As a policy instrument that is deeply rooted in technology assessment, the precautionary principle examines the effects of a given object on humans and the environment. In practice the principle is rarely used to analyze the effects of our safety measures on the object itself or the way it is produced. Yet it is exactly in the effect on the blood procurement system that blood safety regulations based on the precautionary principle have to be particularly careful, as the (...) vast majority of blood products in the Global North are obtained through donations. (shrink)

There is a widespread consensus that a commodification of body parts is to be prevented. Numerous policy papers by international organizations extend this view to the blood supply and recommend a system of uncompensated volunteers in this area—often, however, without making the arguments for this view explicit. This situation seems to indicate that a relevant source of justified worry or unease about the blood supply system has to do with the issue of commodification. As a result, the current (...) health minister of Ontario is proposing a ban on compensation even for blood plasma—despite the fact that Canada can only generate 30 % of the plasma needed for fractionation into important plasma protein products and has to purchase the rest abroad. In the following, I am going to suggest a number of alternative perspectives on the debate in order to facilitate a less dogmatic and more differentiated debate about the matter. Especially in light of the often over-simplified notions of altruism and commodification, I conclude that the debate has not conclusively established that it would be morally objectionable to provide blood plasma donors with monetary compensation or with other forms of explicit social recognition as an incentive. This is especially true of donations for fractionation into medicinal products by profit-oriented pharmaceutical companies. (shrink)

Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. “Unduly” indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. Since the error is at the policy-level, it’s natural and understandable to focus criticism on reformulating or eliminating the offending policies. Policy change is undoubtedly the right goal because the policy is what prevents otherwise safe eligible donors from donating needed blood. (...) But focusing exclusively at the policy-level passes over a largely undiscussed question: if policy change takes time and there is an urgent need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores that otherwise eligible donors could safely donate their blood in addition to their time and money. Here is the central question I will focus on in this paper: is a donor morally justified in lying on a questionnaire to donate blood if they justifiably believe that their blood poses no risk to a recipient and knows that honestly answering a donor questionnaire would unduly defer them from donating? (shrink)

In this essay I argue that childbearing and various kinds of organ donation are morally analogous activities. I argue, further, that the ethos of giftgiving ought to inform our analyses of both of these forms of bodily life support. This reframing of the abortion and organ donation debates yields new insights into two relatively neglected subtopics. First, though frequently asserted, few have demonstrated why bodily life support--especially in the form of childbearing--cannot be morally required. This comparison yields insights (...) into the reasons for such an axiom. Second, while the giving of bodily life support is sometimes exhorted and almost always respected and admired, its intelligibility and political meaningfulness as a moral choice is rarely explored. This analogical wager reveals why one ought to give another bodily life support. In summary, the analogy yields insights crucial to the development of cogent arguments regarding both the grounds for and limits of the responsibility to give bodily life support. Further, the analogy displays the disparity between what has been demanded traditionally of those who are pregnant and of those men (and women) who by virtue of tissue or blood type can offer other forms of bodily life support. The analogy enables reflection on abortion (and organ donation) to develop in a context free of sexist biases. Finally, efforts are made to assess this giftgiving ethos in light of the feminist "hermeneutics of suspicion" regarding arguments which have and can sacralize victimization. (shrink)

A private, for-profit company has recently opened a pair of plasma donation centres in Canada, at which donors can be compensated up to $50 for their plasma. This has sparked a nation-wide debate around the ethics of paying plasma donors. Our aim in this paper is to shift the terms of the current debate away from the question of whether plasma donors should be paid and toward the question of who should be paying them. We consider arguments against paying (...) plasma donors grounded in concerns about exploitation, commodification, and the introduction of a profit motive. We find them all to be normatively inconclusive, but also overbroad in light of Canada’s persistent reliance on plasma from paid donors in the United States. While we believe that there are good reasons to oppose allowing a private company to profit from Canada’s blood supply, these concerns can be addressed if payment is dispensed instead by a public, not-for-profit agency. In short, we reject profiting from plasma while we endorse paying for plasma; we therefore conclude in favour of a new Canadian regime of public sector plasma collection and compensation. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

In accordance with a recent statement released by the World Health Organization, the Canadian province of Ontario is moving to ban payment for plasma donation. This is partially based on contentions that remuneration for blood and blood products undermines autonomy and personal dignity. This paper is dedicated to evaluating this claim. I suggest that traditional autonomy-based arguments against commodification of human body parts and substances are less compelling in the context of plasma donation in Canada, but (...) that there is another autonomy-based objection to paid plasma donation that has not received sufficient attention. Namely, the stigma that surrounds exchanging plasma for payment makes it difficult to make an autonomous decision to engage in this activity. I suggest that this problem can be overcome in one of two ways; by banning payment for plasma, or by reducing the stigma surrounding this practice. I provide an indication of how we might work to achieve the latter, contending that this possibility should be taken seriously, due to the difficulties in achieving a sufficient supply of plasma without remuneration. (shrink)

In Brazil, the social demand for veterinary expertise is growing. However, there is still a shortage of professionals trained in this area to apply specific knowledge to each case. Studies and research into forensic veterinary medicine are necessary for veterinary experts to assist in investigations and legal proceedings. Veterinary medicine has subjects on its curriculum that cover the knowledge needed to apply in the fields of animal health, public health and the environment. The interaction between human and veterinary medicine, as (...) well as other areas of health, is of great importance in the prevention and control of various diseases, both in animals and humans. Some cases of infectious bovine abortion have a major impact not only on cattle farming and animal health, but also on public and environmental health. The concept of "One Health" integrates human medicine and health professionals. In this context, knowledge of infectious abortive diseases that affect animal, human and environmental health is fundamental. Cattle are affected by specific infectious abortive diseases, caused by pathogens with different forms of presentation and transmission mechanisms. These include brucellosis, leptospirosis and listeriosis, which are potentially zoonotic diseases. Controlling these diseases can contribute to effective public health actions and reduce global health risks. In order to establish the diagnosis of these diseases, it is essential to properly collect specimens from live or dead animals under biosafety and biosecurity conditions, following the chain of custody for each case. These procedures allow for greater success in diagnosing the suspected agent and facilitate the investigation of other causes. Animal health standards for the prophylaxis and control of these diseases are established by specific legislation, including those of the Ministry of Agriculture, Livestock and Supply (MALS). This literature review was based on current knowledge on the Pubmed platform, Google Scholar, articles and textbooks. The aim of this article is to identify, understand and discuss the main infectious abortive diseases of cattle in the legal and forensic context, which have an impact on cattle farming, animal health, food safety, public and environmental health. -/- Referências bibliográficas Abdullah, N. M., Mohammad, W. M. Z. W., Shafei, M. N., Sukeri, S., Idris, Z., Arifin, W. N., Nozmi, N., Saudi, S. N. S., Samsudin, S., & Zainudin, A.-W. (2019). Leptospirosis and its prevention: knowledge, attitude and practice of urban community in Selangor, Malaysia. BMC Public Health, 19(1), 1–8. Agrimani, D. S. R., Rui, B. R., Cruz, I. V, Romano, R. M., & Lopes, H. C. (2011). 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R., Zylbersztajn, A., & Avila-Pires, F. D. (2004). Evolução histórica da medicina veterinária preventiva e saúde pública. Ciência Rural, 34(5), 1661–1668. Pinillos, R. G. (2018). One welfare: A framework to improve animal welfare and human well-being. Cabi. Poester, F. P., Goncalves, V. S. P., & Lage, A. P. (2002). Brucellosis in Brazil. Veterinary Microbiology, 90(1–4), 55–62. Porto, Y. F., Pinto Neto, A., Bernardi, F., Possa, M. G., Mota, M. F., Martinez, A. C., Merlini, L. S., & Berber, R. C. (2018). Occurrence of brucellosis, leptospirosis and neosporosis in cows with retained placenta in Southwest Paraná, Brazil. Pesquisa Veterinária Brasileira, 38(8), 1537–1542. Radostits, O. M., Gay, C. C., Blood, D. C., Hinchcliff, K. W., & McKenzie, R. A. (2010). Clínica Veterinária: um tratado de doenças dos bovinos, ovinos, suínos, caprinos e eqüinos (Vol. 1). Guanabara Koogan. Ramos, T. M. V., Balassiano, I. T., Silva, T. S. M., & Nogueira, J. M. R. (2022). Leptospirose: Características da enfermidade em humanos e principais técnicas de diagnóstico laboratorial. Revista Brasileira de Análises Clínicas, 53(3), 211–218. Ribeiro, A. C. A., Araújo, R. V., Rosa, A. S. M., Silva, P. N., Moraes, S. C., & Katagiri, S. (2020). Zoonoses e educação em saúde: Conhecer, compartilhar e multiplicar. Brazilian Journal of Health Review, 3(5), 12785–12801. Rocha, C. F., Mol, J. P. S., Garcia, L. N. N., Costa, L. F., Santos, R. L., & Paixão, T. A. (2017). Comparative experimental infection of Listeria monocytogenes and Listeria ivanovii in bovine trophoblasts. Plos One, 12, 1–13. Rocha, N. S. (2017). Corpo de delito e processos por erro médico veterinário. In R. A. Tostes, S. T. J. Reis, & V. V Castilho (Eds.), Tratado de medicina veterinária legal. Medvep. Rossi, M., Paiva, A., Tornese, M., Chianelli, S., & Troncoso, A. (2008). Brotes de infección por Listeria monocytogenes: Una revisión de las vias que llevan a su aparición. Revista Ciencia y Tecnologia, Escuela de Postgrado, 25, 328–335. Sá, M. I., & Ferreira, C. (2007). Importância das zoonoses na segurança alimentar. Infoqualidade, 11, 14–17. Sakate, R. I., Aragon, L. C., Raghiante, F., Landgraf, M., Franco, B. D. G. M., & Destro, M. T. (2003). Quantificação de Listeria monocytogenes em salames fatiados embalados a vácuo. Archivos Latinoamericanos de Nutrición, 53, 1–5. Salmanov, A. G., Kotsyumbas, I. Y. А., & Trokhymchuk, V. V. (2018). One World — One Health. International Journal of Antibiotics and Probiotics, 2(1), 8–17. Santana, L., Novelli, M., Vidal, A., Pereira, S., Gasparinni, L., Alvarenga, A. M. O., & Motta, O. J. R. (2020). Brucelose: atualização para a prática clínica. Saúde Dinâmica, 5(3), 1–14. Santos-Filho, A. M. P., & Mayrink, R. R. (2017). Medicina Veterinária Forense. In J. A. Velho, G. C. Geiser, & A. Espíndula. (Eds.), Ciências Forenses, uma introdução às principais áreas da criminalística moderna. Millennium. Schmitt, C. I., Krug, F. D. M., Cereser, N. D., & Pinto, F. R. (2017). Brucelose: uma questão de saúde pública. REDVET. Revista Electrónica de Veterinária, 18(9), 1–17. Silva, H. R., Gianoglou, F. M., Campos, M. F., Graciano, E. M. A., & Toledo, R. C. C. (2016). Listeriose: Uma doença de origem alimentar pouco conhecida no Brasil. Higiene Alimentar, 30, 17– 20. Simões, L. S., Sasahara, T. H. C., Favaron, P. O., & Miglino, M. A. (2016). Leptospirose–Revisão. PUBVET, 10, 111–189. Slowinski, K., Tremori, T. M., Massad, M. R. R., Tasaka, A. C., & Rocha, N. S. (2016). Responsabilidade ética e civil do médico-veterinário no ambiente hospitalar. Revista de Educação Continuada em Medicina Veterinária e Zootecnia Do CRMV-SP, 14(2), 30–37. Snak, A., & Osaki, S. C. (2019). Uma revisão sobre três importantes agentes causadores de aborto em bovinos: Neospora caninum, Leptospira sp. e Trypanosoma vivax. Revista de Ciência Veterinária e Saúde Pública, 6(1), 160–195. Sobrinho, O. P. L., Véras, G. M. C., Silva, L. F. B., Oliveira, L. S., Xavier, R. S., Alvim, J. F., Costa, D. A. S., Pereira, Á. I. S., Carlos, M. A. S., Cantanhede, E. K. P., & Santos, M. L. C. (2018). Brucelose bovina: Situação epidemiológica em rebanhos no município de Codó-MA. PUBVET, 12(12), 1–4. Souza, A. O. (2010). Listeriose na gravidez. Revista Médica de Minas Gerais, 20, 433–434. Suárez, Á. C. A., & Parra, C. A. B. (2017). Actualización de la leptospirosis bovina en Colombia. Conexión Agropecuaria JDC, 7(1), 57–77. Tonin, A. A., Azevedo, M. I., Escobar, T. P., Casassola, I., Santos, L. G., Cocco, M., Martins, J. L. R., Schaefe, P. C., & Badke, M. R. T. (2010). Leptospirose bovina: aumento na incidência da Leptospira interrogans sorovar butembo no rebanho do Estado de Santa Catarina, Brasil. Acta Veterinaria Brasilica, 4(4), 294–297. Topazio, J., Tonin, A. A., Machado, G., Noll, J. C. G., Ribeiro, A., Moura, A. B., Carmo, G. M., Grosskopf, H. M., Martins, J. L. R., & Badke, M. R. T. (2015). Antibodies to Leptospira interrogans in goats and risk factors of the disease in Santa Catarina (West side), Brazil. Research in Veterinary Science, 99, 53–57. Tremori, T. M., & Rocha, N. S. (2013). Exame do corpo de delito na Perícia Veterinária (ensaio). Revista de Educação Continuada em Medicina Veterinária e Zootecnia do CRMV-SP, 11(3), 30–35. Urzêda, M., Ribeiro, P. G. M., Nascente, E. P., Espíndola, W. R., Teodoro, J. V. S., Gonçalves, G. B., Carneiro, Y. F., & Souza, W. J. (2020). Soroprevalência de leptospirose em fêmeas bovinas na microrregião do Vale Do Rio Dos Bois, Goiás, Brasil. Brazilian Journal of Development, 6(9), 69614–69622. Vallim, D. C., Barroso Hofer, C., Lisbôa, R. de C., Barbosa, A. V., Rusak, L. A., Reis, C. M. F., & Hofer, E. (2015). Twenty years of Listeria in Brazil: Occurrence of Listeria species and Listeria monocytogenes serovars in food samples in Brazil between 1990 and 2012. BioMed Research International, 2015. Vasconcelos, C. H., Fonseca, F. R., Lise, M. L. Z., & Arsky, M. (2012). Fatores ambientais e socioeconômicos relacionados à distribuição de casos de leptospirose no Estado de Pernambuco, Brasil, 2001-2009. Caderno de Saúde Coletiva, 20(1), 49–56. Viana, K. F., & Zanini, M. S. (2009). Perfil de produtores frente à vacinação contra doenças infecciosas abortivas em rebanhos bovinos do município de Alegre/ES. Archives of Veterinary Science, 14(2), 103–108. Vitas, A. I., & Garcia-Jalon, V. A. E. I. (2004). Occurrence of Listeria monocytogenes in fresh and processed foods in Navarra (Spain). International Journal of Food Microbiology, 90(3), 349–356. (shrink)

Individuals suffering from anorexia-nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. In this paper, I answer this question: if an anorexic, A, wants to refuse food when the food would either be life-saving or prevent serious bodily harm, can A’s refusal be valid? I argue that there is compelling reason to think that anorexics can validly refuse food, even (...) in these extreme circumstances. (shrink)

Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on 'double effect donation.' Where we disagree with these authors is that we see double effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity (...) goes beyond avoiding the aim to kill: not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double effect donation falls foul of the first condition of double effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such donation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others. (shrink)

We argued in a recent issue of this journal that if abortion is restricted,1 then there are parallel obligations for parents to donate body parts to their children. The strength of this obligation to donate is proportional to the strength of the abortion restrictions. If abortion is never permissible, then a parent must always donate any organ if they are a match. If abortion is sometimes permissible and sometimes not, then organ donation is sometimes obligatory and sometimes not. Our (...) argument was based on the following ideas: (a) that a fetus has full moral status, (b) that parents have special obligations to their offspring, fetus or not, and (c) that this special obligation is to protect them. The result is the conclusion that abortion restrictivists cannot also consistently deny that organ donation should be compulsory. (shrink)

Despite the importance of human blood to clinical practice and research, hematology and blood transfusion data remain scattered throughout a range of disparate sources. This lack of systematization concerning the use and definition of terms poses problems for physicians and biomedical professionals. We are introducing here the Blood Ontology, an ongoing initiative designed to serve as a controlled vocabulary for use in organizing information about blood. The paper describes the scope of the Blood Ontology, its (...) stage of development and some of its anticipated uses. (shrink)

In this paper, I discuss full-blooded Platonism (the claim that all possible mathematical objects exist) as a response to the skeptical problem in the philosophy of mathematics as to how empirical beings can cognize non-empirical mathematical objects. I then attempt to develop an analogous position regarding the applicability of concepts to reality in response to the skeptical problem regarding how we can cognize an objective reality through human-constructed concepts. If all concepts meeting certain minimal conditions structure reality under some aspect, (...) then objective knowledge is possible, regardless of how these concepts arose historically. (shrink)

According to most scholars, in the Parts of Animals Aristotle frequently provides explanations in terms of material necessity, as well as explanations in terms of that-for-the-sake-of-which, i.e., final causes. In this paper, I argue that we misunderstand both matter and the way that Aristotle explains things using necessity if we interpret Aristotle as explaining things in terms of material necessity. Aristotle does not use the term “matter” very frequently in his detailed discussions of animal parts; when he does use it, (...) he typically identifies blood as matter. I argue that this is because blood is, for Aristotle, what properly nourishes and grows the other parts of the body and he views nourishment and growth as types of coming-to-be. The second half of the paper turns to necessity as a cause in the Parts of Animals. I argue that in the Parts of Animals Aristotle is not interested in distinguishing between what Aristotle elsewhere treats as very different types of necessity. (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and (...) payment for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

Patients with schizophrenia have a higher risk of cardiovascular diseases and higher mortality from them than does the general population; however, the underlying mechanism remains unclear. Impaired cerebral autoregulation is associated with cerebrovascular diseases and their mortality. Increased or decreased cerebral blood flow in different brain regions has been reported in patients with schizophrenia, which implies impaired cerebral autoregulation. This study investigated the cerebral autoregulation in 21 patients with schizophrenia and 23 age- and sex-matched healthy controls. None of the (...) participants had a history of cardiovascular diseases, hypertension, or diabetes. All participants underwent 10-min blood pressure and cerebral blood flow recording through finger plethysmography and Doppler ultrasonography, respectively. Cerebral autoregulation was assessed by analyzing two autoregulation indices: the mean blood pressure and cerebral blood flow correlation coefficient (Mx), and the phase shift between the waveforms of blood pressure and cerebral blood flow determined using transfer function analysis. Compared with the controls, the patients had a significantly higher Mx (0.257 vs. 0.399, p = 0.036) and lower phase shift (44.3° vs. 38.7° in the 0.07–0.20 Hz frequency band, p = 0.019), which indicated impaired maintenance of constant cerebral blood flow and a delayed cerebrovascular autoregulatory response. Impaired cerebral autoregulation may be caused by schizophrenia and may not be an artifact of coexisting medical conditions. The mechanism underlying impaired cerebral autoregulation in schizophrenia and its probable role in the development of cerebrovascular diseases require further investigation. (shrink)

Entitlement is defined as a sort of epistemic justification that one can possess by default – a sort of epistemic justification that does not need to be earned or acquired. Epistemologists who accept the existence of entitlement generally have a certain anti-sceptical role in mind for it – entitlement is intended to help us resist what would otherwise be compelling radical sceptical arguments. But this role leaves various details unspecified and, thus, leaves scope for a number of different potential conceptions (...) of entitlement. At one extreme there are conceptions that portray entitlement as a weak, attenuated epistemic status and, at the other, we have conceptions that portray entitlement as something potent and strong. Certain intermediate conceptions are also possible. In this paper, I shall argue that the weak and intermediate conceptions of entitlement do not survive careful scrutiny, and the stronger conceptions – while they do, in a way, strain credulity – are the only conceptions that are ultimately viable. (shrink)

In computer science, Artificial Intelligence (AI), sometimes called machine intelligence, is intelligence demonstrated by machines, in contrast to the natural intelligence displayed by humans and other animals. Computer science defines AI research as the study of "intelligent agents": any device that perceives its environment and takes actions that maximize its chance of successfully achieving its goals. Deep Learning is a new field of research. One of the branches of Artificial Intelligence Science deals with the creation of theories and algorithms that (...) allow the machine to learn by simulating neurons in the human body. Most in-depth learning research focuses on finding high-level methods. The strippers analyze a large data set using linear and nonlinear transformations. The method of deep learning is used in the detection of several diseases including blood cell diseases and their classification using the radiography of blood cells to help decision makers to know the type of blood cell and its associated diseases and the results will be presented in detail and discussed. This thesis is using python language and deep learning to detect blood cell diseases and their classifications. The proposed deep learning model was trained, validated and the tested. The accuracy of proposed model was 98.00%. (shrink)

Contemporary republicans have adopted a less-than-charitable attitude toward private beneficence, especially when it is directed to the poor, worrying that rich patrons may be in a position to exercise arbitrary power over their impoverished clients. These concerns have led them to support impartial public provision by way of state welfare programs, including an unconditional basic income (UBI). In contrast to this administrative model of public welfare, I will propose a competitive model in which the state regulates and subsidizes a decentralized (...) and nonstatist provision of support for the poor. This model will fix the historically objectionable features of private provision by having the state prevent collusion among private charities, deliver information to recipients about alternative sources of assistance, and give substantial grants to charities as well as tax incentives and vouchers to donors. I will contend that such an approach would do a better job of minimizing domination of the poor than traditional welfare states and may prove more politically feasible than a UBI, at least in the near term in certain national contexts. (shrink)

This article argues that personal medical data should be made available for scientific research, by enabling and encouraging individuals to donate their medical records once deceased, similar to the way in which they can already donate organs or bodies. This research is part of a project on posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute at the University of Oxford. Ten arguments are provided to support the need to foster posthumous medical data (...) donation. Two major risks are also identified—harm to others, and lack of control over the use of data—which could follow from unregulated donation of medical data. The argument that record-based medical research should proceed without the need to secure informed consent is rejected, and instead a voluntary and participatory approach to using personal medical data should be followed. The analysis concludes by stressing the need to develop an ethical code for data donation to minimise the risks, and offers five foundational principles for ethical medical data donation suggested as a draft code. (shrink)

This article argues that personal medical data should be made available for scientific research, by enabling and encouraging individuals to donate their medical records once deceased, in a way similar to how they can already donate organs or bodies. This research is part of a project on posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute. Ten arguments are provided to support the need to foster posthumous medical data donation. Two major risks (...) are also identified—harm to others, and lack of control over the use of data—which could follow from unregulated donation of medical data. The argument that record-based medical research should proceed without the need to ask for informed consent is rejected, and it instead a voluntary and participatory approach to using personal medical data should be followed. The analysis concludes by stressing the need to develop an ethical code for data donation to minimise the risks providing five foundational principles for ethical medical data donation; and suggesting a draft for such a code. (shrink)

The Significant Interest view entails that even if there were no medical reasons to have access to genetic knowledge, there would still be reason for prospective parents to use an identity-release donor as opposed to an anonymous donor. This view does not depend on either the idea that genetic knowledge is profoundly prudentially important or that donor-conceived people have a right to genetic knowledge. Rather, it turns on general claims about parents’ obligations to help promote their children’s well-being and the (...) connection between a person’s well-being and the satisfaction of what I call their “worthwhile significant subjective interests.” To put this view simply, the fact that a donor-conceived person—who knows she is donor-conceived—is likely to be very interested in acquiring genetic knowledge gives prospective parents a weighty reason to use an identity-release donor. This is because parents should promote their children’s well-being through the satisfaction of their children’s worthwhile significant interests. (shrink)

An effective method to increase the number of potential cadaveric organ donors is to make people donors by default with the option to opt out. This non-coercive public policy tool to influence people’s choices is often justified on the basis of the as-judged-by-themselves principle: people are nudged into choosing what they themselves truly want. We review three often hypothesized reasons for why defaults work and argue that the as-judged-by-themselves principle may hold only in two of these cases. We specify further (...) conditions for when the principle can hold in these cases and show that whether those conditions are met is often unclear. We recommend ways to expand nationwide surveys to identify the actual reasons for why defaults work and discuss mandated choice policy as a viable solution to many arising conundrums. (shrink)

In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging (...) before considering proposals to use nudges to increase the number of registered organ donors, including opt-out donor registration systems and the use of “nudge statements.” In part 2, we discuss the use of nudges to influence the decision-making of family members in circumstances where they have a veto over the donation of their loved one’s organs. (shrink)

Traumatic brain injury is the leading cause of death in children. Children with severe TBI are in need of neurointensive care where the goal is to prevent secondary brain injury by avoiding secondary insults. Monitoring of cerebral blood flow (CBF) and autoregulation in the injured brain is crucial. However, there are limited studies performed in children to investigate this. Current studies report on age dependent increase in CBF with narrow age range. Low initial CBF following TBI has been correlated (...) to poor outcome and may be more prevalent than hyperemia as previously suggested. Impaired cerebral pressure autoregulation is also detected and correlated with poor outcome but it remains to be elucidated if there is a causal relationship. Current studies are few and mainly based on small number of patients between the age of 0–18 years. Considering the changes of CBF and cerebral pressure autoregulation with increasing age, larger studies with more narrow age ranges and multimodality monitoring are required in order to generate data that can optimize the therapy and clinical management of children suffering TBI. (shrink)

The aim of this paper is to explore the metaphysical foundations of Throne of Blood , Kurosawa's reworking of Shakespeare's Macbeth . Using Hegel's theory of tragedy, I develop the distinction between Greek and modern tragedy, with their differing bases in ethical and subjective freedom. I then show that Noh drama also includes a very different metaphysical account, stemming from its theoretical roots in Buddhism. I then use these three differing accounts (Greek, modern and Noh drama) to explore the (...) effect of Kurosawa's use Noh aesthetics in Throne of Blood on the metaphysical ground of the film itself. (shrink)

We present evidence from a pre-registered experiment indicating that a philosophical argument––a type of rational appeal––can persuade people to make charitable donations. The rational appeal we used follows Singer’s well-known “shallow pond” argument (1972), while incorporating an evolutionary debunking argument (Paxton, Ungar, & Greene 2012) against favoring nearby victims over distant ones. The effectiveness of this rational appeal did not differ significantly from that of a well-tested emotional appeal involving an image of a single child in need (Small, Loewenstein, and (...) Slovic 2007). This is a surprising result, given evidence that emotions are the primary drivers of moral action, a view that has been very influential in the work of development organizations. We did not find support for our pre-registered hypothesis that combining our rational and emotional appeals would have a significantly stronger effect than either appeal in isolation. However, our finding that both kinds of appeal can increase charitable donations is cause for optimism, especially concerning the potential efficacy of well-designed rational appeals. We consider the significance of these findings for moral psychology, ethics, and the work of organizations aiming to alleviate severe poverty. (shrink)

The wishes of registered organ donors are regularly set aside when family members object to donation. This genuine overruling of the wishes of the deceased raises difficult ethical questions. A successful argument for providing the family with a veto must (a) provide reason to disregard the wishes of the dead, and (b) establish why the family should be allowed to decide. One branch of justification seeks to reconcile the family veto with important ideas about respecting property rights, preserving autonomy, (...) and preventing harm. These arguments are ultimately unsuccessful. Another branch of arguments is consequentialist, pointing out the negative consequences of removing the veto. Whether construed as concerning family distress or as a potential drop in the organs available, these arguments are unsuccessful; the first fails to recognize the tremendous distress associated with waiting for an organ, while the second has little supporting evidence. A final section considers and rejects whether combining some of the arguments just examined could justify the family veto. We should thus remove the family veto in organ donation. (shrink)

Five arguments are presented in favour of the proposal that people who opt in as organ donors should receive a tax break. These arguments appeal to welfare, autonomy, fairness, distributive justice and self-ownership, respectively. Eight worries about the proposal are considered in this paper. These objections focus upon no-effect and counter-productiveness, the Titmuss concern about social meaning, exploitation of the poor, commodification, inequality and unequal status, the notion that there are better alternatives, unacceptable expense, and concerns about the veto of (...) relatives. The paper argues that none of the objections to the proposal is very telling. (shrink)

We provide a methodology for the creation of ontological partitions in biomedicine and we test the methodology via an application to the phenomenon of blood pressure. An ontology of blood pressure must do justice to the complex networks of intersecting pathways in the organism by which blood pressure is regulated. To this end it must deal not only with the anatomical structures and physiological processes involved in such regulation but also with the relations between these at different (...) levels of granularity. For this purpose our ontology offers a variety of distinct partitions � of substances, processes and functions � and integrates these together within a single framework via transitive networks of part-whole and dependence relations among the entities in each of these categories. The paper concludes with a comparison of this methodology with the approaches of GOTM, KEGG, DIP and BIND and provides an outline of how the methodology is currently being applied in the field of biomedical database integration. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is (...) obligatory to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

The dead donor rule (DDR) prohibits retrieval protocols that would be lethal to the donor. Some argue that compliance with it can be maintained by satisfying the requirements of double‐effect reasoning (DER). If successful, one could support organ donation without reference to the definition of death while being faithful to an ethic that prohibits intentionally killing innocent human life. On the contrary, I argue that DER cannot make lethal organ donation compatible with the DDR, because there are plausible (...) ways it fails DER's requirements. A key takeaway is that the theories of intention and proportionality assumed in DER matter for its plausibility as a constraint on practical reasoning. (shrink)

If a person requires an organ or tissue donation to survive, many philosophers argue that whatever moral responsibility a biological relative may have to donate to the person in need will be grounded at least partially, if not entirely, in biological relations the potential donor bears to the recipient. We contend that such views ignore the role that a potential donor's unique ability to help the person in need plays in underwriting such judgments. If, for example, a sperm donor (...) is judged to have a significant moral responsibility to donate tissue to a child conceived with his sperm, we think this will not be due to the fact that the donor stands in a close biological relationship to the recipient. Rather, we think such judgments will largely be grounded in the presumed unique ability of the sperm donor to help the child due to the compatibility of his tissues and organs with those of the recipient. In this paper, we report the results of two studies designed to investigate the comparative roles that biological relatedness and unique ability play in generating judgments of moral responsibility in tissue donation cases. We found that biologically related individuals are deemed to have a significant moral responsibility to donate tissue only when they are one of a small number of people who have the capacity to help. (shrink)

We explore the ethics of using motivational interviewing, an evidence-based, client-centred and directional counselling method, in conversations with next of kin about deceased solid organ donation. After briefly introducing MI and providing some context around organ transplantation and next of kin consent, we describe how MI might be implemented in this setting, with the hypothesis that MI has the potential to bring about a modest yet significant increase in next of kin consent rates. We subsequently consider the objection that (...) using MI in this context would be manipulative. Although we cannot guarantee that MI would never be used in a problematically manipulative fashion, we conclude that its use would, nevertheless, be permissible as a potential means to increase next of kin consent to deceased solid organ donation. We propose that MI be trialled in consent situations with next of kin in nations where there is widespread public support for organ donation. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data (...) collection were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to ‘transplant tourism’ and ‘organ trade’. This paper presents a ‘depth ethics’ approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body. These will be addressed from a psychoanalytical angle. First, I will outline Lacan’s view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers (...) to as an object a, the ‘partial object’ of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient’s body an empty space emerges, a kind of ‘vacuole’, once occupied by a faltering organ. This space can only be filled by a ‘gift’ from the other, by an object a. Once implanted, however, this implant becomes an ‘extimate’ object: something both ‘external’ and ‘intimate’, both ‘embedded’ and ‘foreign’, and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the ‘fragmented body’ of Frankenstein’s ‘monster’—as an aggregate of replaceable parts—and the multiple organ recipients of today. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the (...) family in the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

I aim to understand how the act of becoming an organ donor impacts whether it is permissible for a family veto to override an individual’s wish to donate. I argue that a Consent Model does not capture the right understanding of donor autonomy. I then assess a Gift Model and a Promise Model, arguing that both fail to capture important data about the ability to revoke one’s donor status. I then propose a Promise Acceptance Model, which construes becoming an organ (...) donor as accepting a promise the state makes to you to use your organs. This model, which implies that family vetoes are impermissible, captures the data other models struggle to accommodate. (shrink)

Applying critical rationalism, all criticism is to be welcomed. A response can help to elucidate matters even when the criticisms are poor, misconceived, and hostile. Thus, we turn to the review.

Critical examination of the concept of property in the body, with particular relevance to Stephen Munzer's work on umbilical cord blood.

In the beginning of the COVID pandemic, researchers and bioethicists called for human challenge trials to hasten the development of a vaccine for COVID. However, the fact that we lacked a specific, highly effective treatment for COVID led many to argue that a COVID challenge trial would be unethical and we ought to pursue traditional phase III testing instead. These ethical objections to challenge trials may have slowed the progress of a COVID vaccine, so it is important to evaluate their (...) merit. One common way of doing so is to make an analogy to other social practices that are relevantly similar and which we currently sanction. We submit that non-directed live organ donation (NDLOD) is a promising analogy. After arguing that the risks to volunteers for each activity appear similar, we explore potential disanalogies that would undermine the comparison. We note that there are differences in both the kind and certainty of benefit secured by NDLOD compared to challenge trials. We conclude these differences are insufficient to make NDLOD permissible and challenge trials impermissible. Ultimately, if we think the risks associated with NDLOD are ethically permissible, then we should think the same of the risks associated with COVID challenge trials. (shrink)

Deceased organ donation is widely considered as a case of easy rescue―that is, a case in which A may bestow considerable benefits on B while incurring negligent costs herself. Yet, the policy implications of this observation remain unclear. Drawing on Christopher H. Wellman’s samaritan account of political obligations, the paper develops a case for a so-called opt-out system, i.e., a scheme in which people are defaulted into being donors. The proposal’s key idea is that we may arrange people’s options (...) in specific ways for the sake of others. (shrink)

This academic paper on Ethical issues of using umbilical cord blood stem cell therapy of John Stuart Mill perspective aim to investigate the new approaches in the treatment of diseases by using umbilical cord blood stem cells. And also to study ethical issues from the use of umbilical cord blood stem cells in the treatment of diseases considered by Mill’s utilitarianism. 21st century, the medical industry was interested in organ transplantation from stem cells especially stem cells from (...) the umbilical cord to treat chronic and degenerative organ diseases, blood cancer and organ transplantation which successful and widespread throughout the world. Thailand has about 900 new children with Leukemia every year. About 50 percent are leukemia which needs to be treated correctly and urgently. In general Standardized chemotherapy but if the cancer patient has a bad prognosis Or have recurrent cancer Patients need to be treated with bone marrow transplants or stem cells to have a chance to heal. According to Mill’s Utilitarianism, the ethical concepts that determine what is the basic criterion used to determine whether it should or should not concern with the popular benefit that the criterion used is the amount of happiness that results from actions. Treating the disease using stem cells will make the patient recover from the disease, healthier and happier in life. As Mill said "The correctness of an action depends on the tendency that the action will lead to happiness. (shrink)

Assisted reproduction using donor gametes is a procedure that allows those who are unable to produce their own gametes to achieve gestational parenthood. Where conception is achieved using donor sperm, the child lacks a genetic link to the intended father. Where it is achieved using a donor egg, the child lacks a genetic link to the intended mother. To address this lack of genetic kinship, some fertility clinics engage in the practice of matching the ethnicity of the gamete donor to (...) that of the recipient parent. The intended result is for the child to have the phenotypic characteristics of the recipient parents. This paper examines the philosophical and ethical problems raised by the policy of ethnic matching in gamete donation. I consider arguments for the provision of ethnic matching based on maximising physical resemblance and fostering ethnic identity development. I then consider an argument against ethnic matching based on the charge of racialism. I conclude that while the practice of ethnic matching in gamete donation could promote positive ethnic identity development in donor-conceived children from historically subjugated ethnic minorities, it also risks endorsing the problematic societal attitudes and assumptions regarding ethnicity that enabled such subjugation in the first place. (shrink)

As a writer, it is hard to defend oneself from the accusation of being a robot. Even though the argument is ad hominem it perhaps is too difficult to create a “reversed” Turing test. It is suggested in this article that editors of flesh and blood still are necessary.