Human dignity—is it a useful concept in bioethics, one that sheds important light on the whole range of bioethical issues, from embryo research and assisted reproduction, to biomedical enhancement, to care of the disabled and the dying? Or is it, on the contrary, a useless concept—at best a vague substitute for other, more precise notions, at worst a mere slogan that camouflages unconvincing arguments and unarticulated biases?

Most bioethicists who address questions to which global justice matters have not considered the significance of the disputes over the correct theory of global justice. Consequently, the significance of the differences between theories of global justice for bioethics has been obscured. In this paper, I consider when and how these differences are important. I argue that certain bioethical problems can be resolved without addressing disagreements about global justice. People with very different views about global justice can converge on the (...) existence of a duty to aid the very badly off — those in absolute poverty — wherever they may be. However, despite agreement on extreme cases, there should be disagreement over the extent of international obligations to those who are only relatively poor. Consequently, different theories of justice will diverge in their implications for a number of important problems in contemporary bioethics. I close by sketching in more detail two contemporary bioethical issues —concerning pharmaceutical patents and the health worker brain drain —and show how responses to them might be developed by cosmopolitan and statist liberals. (shrink)

This entry summarizes an emerging subdiscipline of both empirical bioethics and experimental philosophy (“x-phi”) which has variously been referred to as experimental philosophical bioethics, experimental bioethics, or simply “bioxphi”. Like empirical bioethics, bioxphi uses data-driven research methods to capture what various stakeholders think (feel, judge, etc.) about moral issues of relevance to bioethics. However, like its other parent discipline of x-phi, bioxphi tends to favor experiment-based designs drawn from the cognitive sciences – including psychology, neuroscience, (...) and behavioral economics – to tease out why and how stakeholders think as they do. (shrink)

English-speaking research on morally right decisions in a healthcare context over the past three decades has been dominated by two major perspectives, namely, the Four Principles, of which the principle of respect for autonomy has been most salient, and the ethic of care, often presented as a rival to not only a focus on autonomy but also a reliance on principles more generally. In my contribution, I present a novel ethic applicable to bioethics, particularly as it concerns human procreation, (...) that I argue is a promising alternative to these two approaches. According to this new moral theory, an act is right just insofar as it treats people’s capacity to commune with respect, where communing is a matter of identifying with others and exhibiting solidarity with them. This ethic is inspired by relational ideals of communion and harmony from the African philosophical tradition, but is shown to be attractive to a broad, indeed global, audience, with regard to its implications for the morality of reproduction. (shrink)

This is the table of contents of and introduction to a textbook entitled Bioethics in Canada. It is designed mainly for use in Canada. Of the 51 articles that it contains, 26 are written by Canadians.

The theory of evolution of complex and comprising of human systems and algorithm for its constructing are the synthesis of evolutionary epistemology, philosophical anthropology and concrete scientific empirical basis in modern (transdisciplinary) science. «Trans-disciplinary» in the context is interpreted as a completely new epistemological situation, which is fraught with the initiation of a civilizational crisis. Philosophy and ideology of technogenic civilization is based on the possibility of unambiguous demarcation of public value and descriptive scientific discourses (1), and the object and (...) subject of the cognitive process (2). Both of these attributes are no longer valid. For mass, everyday consciousness and institutional philosophical tradition it is intuitively obvious that having the ability to control the evolutionary process, Homo sapiens came close to the borders of their own biological and cultural identity. The spontaneous coevolutionary process of interaction between the «subject» (rational living organisms) and the «object» (material world), is the teleological trend of the movement towards the complete rationalization of the World as It Is, its merger with the World of Due. The stratification of the global evolutionary process into selective and semantic (teleological) coevolutionary and therefore ontologically inseparable components follows. With the entry of anthropogenic civilization into the stage of the information society, firsty, the post-academic phase of the historical evolution of scientific rationality began, the attributes of which are the specific methodology of scientific knowledge, scientific ethos and ontology. Bioethics as a phenomenon of intellectual culture represents a natural philosophical core of modern post- academic (human-dimensional) science, in which the ethical neutrality of scientific theory principle is inapplicable, and elements of public-axiological and scientific-descriptive discourses are integrated into a single logic construction. As result, hermeneutics precedes epistemology not only methodologically, but also meaningfully, and natural philosophy is regaining the status of the backbone of the theory of evolution – in an explicit form. (shrink)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, (...) especially when principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

This article provides a brief introduction to some contemporary challenges found in the intersection of bioethics and international criminal law involving genetic privacy, organ trafficking, genetic engineering, and cloning. These challenges push us to re-evaluate the question of whether the international criminal law should hold corporations criminally liable. I argue that a minimalist and Strawsonian conception of corporate responsibility could be useful for deterring the wrongs outlined in first few sections and in answering compelling objections to corporate criminal liability.

This paper begins by saying enough about eugenics to explain why disability is central to eugenics (section 2), then elaborates on why cognitive disability has played and continues to play a special role in eugenics and in thinking about moral status (section 3) before identifying three reasons why eugenics remains a live issue in contemporary bioethics (section 4). After a reminder of the connections between Nazi eugenics, medicine, and bioethics (section 5), it returns to take up two more (...) specific clusters of issues at the intersection of eugenics, disability, and bioethics. These concern questions of life, death, and reproductive value (section 6) and the value of standpoint theory and epistemology for understanding some of the tensions between bioethics and disability in light of a shared eugenic past (section 7). (shrink)

This is the second edition of the textbook Bioethics in Canada. It is the most up to date bioethics textbook on the Canadian market. Twenty-nine of its 54 contributions are by Canadians. All the chapters carried over from the first edition are revised in full (especially the chapters on obligations to the global poor, on medical assistance in dying, and on public health). It comprises *new* chapters on emerging genetic technologies and on indigenous peoples' health. It contains *new* (...) case studies focusing on ethical issues and problems of relevance to Canadians. From the Preface: This anthology is designed for those teaching bioethics in colleges and universities in Canada. It comprises articles from researchers exploring the main problems of bioethics from a diversity of perspectives and ethical traditions. It includes in particular articles by Canadian researchers who appear in anthologies less often than they should. The hope is that the reader will, as a result, better appreciate the rich reservoir of talent present among those working in bioethics in Canada and Canadian bioethicists working abroad. In addition, this volume intentionally aims to educate the reader about the policies and laws regulating the most important and pressing bioethical problems facing Canadians. The hope is that the reader will develop a nuanced view of the nature, importance, and impact of bioethics in Canada. (shrink)

Should we do whatever science lets us do? This short introduction in the 'All That Matters' series shows how developments in biotechnology, such as genetics, stem cell research and artificial reproduction, arouse both our greatest hopes and our greatest fears. Many people invest the new biotechnology with all the aspirations and faith once accorded to religious salvation. But does everyone benefit equally from scientific progress? This book argues that although we've entered new scientific territory, there is no need to jettison (...) our existing moral sense. By discussing a range of real-life cases, it equips readers to make up their own minds on these important questions. Good science and good ethics needn't be contradictory. (shrink)

Alongside a revival of interest in Thomism in philosophy, scholars have realised its relevance when addressing certain contemporary issues in bioethics. This book offers a rigorous interpretation of Aquinas's metaphysics and ethical thought, and highlights its significance to questions in bioethics. Jason T. Eberl applies Aquinas’s views on the seminal topics of human nature and morality to key questions in bioethics at the margins of human life – questions which are currently contested in the academia, politics and (...) the media such as: When does a human person’s life begin? How should we define and clinically determine a person’s death? Is abortion ever morally permissible? How should we resolve the conflict between the potential benefits of embryonic stem cell research and the lives of human embryos? Does cloning involve a misuse of human ingenuity and technology? What forms of treatment are appropriate for irreversibly comatose patients? How should we care for patients who experience unbearable suffering as they approach the end of life? _Thomistic Principles and Bioethics_ presents a significant philosophical viewpoint which will motivate further dialogue amongst religious and secular arenas of inquiry concerning such complex issues of both individual and public concern. (shrink)

The practical problem of how to conduct oneself as a Christian and a Philosopher or Bioethicist in public debate an when asked to be engaged in government committees is difficult. One solution that has had some support has been to approach the issues on the grounds of our natural law tradition but understood anthropocentrically – the ultimate end is not communion with God by integral human development. This is often called New Natural Law (NNL). This separation of Philosophy and Theology (...) has had its critics and most notably the current Poe and his immediate predecessor. In their own writing addressed to people of goodwill, they took a different approach that was essentially Christocentric and involving s close partnership between Philosohy and Theology. In my own experience over thirty years of public involvement in Bioethics, I have discovered that the NNL approach has two overwhelming problems. What is offered to the secular dialogue, as an anthropocentric natural law, often sounds false to secular others because we propose something guided by our beliefs, but failing to acknowledge that contribution. However something that I have discovered latterly in that approach is in fact false by our own standards. By the strictures we impose on our contribution we in fact ignore the New Law instituted by Christ, the law of love. The New Natural Law (NNL) Project has proved to be a failure where it has been tried, and, I know realize, was doomed from the outset, because in being anthropocentric it was essentially lacking and the answers that it gave to problems were often unsatisfactory because lacking love and the particular demand of needing to be capable of being oriented towards God, the God of love. The NNL approach tended to produce a casuistry that was too liberal and too lacking in understanding of the essential role that affectivity plays in our lives, created as we are in the imago dei, in the image and likeness of the God of love. Such a morality demands much more than anthropocentricism can demand. In recognizing these difficulties I propose instead a more pragmatic approach that reflects a partnership between Philosophy and Theology as espoused by the Second Vatican Council, and by Pope’s Benedict XVI and Pope John Paul II, and which engages the work of Alasdair MacIntyre and Servais Pinckaers. An approach that I have tried with some success in chairing government committees. (shrink)

Recent bioethical issues that have emerged in the field of medicine include, but are not limited to, eugenics (artificial insemination), palliative care (end of life care), euthanasia (medical resuscitation), abortion, and the development of enhanced human body parts. These bioethical issues have raised ethical questions related to the use of modern technology and how it may affect the future of society. These questions consider issues such as: what is the identity of future children? Have human beings become a commodity exchanged (...) by those who have the ability to own them? What is the meaning of justice in medical treatment? How can physicians and nurses perform humanitarian work? -/- Discussions of these questions should begin by determining their relationships with typical social and cultural values in society, such as life and death, marriage, family, fatherhood, motherhood, relatives, and next-of-kin. -/- This paper presents a review of the important Arabic literature that has been written on these bioethical issues to show the contributions of Arab scholars in this field. Arabic studies in bioethics can be classified into three types: original Arabic writings, translated studies, and congresses held in the Arab region. (shrink)

Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology (Ickes...

The monograph includes works of specialists and scientists - active members of the bioethical movement In Ukraine, and regular participants in national congresses on bioethics in Kyiv for the last 20 years. Over the years, bioethics has become widely used our lives It is evidenced, in particular, by the list of topics that are presented in the collective monographs, namely: philosophical and philosophical aspects of bioethics and dissemination bioethical norms and rules in various spheres of human activity. (...) Most articles include both theoretical aspects of bioethics and examples of practical application of bioethical principles. The book is intended for scientists, doctors, philosophers, jurists, teachers and students of higher educational institutions, as well as a wide range of readers who are interested in bioethical issues. (shrink)

The recent encyclical of Pope Francisco has been classified by many as the encyclical on the climate and the environment. However, father Francisco not only mentions several of the environmental problems of today’s world, including the more dramatic, but analyses the causes of such problems and seeks to shed plenty of light to find solutions. In the present investigation, it delves into the importance of the message of hope from Pope Francisco facing the serious crisis which describes in his Encyclical (...) insists on hope as a core element of an ethic that will help to get out of these problems, because without hope there is no possible ethics. The Encyclical is situated in the field of bioethics demonstrating the concern of the Pope at the general situation of the planet Earth, placing the human person at the Centre of this reflection, to then describe the positive elements of the diagnosis of the reality and bets that allow you to build a vision of hope. -/- La reciente encíclica del Papa Francisco ha sido catalogada por muchos como la encíclica sobre el clima y el medio ambiente. Sin embargo, el Papa Francisco no solo menciona varios de los problemas ambientales del mundo actual, incluyen-do los más dramáticos, sino que analiza las causas de dicha problemática y busca arrojar abundante luz para encontrarle soluciones. En la presente investigación, se ahonda en la importancia del mensaje de esperanza del Papa Francisco frente a la grave crisis que describe en su encíclica y se insiste en la esperanza como elemento medular de una ética que ayude a salir de dichos problemas, pues sin esperanza no hay ética posible. Se sitúa la encíclica en el ámbito de la bioética evidenciando la preocupación del Papa por la situación general del planeta Tie-rra, poniendo a la persona humana en el centro de dicha reflexión, para luego describir los elementos positivos del diagnóstico de la realidad y las apuestas que permiten construir una visión de esperanza. (shrink)

This article aims to develop a Lacanian approach to bioethics. Point of departure is the fact that both psychoanalysis and bioethics are practices of language, combining diagnostics with therapy. Subsequently, I will point out how Lacanian linguistics may help us to elucidate the dynamics of both psychoanalytical and bioethical discourse, using the movie One flew over the Cuckoo’s Nest and Sophocles’ tragedy Antigone as key examples. Next, I will explain the ‘topology’ of the bioethical landscape with the help (...) of Lacan’s three dimensions: the imaginary, the symbolical and the real. This will culminate in an assessment of the dynamics of bioethical discourse with the help of Lacan’s theorem of the four discourses. Bioethics, I will argue, is not a homogeneous discourse. Rather, four modalities of bioethical discourse can be distinguished, all of them displaying specific weaknesses and strengths, opportunities and threats. This will be elucidated with the help of two case studies, namely the debates on human reproductive technologies and on the use of animals as biomedical research models. (shrink)

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care (...) to patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs. (shrink)

One interesting aspect of the Hwang-case has been the way in which this affair was assessed by academic journals such as Nature. Initially, Hwang’s success was regarded as evidence for the detrimental effects of research ethics, slowing down the pace of research in Western countries. Eventually, however, Hwang’s debacle was seen as evidence for the importance of ethics in the life sciences. Ironically, it was concluded that the West maintains its prominence in science (as a global endeavour) precisely because it (...) has its ethics in place. Bioethics was now seen as an indispensable part of quality control. In this article, I will claim that the Hwang case rather reveals that there is no reason for complacency and that there are substantial challenges awaiting us. They have to do with major transformations in the way knowledge is produced and research in the life sciences is conducted (such as the increase in pace and scale, globalisation and the growing importance of ICT and bioinformation). These transformations call for a different kind of bioethics. The focus must shift from duties of autonomous researchers concerning visible research subjects (“micro-ethics”) to responsibilities of institutionalised research networks in managing and processing large amounts of bioinformation (“macro-ethics”). Concepts such as transparency, reliability and benefit-sharing will become more important than concepts such as informed consent. Basically, it is a resurgence of the tension between the Kantian and the Hegelian view of ethics. The contours of macro-ethics will be elaborated notably as it is emerging in bioethical debates over biobanking and genetic databanks. (shrink)

Introductory and advanced textbooks in bioethics focus almost entirely on issues that disproportionately affect disabled people and that centrally deal with becoming or being disabled. However, such textbooks typically omit critical philosophical reflection on disability, lack engagement with decades of empirical and theoretical scholarship spanning the social sciences and humanities in the multidisciplinary field of disability studies, and avoid serious consideration of the history of disability activism in shaping social, legal, political, and medical understandings of disability over the last (...) fifty years. For example, longstanding discussions on topics such as euthanasia, physician aid-in-dying, pre-implantation genetic diagnosis, prenatal testing, selective abortion, enhancement, patient autonomy, beneficence, non-maleficence, and health care rationing all tend to be premised on shared and implicit assumptions regarding disability, especially in relation to quality of life, yet with too little recognition of the way that “disability” is itself a topic of substantial research and scholarly disagreement across multiple fields. This is not merely a concern for academic and medical education; as an applied field tied to one of the largest economic sectors of most industrialized nations, bioethics has a direct impact on healthcare education, practice, policy, and, thereby, the health outcomes of existing and future populations. It is in light of these pressing issues that the Disability Bioethics Reader is the first reader to introduce students to core bioethical issues and concepts through the lens of critical disability studies and philosophy of disability. The Disability Bioethics Reader will include over thirty-five chapters covering key areas such as: critical histories and state-of-the-field analyses of modern medicine, bioethics, disability studies, and philosophy of medicine; methods in bioethics; concerns at the edge- and end-of-life; enhancement; disability, quality of life, and well-being; prenatal testing and abortion; invisible disabilities; chronic illness; healthcare justice; genetics and genomics; intellectual disability and neurodiversity; ethics and diagnosis; and epistemic injustice in healthcare. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Attempt of trans-disciplinary analysis of the evolutionary value of bioethics is realized. Currently, there are High Tech schemes for management and control of genetic, socio-cultural and mental evolution of Homo sapiens (NBIC, High Hume, etc.). The biological, socio-cultural and technological factors are included in the fabric of modern theories and technologies of social and political control and manipulation. However, the basic philosophical and ideological systems of modern civilization formed mainly in the 17–18 centuries and are experiencing ever-increasing and destabilizing (...) risk-taking pressure from the scientific theories and technological realities. The sequence of diagnostic signs of a new era once again split into technological and natural sciences’ from one hand, and humanitarian and anthropological sciences’, from other. The natural sciences series corresponds to a system of technological risks be solved using algorithms established safety procedures. The socio-humanitarian series presented anthropological risk. Global bioethics phenomenon is regarded as systemic socio-cultural adaptation for technology-driven human evolution. The conceptual model for meta-structure of stable evolutionary strategy of Homo sapiens (SESH) is proposes. In accordance to model, SESH composed of genetic, socio-cultural and techno-rationalist modules, and global bioethics as a tool to minimize existential evolutionary risk. An existence of objectively descriptive and value-teleological evolutionary trajectory parameters of humanity in the modern technological and civilizational context (1), and the genesis of global bioethics as a system social adaptation to ensure self-identity (2) are postulated. -/- . (shrink)

This introduction begins with two simple case studies that reveal a background of socio-economic complexities that hinder development. The availability of healthcare and the issue of cross-border justice are the key points to be addressed in this study. The chapters consider philosophy, economics, and bioethics in order to provide a global perspective. Two theories come into play in this book—the ideal and non-ideal—which offer insight on why and how things are done.

The term "human dignity" is the source of considerable confusion in contemporary bioethics. It has been used by Kantians to refer to autonomy, by others to refer to the sanctity of life, and by still others to refer—albeit obliquely—to an important but infrequently discussed set of human goods. In the first part of this article, I seek to disambiguate the notion of human dignity. The second part is a defense of the philosophical utility of such a notion; I argue (...) that there is nothing implausible about appealing to a deontological "principle of dignity" to solve bioethical problems, especially those concerning the development of new biotechnologies. There may, however, be problems associated with any attempt to use dignity as a basis for public policy. This sort of worry is explained and briefly addressed in the final section. (shrink)

Background There has been debate on whether a global or unified field of bioethics exists. If bioethics is a unified global field, or at the very least a closely shared way of thinking, then we should expect bioethicists to behave the same way in their academic activities anywhere in the world. This paper investigates whether there is a 'global bioethics' in the sense of a unified academic community. Methods To address this question, we study the web-linking patterns (...) of bioethics institutions, the citation patterns of bioethics papers and the buying patterns of bioethics books. Results All three analyses indicate that there are geographical and institutional differences in the academic behavior of bioethicists and bioethics institutions. Conclusion These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (shrink)

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about (...) how to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond. (shrink)

Commentary about the role of AI in bioethics for the 10th anniversary issue of AJOB: Empirical Bioethics.

As the technosciences, including genomics, develop into a global phenomenon, the question inevitably emerges whether and to what extent bioethics can and should become a globalised phenomenon as well. Could we somehow articulate a set of core principles or values that ought to be respected worldwide and that could serve as a universal guide or blueprint for bioethical regulations for embedding biotechnologies in various countries? This article considers one universal declaration, the UNESCO Declaration on Bioethics and Human Rights (...) ( 2005a ). General criticisms made in a recent special issue of Developing World Bioethics are that the concepts used in the Declaration are too general and vague to generate real commitment; that the so-called universal values are not universal; and, that UNESCO should not be engaged in producing such declarations which are the domain of professional bioethicists. This article considers these and other criticisms in detail and presents an example of an event in which the Declaration was used: the request by the Republic of Sakha, in Siberia, for a UNESCO delegation to advise on the initiation of a bioethics programme. The Declaration was intended to provide an adequate “framework of principles and procedures to guide states in the formulation of their legislation, policies and other instruments in the field of bioethics” (article 2a). The Declaration was produced, and principles agreed upon, in an interactive and deliberative manner with world-wide expert participation. We argue that the key issue is not whether the general principles can be exported worldwide (in principle they can), but rather how processes of implementation and institutionalisation should take shape in different social and cultural contexts. In particular, broader publics are not routinely involved in bioethical debate and policy-making processes worldwide. (shrink)

The late Robert Veatch, one of the United States’ founders of bioethics, never tired of reminding us that the paradigm-shifting contribution that bioethics made to patient care was to liberate patients out of the hands of doctors, who were traditionally seen to know best, even when they decidedly did not know best. It seems to us that with the advent of COVID-19, health policy has come full-circle on this. COVID-19 gave rise to a large number of purportedly “ethical” (...) guidance documents aiming to assist health care providers and practitioners with responding to the ethical challenges that might arise in their response to the pandemic. Ethics has two primary functions: provide clear action guidance, and provide clear action justification. The documents in question arguably reflect the ultimate policy triumph of bioethical “principlism”, and, perhaps surprisingly, as a corollary, the ultimate triumph of “doctor-knows-best”. (shrink)

Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist (...) reasons. However, it is not clear what justifies the judgment that someone or something is inauthentic. This article discusses one recent theory of what justifies judgments of inauthenticity. It is argued that the theory is seriously limited, as it only provides guidance in three out of nine identified cases. There are at least six authenticity-related problems to be solved, and autonomy theorists thus have reason to engage with the topic of authenticity in practical biomedicine. (shrink)

50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead (...) for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”. (shrink)

Like most bioethical discussion, examination of human biobanks has been largely framed in terms of research subjects’ rights, principally informed consent, with some gestures toward public benefits. However, informed consent is for the competent, rights-bearing individual: focussing on the individual, it thus neglects social, economic and even political matters; focussing on the competent rights-bearer, it does not serve situations where consent is plainly inappropriate (eg, the young child) or where coercion can obviously be justified (the criminal). Using the British experience (...) of large-scale biobanking, I argue that the focus on consenting individuals distorts our ways of thinking about biobanks and has serious practical ramifications. This becomes clear if we contrast the case of adult biobanks intended for medical research with two other forms of biobanking. Thus child cohort studies – vital for sound scientific investigation of the interplay of genetics and environment in health – have been very badly funded next to adult studies. On the other hand, forensic databases have attracted massive investment, but little debate – partly owing to a sense that here, at least, is a case where consent is not relevant. Contrasting these central types of biobanking, I will suggest that there are powerful factors at work in limiting ‘ethics’ to individual rights. Projects of this size should direct our attention to more overtly political questions concerning priority setting and organisation of medical research. (shrink)

Topic modeling—a text‐mining technique often used to uncover thematic structures in large collections of texts—has been increasingly frequently used in the context of the analysis of scholarly output. In this study, we construct a corpus of 19,488 texts published since 1971 in seven leading journals in the field of bioethics and philosophy of medicine, and we use a machine learning algorithm to identify almost 100 topics representing distinct themes of interest in the field. On the basis of intertopic correlations, (...) we group the content‐based topics into eight clusters, thus providing a novel, fine‐grained intellectual map of bioethics and philosophy of medicine. Moreover, we conduct a number of diachronic analyses, examining how the “prominence” of different topics has changed across time. In this way, we are able to observe the distinct patterns in which bioethics and philosophy of medicine have evolved and changed their focus over the past half a century. (shrink)

In this article I offer a critique of certain moral perspectives that are found in the second edition of Engelhardt’s Foundation of Bioethics. These views are spelled out in explicit detail in his second edition, and follow on the heels of a profound religious conversion. I question some of the conclusions that Engelhardt reaches as they touch upon moral frameworks, pluralism, and a ‘secular’ bioethics.

This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to (...) contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments. (shrink)

Parental Obligations and Bioethics: The Duties of a Creator collects and supplements Bernard G. Prusak’s work on the ethics of procreation and parenthood, and applies his unique theoretical approach to related issues in bioethics and social philosophy. In this review, I’ll first summarize what I take to be the argumentative core of the book, and then offer a brief critical assessment.

The goal of this work is to analyse the paradigmatic concept of universal values important for bioethics such as autonomy, beneficence, justice and developing contextual approaches in resolving the moral questions on bioethics. It also aims to reveal and analyse the importance of universal approaches despite the basic non-liminality of a context and subjectivity. Keywords: autonomy, contextualism, subjectivity, universal values, metaethics, normativity.

Editorial for latest issue introducing papers from a symposium held as part of the Irish President's Initiative on Bioethics and others questioning whether autonomy is losing its influence as a predominant principle in bioethics.

This chapter delves into the museological side of ‘the way forward’ to conservation for planetary health bioethics. Specifically, it highlights the crucial role that museums play – their curatorial or exhibition interventions, conservation operations, development policies, or practices – which present or represent the vital relationship between human and planetary health. While it is not new to stress the significance of museums’ link to the environment and environmental education, it is necessary to re-examine recent cases in light of the (...) rapid changes brought about by climate change and the constant call for sustainability. We thus offer a review of some recent literature that appraises the museum’s role in bioethically considering the health of our living planet. Learning this role taps into relatively new themes such as ecomuseums and architectural heritage, or critical eco-museology. (shrink)

Pain medication is one of the responses to the mercy argument that utilitarian ethicists use for justifying active euthanasia on the grounds of prevention of cruelty and appeal to beneficence. The researcher reinforces the significance of pain medication in meeting this challenge and considers it the most preferred response among various other responses. It is because of its realism and effectiveness. In exploring the mechanism and considerations related to pain medication, the researcher briefly touches the Catholic ethical position on the (...) issue, a position that cannot be ignored in the development of contemporary bioethics. The researcher particularly deliberates on the contemporary Islamic discourse on the issue; by furthering the debate in line with the Islamic legal maxims and general guidance from the primary sources of Islamic law and ethics. The resolution on the issue is sought by synthesizing the views and legal maxims (al-Qawaid al-Fiqhiyyah) on the issue, which in conclusion provide justification for pain medication by considerably regarding pain as necessity and pressing need. However, such resolution allows pain medication to the limit and proportion that removes the pain and prohibits overdosing the patient with medication that may directly cause the death. (shrink)

Peer commentary on: Blumenthal-Barby, J. S. (2016). Biases and heuristics in decision making and their impact on autonomy. The American Journal of Bioethics, 16(5), 5-15.

Bioethics, neuroscience, medicine are contributing to a debate on the definition and criteria of death. This topic is very controversial, and it demonstrates clashing views on the meaning of human life and death. Official medical and legal positions agree upon a biological definition of death as irreversible cessation of integrated functioning of the organism as a whole, and whole-brain criterion to ascertain death. These positions have to face many criticisms: some scholars speak of logical and practical inconsistency, some others (...) of invalid scientific theory about the supreme integrator. In this paper some criticisms are exposed and discussed in order to reconstruct the state of the art in bioethical debate. -/- . (shrink)

This collection of papers is the fifth in a series of books from RUSHSAP, UNESCO Bangkok offering Asia and Pacific perspectives on ethics - each focusing on specific themes. The contents come from submitted papers to the UNESCO Bangkok Bioethics conferences held in 2005 and they are assembled thematically. They also include discourse from the conference, as intercultural communication is part of the essence of deliberation on bioethics.

The guiding premise from which this special report begins is the conviction and hope that justice is at the normative heart of medicine and that it is the perpetual task of bioethics to bring concerns of justice to bear on medical practice. On such an account, justice is medicine's lifeblood, that by which it contributes to life as opposed to diminishing it. It is in this larger, historical, intersectional, critical, and ethically minded context that we must approach pressing questions (...) facing medicine, including the question of the import and role of genomic knowledge for human life. The second premise is that, at least in principle, the knowledge generated by genomics can be a gift or a weight, or both at the same time. That is to say that, on the one hand, genomic knowledge is a gift, creating novel insights into the genetic drivers of disease and into the geographical paths of our ancestors. And on the other hand, it is a weight, creating new obligations, new forms of social classification, and new forms of surveillance. Because it is in many ways the “common sense” of the day that genomic knowledge is a gift, this special report, which contains nine essays, concentrates on the ways in which such knowledge can be a weight, a weight that has the potential to thwart—and historically has thwarted—medicine from genuinely advancing justice . (shrink)

This article seeks to investigate to what extent the resulting empirical data from various experiments in Moral Psychology (some behavioral, others based on evidence from neuroimaging and in patients with brain lesions associated with moral competence areas) , can contribute to a better understanding of the psychological processes (cognitive and emotional) underlying to our moral practical judgments, helping us to understand the mechanisms that influence our assessment of moral dilemmas in general and bioethics in particular. Various experiments are discussed (...) (and the theoretical models that are supported) that reveal aspects such as the role of disgust or repugnance in the production of moral judgments, the competitive or cooperative role of emotions and cognitions in impersonal and personal moral dilemmas -and between the above mentioned, easy and difficult-, the neurophysiological bases of deontologist and consequentialist, the value attributed to the intent and the results of action, etc. The relevance of these experiments are analyzed to understand the evaluative and deliberative processes concerning various bioethical dilemmas, for which appeals to examples of conflict situations involved and our emotional resources (that activate immediate assessment ) and our higher cortical areas interact (cognitive processes responsible for slower deliberative and reflexive). (shrink)

By the early 2000s, it was already being mentioned that one of the issues affecting bioethics was a lack of wonder or amazement. Today, we see the patient, the weak and the helpless have become clients or objects placed at the disposal of personal, community and entrepreneurial whims based on functionality or utility that can take on a life of its own. Accordingly, the authors of this article propose wonder or amazement as an attitude that not only makes it (...) possible to place the human being at the center and starting point of bioethical reflection, but it is those who suffer the most, the weak and the defenseless, who are predominantly at that center or starting point. -/- A comienzos de la década del 2000 ya se mencionaba que una de las cuestiones que aquejaba la Bioética era la falta de asombro. En la actualidad vemos que el paciente, el débil y el indefenso han pasado a ser clientes u objetos puestos a disposición de caprichos personales, comunitarios o empresariales basados en la funcionalidad o utilidad que pueda tener una vida en particular. Es por eso que en este trabajo proponemos el asombro como una actitud que permite no solo situar a la persona humana como centro y punto de partida de la reflexión bioética, sino que en dicho centro esté de manera preponderante el que más sufre, el débil y el indefenso. (shrink)

One of the many proposals put forth recently in the revival of bioethics concerns solidarity, which is part of the agenda for the discipline in the twenty-first century. In this article, solidarity is proposed as a bioethical value, inasmuch as it cannot be achieved without considering the person towards whom one shows solidarity and without taking into account his or her environment. It is not possible to make bioethical judgments or to accomplish in-depth biological thinking when forgetting the person (...) who is at the source or heart of the matter. Based on a study of the experience of a group of health volunteers in Medellin (Colombia), this research found evidence of the existence of three elements that, together, serve as a hinge between solidarity and bioethics. -/- Entre las muchas propuestas que se han hecho recientemente en ese resurgir de la bioética se encuentra la solidaridad, consti­tuyéndose parte de la agenda del siglo XXI sobre esta disciplina. Proponemos la solidaridad como un valor bioético puesto que así como no se puede ser solidario sin tener en cuenta a la persona con quien soy solidario y su entorno, no se pueden emitir juicios bioéticos o hacer una reflexión bioética de fondo olvidando a quien se tiene en frente. A partir de un estudio de la expe­riencia de una población de voluntarios del sector salud en Medellín, Colombia, se logró evidenciar que existen tres elementos que, en conjunto, sirven de bisagra entre la solidaridad y la bioética. (shrink)

Some advances in bioethics regarding ethical considerations that arise in the context of medical research can also be relevant when thinking about the ethical considerations that arise in the context of SoTL research. In this article, I aim to bring awareness to two potential ethical challenges SoTL researchers might face when playing a dual role of teacher and researcher that are similar to the challenges physicians face in their dual role of physician and researcher. In this article, I argue (...) that two commonly discussed concerns in bioethics---the need for clinical equipoise and the possibility of a therapeutic misconception---have analogies when conducting some types of research on students. I call these counterparts educational equipoise and the educational misconception. (shrink)