This article explores the Nuffield Council on Bioethics’ recent report about non-invasive prenatal testing. Given that such testing is likely to become the norm, it is important to question whether there should be some ethical parameters regarding its use. The article engages with the viewpoints of Jeff McMahan, Julian Savulescu, Stephen Wilkinson and other commentators on prenatal ethics. The authors argue that there are a variety of moral considerations that legitimately play a significant role with regard to (...) (prospective) parental decision-making in the context of NIPT, for example, views on the morality of abortion and understandings of the impact of disability on quality of life. The variable nature of such considerations, both singularly and combined, suggests that any approach to NIPT should be sensitive to and understanding of similarly variable parental assessments and decisions. The implications of the approach developed for current and future policies in this area are explored, along with the impact of such arguments on ideas about procreative beneficence. (shrink)

If our sense of happiness is closely connected to brain functions, it might become possible to manipulate our brain in a much more refined and effective way than current methods allow. In this paper I will make some remarks on the manipulation of the sense of happiness and illuminate the relationship between human dignity and happiness. The President’s Council on Bioethics discusses this topic in the 2003 report Beyond Therapy, and concludes that the use of SSRIs might make (...) us “feel happy for no good reason at all, or happy even when there remains much in one’s life to be truly unhappy about.” I will extend their line of thought through two thought experiments. In the first, a “perfect happiness” drug is given to a person, and in the second a happiness device with an on/off switch is placed inside a person. The first case leads us to conclude that a life with dignity means a life free from domination by the sense of happiness and the sense of unhappiness. The second case leads us to conclude that a life with dignity requires substantive freedom to choose unhappiness. At the end of this paper, I present a new interpretation of “human dignity,” that is, “a life with dignity means a life in which we are able to explore our own life, equipped with both happiness and unhappiness, without regret, through relationships with others, without being exploited by the desires of anyone, and without being dominated by our own desires.”. (shrink)

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

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

A remarkable event occurred at the December 3, 2004, meeting of the U. S. President’s Council on Bioethics. Council member William Hurlbut, a physician and Consulting Professor in the Program in Human Biology at Stanford University, formally unveiled a proposal that he claimed would solve the ethical problems surrounding the extraction of stem cells from human embryos. The proposal would involve the creation of genetically defective embryos that “never rise to the level of integrated organismal existence essential (...) to be designated human life with potential,” and therefore could be used as morally acceptable sources of stem cells for research and therapy. The aim of this essay is to show that Hurlbut’s proposal does not solve the ethical problems associated with human embryonic stem cell research. Two major reasons are presented. First, the proposal, which involves modification of a somatic cell nucleus, suffers from an ethical problem that is common to all types of human genetic engineering: since the procedure is not foolproof, there will be failures. In the case of the procedure Hurlbut proposes, some normal (albeit cloned) embryos will be produced. Second, the embryo engineered in the manner described is, at least in the early stages of its development, fully human despite its genetic defect. This essay also will show how a reasonable person might mistakenly view the proposal as legitimate if he or she makes the error of conflating genetic determinism with Aristotelian teleology. Finally, it will argue that ethical clarity can be achieved by seeing the embryo as a holistic entity possessing emergent properties that cannot simply be spelled out by genes. (shrink)

The recent successful conversion of adult cells into induced pluripotent stem (iPS) cells through direct reprogramming opens a new chapter in the study of disease and the development of regenerative medicine. It also provides a historic opportunity to turn away from the ethically problematic use of embryonic stem cells isolated through the destruction of human embryos. Moreover, because iPS cells are patient specific, they render therapeutic cloning unnecessary. To maximize therapeutic benefit, adult stem cell research will need to be pursued (...) in parallel with studies using iPS cells. Among the four alternative methods presented by the President’s Council on Bioethics, direct reprogram- ming is the most ethically acceptable. Nonetheless, iPS cells are tainted by their association with the human embryonic stem cell lines, derived in the past, which will be required for their validation. This concern is one that can be resolved. Human iPS cells will serve to stem the tide of human embryonic stem cell research, changing it and diverting stem cell research in a more ethical direction. (shrink)

Sports physicians are continuously confronted with new biotechnological innovations. This applies not only to doping in sports, but to all kinds of so-called enhancement methods. One fundamental problem regarding the sports physician's self-image consists in a blurred distinction between therapeutic treatment and non-therapeutic performance enhancement. After a brief inventory of the sports physician's work environment I reject as insufficient the attempts to resolve the conflict of the sports physician by making it a classificatory problem. Followed by a critical assessment of (...) some ideas from the US President's Council on Bioethics, the formulation of ethical codes and attempts regarding a moral topography, it is argued that the sports physician's conflict cannot be resolved by the distinction between therapy and enhancement. Instead, we also have to consider the possibility that the therapy-based paradigm of medicine cannot do justice to the challenges of the continuously increasing technical manipulability of the human body and even our cognitive functions as well. At the same time we should not adhere to transhumanist ideas, because non-therapeutic interventions require clear criteria. Based on assistive technologies an alternative framework can be sketched that allows for the integration of therapeutic and non-therapeutic purposes. After a thorough definition of standards and criteria, the role of the sports physician might be defined as that of an assistant for enhancement. Yet the process of defining such an alternative framework is a societal and political task that cannot be accomplished by the sports physicians themselves. Until these questions are answered sports physicians continue to find themselves in a structural dilemma that they partially can come to terms with through personal integrity. (shrink)

This essay aims to tell the story of the “altered nuclear transfer-oocyte assisted reprogramming,” or ANT-OAR, proposal—from its conception by Professor William Hurlbut of the President’s Council on Bioethics—to its adoption and promotion by a group of conservative, mostly Catholic philosophers, theologians and scientists—to its eventual demise in Congress. It also will give some reflections on how ANT-OAR promotes a genetically deterministic view of the human organism and can lead down a slippery slope into a future in which (...) human cloning and human genetic engineering are more acceptable. For these reasons, it will be argued, ANT-OAR should be opposed by all who are against human genetic modification regardless of their political orientation. (shrink)

It seems certain that one day we will allow the genetic technology which will enhance our offspring. A highly effective new tool, called CRISPR, which allows for carving out genes, is already being used to edit the genomes of animals. In July 2017, the FDA legalized that germline drugs for therapeutic purposes could be sold in the market. It is a high time, now, that we need engage in discussions about the ethics of germline intervention. To contribute to the discussion (...) by showing our thought and to educate the public, we write this paper. (shrink)

En 1968 ocurrieron dos hechos sobre los cuales cabe hacer una reflexión orientada por la bioética: la llamada Revolución del 68 y la aparición de la Carta encíclica Humanae Vitae. El Concilio Vaticano II, que fue presentado como una actualización de la Iglesia católica al mundo moderno, fue el escenario de los estudios previos a la redacción del documento pontificio, donde Pablo VI dejó clara la postura del Magisterio de la Iglesia sobre la moral sexual y anticipa los errores prácticos (...) que se seguirían a planteamientos conceptuales antropológicos erróneos o equivocados sobre esa temática. Hay necesidad de rehabilitar la Humanae vitae para volver a percibir el acto conyugal en su “verdad inalterable”, donde no se puede separar el bien y la belleza de la donación mutua de los cónyuges, que redunda en el bien común de la sociedad para defender su célula básica y nuclear que es la familia. In 1968, two events occurred on which it is worth reflecting on bioethics: the so-called Revolution of 1968 and the appearance of the Encyclical Letter Humanae Vitae. The Second Vatican Council, which was presented as an update of the Catholic Church to the modern world, was the scene of the studies prior to the drafting of the pontifical document, where Paul VI made clear the position of the Magisterium of the Church on sexual morality and it anticipates the practical errors that would follow erroneous or mistaken anthropological conceptual approaches on this subject. There is a need to rehabilitate Humanae vitae in order to re-perceive the conjugal act in its "unalterable truth", where good and beauty cannot be separated from the mutual donation of the spouses, which results in the common good of society to defend its basic and nuclear cell which is the family. (shrink)

Abstract -/- In 1998, the Council for Science and Technology established the Bioethics Committee and asked its members to examine the ethical and legal aspects of human cloning. The Committee concluded in 1999 that human cloning should be prohibited, and, based on the report, the government presented a bill for the regulation of human cloning in 2000. After a debate in the Diet, the original bill was slightly modified and issued on December 6, 2000. In this paper, I (...) take a closer look at this process and discuss some of the ethical problems that were debated. Also, I make a brief analysis of the concept “the sprout of human life.” Not only people who object to human cloning, but also many of those who seek to promote research on human cloning admit that a human embryo is the sprout of human life and, hence, it should be highly respected. I also discuss the function of the language of utilitarianism, the language of skepticism, and religious language appeared in the discussion of human cloning in Japan. (shrink)

Interview on the commodified body with Donna Dickenson by Alana Cattapan.

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

This paper has two goals. The first is to argue that the field of bioethics in general and the literature on ideal vs. nonideal theory in particular has underemphasized a primary problem for normative theorizing: the role of conditioning principles. I define these as principles that implicitly or explicitly ground, limit, or otherwise determine the construction and function of other principles, and, as a result, profoundly impact concept formation, perception, judgment, and action, et al. The second is to demonstrate (...) that ableism is one such conditioning principle and that it undermines the field of bioethics and the practice of biomedicine from achieving the aim of justice as fairness. After briefly addressing the history and critiques of principlism in bioethics, I lay out and defend my account of conditioning principles. I then argue that ableism is one such principle and demonstrate it at work through an analysis of a storied debate between Eva Kittay, Peter Singer, and Jeff McMahan. In conclusion, I contend that the ethical and philosophical dangers of conditioning principles are too easily exacerbated by ideal theory frameworks, and I do so by demonstrating how they are especially liable to generate epistemic injustice, especially contributory and hermeneutical injustice. (shrink)

Since the last ice age, when ice enveloped most of the northern continents, the earth has warmed by about five degrees. Within a century, it is likely to warm by another four or five. This revolution in our climate will have immense and mostly harmful effects on the lives of people not yet born. We are inflicting this harm on our descendants by dumping greenhouse gases into the atmosphere. We can mitigate the harm a little by taking measures to control (...) our emissions of these gases, and to adapt to the changes by, for instance, building sea walls around coastlines threatened by rising sea levels. But these measures will be very expensive, and the costs will be born by us, the present generation, whereas the benefits will come to future generations. How much should we sacrifice for the sake of the future? Economists and philosophers have independently worked on the question of our responsibility to future generations. This book brings their work together and applies it to global warming. It suggests a programme for future research on the economic and ethical issues. The book is intended for economists, and for philosophers and other social scientists who have a little knowledge of economic methods. (shrink)

Having scandalous unethical research practices in the mid and late 20th century, study protocols of biomedical research reviewed by the Ethics Committee (EC) has become the accepted international standard. The Declaration of Helsinki uniformly requires that all biomedical research involving human participants, including research on identifiable human material or data, should be approved by the EC. Today, concerns over the quality of the EC functions worldwide. There are research globally in this regard but no data are available from Bangladesh. Hence, (...) we conducted a questionnaire based pilot study on knowledge and attitude of EC members on bioethics and structure & function of EC in Bangladesh. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on (...) differences in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

The Orthodox Church has been given the fullest of truth by the inspiration of the Holy Spirit, truth honored and valued in the communion of the Saints. For men, to grasp divine truth is a progressive process part of a permanent development. Each and every person walks along this path together with other people, without being the same as the others. Every person is offered and understands truth according to their own religious experience and skills to understand. Ultimate truth exists (...) and it has been revealed completely, but the way in which it is grasped varies from one person to another. “This is not a narrowly doctrinal vision of theological truth. However, it is an essentially spiritual vision for worldly reality, one that removes arrogance from authority and opens new ways of approaching believers of other religions. It presupposes magnanimity and charity, faith and hope, tolerance and reconciliation. It opposes forceful conversion and conflinct, imposition and intolerance, aggression and violence”.85 This approach prevents us from assigning to God intentions and plans which are exclusively ours. Thus, whenever we have a dialogue with those of different beliefs and ideologies, we must always start from God’s sacrificial love for all men. (shrink)

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

The words of Father Professor Dumitru Staniloae have largely found their meaning in the documents of the Council of Crete. “The Mission of the Church in Today’s World” asks itself for a present apologetic message renewal. The theological debate on what are the meanings of “the dignity of the human person” is therefore more than a necessity of our days. Under these conditions inter-Christian and inter-religious dialogue take place, overcoming radical fundamentalism. By grasping the fact that “God is everything (...) in all the things”, we will be able to overcome any preconception and become true confessors of the gospel in the nowadays world. (shrink)

In this article, I argue that the neuroethics of cognitive enhancement can help us bridge the explanatory gap between metaethics and bioethics and throw light on the classic gap between moral beliefs and neural correlates of brain processes. Insofar as it unveils the irreducibility of first-person propositional attitudes, neuroethics allows for justifying cosmetic, pharmacological interventions so as to bring about human enhancement, regardless of descriptive accounts of its neural correlates and independently of the cognitivist, noncognitivist or hybrid inputs of (...) metanormative theories. Precisely because it cannot provide the ultimate grounds for any conservative, libertarian or liberal attitudes towards cognitive enhancement, neuroethics is better conceived in terms of a Rawlsian-like wide reflective equilibrium, procedurally and without any specific substantive commitment to any moral or comprehensive doctrine of sorts. (shrink)

The study investigated the impact of parental income on students' academic performance in secondary schools in Kitswamba and Rugendabara-Kikongo town councils in Kasese District. A cross-sectional research design was used, with data collected from 286 students and five head teachers. The findings showed that family income significantly influenced students' academic performance. The findings have implications for parents, teachers, policymakers, and administrators in the education sector, emphasizing the importance of parental income in determining academic success.

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)

The Global Forum on Bioethics in Research (GFBR) served as a global platform for debate on ethical issues in international health research between 1999 and 2008, bringing together research ethics experts, researchers, policy makers and community members from developing and developed countries. In total, nine GFBR meetings were held on six continents. Work is currently underway to revive the GFBR. This paper describes the purpose and history of the GFBR and presents key elements for its reinstatement, future functioning and (...) sustainability. Potential participants and sponsors are encouraged to contribute actively to the future of this unique international research ethics event. (shrink)

In this article, I present a new interpretation of the pro-life view on the status of early human embryos. In my understanding, this position is based not on presumptions about the ontological status of embryos and their developmental capabilities but on the specific criteria of rational decisions under uncertainty and on a cautious response to the ambiguous status of embryos. This view, which uses the decision theory model of moral reasoning, promises to reconcile the uncertainty about the ontological status of (...) embryos with the certainty about normative obligations. I will demonstrate that my interpretation of the pro-life view, although seeming to be stronger than the standard one, has limited scope and cannot be used to limit destructive research on human embryos. (shrink)

In 1513, the Fifth Council of the Lateran significantly impacted on early-modern Christian philosophy. As is well known, the papal bull Apostolici regiminis condemned certain philosophical doctrines contradicting the personal immortality of the soul. Moreover,the bull prohibited to defend the notion of a double truth in philosophical disputations and urged universities to meet the prescriptions of this decree. This article will shed light on how thispapal intervention in the practice of schooling was met at the early Jesuit college in (...) Rome and the role of Diego de Ledesma, the college’s educational designer, in implementing the bull’s concerns. (shrink)

If bioethical questions cannot be resolved in a widely acceptable manner by rational argument, and if they can be regulated only on the basis of political decision-making, then bioethics belongs to the political sphere. The particular kind of politics practiced in any given society matters greatly: it will determine the kind of bioethical regulation, legislation, and public policy generated there. I propose approaching bioethical questions politically in terms of decisions that cannot be “correct” but that can be “procedurally legitimate.” (...) Two procedures in particular can deliver legitimate bioethical decisions, once combined: expert bioethics committees and deliberative democracy. Bioethics so understood can exceed bioethics as a moral project or as a set of administrative principles to regulate medical practice; it can now aspire to a democratic project that involves ordinary citizens as far as reasonably possible. I advance this argument in four steps: (1) using the example of human germline gene editing, (2) I propose a general understanding of proceduralism, and (3) then combine two types and (4) conclude with a defense of majoritarian proceduralism. I develop this argument in terms of one example: germline gene editing. (shrink)

In the past decade UNESCO has pursued a leadership role in the articulation of general principles for bioethics, as well as an extensive campaign to promulgate these principles globally.1 Since UNESCO's General Conference adopted the Universal Declaration on Bioethics and Human Rights in 2005, UNESCO's Bioethics Section has worked with member states to develop a "bioethics infrastructure." UNESCO also provides an "Ethics Teacher Training Course" to member states and disseminates a "core curriculum," primarily targeting medical students. (...) The core curriculum orients itself by the Universal Declaration on Bioethics and Human Rights and aims to articulate a set of "bioethical principles" that provide a "common global . (shrink)

A number of controversial topics related to bioethics and biotechnology 17 papers that deal with various aspects of release and development of genetically modified organisms (GMOs), stem cells and cloning, privacy and bio-banking.

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

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability (...) and politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and since these two concepts are intrinsically broad, we demarcate their scope by focusing on specific issues such as poverty, gender, health governance, and armed conflicts. Lastly, we provide suggestions for the ways forward. (shrink)

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

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

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

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

This paper discusses how the general and abstract concept of legitimacy applies to international institutions, using the United Nations Security Council as an example. We argue that the evaluation of the Security Council’s legitimacy requires considering three significant and interrelated aspects: its purpose, competences, and procedural standards. We consider two possible interpretations of the Security Council’s purpose: on the one hand, maintaining peace and security, and, on the other, ensuring broader respect for human rights. Both of these (...) purposes are minimally morally acceptable for legitimacy. Second, we distinguish between three different competences of the UNSC: 1) the decision-making competence, 2) the quasi-legislative competence, and 3) the referral competence. On this basis, we argue that different procedural standards are required to legitimise these competences, which leads to a more differentiated understanding of the Security Council’s legitimacy. While maintaining that the membership structure of the Council is a severe problem for its legitimacy, we suggest other procedural standards that can help to improve its overall legitimacy, which include broad transparency, deliberation, and the revisability of the very terms of accountability themselves. (shrink)

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

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

In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment (...) choices are sensitive to preferences. Here, we analyze a discussion in the Mishna, a foundational text of rabbinic Judaism, regarding patient autonomy in the setting of religiously mandated fasting, and commentaries in the Babylonian and Palestinian Talmuds, finding both a more expansive notion of such autonomy and a potential metaphysical grounding for it in the importance of patient self-knowledge. (shrink)

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

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

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)

Purpose/Background. The present research focuses on the debate on transhumanism/bioconservatism from the perspective of empirical bioethics, that is, making use of em-pirical evidence in the process of moral reasoning. Its objective is to propose a metho-dological guide for the approach and resolution of moral problems concerning human enhancement. Methodology/Approach. The method Step-wise Ethical Human Enhancemet (SWEH) is proposed. It is a guide consisting of 11 questions that are the result of the adaptation of the guidelines for identifying a human (...) enhancement procedure as ethical developed by Julian Savulescu to the method of Step-wise Empirical Contributions elaborated by Pascal Borry. An applicative example on the morality of biohacking RFID implants is provided. Results/Findings. SWEH proposes that human enhancement procedures might be approached as specific problems and that the identified moral norm might be rewritten as a descriptive proposition that serves as a hypothesis that will be evaluated in the light of empirical evidence. The evaluation of the proposition, and thus of moral reasoning, will be done with the help of the information gathered by the 11 questions. Discussion/Conclusions/Contributions. SWEH can serve to provide a first answer on the morality of a specific human enhancement procedure, but not an absolute one, as the result may vary depending on the information obtained in the future. It also highli-ghts gaps in empirical research related to the procedure it addresses. The method is a first methodological guide that could be revised and improved. (shrink)

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

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

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

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

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

Autonomy in bioethics is coming under sustained criticism from a variety of perspectives. The criticisms, which target personal or individual autonomy, are largely justified. Moral conceptions of autonomy, such as Kant’s, on the other hand, cannot simply be applied in bioethical situations without moralizing care provision and recipience. The discussion concludes with a proposal for re-thinking autonomy by focusing on what different agents count as reasons for choosing one rather than another course of action, thus recognising their involvement in (...) the decision process. (shrink)