between individual human rights and the ethics of medical practice long enshrined in a range of World Medical Association (WMA) and other medical codes. These have been powerful (...) instruments exhorting individual practitioners to promote health and to defend universal principles in order to protect their patients and the physician-patient relationship even in the face of authoritarian state coercion and imposed national ideologies and policies. There has been widespread support for this approach and this should be intensified. (shrink)