Because of accelerating technological progress, humankind may be rapidly approaching a critical phase in its career. In addition to well-known threats such as nuclear holocaust, the propects of radically transforming technologies like nanotech systems and machine intelligence present us with unprecedented opportunities and risks. Our future, and whether we will have a future at all, may well be determined by how we deal with these challenges. In the case of radically transforming technologies, a better understanding of the transition dynamics from (...) a human to a "posthuman" society is needed. Of particular importance is to know where the pitfalls are: the ways in which things could go terminally wrong. While we have had long exposure to various personal, local, and endurable global hazards, this paper analyzes a recently emerging category: that of existential risks. These are threats that could case our extinction or destroy the potential of Earth - originating intelligent life. Some of these threats are relatively well known while others, including some of the gravest, have gone almost unrecognized. Existential risks have a cluster of features that make ordinary risk management ineffective. A final section of this paper discusses several ethical and policy implications. A clearer understanding of the threat picture will enable us to formulate better strategies. (shrink)

Informed by a search of the literature about the usage of genetic testing information (GTI) by insurance companies, this paper presents a practical ethical analysis of several distinct public policy options that might be used to govern or constrain GTI usage by insurance providers. As medical research advances and the extension to the Human Genome Project (2016, https://en.wikipedia.org/wiki/human_genome_project_-_write) moves to its fullness over the next decade, such research efforts will allow the full synthesis of human DNA to be connected to (...) predictive health dispositions. As testing costs fall, there will be ever more pressure for citizens to disclose GTI. Genetic testing information is integral to future medical care because it can be used to better assess individually tailored medical therapies as well as to allow a more informed risk analysis by the insurance industry, which in some countries such as the USA underwrites a majority of citizen medical expenses. As discussed in this examination, the revelation of people’s uniquely personal GTI to insurers has enormous societal implications. The major contribution of the paper is to offer policy makers and concerned citizens a nuanced articulation of the basic options to regulate GTI, with a special consideration for ethical fairness and equity. As genetic-based medicine blossoms and pressures to reduce healthcare costs increase, there will be an ever greater impetus for countries to revisit their genetic testing policies. Organizations and policy makers striving to create GTI oversights perceived to be both “fair and effective” need to be aware of the ethical perspectives discussed in this paper. (shrink)

Cognitive enhancement takes many and diverse forms. Various methods of cognitive enhancement have implications for the near future. At the same time, these technologies raise a range of ethical issues. For example, they interact with notions of authenticity, the good life, and the role of medicine in our lives. Present and anticipated methods for cognitive enhancement also create challenges for public policy and regulation.

This study is a contribution to the bioethical debate about new and possibly emerging reproductive technologies. Its point of departure is the intuition, which many people seem to share, that using such technologies to select non-disease traits – like sex and emotional stability - in yet unborn children is morally problematic, at least more so than using the technologies to avoid giving birth to children with severe genetic diseases, or attempting to shape the non-disease traits of already existing children by (...) environmental means, like education. The study employs philosophical analysis for the purpose of making this intuition intelligible and judging whether it is justified. Different ways in which the moral problems posed by reproductive technologies are often framed in bioethical debates are criticised as inadequate for this task. In particular, it is argued that the intuition cannot fully be made sense of in terms of harm to the children that such technologies help create. The study attempts to elaborate an alternative to that broadly consequentialist approach, by drawing on Martin Heidegger’s philosophy of technology, Hans Jonas’s ethics, and Aristotle’s practical philosophy, as it has been received and developed in the hermeneutical tradition. It is suggested that reproductive choices, unlike decisions for already born children, are characterised by a peculiar one-sidedness: the future child appears to the parents as something wholly theirs to decide about, not as a concrete other with whom they must interact in a responsive and attuned way. This is problematic because it means that such choices cannot call upon the particularised moral understanding only gained in interpersonal encounters. In particular, it makes them easily shaped by various tendencies, to which parents are always susceptible, to relate to children in instrumentalising ways, and at risk of reinforcing such tendencies. However, this does not mean that all uses of reproductive technologies are equally troubling. When selecting against severe disease the parents can rely on a widely shared illness experience to escape the dangers that one-sidedness involves. It is concluded that the intuition under discussion, thus explicated and in some ways qualified, makes sense morally. (shrink)

“HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value” (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration (...) of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA. (shrink)

This paper provides a marketing ethics analysis that addresses the practice of selling genetic tests directly to the consumer. It details the complexity of this emergent sector by articulating the panoply of evolving ethical/social questions raised by this development. It advances the conversation about DTC genetic testing by reviewing the business and healthcare literature concerning this topic and by laying out the inherent ethical complications for consumers, marketers, and regulators. It also points to several possible public and company policy adjustments. (...) Because this area is relatively new and incredibly dynamic, its current discussion is necessarily an exercise in the “logic of discovery” rather than the “protocol of validation”. The paper serves as a primer for the types of GT being promoted. It also calls for a public discourse in the academic and general community to uncover and define the ethical guidelines and systemic adjustments necessary to create fairness in the various DTC transactions occurring between genetic test sellers and the buyers/clients of their services. (shrink)

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake reference to the following (...) fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice. (shrink)

ABSTRACTHans Jonas’ philosophy of responsibility is a major contribution to environmental ethics and political theory, but aspects of it have proven controversial. Jonas’ critics, in particular Richard Wolin, have argued that his thought is deeply reactionary. By contrast, Nathan Dinneen has sought to show that Jonas’ apparent eco-authoritarianism is misunderstood. I argue here that Dinneen’s interpretation is too probably too generous, but also that Wolin’s wholesale critique is fundamentally misguided. Rather, the vast majority of Jonas’ thought is of enduring value, (...) including a nascent ecological republicanism which has thus far been overlooked by commentators. (shrink)

In this paper, the relations between science and technology, intervention and representation, the natural and the artificial are analysed on the background of the formation of modern science in the sixteenth century. Due to the fact that technique has been essential for modern science from its early beginning, modern science is characterised by a hybridisation of knowledge and intervention. The manipulation of nature in order to measure its properties has steadily increased until artificial things have been produced, such as laser (...) beams, chemical compounds, elementary particles. Furthermore, the structural bracing of natural science, technological development, and industrial exploitation of nature go also back to the foundation of modern science. In order to strengthen the debate on technoscience against this background, the specific characteristics of technoscientific objects have to be clarified as have the specific characteristics of the social organisation of technoscience and its performance. (shrink)

The architect who plans and designs our living environment in town and country can neither think exclusively technologically nor act completely independently. Rather, his designs and actions are always in moral relation to the environment, i. e. to nature and landscape as well as to the city/town or the people who live daily with and within the built space and thus have a kind of effective group affiliation. But to what extent does architecture – in the sense of Hegel’s phrase (...) the “sensuous in the meaningful” – already possess ethical implications? (shrink)

Ein Topos in institutionellen Stellungnahmen zu „Genome Editing am Menschen“ ist die Forderung nach einem Moratorium. Dieses soll einerseits dazu dienen, zu einer angemessenen Risikoabklärung zu gelangen, und andererseits einer gesellschaftlichen und ethischen Diskussion hinreichend Raum zu geben, um zu entscheiden, ob die vom Moratorium betroffenen Eingriffe überhaupt grundsätzlich erwünscht sind. Dabei scheint das Moratorium eine kompromisshafte Lösung zu sein, auf die sich die Mitglieder in weltanschaulich pluralen Ethikgremien verständigen können. Die Analyse der zu Genome Editing in den Jahren 2015 (...) bis 2018 verfassten Stellungnahmen zeigt jedoch ein deutlich komplexeres Bild: Was als konsensuale Kompromissformel erscheint, stellt sich als vielfach konflikthaftes Lösungsmodell dar. Umstritten ist in den unterschiedlichen Moratoriumsmodellen der Umfang (was alles ist vom Moratorium betroffen?), die Dauer (gibt es ein konkretes Datum, bis zu dem das Moratorium gilt?), der Zweck (dient es bloß der Risikoabschätzung oder auch der ethischen und/oder gesamtgesellschaftlichen Diskussion?) und die Frage, was für eine Maßnahme am Ende des Moratoriums getroffen werden soll. Zudem ist zwischen impliziten und expliziten Moratorien zu unterscheiden und zu untersuchen, was mit dem Moratoriumsvorschlag jeweils nicht verursacht werden soll (zum Beispiel die Grundlagenforschung einschränken). Am Ende der ethischen Analyse zeigt sich, dass mit klarer bestimmten Moratoriumsforderungen ein stärkeres Bewusstsein des Aufschub-Charakters dieser spezifischen Empfehlung einhergeht. So lässt sich auch das Ethos der Verantwortlichkeit – gegenüber jetzt Lebenden sowie künftigen Generationen – besser realisieren. (shrink)

Like every major new technology, genetic engineering is affecting the hopes and fears of many people. The risks involved are perceived differently by different groups. One group regards genetic engineering as a simple extension of older techniques with no special risks, e.g. traditional breeding. This conservative denial of special risks is confronted with a different kind of conservatism from a group which, in the name of the preservation of nature, opposes any kind of genetic engineering. A third group, rooted in (...) the liberal tradition, is prepared to accept the risks of genetic engineering as long as they are outweighed by prospective benefits. The liberal as well as the two conservative approaches, however, face serious difficulties in trying to develop a sound ethical argument concerning genetic engineering. In order to avoid these difficulties, an ethical approach focused on paradigmatic examples of good and evil is proposed. Such examples constitute rules of moral description, much as standards of measurement constitute rules of physical description. These rules are elaborated and interpreted in processes of social learning. In the present state of development of genetic engineering, such social learning requires appropriate institutional procedures. (shrink)

A presente obra assume-se como um projeto genuinamente interdisciplinar de reflexão ética, interrogando os seus fundamentos e explorando as suas interseções com diversas áreas das Ciências Humanas e Sociais. Reunindo especialistas de distintas áreas, oriundos de países diferentes, o livro tem como fio condutor um diálogo polifónico com o pensamento ético contemporâneo, enraizando-se na tradição crítica que procura refundar a racionalidade prática na construção humana de sentido e, por conseguinte, refutar o niilismo e o relativismo axiológico absoluto.

The professional and institutional responsibility for handling genetic knowledge is well discussed; less attention has been paid to how lay people and particularly people who are affected by genetic diseases perceive and frame such responsibilities. In this exploratory study we qualitatively examine the attitudes of lay people, patients and relatives of patients in Germany and Israel towards genetic testing. These attitudes are further examined in the national context of Germany and Israel, which represent opposite regulatory approaches and bioethical debates concerning (...) genetic testing. Three major themes of responsibility emerged from the inter-group and cross-cultural comparison: self-responsibility, responsibility for kin, and responsibility of society towards its members. National contrast was apparent in the moral reasoning of lay respondents concerning, for example, the right not to know versus the duty to know (self-responsibility) and the moral conflict concerning informing kin versus the moral duty to inform (responsibility for kin). Attitudes of respondents affected by genetic diseases were, however, rather similar in both countries. We conclude by discussing how moral discourses of responsibility are embedded within cultural (national, religious) as well as phenomenological (being affected) narratives, and the role of public engagement in bioethical discourse. (shrink)

Recent contributions to discussions on paediatric cochlear implantation in Norway indicate two mutually exclusive doctrines prescribing the best course of post-operative support for a child with cochlear implants; bilingually with sign language and spoken language simultaneously or primarily monolingually with speech only. This conflict constitutes an ethical problem for parents responsible for choosing between one of the two alternatives. This article puts forth the precautionary principle as a possible solution to this problem. Although scientific uncertainty exists in the case of (...) both doctrines, there exists a scenario of possible irreversible harm to some of the children habilitated monolingually. An application of the precautionary principle may hence suggest that it is rational to agree on the bilingual approach, at least for the time-being. (shrink)