Unlike the principles of Kant, Mill, and Rawls, those of principlism are not action guides that stem from an underlying, integrated moral theory. Hence problems arise in reconciling the principles with each other and, indeed, in interpreting them as action guides at all, since they have no content in and of themselves. Another approach to "theory and method in bioethics" is presented as an alternative to principlism, though actually the "alternative" predates principlism by about 10 years. The alternative's account of (...) morality stays close to ordinary, common morality with its rules and ideals, which in turn are grounded in aspects of human nature. As such, morality must be understood to be a rational, impartial, and public system that is incumbent on everyone. Morality is a unified and integrated system. The moral rules and ideals are also "culture-" and "profession-sensitive" in that they are interpreted more specifically within these various contexts. (shrink)

The attitudes of the Greeks, a Mediterranean population, to the issue of telling the truth to the patient have been studied. There is no clear answer to the question: 'Do the Greeks wish to be informed of the nature of their illness?'. The answer is: 'It depends'. It depends on age, education, family status, occupation, place of birth and residence and on whether or not they are religious people. However, it does not depend on their sex--men and women have similar (...) reactions to the issue of truth-telling. Although the present study shows lower percentages of those who wish to know the truth than studies on other populations, the conclusion is that, emphasising the need for good communication between doctors and patients, doctors should not lie, but should disclose to their patients the part of the truth they are ready to accept. (shrink)

Malta traditionally enjoys a Roman Catholic Society, with the official religion of the country being cited in the second article of the constitution. Recently the government proposed to legislate to regulate human reproductive technology, in particular In Vitro Fertilization, which has been practiced for over two decades without controlling legislation. A Parliamentary Committee for social affairs was set up to study the situation inviting most stakeholders. The arguments gravitated mostly on issues of the status of the embryo and the media (...) played a considerable role. At the end of the discussion the Archbishop made a statement which pointed out that IVF involves destruction of embryos and the process stopped. This article examines what caused the deterioration of the process and points favourably towards a way forward within the context of a Catholic Country. (shrink)

Autor u ovom doprinosu podastire rezultate istraživanja ideje i korijena mediteranske bioetike. Postoji li uopće jedna regionalna, upravo mediteranska bioetika? Ako postoji, nameće se pitanje o njezinim teorijskim korijenima. Ako njezini teorijski korijeni uistinu počivaju na sveobuhvatnome kulturnom tlu mediteranskoga kompleksa, onda nije beznačajno pitanje o njezinu odnosu prema drugim regionalnim bioetikama. Međutim, odgovor na pitanje o teorijskim korijenima mediteranske bioetike podrazumijeva također odgovor na pitanje o njezinim praktičkim – upravo etičkim – korijenima. Drugim riječima, koja etika može stajati i (...) stvarno stoji u temeljima mediteranske bioetike, kao njezin odlučujući raison d’être regionalne bioetike? Pritom regionalno određenje bioetike kao mediteranske ne označava puko zemljopisno razgraničenje nego podrazumijeva i uključuje bitne elemente historijske realizacije jednoga kulturnoga kruga koji je pokazao i pokazuje svoje enormne teorijske i praktičke učinkovitosti na razini stvaranja jedne zasebne, upravo Zapadne civilizacije. I upravo kao što kompleks Zapadne civilizacije, svojom misaonom prodornošću i praktičkom učinkovitošću, probija i nadilazi okvire zemljopisnoga ograničenja, to se isto razložno može očekivati od regionalne mediteranske boetike u kojoj ono regionalno ima značenje začeća, kolijevke i izvora ideje koja određuje, karakterizira i uvjetuje ljudsko istraživanje smisla i sreće iz jedne metapovijesne perspektive. Izvanjsko, tj. civilizacijsko istraživanje smisla i značenja korijena mediteranske bioetike u slijedećem koraku treba ustupiti mjesto unutrašnjem, tj. filozofijskom istraživanju smisla i značenja njezinih korijena. Autor upravo u ovom doprinosu podastire neke rezultate istraživanja korijena mediteranske bioetike te nekih njezinih idejnih određenja i usmjerenja.The paper presents the results of the author’s research of the idea and roots of Mediterranean bioethics. Is there such a thing as regional, Mediterranean bioethics at all? If it does exist, we must ask about its theoretical fountainhead. If, furthermore, its theoretical source truly rests on the all-embracing cultural soil of the Mediterranean complex, then the question of its relation to other regional bioethics is not inconsequential. However, the answer to the question of the theoretical roots of Mediterranean bioethics assumes an answer to the question of its practical – i.e. ethical – fountainhead. In other words, which ethics can be and indeed is the very bedrock of Mediterranean bioethics as its decisive raison d’être of regional bioethics? It must, however, be noted that defining bioethics as Mediterranean is not some mere geographical demarcation, but rather implies and involves the vital elements of the historical realisation of a cultural circle that has demonstrated its superlative theoretical and practical efficiencies at the level of creating a distinctive, namely the Western, civilisation. Just as the complex of Western civilisation transcends and exceeds the limits of geographical boundaries with its reflective penetration and practical efficiency, the same can reasonably be expected from regional Mediterranean bioethics, in which the regional determines the conception, the cradle and source of the idea that determines, characterises and conditions the human research of meaning and happiness from a meta-historical perspective. The external, i.e. civilisational, research of the meaning and significance of the roots of Mediterranean bioethics is to be followed by the internal, i.e. philosophical, research of the meaning and significance of its roots. This paper presents some of the results of the author’s research of the source of Mediterranean bioethics and a number of its ideaistic determinations and orientations. (shrink)

The historical stages through which Latin American society has passed are at least four: the first, dominated by a particular sort of ethic I have termed the “ethic of the gift;” then the period of conquest, in which the prevalent ethic was one of war and subjection by force, which I call the “ethic of despotism;” followed by the colonial age, in which a new ethical model of “paternalism” emerged; and finally the stage of the “ethic of autonomy,” which began (...) with the independence movements of the 18th and 19th centuries and is far from ended. Independence was won by the criollos from European domination with very little participation by the Indian population. The latter was left out of the democratic process and saw itself relegated to a worse situation than in the centuries of colonial rule, for it was no longer protected by the paternalism of the Laws of the Indies of 1542. This is the reason for the division of the Latin American society of the last century into two quite different social strata: one bourgeois, which has assimilated the liberal revolution, and enjoys a health care quite similar to that available in any other Western country and hence faces the same bioethical problems as any developed Western society; the other a very poor stratum, without any economic or social power and hence unable to exercise its civil rights, such as the rights to life and to humane treatment. In this population sector, which is numerically the larger, the major bioethical problems are those of justice and the distribution of scarce resources. The study of Latin American medical ethics can earn for these subjects, whose deplorable condition has been essentially ignored in the bioethics of the first-world countries, the importance they merit. (shrink)

This paper discusses the issue of whether we have responsibilities to future generations with respect to genetic screening, including for purposes of selective abortion or discard. Future generations have been discussed at length among scholars. The concept of ‘Guardianfor Future Generations’ is tackled and its main criticisms discussed. Whilst germ-line cures, it is argued, can only affect family trees, genetic screening and testing can have wider implications. If asking how this may affect future generations is a legitimate question and since (...) we indeed make retrospective moral judgements, it would be wise to consider that future generations will make the same retrospective judgements on us. Moreover such technologies affect present embryos to which we indeed can be considered to have an obligation. (shrink)

Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address the dynamics (...) of the roles of patient, family and physician therein across two countries from East and West, namely, India and Germany. In India, where illness is more a shared family affair than an individual incident, a physician is likely to respect the family’s wishes and may withhold the ‹naked truth’ about the diagnosis of a fatal disease to the patient. In Germany, a physician is legally required to inform the patient about the disease. In India, advance directive being virtually non-existent, the family acts as the locus of the decision-making process, taking into account the economic cost of available medical care. In Germany, advance directive is regarded as mandatory and healthcare is covered by insurance. Family and the physician appear to play larger roles in ethical decision making for patients in India than for those in Germany, who place greater emphasis on autonomy of the individual patient. Our study explicates how culture matters in ethical decision-making and why the bioethical discourse is necessary in the concrete realities of the socio-cultural context. To explore the possibility of finding a common ground of morality across different cultures while acknowledging and respecting cultural diversity, thus remains a formidable challenge for the bioethicists. (shrink)