Through extensive training, experts acquire specialized knowledge and abilities. In this paper, I argue that experts also acquire specialized visual experiences. Specifically, I articulate and defend the account that experts enjoy visual experiences that represent gestalt properties through perceptual learning. I survey an array of empirical studies on face perception and perceptual expertise that support this account. I also look at studies on perceptual adaptation that some might argue present a problem for my account. I show how the data are (...) subject to an interpretation that is friendly to it. Last, I address two theoretical objections to the claim that visual experiences represent gestalt properties. (shrink)

Educators are increasingly concerned with the use of artificial intelligence (AI) in student writing. Much of the concern focuses on the issue of students using ChatGPT to complete their work. I introduce the CUPID model for instructors to use when thinking about how to pedagogically handle ChatGPT. The CUPID model lays out five general approaches: Catch, Utilize, Prevent, Ignore, and Disincentivize. I suggest that instructors should especially consider using certain assignments that fall under the approach “Disincentivize”. Philosophy instructors in particular (...) should assign more low-stakes writing, such as journals and reflection pieces. The adoption of low-stakes writing assignments aims to discourage students from relying on AI while promoting clarity of thought and deeper engagement with philosophical ideas. (shrink)

When someone says she believes that God exists, is she expressing the same kind of mental state as when she says she thinks that a lake bigger than Lake Michigan exists⎯i.e., does she refer to the same kind of cognitive attitude in both cases? Using evidence from linguistic corpora (Study 1) and behavioral experiments (Studies 2-4), the current work provides evidence that individuals typically use the word “believe” more in conjunction with statements about religious credences and “think” more in conjunction (...) with factual statements, pointing to two different understandings of claims made with these two terms. These patterns do not appear to reflect low-level differences based on the amount of consensus surrounding a particular claim, the extent to which the truth of a particular claim is known to the participant, or linguistic differences between religious and factual statements. We discuss implications of these findings for religious cognition (e.g., as supporting the theory that religious credences are qualitatively distinct from factual beliefs) as well as cognitive processes more broadly. Finally, we relate the present findings to prior theoretical work on differences between factual belief and religious credence. (shrink)

Lee (2017) calls for greater attention to the shared epistemological and normative grounds of both public health ethics and environmental ethics, and to Potter’s original conception of bioethics, which, as she rightly observes, has been largely disregarded in contemporary North American bioethics scholarship and practice. In a previous publication we also argued in favor of reviving the Potterian approach to bioethics; we built a case grounded in “the relatively new field of molecular epigenetics [that] provides novel information that should serve (...) as additional justification for expanding the scope of bioethics to include environmental and public health concerns.”. (shrink)

While there has been significant discussion in the health sciences and ethics literatures about problems associated with publication practices (e.g., ghost- and gift-authorship, conflicts of interest), there has been relatively little practical guidance developed to help researchers determine how they should fairly allocate credit for multi-authored publications. Fair allocation of credit requires that participating authors be acknowledged for their contribution and responsibilities, but it is not obvious what contributions should warrant authorship, nor who should be responsible for the quality and (...) content of the scientific research findings presented in a publication. In this paper, we review arguments presented in the ethics and health science literatures, and the policies or guidelines proposed by learned societies and journals, in order to explore the link between author contribution and responsibility in multi-author multidisciplinary health science publications. We then critically examine the various procedures used in the field to help researchers fairly allocate authorship. (shrink)

Since the 1970s, there has been rapid and wide ranging development in the field of new reproductive technologies (NRT). With donor insemination (DI) and in vitro fertilization (IVF), previously infertile couples have been given new hope and the chance to have children. A more recent addition to these new methods of reproduction has been the combination of DI and IVF with surrogate mother arrangements.[1] This technique has subtly changed the realm of reproduction, for with the addition of a third party (...) (the surrogate) to the reproductive environment, the nature of motherhood, fatherhood, and the allocation of parental rights and duties has come into question.... In other words, has commercial surrogacy changed the traditional Western understanding of motherhood and does it do an injustice to the surrogate, the contracting mother, and/or women in general? I will argue that the fragmentation of the legal concept of ‘mother’ has created a range of social and ethical problems that need to be addressed; nevertheless, the basic societal definition of ‘motherhood’ remains substantially unchanged. (shrink)

A current advance within the agricultural industry is the use of genetic engineering to produce novel crops for food production. This technology raises questions about how societies should position themselves with respect to genetically modified (GM) crop development and implementation; namely, how should the potentials and risks of this technology be evaluated? We argue that current methods to evaluate the risks and benefits of GM crops are inadequate and not conducive to the strategic development of this technology, where a way (...) to ameliorate technology assessments for GM crops is to include farmers in the research process of evaluating these crops prior to their commercialization. However, particularities concerning the ethical status of such research require special consideration and vigilance. For example, in such technology assessment initiatives, farmers would occupy both the roles of research participant and research investigator. Other particularities surface due to factors related to the nature of GM crops. These particularities are examined with reference to concepts drawn from the field of research ethics, namely informed consent, compensatory decisions, and issues of participant inclusion/exclusion. (shrink)

Nanotechnology research is beginning to see widespread coverage in the media and popular science literatures, but discussions of hopes and fears about nanotechnology have already become polarised into utopian and dystopian visions. More moderate discussions focus on the near-term applications of nanotechnologies, and on potential benefits and harms. However, in exploring the social and ethical implications of nanotechnology, important lessons should be learned from experiences in other fields. In particular, studies of the ethical, legal, and social issues of genetics research (...) have successfully mapped out many of the issues that arise when new technologies are deployed. It is our contention that, for the most part, the ethical and social issues arising in nanomedicine are not altogether new, and thus do not require novel ethical principles or frameworks, nor a massive investment in ‘NELSI’ research. Instead, what is needed is support for the development of a culture of ethics amongst scientists and clinicians, basic scientific and medical knowledge for bioethicists, and a social competency for citizens to participate actively in debates about the implications of new technologies in general. (shrink)

Public discussions of ethical issues related to the biotechnology industry tend to treat "biotechnology" as a single, undifferentiated technology. Similarly, the pros and cons associated with this entire sector tend to get lumped together, such that individuals and groups often situate themselves as either "pro-" or "anti-" biotechnology as a whole. But different biotechnologies and their particular application context pose very different challenges for ethical corporate decision-making. Even within a single product category, different specialty products can pose strikingly different ethical (...) challenges. In this paper, we focus on the single over-arching category of "genetic testing" and compare tests for disease susceptibility and drug response. We highlight the diversity of ethical challenges - grouped under the broad categories of "truth in advertising" and "protecting intellectual property" - raised by the commercialization and marketing of these technologies. By examining social and technical differences between genetic tests, and the associated corporate ethics challenges posed by their commercialization, our intent is to contribute to the nascent business ethics literature examining issues raised by the development and marketing of genetic tests. (shrink)

There is a widely acknowledged shortage of and an increasing demand for transplantable human organs and tissues (e.g., kidney, heart, lung, liver, cornea) in developed and developing countries around the world. In response to this need, Lott and Savulescu (2007) propose the creation of a human embryonic stem (hESC) bank to facilitate the equitable and efficient dissemination of human leukocyte anti- gen (HLA) matched tissues and organs to patients in need of replacement. Although not an unreasonable proposal, the authors go (...) on to make a much stronger claim. They argue that hESCs are such important tools for addressing the massive unmet global need for organs that it is ethically justified to require mandatory banking of spare embryos, and they argue for the use of financial (or other) inducements to procure embryos for the derivation of hESCs. (shrink)

Antimicrobial resistance is a growing public health concern and is associated with the over- or inappropriate use of antimicrobials in both humans and agriculture. While there has been reco- gnition of this problem on the part of agricultural and public health authorities, there has none- theless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and (...) the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicro- bial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethi- cal norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production. (shrink)

Imagine that you are part of the editorial board of a young bioethics journal committed to publishing open access (OA) and to ensuring accessibility to high quality and innovative scholarship. To support junior and interna- tional scholars who might not otherwise find places for their work in the leading Western bioethics journals, you do not charge author fees. Imagine also that you have no financial resources to pay for a professional website, auto- mated submissions manager, or even a part-time coordina- (...) tor: Your government has cut all grants for journals, you cannot go to industry for private funding because of the evident risk of apparent conflicts of interest, and your strapped-for-cash institution cannot afford to offer you any support. If one of the major publishers were to approach you to sign a deal, the temptation would be strong to accept. However, this would likely mean putting aside your ideals: It would be impossible to stay a “Green OA” publication (i.e., free of author publication charges) or supportive of junior and international scholars (because of pressures to “increase credibility” through artificially high rejection rates, for example). (shrink)

This case study examines some of the challenges, and in particular conflicts of interest, that professors face in writing letters of reference for their students.

In seeking to clarify the concept of conflict of interest (COI) in debates about physician–industry relationships, Howard Brody (2011) highlights the extent to which the prob- lem turns on a common pejorative understanding of COI. Whether it is the academic or public policy “pharmapologists” or “pharmascolds” talking about COI, there is often a straightforward and overly simplistic correlation made: that is, a conflict of interest—by definition—leads to fraudulent or corrupt behavior. The same type of reasoning is com- monly found in (...) discussions about COI outside the health sciences, most notably in news stories about the awarding of government contracts or the behaviour of corporate executives. The problem is that in focusing on dramatic failures to manage COI (e.g., around Vioxx), there is a tendency to strongly associate COI with extreme forms of financial and even criminal misconduct, leaving the public, policymakers, academics, and professionals with a skewed and limited understanding of the concept. (shrink)

The case of Andrew Gobea, the first child to receive experimental gene therapy for SCID, and a reflection on the associated ethical implications of gene therapy research.

The case study presented by Winch and Sinnott (2011) shows not only how difficult it is for clinicians and researchers to identify conflicts of interest (COI), but also how damaging it can be when there are unin- formed and uncoordinated policy responses by senior administrators.

Research on research ethics—regarding both the governance and practice of the ethical review of human subjects research—has a tumultuous history in North America and Europe. Much of the academic literature focuses on issues to do with regulating the conduct and quality of ethics review of research protocols by ethics committees (research ethics boards (REBs) in Canada and institutional review boards (IRBs) in the United States). In addition, some of the literature attends to issues particular to the review of qualitative research, (...) and still other literature addresses the challenges posed by and the need for research on REBs/IRBs. It is this third group of literature within which our article is situated. (shrink)

Genetic testing in the workplace is a technology both full of promise and fraught with ethical peril. Though not yet common, it is likely to become increasingly so. We survey the key arguments in favour of such testing, along with the most significant ethical worries. We further propose a set of pragmatic criteria, which, if met, would make it permissible for employers to offer (but not to require) workplace genetic testing.

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Dans notre société de plus en plus digitalisée, avons-nous vraiment le choix d’adopter ou non les technologies? Comment cette digitalisation impacte-t-elle les personnes âgées en particulier et son écosystème? Quels sont les enjeux éthiques soulevés par cette digitalisation? Ce texte vise à amener des éléments de réflexions en lien avec ces enjeux selon le point de vue de divers experts des domaines de la technologie, du vieillissement et de la bioéthique. Ces experts se sont rencontrés lors d’un symposium ayant eu (...) lieu à Angers, France, en octobre 2019. Le texte est un compte-rendu des échanges et points de vue de ces experts, ainsi que des discussions ouvertes qu’ils ont eues avec l’assistance, portant sur les principaux enjeux soulevés par cette digitalisation selon la perspective des personnes âgées, des proches-aidants, des soignants, de la société et de la recherche. (shrink)

L’érosion actuelle de la confiance du public envers les campagnes de vaccination et les décisions de politiques publiques qui y sont associées, aggravée par des scandales comme ceux relatifs à la pandémie H1N1 et l’utilisation du Tamiflu™, risque de diminuer de façon significative l’efficacité de ces interventions importantes pour la santé publique. Un manque de confiance de la population envers les acteurs de santé publique peut conduire à une méfiance accrue face aux interventions, pouvant ainsi compromettre l’atteinte des objectifs recherchés (...) par une intervention spécifique et, conséquemment, avoir un impact important sur les bénéfices attendus pour la population visée par cette intervention. Dans la production des avis d’experts, les membres des comités consultatifs d’experts en immunisation (CCEI) peuvent avoir une influence importante sur la prise de décision publique, notamment, sur la sélection par les décideurs de santé publique de vaccins en particulier et la façon dont les campagnes de vaccination seront déployées. En contrepartie de cette influence sur les décisions publiques, une indépendance et une transparence sont attendues de leur part puisque des mécanismes de divulgation et de gestion de conflits d’intérêts (CI) imparfaits peuvent affecter négativement la confiance du public à l’égard de telles décisions. Il apparaît donc important de s’assurer que des mécanismes de gestion des CI, transparents et robustes, existent pour ces comités. Dans cette étude, les avis ou rapports d’évaluation de la pertinence de la vaccination préparés par un CCEI au Québec ont été examinés pour quatre types de maladies évitables par la vaccination (infections invasives à méningocoques et à pneumocoques, coqueluche et virus du papillome humain). Le but était de : 1) identifier les CI divulgués par les membres du CCEI dans leurs rapports comparativement à ceux déclarés dans leurs publications scientifiques pour ces mêmes infections ; 2) analyser la nature des CI (réel, potentiel, apparent, personnel, financier, institutionnel, etc.) et l’impact potentiel (risque) sur la prise de décision impartiale et sur la confiance du public ; et 3) évaluer les mécanismes de gestion de CI actuellement utilisés par ce CCEI. Les résultats de cette étude montrent que très peu de rapports du CCEI contiennent une section sur les CI par rapport à la pléthore divulguée dans les publications scientifiques publiées par les membres du CCEI. De plus, les CI divulgués dans les rapports fréquemment ne correspondent pas à ceux décrits dans les publications scientifiques. Il serait donc important d’introduire des mesures visant à accroître la transparence des experts en immunisation et d’améliorer les mécanismes de divulgation et de gestion des CI afin de veiller à ce que la confiance du public envers les décideurs en santé publique soit maintenue et améliorée. (shrink)

Ongoing research in the fields of genetics and biotechnology hold the promise of improved diagnosis and treatment of genetic diseases, and potentially the development of individually tailored pharmaceuticals and gene therapies. Difficulty, however, arises in determining how these services are to be evaluated and integrated equitably into public health care systems such as Canada's. The current context is one of increasing fiscal restraint on the part of governments, limited financial resources being dedicated to health care, and rising costs for new (...) health care services and technologies. This has led to increasing public debate in the last few years about how to reform public health care, and whether we should prohibit, permit or perhaps even encourage private purchase of health care services. ;In Canada, some of these concerns have crystallized around the issue of gene patents and commercial genetic testing, in particular as illustrated by the case of Myriad Genetics' patented BRACAnalysis test for hereditary breast and ovarian cancer. While most Canadians who currently access genetic services do so through the public health care system, for those with the means, private purchase is becoming an option. This situation raises serious concerns---about justice in access to health care; about continued access to safe and reliable genetic testing supported by unbiased patient information; and about the broader effects of commercialization for ongoing research and the Canadian public health care system. Commercial genetic testing presents a challenge to health care professionals, policy analysts, and academics concerned with the social, ethical and policy implications of new genetic technologies. Using the Myriad case as an exemplar, tools from moral philosophy, the social sciences, and health policy and law will be brought to bear on the larger issues of how as a society we should regulate commercial research and product development, and more coherently decide which services to cover under public health insurance and which to leave to private purchase. Generally, the thesis is concerned with the question of "how best to bring capital, morality, and knowledge into a productive and ethical relationship". (shrink)

After six years (2012-2017) of publishing innovative bioethics scholarship, BioéthiqueOnline becomes the Canadian Journal of Bioethics/Revue canadienne de bioéthique. As executive editors of BioéthiqueOnline, we frequently heard from members of the Canadian bioethics community of the need to develop a platform with the right branding to showcase the value and the richness of our collective reflections, both locally and internationally. Following discussions with colleagues across the country, we came to the conclusion that BioéthiqueOnline had developed a unique expertise publishing bioethics (...) scholarship, but that the original name, created to convey the bilingual and open access mission of the journal, was not enthusiastically received. So the time has come to upgrade and rebrand as the Canadian Journal of Bioethics (CJB). (shrink)

Genetics research and biotechnology development - while holding the promise of improved pharmaceuticals, medical treatments, and foods - is also raising concerns about the impact of market forces on scientific inquiry, product development, and the provision of health care.

Jusqu’à présent, les discussions au sein de la communauté universitaire et dans la littérature scientifique sur la conduite responsable en recherche (CRR), incluant l’intégrité scientifique et l’éthique de la recherche, ont principalement été menées par les chercheurs en sciences de la santé et en sciences fondamentales. Préoccupés, à juste titre, par des problèmes d’inconduite, leurs effets négatifs sur la rigueur scientifique et la confiance du public dans l’entreprise de la recherche, ces débats ont conduit à l’élaboration et à la mise (...) en œuvre de lignes directrices nationales et de politiques institutionnelles. Ces lignes directrices visent entre autres à promouvoir la CRR, notamment dans le but de prévenir ces inconduites. Cependant, pour garantir la pertinence et une application appropriée de ces normes à tous les domaines universitaires, il est nécessaire que les sciences humaines et sociales (SHS) contribuent plus directement à ces discussions. Un tel engagement devrait permettre d’exprimer les particularités disciplinaires et méthodologiques des SHS, dont certaines peuvent être très différentes des sciences appliquées et fondamentales. Cela permettrait également de s’assurer que la littérature sur la CRR ainsi que les politiques et les directives qui en découlent soient à la fois fondées sur des principes universellement généralisables, mais aussi appliquées avec nuance afin de refléter la diversité des pratiques disciplinaires. Dans ce chapitre, nous explorons trois grands domaines dans lesquels les SHS pourraient contribuer à façonner les discussions dans la littérature sur la CRR, tout en informant les chercheurs en SHS des meilleures pratiques en matière de CRR : l’autorat/paternité, la collaboration et l’autorégulation. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (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)

In Québec, the Act Respecting Access to Documents Held by Public Bodies and the Protection of Personal Information provides an exception to transparency to most public institutions where public health research is conducted by allowing them to not disclose their uses of personal data. This exceptionalism is ethically problematic due to important concerns and we argue that all those who conduct research should be transparent and accountable for the work they do in the public interest.

For Van Rensselaer Potter (1911–2001), Global Bio-Ethics is about building on the legacy of Aldo Leopold (1887–1948), one of the most notable forest managers of the twentieth century who brought to light the importance of pragmatism in the sciences and showed us a new way to proceed with environmental ethics. Following Richard Huxtable and Jonathan Ives's methodological 'Framework for Empirical Bioethics Research Projects' called 'Mapping, framing, shaping,' published in BMC Medicine Ethics (2019)), we propose operationalizing a framework for Global Bio-Ethics (...) by hybridizing approaches in empirical bioethics and ecosystem management. We explain this framework using the metaphor of forest management. This mixed approach is articulated through three phases: (1) mapping the “landscape” to build a working theory, (2) framing the “scene” to prepare the fieldwork, and (3) shaping bioethics “tools” to stimulate cooperation. Applying this methodology, an adaptive management cycle is outlined to help ensure that political processes are sustainable and socially acceptable, still based on strategic and ethical thinking, but also capable of reshaping failing policies. (shrink)

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance (...) operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics. (shrink)

BioéthiqueOnline was launched in March 2012 as a non-peer reviewed journal with the aim of providing a platform to facilitate and encourage the development of a bilingual bioethics community in Canada and internationally. In light of discussions amongst the Editorial Committee over the past few months regarding the growth of the journal, we have decided to move to a peer-reviewed process for articles submitted to the journal.

Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. The survey, in which forty-five (...) Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists “in the field”. Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions. (shrink)

Van Rensselaer Potter (1911-2001), le biologiste à l’origine du terme « bioéthique » dans les écrits nord-américains, considère que « real bioethics falls in the context of the ideals of […] Aldo Leopold », un forestier, philosophe et poète ayant marqué le XXe siècle. Associer Leopold à Potter a pour effet de placer la bioéthique dans la famille des éthiques de l’environnement, ce qui la différencie du sens conventionnel retenu en médecine et en recherche depuis le Rapport Belmont (1979), une (...) déclaration ayant propulsé l’institutionnalisation de la bioéthique en Amérique du Nord. Cependant, diviser la bioéthique entre le médical et l’environnemental est réducteur. Potter propose au contraire une bioéthique globale s’intéressant aux enjeux situés à leur interface, dont ceux concernant la terre, la vie sauvage, la surpopulation, la consommation, etc. Cet article vise à amorcer un nouveau chantier d’analyse de la pensée de Potter en s’appuyant sur l’héritage de Leopold en biologie. Une synthèse de cette vision potterienne est proposée de manière à considérer son œuvre comme un tout cohérent s’intégrant aux grands débats qui transcendent les XXe et XXIe siècles. Sa vision apparaît comme une sagesse collective et prospective sous la forme d’une science de la survie et d’un code de bioéthique. Dépassant l’éthique de l’environnement, son association avec Leopold offre un modèle de la complexité s’imposant comme cas indissociable du contexte qui l’englobe, en améliorant nos façons d’intervenir en pratique dans un monde en constante transformation, à titre de gouvernance adaptative et de sagesse de la responsabilité. (shrink)

Concern about the ethics of clinical drug trials research on patients and healthy volunteers has been the subject of significant ethical analysis and policy development—protocols are reviewed by Research Ethics Committees and subjects are protected by informed consent procedures. More recently attention has begun to be focused on DNA banking for clinical and pharmacogenetics research. It is, however, surprising how little attention has been paid to the commercial nature of such research, or the unique issues that present when subjects are (...) asked to consent to the storage of biological samples. Our contention is that in the context of pharmacogenetic add-on studies to clinical drug trials, the doctrine of informed consent fails to cover the broader range of social and ethical issues. Applying a sociological perspective, we foreground issues of patient/subject participation or ‘work’, the ambiguity of research subject altruism, and the divided loyalties facing many physicians conducting clinical research. By demonstrating the complexity of patient and physician involvement in clinical drug trials, we argue for more comprehensive ethical review and oversight that moves beyond reliance on informed consent to incorporate understandings of the social, political and cultural elements that underpin the diversity of ethical issues arising in the research context. (shrink)

In Canada, there are currently no guidelines at either the federal or provincial level regarding the provision of kidney transplantation services to foreign nationals (FN). Renal transplant centres have, in the past, agreed to put refugee claimants and other FNs on the renal transplant waiting list, in part, because these patients (refugee claimants) had health insurance through the Interim Federal Health Programme to cover the costs of medication and hospital care. However, severe cuts recently made to this programme have forced (...) clinicians to question whether they should continue with transplants for FNs, for financial and ethical reasons. This paper first examines different national policies (eg, in Canada, USA, France and the UK) to map the diversity of approaches regarding transplantation for FNs, and then works through different considerations commonly used to support or oppose the provision of organs to these patients: (1) the organ shortage; (2) the free-rider problem; (3) the risk of becoming a transplant destination; (4) the impact on organ donation rates; (5) physicians’ duties; (6) economic concerns; (7) vulnerability. Using a Canadian case as a focus, and generalising through a review of various national policies, we analyse the arguments for and against transplantation for FNs with a view to bringing clarity to what is a sensitive political and clinical management issue. Our aim is to help transplant centres, clinicians and ethicists reflect on the merits of possible options, and the rationales behind them. (shrink)

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, (...) Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

Depuis 2020, le monde a connu une situation sanitaire exceptionnelle à la suite de la pandémie de Covid-19, faisant face à une incertitude dans le monde médical clinique, de la recherche et dans l’ensemble des domaines connexes en santé publique. Le caractère imprévisible et l’absence de données fiables en lien avec ce virus ont fait émerger une quantité d’enjeux éthiques concrets, cela a donc révélé un domaine particulier, la bioéthique, et plus particulièrement une profession, les bioéthiciens. Les « bioéthiciens » (...) se sont fait connaître du grand public en se dressant parfois comme des garde-fous contre des dérives sanitaires, à d’autres moments comme des lanceurs d’alertes face à des injustices naissantes, ou comme critiques, polémistes et parfois même militants dans les médias ou en tant qu’acteurs de première ligne dans les systèmes politico-sanitaires. Ces divers rôles et pratiques illustrent bien la diversité et l’hétérogénéité du domaine de la bioéthique. Toutefois, l’absence de professionnalisation traditionnelle et formelle de la bioéthique complexifie la compréhension de ce champ disciplinaire. Même en Amérique du Nord, où la pratique de la bioéthique est professionnalisée, il ne s’agit toujours pas d’une profession officiellement reconnue et le terme « bioéthicien » lui-même peut être controversé. La forte présence de cette profession durant la pandémie de Covid-19 a révélé l’importance de décrire ce qu’est un bioéthicien, les fonctions qu’il occupe et en quoi consistent ses interventions. Nous apportons cette clarification nécessaire en expliquant la nature de la bioéthique contemporaine dans toute sa diversité. Comme nous l’a démontré la pandémie de Covid-19, les bioéthiciens représentant un soutien et un guide indispensable de nos jours menés par leur esprit critique et leur réflexivité permanente. (shrink)

While every health care system stakeholder would seem to be concerned with obtaining the greatest value from a given technology, there is often a disconnect in the perception of value between a technology’s promoters and those responsible for the ultimate decision as to whether or not to pay for it. Adopting an empirical ethics approach, this paper examines how five Canadian medical device manufacturers, via their websites, frame the corporate “value proposition” of their innovation and seek to respond to what (...) they consider the key expectations of their customers. Our analysis shows that the manufacturers’ framing strategies combine claims that relate to valuable socio-technical goals and features such as prevention, efficiency, sense of security, real-time feedback, ease of use and flexibility, all elements that likely resonate with a large spectrum of health care system stakeholders. The websites do not describe, however, how the innovations may impact health care delivery and tend to obfuscate the decisional trade-offs these innovations represent from a health care system perspective. Such framing strategies, we argue, tend to bolster physicians’ and patients’ expectations and provide a large set of stakeholders with powerful rhetorical tools that may influence the health policy arena. Because these strategies are difficult to counter given the paucity of evidence and its limited use in policymaking, establishing sound collective health care priorities will require solid critiques of how certain kinds of medical devices may provide a better (i.e., more valuable) response to health care needs when compared to others. (shrink)

Dieser Versuch einer philosophischen Autobiographie ist hauptsächlich der Geschichte meiner Ideen und Anregungen im Bereich der Philosophie gewidmet. In dieser Zusammenfassung werden vor allem meine philosophischen Begegnungen und Veröffentlichungen besprochen. Es ist weniger die Geschichte meines privaten Lebens, da bei mir privates und berufliches Leben zum großen Teil zusammenfallen.

Der Bund-Länder-Beschluss zu Weihnachten erlaubt „Treffen mit 4 über den eigenen Hausstand hinausgehenden Personen“, aber nur bezüglich Mitglieder des „engsten Familienkreis[es], also Ehegatten, Lebenspartnern und Partnern einer nichtehelichen Lebensgemeinschaft sowie Verwandten in gerader Linie, Geschwistern, Geschwisterkindern und deren jeweiligen Haushaltsangehörigen.“ Obwohl es bei diesen Regelungen gar nicht um die sexuelle Orientierung oder Geschlechtsidentität der Personen geht, sind sie dennoch heteronormativ, bevorteilen also solche Lebensformen, die nach den Normen klassischer heterosexueller Beziehungsmodelle funktionieren. Oder andersherum gesagt: Sie benachteiligen zwar Singles und Menschen (...) ohne klassische Familie unabhänging davon, ob sie hetero, schwul, lesbisch, trans* oder non-binary sind, aber sie werten darüber hinaus queere Lebensformen ab. (shrink)

Auch zu Beginn des 21. Jahrhunderts lebt ein großer Teil der Menschheit in bitterer Armut. Daraus ergibt sich die brennende Frage, was die Bürgerinnen und Bürger wohlhabender Länder extrem armen Menschen moralisch schulden. Valentin Beck beantwortet sie im Rahmen einer umfassenden Theorie der globalen Verantwortung. In seinem glänzend geschriebenen Buch behandelt er zentrale Fragen der Theorie globaler Gerechtigkeit, unterzieht unsere Verflechtung in globale soziale Strukturen einer detaillierten Analyse und wirft so ein neues Licht auf eine der größten moralischen Herausforderungen unserer (...) Zeit. Wir müssen mit Blick auf den politischen und individuellen Umgang mit der Weltarmut umdenken, so lautet die zentrale Forderung dieser Studie. (shrink)

Um die menschliche Farbwahrnehmung zu durchleuchten und nach transkulturellen Invarianten oder Variationen zu fahnden, pflegen anglophone Forscher seit Gladstones Pionierstudie aus dem Jahr 1858 zu untersuchen, wie die Farbwörter in den Sprachen anderer Zeiten und Länder funktionieren. Während die beachtlichen Ergebnisse dieser Forschung aus neuerer Zeit sehr wohl ins Schwarze treffen könnten, ist ihre Methode kritisch zu sehen: Bei der Untersuchung fremder Sprachen und Wahrnehmungsweisen erscheint es unstatthaft, eine bestimmte Ordnung des Farbenraumes vorauszusetzen, die auf Newton zurückgeht und selbst in (...) der europäischen Wissenschaft nicht ohne Alternativen ist. (shrink)

Seit kurzem wird des öfteren in Deutschland die Ansicht geäußert, Deutschland solle nun seine fremdenfeindliche Vergangenheit im Zweiten Weltkrieg endlich hinter sich lassen und von nun ab als >>normalisiertes<< Land der Zukunft gegenübertreten. Diese Meinung entsteht aus der Voraussetzung, daß Deutschland durch seine Geschichte von Xenophobie und Genozid im Zweiten Weltkrieg als abnormal, als ungewöhnlich gekennzeichnet ist. Aber das ist nicht wahr. Deutschlands blutige Geschichte ist mit derjenigen der Vereinigten Staaten, Großbritanniens, der Niederlande, Rußlands, Chinas, Japans, der Türkei, Vietnams, Kambodschas, (...) Somalias, Ruandas, des Irak, des Kosovo, Bosniens, und anderer Länder vergleichbar. Zu vergleichen bedeutet weder zu relativieren, noch zu entschuldigen, sondern bloß anzuerkennen, daß die Verbrechen gegen die Menschlichkeit, die in verschiedenen Ländern stattfinden, einige gemeinsame Eigenschaften haben. (shrink)

Dieser Beitrag macht auf die Krise in den globalen Wertschöpfungsketten, die durch die Covid-19 Pandemie verursacht wurde, aufmerksam und gibt dazu einige Denkanstöße aus normativer Perspektive. Es wird gezeigt, dass die Pandemie ein grelles Schlaglicht auf die strukturellen Probleme der Globalisierung wirft. Zu diesen gehört die Gestaltung der globalen Marktwirtschaft über nationale, supranationale und internationale Institutionen, die in der Regel zur Benachteiligung einiger Länder und zum Vorteil für andere führt. Dies wird zunächst am Beispiel der Textilindustrie von Bangladesch erläutert. Danach (...) wird das Problem der Verteilungsgerechtigkeit aus der Perspektive der strukturellen Ungerechtigkeit betrachtet. Der Beitrag befasst sich in diesem Zusammenhang mit den systematischen Problemen entlang der globalen Lieferketten. (shrink)

Bowin begins with an apparent paradox about Aristotelian infinity: Aristotle clearly says that infinity exists only potentially and not actually. However, Aristotle appears to say two different things about the nature of that potential existence. On the one hand, he seems to say that the potentiality is like that of a process that might occur but isn't right now. Aristotle uses the Olympics as an example: they might be occurring, but they aren't just now. On the other hand, Aristotle says (...) that infinity "exists in actuality as a process that is now occurring" (234). Bowin makes clear that Aristotle doesn't explicitly solve this problem, so we are left to work out the best reading we can. His proposed solution is that "infinity must be...a per se accident...of number and magnitude" (250). (Bryn Mawr Classical Review 2008.07.47). (shrink)

Der normative Gehalt des Subsidiaritätsprinzips und seine Bedeutung für die Politische und Soziale Union Europas (S. 201-203) 1. Die Entwicklung des Maßstabs normativer Subsidiarität im ersten Kapitel beruht auf der Erkenntnis, dass dem Subsidiaritätsprinzip insbesondere von seinen protestantischen Wurzeln und seiner Ausprägung in der katholischen Soziallehre her ein spezifisch normativer Kerngehalt innewohnt, der als Idee auch dem Grundgesetzt als zwar weltanschaulich neutraler, aber nicht wertneutraler politischer Ordnung zugrunde liegt. Ausgehend von einem Menschenbild, das christliche Personalität und gesellschaftliche Solidarität umfasst, setzt (...) der materiale Gehalt des Subsidiaritätsprinzip insofern Grenzen, "als die Legitimation einer politischen Gemeinschaft nur von der Einzelperson im Sinne des individualistischen Liberalismus erfolgen kann und als die Anwendung des Subsidiaritätspinzips der Solidarität sozialer Einheiten bedarf. 2. Das ursprünglich von den deutschen Ländern anvisierte Ziel einer Verankerung des Strukturprinzips des Föderalismus im Vorfeld des Maastrichter Vertrages, ergänzt um das Subsidiaritätsprinzip als Prinzip der Kompetenzausübung, scheiterte am Widerstand Großbritanniens. Die Briten setzten das föderative Prinzip mit einem zentralistischen Bundesstaat gleich, den sie auf jeden Fall verhindern wollten. Fortan verbanden die Deutschen, insbesondere die deutschen Länder und Bundesregierung mit Unterstützung der beiden großen Kirchen einschließlich der kirchlichen Wohlfahrtsverbände, mit dem Subsidiaritätsprinzip neben einer Föderalisierung der Europäischen Union auch das Ziel, die Gesundheits- und Sozialpolitik auf europäischer Ebene auszubauen. Wenig später, schon im Verlauf der der Ratifikation des Vertrages, wird das Subsidiaritätsprinzip seitens der Bundesregierung und der deutschen Länder auf den Vorrang der der unteren Ebene umgemünzt. 3. Parallel zum Subsidiaritätsstreit in den 60er Jahren wird die Nähe zur Person bzw. zum Bürger instrumentalisiert, um dem Subsidiaritätsbegriff den Inhalt zu geben, der aus machtpolitischen Interessen opportun erscheint. Im innerdeutschen Subsidiaritätssstreit der 60er Jahre wurde die funktionale Dimension des Prinzips in den Vordergrund gedrängt, wohingegen seit 1993 seitens der Bundesregierung und der deutschen Länder im europäischen Kontext die territoriale Dimension des Prinzips, die sich gegen europäische Institutionen als Inbegriff bürgerferner, nicht demokratisch legitimierter Politik richtet, hervorgehoben wird. In beiden Fällen geht die aus Gründen normativer Subsidiarität gebotene Balance zwischen Identität und Funktion, zwischen Demokratie und Effizienz, verloren. 4. In den 60er Jahren haben die Verbände der freien Wohlfahrtspflege ihre Freiheit gegen Staatsnähe eingetauscht. Daraus entstanden neo-korporatistische Strukturen, die die Verbände zu mächtigen Trägern sozialer Dienstleistungen werden ließen. Die Rolle der Verbände als intermediäres Bindeglied zwischen Bürger und Staat wurde vernachlässigt. 5. In den 90er Jahren im europäischen Kontext die funktionale Dimension des Subsidiaritätsprinzip auf den territorialen Rahmen der Mitgliedstaaten zurecht gestutzt. Im Vordergrund steht nicht die bestmögliche Lösung eines Problems. Man gibt sich mit der vermeintlich "ausreichenden" Lösung auf mitgliedsstaatlicher Ebene zufrieden. Die systematische Auslegung, die im Hinblick auf die Sicherung der Funktionsfähigkeit der Gemeinschaft von besonderer Bedeutung ist, ergibt hingegen, "dass das Subsidiaritätspinzip als Kompetenzausübungsprinzip verfasst ist und zweitens, dass eine Entscheidung sowohl auf der Ebene der Gemeinschaft als auch auf Ebene der Mitgliedstaaten bürgernah sein kann." Deutlich tritt hier die Kluft zwischen rechtlicher Konzeption, die Ausdruck universeller Geltung des Prinzips ist, und verfolgten politischen Eigeninteressen der Akteure hervor. 6. Wenngleich bei den Verbänden der freien Wohlfahrtspflege, insbesondere den kirchlichen, der Territorialaspekt des Subsidiaritätsprinzips dominiert, gibt es Anzeichen dafür, dass die Überzeugung wächst, dass ohne eine sachbezogene, auf weitere Integration gerichtete Europapolitik auch die drei Wohlfahrtspflege in Deutschland nicht aufrechtzuerhalten ist. So vertreten die kirchlichen Verbände im Rahmen einer von der Kommission initiierten Konsultation zu Armut und Ausgrenzung in Europa die Ansicht, dass eine Lösung auf mitgliedsstaatlicher Ebene nicht ausreichend sei. In welcher Form die sozialpolitische Verantwortung auf europäischer Ebene wahrgenommen werden soll, bleibt offen. 7. Weder das Hervorheben der Nation als die maßgebliche territoriale Größe, die ihren Bürgern Schutz und Sicherheit bieten kann, noch die Vorstellung, Europas Vielfalt durch die Mobilisierung der Selbstregulierungskräfte der Gesellschaft erhalten zu können, bieten Perspektiven, das Demokratie-Effizienz-Dilemma zu überwinden. 8. Der Erhalt europäischer Demokratien ist ohne das Herausbilden transnationaler Formen von Demokratie nicht denkbar. Denn der Nationalstaat allein kann die Substanz der Demokratie nicht gewährleisten. Der nationale Wohlfahrtsstaat wird ausgehöhlt. Übrig bleibt die leere Hülle nationaler Souveränität. 9. Aussicht bietet eine zivilgesellschaftliche Verschränkung von Politik und Gesellschaft. Repräsentative nationale Akteure kooperieren zur Erfüllung einer europäischen Aufgabe und entwickeln daraus eine europäische Identität. Aufgrund ihrer assoziativen Funktion sind hier vor allem zivilgesellschaftliche Akteure gefragt. Hier eröffnet sich den Wohlfahrtsverbänden die Chance, sich auf ihre Wurzeln zu besinnen und verstärkt ihre Rolle in der Gesellschaft wahrzunehmen, um sich so die Position der Repräsentativität nachhaltig zu sichern. 10. Eine gleichgewichtige funktionale Repräsentation wirtschaftlicher, sozialer und kultureller Interessen einschließlich Repräsentationsmonopol und Mitverantwortung für die ausgehandelten Ergebnisse kann einen Beitrag zur Behebung des europäischen Demokratiedefizit leisten. Dies setzt voraus, dass die Europäische Union staatsähnliche Eigenschaften ausbildet, die sie dazu befähigt, Verhandlungsgleichgewichte zwischen den Repräsentanten der verschiedenen Interessen herzustellen und autonom über Umverteilungsfragen zu entscheiden und eine entsprechende Politik auch durchzusetzen. (shrink)

Many global catastrophic risks are threatening human civilization, and a number of ideas have been suggested for preventing or surviving them. However, if these interventions fail, society could preserve information about the human race and human DNA samples in the hopes that the next civilization on Earth will be able to reconstruct Homo sapiens and our culture. This requires information preservation of an order of magnitude of 100 million years, a little-explored topic thus far. It is important that a potential (...) future civilization will discover this information as early as possible, thus a beacon should accompany the message in order to increase visibility. The message should ideally contain information about how humanity was destroyed, perhaps including a continuous recording until the end. This could help the potential future civilization to survive. The best place for long-term data storage is under the surface of the Moon, with the beacon constructed as a complex geometric figure drawn by small craters or trenches around a central point. There are several cost-effective options for sending the message as opportunistic payloads on different planned landers. (shrink)

In 'Chrysippus' Puzzle about Identity', John Bowin (thereafter JB) cogently strengthens David Sedley's reading of the puzzle of Chrysippus as a reductio ad absurdum of the Growing Argument. For Sedley, Chrysippus reduces to absurdity the assumption that matter is the sole principle of identity by refuting its presupposition that the two protagonists of the puzzle, namely Theon and Dion, are related as part to the whole. According to Plutarch's Comm. not. 1083 a8-c1, however, the Growing Argument concludes by posing that (...) growth is actually 'generation' and 'destruction'. In order to avoid the contradiction, Theon should have perished rather than become a part of Dion. JB attempts to answer the questions of whether within the Growing Argument there are elements against Theon being a living part of Dion. He shows that in both Epicharmus' fragment 2 and Plutarch's Comm.not. 1083b 308 "there is nothing to block the inference from matter being the sole principle of identity to the possibility that Theon could be a part of Dion" (246). Again, in exploring whether the above contradiction can be solved, he convincingly argues against Epicharmus' and Plutarch's reading of growth as generation and destruction. In the last part of his article, JB stresses that the reductio ad absurdum of the Growing Argument can be tackled without introducing the concept of 'peculiarly qualified individuals'. (Bryn Mawr Classical Review 2004.04.12). (shrink)