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

The paper examines Fritz Jahr as a possible role-model in bioethical education. It consists of two parts. The first part builds upon the acknowledged data and theories about how Fritz Jahr proposed the bioethical imperative and changed his way of thinking. It provides arguments for and against known claims and expands the knowledge background with the focus on reconstructing the thought process and some presumptions that led to the formulation of bioethical imperative. The second part uses (...) these results to infer five features to show how we can extract and define methodological features from Jahr’s personality and activity, which confirm and enhance integrative projects. An attempt has been made to understand that something such as “Jahrian methodology”, might be sensible enough to provide scientific knowledge and cultural orientation without simplifying the bios, but that it is pointless without integration with educational models, and to emphasise this I conclusively consider the role of bioethicists in the 21st century. (shrink)

Scientisationisagrowingtrendasindividualsworldwideharnessscientific tools and knowledge to solve problems. This phenomenon is evident in biomedical research, which has increased across sub-Saharan Africa, and when encountering bioethical issues arising during the course of such research. This research synthesis considers how the constructs of culture, actors, and resources in the region shape undergraduate bioethics education. Using a lens of sociological neo-institutionalism, taken-for-granted bioethical scripts, like informed consent and medical confidentiality, are evident in this education; however, actual implementation demonstrates the way (...) they are often adapted and contextualised, with implications for students and instructors, and ultimately patients and research participants. The education considered is that for undergraduates in health sciences and medicine because they are prominent actors in research and clinical practice across the region. In considering insights from this literature, the aim is to positively impact health across sub-Saharan Africa. (shrink)

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

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...) comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

Bioethicists’ views diverge public opinion on various ethical issues, particularly in healthcare. For instance, bioethicists generally oppose payment for organs and advocate for preventing death at any age, whereas the public is more supportive of organ payment and prioritizing younger patients. I offer four arguments on how best to view this divergence. (a) Bioethicists’ specialized training, objectivity, and reliance on research often lead to views that differ from those of the public, which may be less informed and more influenced by (...) biases. (b) Further, divergence between expert and public opinion is a normal and sometimes necessary aspect of bioethics. Divergence can lead to more informed and progressive ethical practices. (c) While public input is valuable, achieving meaningful engagement is difficult due to varying values, risk perceptions, and socioeconomic circumstances. Effective bioethics would balance expert knowledge with public input, aiming for policies that are both scientifically sound and democratically legitimate. (d) Maintaining public trust in bioethics does not require full alignment with public opinion. Instead, bioethicists should focus on educating the public and incorporating informed public perspectives into their analysis and recommendations. (shrink)

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

In our article, Where the ethical action is, we argue that medical and ethical modes of thought are not different in kind but merely different aspects of a clinical situation. In response, Emmerich argues that in so doing, we neglect several important features of healthcare and medical education. Although we applaud the spirit of Emmerich’s response, we argue that his critique is an attempt at a general defence of the value of bioethical expertise in clinical practice, rather than (...) a specific critique of our account. (shrink)

This paper assesses the state of research ethics in low- and middle-income countries and the achievements of the Fogarty International Center's bioethics training program since 2000. The vision of FIC for the next decade of research ethics education is encapsulated in four proposed goals: (1) Ensure sufficient expertise in ethics review by having someone with long-term training on every high-workload REC; (2) Develop LMIC capacity to conduct original research on critical ethical issues by supporting doctoral and postdoctoral training and (...) career paths for research ethicists; (3) Make research training and review at LMIC institutions sustainable by identifying additional funding mechanisms and models; (4) Make institutional research systems more ethical and efficient through context-specific training integrated into all levels of scientific training. (shrink)

With regard to existing concept of the moral education (ethics) in Slovakia, the questions of ethics and morals are only one of the partial sections. The dominant role is played by psychology based on Roberto Olivar’s concept with emphasis on pro–socialization and on Erickson’s concept of the psychosocial development. From the philosophy basis point of view, only Aristotle, even in reduced form and Spranger’s concept of the life forms are mentioned. Philosophy and ethics are only complements to more psychologically (...) based educational program which is resulting from the problematic division of a social and moral experience into egoistic and prosocial. Egoism is presented in a distorted form and is characterized as the cause of all moral evil. However, there are several different types of understanding of the term egoism in philosophy and ethics as for example psychological and ethical egoism, or self-interest. Ethical egoism or self-interest cannot be identified with selfishness. The main aim of moral education should not be only to form the desired children and youth moral orientation but on the other hand, to form morally self-confident individuals who are able to solve the moral problems, to help the others to solve them as well and to be able to bear moral responsibility for their own deeds. (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)

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

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

The curriculum design, faculty characteristics, and experience of implementing masters' level international research ethics training programs supported by the Fogarty International Center was investigated. Multiple pedagogical approaches were employed to adapt to the learning needs of the trainees. While no generally agreed set of core competencies exists for advanced research ethics training, more than 75% of the curricula examined included international issues in research ethics, responsible conduct of research, human rights, philosophical foundations of research ethics, and research regulation and ethical (...) review process. Common skills taught included critical thinking, research methodology and statistics, writing, and presentation proficiency. Curricula also addressed the cultural, social, and religious context of the trainees related to research ethics. Programs surveyed noted trainee interest in Western concepts of research ethics and the value of the transnational exchange of ideas. Similar faculty expertise profiles existed in all programs. Approximately 40% of faculty were female. Collaboration between faculty from low- and middleincome countries (LMICs) and high-income countries (HICs) occurred in most programs and at least 50% of HIC faculty had previous LMIC experience. This paper is part of a collection of papers analyzing the Fogarty International Research Ethics Education and Curriculum Development program. (shrink)

This article intends to show that the defense of ‘‘understanding’’ as one of the major goals of science education can be grounded on an anti-reductionist perspective on testimony as a source of knowledge. To do so, we critically revisit the discussion between Harvey Siegel and Alvin Goldman about the goals of science education, especially where it involves arguments based on the epistemology of testimony. Subsequently, we come back to a discussion between Charbel N. El-Hani and Eduardo Mortimer, on (...) the one hand, and Michael Hoffmann, on the other, striving to strengthen the claim that rather than students’ belief change, understanding should have epistemic priority as a goal of science education. Based on these two lines of discussion, we conclude that the reliance on testimony as a source of knowledge is necessary to the development of a more large and comprehensive scientific understanding by science students. (shrink)

In this paper, findings from research in neuroscience of morality will be reviewed to consider the purposes of moral education. Particularly, I will focus on two main themes in neuroscience, novel neuroimaging and experimental investigations, and Bayesian learning mechanism. First, I will examine how neuroimaging and experimental studies contributed to our understanding of psychological mechanisms associated with moral functioning while addressing methodological concerns. Second, Bayesian learning mechanism will be introduced to acquire insights about how moral learning occurs in human (...) brains. Based on the reviewed neuroscientific research on morality, I will examine how evidence can support the model of moral education proposed by virtue ethics, Neo-Aristotelian moral philosophy in particular. Particularly, two main aims of virtue ethics-based moral education, the habituation of virtues and the cultivation of phronesis, will be discussed as the important purposes of moral education based on neuroscientific evidence. (shrink)

NIH's fogarty international Center has provided grants for the development of training programs in international research ethics for low- and middle-income (LMIC) professionals since 2000. Drawing on 12 years of research ethics training experience, a group of Fogarty grantees, trainees, and other ethics experts sought to map the current capacity and need for research ethics in LMICs, analyze the lessons learned about teaching bioethics, and chart a way forward for research ethics training in a rapidly changing health research landscape. This (...) collection of papers is the result. (shrink)

In response to the increasing need for research ethics expertise in low and middle income countries (LMICs), the NIH's Fogarty International Research Ethics Education and Curriculum Development Program has provided grants for the development of training programs in international research ethics for LMIC professionals since 2000. This collection of papers draws upon the combined expertise of Fogarty grantees, trainees, and other experts to assess the state of research ethics in LMICs, and the lessons learned over 12 years of international (...) research ethics education; to assess future needs; and to chart a way forward to meet those needs. In this introductory paper we briefly sketch the evolution of research ethics as applied to LMIC research, the underpinning and evolution of the Fogarty bioethics program, and summarize key conclusions from the other papers in the collection. (shrink)

The aim of this work is to familiarize the reader with the presence and development of bioethics in Serbia. First, the introduction analyzes the term of bioethics and considers its disciplinary founding. In order to give as full a picture of the actual state of bioethics in Serbia as possible, its reception is considered from two main standpoints: the standpoint of the bioethical education and the standpoint of relevant legal regulations and institutionalization. Attention is also drawn to certain (...) omissions in the approach to bioethical issues, with special view of the questions of cloning and euthanasia, and to moments that should contribute to its full scientific and institutional affirmation. (shrink)

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.

From 1900 onwards, scientists and novelists have explored the contours of a future society based on the use of “anthropotechnologies” (techniques applicable to human beings for the purpose of performance enhancement ranging from training and education to genome-based biotechnologies). Gradually but steadily, the technologies involved migrated from (science) fiction into scholarly publications, and from “utopia” (or “dystopia”) into science. Building on seminal ideas borrowed from Nietzsche, Peter Sloterdijk has outlined the challenges inherent in this development. Since time immemorial, and (...) at least since the days of Plato’s Academy, human beings have been interested in possibilities for (physical or mental) performance enhancement. We are constantly trying to improve ourselves, both collectively and individually, for better or for worse. At present, however, new genomics-based technologies are opening up new avenues for self-amelioration. Developments in research facilities using animal models may to a certain extent be seen as expeditions into our own future. Are we able to address the bioethical and biopolitical issues awaiting us? After analyzing and assessing Sloterdijk’s views, attention will shift to a concrete domain of application, namely sport genomics. For various reasons, top athletes are likely to play the role of genomics pioneers by using personalized genomics information to adjust diet, life-style, training schedules and doping intake to the strengths and weaknesses of their personalized genome information. Thus, sport genomics may be regarded as a test bed where the contours of genomics-based self-management are tried out. (shrink)

The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I offer (...) an overview of recent disability theory, outline a set of responsibilities clinicians have to disability communities, and provide recommendations for clinicians who hope to justly treat patients with disabilities and improve their care and health outcomes. (shrink)

Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of (...) the overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

In this peer commentary on L. Syd M. Johnson’s “Inference and Inductive Risk in Disorders of Consciousness,” I argue for the necessity of disability education as an integral component of decision-making processes concerning patients with DOC and, mutatis mutandis, all patients with disabilities. The sole qualification Johnson places on such decision-making is that stakeholders are educated about and “understand the uncertainties of diagnosis and prognosis.” Drawing upon research in philosophy of disability, social epistemology, and health psychology, I argue that (...) this educational qualification is insufficient to address systemic ableism and other forms of epistemic bias in quality of life judgments. (shrink)

It is my pleasure to present you the first issue of the Argument: Biannual Philosophical Journal, published by the Department of Philosophy and Sociology, Pedagogical University of Cracow. This is a peer-reviewed journal founded to facilitate dialogue between Polish and international scholars and, on the other hand, to build bridges between professional philosophers and a wider educated public. We are open to the publishing of scholarly studies in history of philosophy as well as papers reporting the on-going debates in contemporary (...) philosophy, representing various currents in philosophical inquiry, including continental, analytic, non-Western traditions and comparative perspectives. We also publish polemical papers, responses and interviews, book reviews and notices from professional philosophers. Besides, we are open to critical and innovative suggestions concerning teaching methods and the purposes of up-to-date philosophical education. As the name itself suggests, the Argument is intended to provoke rational argument, encourage clear and precise reasoning, and enhance the essential philosophical need for justification and well-founded argument that support the presented views and clarify the accepted positions. the Argument is also intended to serve as a forum for dedicated philosophical debate, polemics and dispute implied by the plurality of the methods and possible interpretations developed within contemporary philosophy. Being aware of the variety of socio-epistemic dimensions of scholarship we also encourage critical, inter-disciplinary and creative articles on topics of traditional and emerging interest. Therefore, we welcome papers on such varied specialisations as: metaphysics, ontology, epistemology, axiology, logic, philosophy of religion, philosophy of mind, political philosophy, philosophy of science, as well as philosophical education, gender and feminist thought, bioethics, environmental philosophy, etc. Favouring methodological and thematic plurality we also want to present philosophy as a rich field of great cultural and social value. (shrink)

What are and where are the ethical limits of neuroeducation? The article reflects on a necessary question for the evolution of cognitive processes through critical deliberation, the delimitation of boundaries and the estimation of progress. On the one hand, it argues that the experimental turn could call into question the ethical and humanistic goal of education; on the other hand, it argues that a systematic renunciation of neuroscientific advances would also mean abandoning the quest for human flourishing. The humanities (...) alone do not provide the biopsychosocial approach from which we must understand our self-realisation. Thus, the first of the limits that is the origin of all the others arises from a scientific-humanist dilemma. The new boundaries to be delimited are the neuroscientific implications in themselves and how these are translated into educational, if they were to be valid in this field. Here neuromyths play an important role. It is precisely neuroethics as an applied ethics or branch of bioethics that takes up these aspects through neuroeducational ethics and educational neuroethics. In its fundamental branch, this discipline opens up the debate on moral neuroeducation. But the possibility of reducing morality and all that we are to our neural bases leads to new limits. To overcome them, he highlights the potential of a sociocultural and biological symbiosis with the notions of 'neuroculture' and 'proactive epigenesis'. Finally, the essay deliberates on the more speculative boundaries between what we are and our possibilities for understanding it on the basis of transhumanism. ____________________________________________________________________________________________________ ______________________________________________________________________________________________¿Cuále s son y dónde están los límites éticos de la neuroeducación? El artículo reflexiona sobre una cuestión necesaria para el devenir de los procesos cognitivos mediante la deliberación crítica, la delimitación de fronteras y la estimación del progreso. Su hilo argumental proyecta, por un lado, que el giro experimental podría poner en entredicho el objetivo ético y humanista de la educación; por otro lado, que una renuncia sistemática a los avances de las neurociencias supondría, igualmente, abandonar la búsqueda del florecimiento humano. Las humanidades solo no brindan el enfoque biopsicosocial desde el que hemos de entender nuestra autorrealización. Por ende, el primero de los límites que es origen de todos los demás surge dada una disyuntiva científico-humanista. Los nuevos confines a delimitar subyacen de las implicaciones neurocientíficas en sí mismas y de cómo estas se trasladan a la praxis escolar, si es que tuviesen validez en este campo. Aquí los neuromitos juegan un papel importante. Precisamente, la neuroética como ética aplicada o rama de la bioética recoge estos aspectos mediante la ética neuroeducativa y la neuroética educativa. En su rama fundamental, dicha disciplina abre el debate sobre la neuroeducación moral. Pero la posibilidad de reducir lo moral y todo lo que somos a nuestras bases neurales deriva en nuevos límites. Para superarlos, destaca el potencial de una simbiosis sociocultural y biológica con las nociones de ‘neurocultura’ y de ‘epigénesis proactiva’. Finalmente, el ensayo delibera sobre los límites más especulativos entre lo que somos y nuestras posibilidades para entenderlo en base al transhumanismo._____________________________________________________________________________________ ____________________________________________________________________________________________________ _______HOW TO CITE / CÓMO CITAR: Castillo, P. (2023). Los límites éticos de la neuroeducación. Teoría de la Educación. Revista Interuniversitaria, 35(2), 191-208. (shrink)

AI is increasingly becoming based upon Internet-dependent systems to handle the massive amounts of data it requires to function effectively regardless of the availability of stable Internet connectivity in every affected community. As such, sustainable development (SD) for rural and mountain communities will require more than just equitable access to broadband Internet connection. It must also include a thorough means whereby to ensure that affected communities gain the education and tools necessary to engage inclusively with new technological advances, whether (...) they be focused on machine learning algorithms or community infrastructure, as they will be increasingly dependent upon the automational capabilities of AI. In this essay, an exploration will be conducted into the means whereby student-engaged learning (SEL) can effectively be utilized to provide targeted, inclusive education to rural and mountain communities regarding the implications of AI for SD. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to (...) both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

Two chapters -- "Common Arguments about Abortion" and "Better (Philosophical) Arguments About Abortion" -- in one file, from the open access textbook "Introduction to Ethics: An Open Educational Resource" edited by Noah Levin. -/- Adults, children and babies are arguably wrong to kill, fundamentally, because we are conscious, aware and have feelings. Since early fetuses entirely lack these characteristics, we argue that they are not inherently wrong to kill and so most abortions are not morally wrong, since most abortions are (...) done early in pregnancy before consciousness and feeling develop in the fetus. Furthermore, since the right to life is not the right to someone else’s body, fetuses might not have the right to the pregnant woman’s body, and so she has the right to not allow the fetus use of her body; this further justifies abortion, at least, until technology allows for the removal of fetuses to other wombs. Since morally permissible actions should be legal, abortions should be legal. -/- In the course of arguing for these claims, we: -/- discuss how to best define abortion; dismiss many common “question-begging” arguments that merely assume their conclusion, instead of giving genuine reasons for them; refute some often-heard “everyday arguments” about abortion; explain why some influential philosophical arguments against abortion are unsuccessful; provide some positive arguments that at least early abortions are not wrong; briefly discuss the ethics and legality of later abortions, and more. -/- Little of this discussion should be taken as absolute “proof” of anything, as this is merely a reasoned introduction to the issues: much more needs to be discussed, always. (shrink)

BACKGROUND Preconception sex selection for non-medical reasons is a controversial issue in bioethics. Little research has described preferences for preconception sex selection among Arab populations. This study describes the sex preference and interest in employing sex selection techniques among pregnant women in northern Jordan. -/- METHODS A self-reported questionnaire was administered to 600 pregnant women in Irbid, Jordan. χ2 test and binary logistic regression were used to examine the factors associated with interest in preconception sex selection. -/- RESULTS In general, (...) the interest in using sex selection was low. Women who preferred boys were more likely to be interested in sex selection, if paid for by the couple [odds ratio (OR) = 4.40, 95% confidence interval (CI): 1.75–11.11] or by health insurance (OR = 3.42, 95% CI: 1.94–6.06), or, if feasible, administered through oral medication (OR = 8.84, 95% CI: 5.05–15.63). Women with lower education were more likely to be interested in sex selection, if paid by health insurance (OR = 1.96, 95% CI: 1.10–3.45) and were more likely to believe that sex selection is legal (OR = 1.79, 95% CI: 1.06–2.86). Women who had no boys were more likely to be interested in sex selection, if paid by health insurance (OR = 1.94, 95% CI: 1.10–3.42) or, if feasible, through medication (OR = 3.03, 95% CI: 1.82–5.00). -/- CONCLUSIONS The majority of participants were not in favor of using preconception sex selection. Those with a preference to have boys, with lower education, and those with an imbalanced family were more likely to be interested in using sex selection technology. (shrink)

Are universities justified in trying to regulate student use of cognitive enhancing drugs? In this article I argue that they can be, but that the most appropriate kind of regulatory intervention is likely to be voluntary in nature. To be precise, I argue that universities could justifiably adopt a commitment contract system of regulation wherein students are encouraged to voluntarily commit to not using cognitive enhancing drugs. If they are found to breach that commitment, they should be penalized by, for (...) example, forfeiting a number of marks on their assessments. To defend this model of regulation, I adopt a recently-proposed evaluative framework for determining the appropriateness of enhancement in specific domains of activity, and I focus on particular existing types of cognitive enhancement drugs, not hypothetical or potential forms. In this way, my argument is tailored to the specific features of university education, and common patterns of usage among students. It is not concerned with the general ethical propriety of using cognitive enhancing drugs. (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)

Este volumen monográfico, desde una visión interdisciplinar aporta al estudio de la familia, así como al reconocimiento que se requiere en el ámbito educativo secundario y superior de una estructura consolidada del estudio de la bioética para una correcta educación en el cuidado de la vida, y de las políticas públicas que den estabilidad a la vida del hogar. 21 textos, dividos en cuatro secciones, desde el marco antropológico de la persona y la familia, abordan diversos ámbitos y temas relativos (...) al contexto familiar, tales como: el contexto psico-pedagógico, la bioética, el ciclo de vida familiar y la pastoral familiar. (shrink)

Education on authorship was delivered and evaluated by pre test and post test questionnairen on 30 post graduate medical students at the Department of Anestheology, Dhaka Medical College, Bangladesh between January and June 2019 to understand the knowledge, skill and attitude of post graduate medical students on authorship. Result: Before intervention, majority (60%) of the students felt that who perform the research work should be the author of the article. But 40% students were divided and felt that who advised (...) the design of the research (20%), who provided the grants (10%) and Chief/Head of the division (10%) should be the author of the article respectively. Maximum (70%) respondents did not know the order of authorship. Of 40% respondent felt that the PI should be always the first author and 40% don’t know the answer. Half of the students (50%) felt that keeping honorary author increased the opportunity of acceptance of publication. Of 36.7% and 13.3% of students felt that keeping honorary author increased the article’s value and made good relation to them to get some extra facility from them respectively. Of 20% participants were pressurized by lab head/head of department for inclusion of their name as an author. Half of the (56.7 %) respondents felt that the author’s contribution should be stated in the article. Only few 4 (13.3%) respondents said that their institute had guideline for authorship. However, after education 100% of students felt that who perform the research work should be only the author of the article. All (100%) respondents understood the order of authorship. Most of the students (86%) felt that PI should be always the first author. Of 100% respondent felt supervisor of the research should be the last author. All students (100%) felt author’s contribution should be mentioned in the article. All (100%) students did not want to include as author those who help in research design and secured grant; and they did not like to keep honorary author in their article. All (100%) students expressed that their institute had no guideline for authorship. After intervention, three groups of students were asked to write one page of article on Anesthesiology. Interestingly, they did not include any name in the author by line who were not participate or had any contribution in the writing. Conclusion: The comparative data between pre- and post-text have highlighted a general lack of understanding of the basic concept of authorship ethics which significantly improved after the intervention. The results also indicate that the education on authorship improved the awareness of postgraduate medical students in a particular centre. (shrink)

In society, human vulnerability is associated with multiple causes such as poverty, injustice, discrimination and illnesses, among others. In the midst of this panorama of external agents that lead human beings to situations of vulnerability, some clearly see – although others not so much – a vulnerability proper to the human person, simply because they exist. This approach to vulnerability is considered to be a conditio humana that affects everyone. Precisely because it is a conditio humana, vulnerability is closely related (...) to autonomy. For this reason, in this article we have attempted to deepen in the interrelationship between autonomy and vulnerability, focusing on an anthropological vulnerability, and determining whether vulnerability constitutes an impediment for autonomy, as vulnerability and autonomy seem to be the representatives of polar opposites: one that is limited and can do nothing or very little, and the other that can do everything and has no limits. -/- La vulnerabilidad humana está asociada en la sociedad a múltiples causas, tales como la pobreza, la injusticia, la discriminación, las enfermedades, entre otras. En medio de este panorama de agentes externos que lleven a los seres humanos a situaciones vulnerables, se deja ver, para unos claramente, para otros no tanto, una vulnerabilidad propia a la persona humana por el simple hecho de existir. Uno de los enfoques de la vulnerabilidad es considerarla como una conditio humana que nos afecta a todos, asunto que ha sido insistentemente ratificado por el pensamiento contemporáneo. Justamente, por ser una conditio humana, la vulnerabilidad se encuentra en estrecha relación con la autonomía. Es así que en este trabajo nos hemos propuesto ahondar en ese entramado de autonomía y vulnerabilidad, tomando el enfoque de la vulnerabilidad antropológica con el fin de describir la interrelación entre dichos principios y determinando si la vulnerabilidad constituye un “freno” o no para la autonomía, pues vulnerabilidad y autonomía parecen ser los representantes de dos polos opuestos, el del que se encuentra limitado y no puede hacer nada o hace poco, y el del que puede hacerlo todo sin ningún límite. (shrink)

Though it is evident that seriously and irreversibly defective infants are born in Poland, as well as in other socialist countries we do not know really what is the existing medical practice concerning their treatment or non-treatment. No representative empirical investigations were conducted with respect to it. We believe, however, that for the majority of doctors this is not a genuine moral problem at all. They feel simply morally, legally, and professionally obliged to treat those unhappy creatures without any regard (...) to economic and moral cost of treatment. It is highly plausible that this attitude is common to all socialist countries. All the factors mentioned in this paper (religion, ideology, medical education, paternalism, remembrance of Nazi doctors’ criminal practice, the legal situation, and the health care system) have a direct influence on the moral beliefs and attitudes of doctors in socialist countries. And even in those countries in which there are different religious traditions (like the Soviet Union, Yugoslavia, or the German Democratic Republic) there is a deeply-entrenched belief that preserving any human life is the principal and absolute duty of a doctor, one which must be fulfilled at any cost. We should also keep in mind that in this part of the world hardly any distinction at all is made between euthanasia and ordinary murder. (shrink)

Goold and Stern (2006) offer a much needed dose of insight into the weakness of medical education from the perspective of resident and nonresident physicians. One of their findings pertains not to...

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. Study (...) data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

Many people report that reading first-person narratives of the experience of illness can be morally instructive or educative. But although they are ubiquitous and typically sincere, the precise nature of such educative experiences is puzzling—for those narratives typically lack the features that modern philosophers regard as constitutive of moral reason. I argue that such puzzlement should disappear, and the morally educative power of illness narratives explained, if one distinguishes two different styles of moral reason: an inferentialist style that generates the (...) puzzlement and an alternative exemplarist style that offers a compelling explanation of the morally educative power of pathographic literature. (shrink)

Aim: The aim of this study is to reveal the convergence of public health ethics, institutional, collective, and individual ethics obligation during the COVID-19 pandemic and give some explanations with online media reports. Method: The study method is qualitative content analysis; this method was chosen as it would suit best the purpose of the study. The Turkish Medical Association, Turkish Public Health Association, and online newspaper articles and videos have been scanned using keywords. After that, related online reports and interviews (...) have been classified and analyzed according to the context in between May 22, 2020 and November 16, 2020. No official ethical permission was obtained as the study was conducted through open access internet news sites. Results: The COVID-19 scientific committee and the Ministry of Health has suggested a new way of normal life called controlled social life for all places in Turkey. In the frame of these recommendations, with the Google research engine, many articles of online media including some announcements of medical and legal associations, interviews, and calls made by the authorities were selected and analyzed. These articles and interviews containing each problem and pieces of information provided for the common understandings of the society were selected and evaluated at three topics individual, collective and state and institutional responsibility and obligations. Conclusion: Although the warnings of associations, health authorities, and scientists are mostly about personal-civil responsibility, some occurring practices have caused violations. In addition, the level of education, perception capacity, and habits that include existing social-cultural and religious rituals have prevented people from adapting to this new style of life, in other words, controlled social life. Therefore, besides the original national culture and customs, universal ethical responsibilities and obligations should teach starting from primary school and should consist of whole life understanding as a higher perspective. (shrink)

Purpose: The objective of this study is to determine the importance of supplementary medical ethics course for resident physicians. In this study, we assessed the current state of their knowledge of medical ethics and aimed to improve and deepen their understanding of clinical scenarios to increase their awareness of the link between the practice of medicine and ethical issues. Methods: The course was held for groups of 10-12 people for 3 days a week for a total of 6 hours. Tests (...) given prior to and following completion of the course were used to assess the effectiveness of a medical ethics training course in which 120 resident physicians completed. The evaluation was made on the basis of the same pre-and post-tests (14 scenarios) and direct observation of participants. Result and Discussion: The average age was 28.23 ± 4.08 and 25% were female and 75% were male. Of the participants, 68.3% were training to be internists, 24.2% were training to be surgeons, and 7.5% were training in laboratory medicine. There was a significant statistical difference between the mean total scores of both tests (p=0.00). After completing the course, residents took into account the medical ethical principles while discussing ethical decisions. Conclusion: After finishing the course, participants defended their responses in regard to issues of medical ethics more carefully and articulated their thoughts more clearly. Our experience demonstrated that the trainees benefited from a structured curriculum in medical ethics. We believe that the development and implementation of our course may serve as a case study for training resident physicians in medical ethics. (shrink)

The purpose of cultural competence education for medical professionals is to ensure respectful care and reduce health disparities. Yet as Berger and Miller (2021) show, the cultural competence framework is dated, confused, and self-defeating. They argue that the framework ignores the primary driver of health disparities—systemic racism—and is apt to exacerbate rather than mitigate bias and ethnocentrism. They propose replacing cultural competence with a framework that attends to two social aspects of structural inequality: health and social policy, and institutional-system (...) activity; and two psychological aspects of structural inequality: the clinical encounter, and the epistemic. -/- We agree with the structural approach. To that end, we think it would be fruitful to include attention to physical contributors to structural inequality, namely the material artifacts used in medicine. Devices, tools, and technologies can materialize biases, perpetuate oppression, and contribute to health disparities. Granted, not everything that interests philosophers can be squeezed into medical education. Nevertheless, there are compelling reasons for including the study of material artifacts in education designed to reduce health disparities. First, devices and tools often carry forward biases from the past, and keep biases hidden from plain sight. Second, by studying these artifacts, future clinicians can begin to see themselves as part of a larger sociotechnical system. Finally, as medicine becomes increasingly tech-laden, it’s important for clinicians to see how material artifacts (including algorithms) connect individuals to structures. This will help to undermine oversimplified narratives according to which objective tools and technologies can correct for the bias and subjectivity of flawed human beings. (shrink)

Cloning research caught a great deal of attention when Dolly the sheep was born (§4). While some fear surrounded the attainment (§§14-15), Wilmutʼs research itself has grown well, providing a less vicious manner to gain ES cells (§12). In this article, we review the progress of cloning research along with the concern of medical circles about its application to reproductive cloning, that is to say, making replicas of human beings (§§16-21). Note that all the content is ascribed to the author (...) alone, not to Musashino University. (shrink)

The author studies the role of Christianity in two forms of 9th century political ethics in the history of Great Moravia, represented by the Great Moravian rulers Rastislav and Svatopluk. Rastislav’s conception predominantly uses the pre-Erasmian model of political ethics based on the pursuit of welfare for the country and its inhabitants by achieving the clerical-political independence of Great Moravia from the Frankish kingdom and, moreover, by utilising Christianity for the advancement of culture, education, literature, law and legality, as (...) well as by spreading Christian ethics and morality in the form of the Christian code of ethics expressed in ethicallegal documents. Svatopluk’s political conception was a prototype of Machiavellian political ethics, according to which one is, in the interest of the country and its power and fame, allowed to be a lion and/or a fox. Svatopluk abused Christianity in the name of achieving his power-oriented goals. Great Moravia outlived Rastislav; it did not, however, outlive Svatopluk, as, shortly after his death, it broke up and ceased to exist. The author came to the conclusion that Rastislav’s conception was more viable, as its cultural heritage lives on in the form of works by Constantine and Methodius. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Robert Sparrow recently argues that state-driven moral bioenhancement is morally problematic because it inevitably invites moral perfectionism. While sharing Sparrow’s worry about state-driven moral bioenhancement, I argue that his anti-perfectionism argument is too strong to offer useful normative guidance. That is, if we reject state-driven moral bioenhancement because it cannot remain neutral between different conceptions of the good, we might have to conclude that all forms of moral enhancement program ought not be made compulsory, including the least controversial and most (...) popular state-driven program: compulsory (moral) education. -/- In this paper, I argue that instead, the spirit of Sparrow’s worry should be recast in the language of the capability approach – an approach that strives to enhance people’s capabilities to develop their own conceptions of the good by restricting itself from endorsing thick conceptions of the good. The distinction made regarding thick and thin conceptions of the good helps better capture sentiments against state-driven bioenhancement programs without falling prey to the issues I raise against Sparrow’s anti-perfectionist arguments. (shrink)

Medical students commonly learn how to administer pelvic exams by practicing on unconscious patients, often without first obtaining explicit consent from patients to do so. While twenty-one states currently have laws that require teaching hospitals to obtain consent from patients to participate in this educational experience, opposition from the medical community has stymied legislative progress. In this paper, I respond to the two most common reasons offered to oppose legislation, which appeal to (1) the educational benefits of these exams, or (...) (2) protecting institutional autonomy. Kantian ideas about autonomy help to illuminate the problematic ways in which these arguments supplant the importance of women’s choices over how their bodies are used while seeking medical treatment. Ultimately, neither argument offers sufficient reason to oppose laws that require explicit consent before administering training pelvic exams. (shrink)

Membership of a layperson is mandatory in the research ethics committee. According to World Health Organization (WHO), still there is a quorum of the ethics committee meeting (EC), however, the EC meeting should be adjourned if the absentee of a lay person. So layperson is a very important position in the EC. A layperson is a person whose primary area of interest is not scientific, however, they share their insight into the research to protect the research participants. Actually who and (...) what lay members represent on ethics committees remains unclear, and the question of what laypersons mean what is their educational status, and what is their role in the research ethics committee is also not clear. In some Institution Review Boards (IRB)s, use the term public representatives instead of lay persons. Moreover, the education qualification of the layperson is as high as Ph.D. This paper argues why not the nomenclature should change to a public representative instead of a layperson in the IRBs. If the nomenclature is changed to establish their positive image in the IRB and also increases their self of security, respect, and self-esteem. (shrink)

The Disabilities Act of 1990 and the Developmental Disabilities Assistance and Bill of Rights Act of 2000 of United States in act to prevent social exclusion of people with intellectual and developmental disabilities (IDDs) and to cut back on unneeded expenditures to society. However, despite the protective legislation, the rights of adults with neurodevelopmental disorders have not yet been fully realised. There are several obstacles to overcome the neurological development related health care services, including health care usage, educational and career (...) pathways, family and social lives, self-fulfilment, and quality of life. There are significant gaps in the transition process that affect the health care systems. Lack of transition and transfer planning, neurodevelopmental disorder health care pathway services have lack of experience, education, and expertise which result the inadequate growth of the health care quality and create communication gap in between service providers and service users. The aim of this short communication is to mention and clarify the ethical concerns of neurodevelopmental service evaluation. (shrink)