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)

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

In The Future of Human Nature, Jürgen Habermas raises the question of whether the embryonic genetic diagnosis and genetic modification threatens the foundations of the species ethics that underlies current understandings of morality. While morality, in the normative sense, is based on moral interactions enabling communicative action, justification, and reciprocal respect, the reification involved in the new technologies may preclude individuals to uphold a sense of the undisposability of human life and the inviolability of human beings that is necessary for (...) their own identity as well as for reciprocal relations. Engaging with liberal bioethics and Catholic approaches to bioethics, the article clarifies how Habermas’ position offers a radical critique of liberal autonomy while maintaining its postmetaphysical stance. The essay argues that Habermas’ approach may guide the question of rights of future generations regarding germline gene editing. But it calls for a different turn in the conversation between philosophy and theology, namely one that emphasizes the necessary attention to rights violations and injustices as a common, postmetaphysical starting point for critical theory and critical theology alike. In 2001, Jürgen Habermas published a short book on questions of biomedicine that took many by surprise.[1] To some of his students, the turn to a substantive position invoking the need to comment on a species ethics rather than outlining a public moral framework was seen as the departure from the “path of deontological virtue,”[2] and at the same time a departure from postmetaphysical reason. Habermas’ motivation to address the developments in biomedicine had certainly been sparked by the intense debate in Germany, the European Union, and internationally on human cloning, pre-implantation genetic diagnosis, embryonic stem cell research, and human enhancement. He turned to a strand of critical theory that had been pushed to the background by the younger Frankfurt School in favor of cultural theory and social critique, even though it had been an important element of its initial working programs. The relationship of instrumental reason and critical theory, examined, among others, by Max Horkheimer, Theodor W. Adorno, and Herbert Marcuse and taken up in Habermas’ own Knowledge and Interest and Theory of Communicative Action became ever-more actual with the development of the life sciences, human genome analysis, and genetic engineering of human offspring. Today, some of the fictional scenarios discussed at the end of the last century as “science fiction” have become reality: in 2018, the first “germline gene-edited” children were born in China.[3] Furthermore, the UK’s permission to create so-called “three-parent” children may create a legal and political pathway to hereditary germline interventions summarized under the name of “gene editing.”In this article, I want to explore Habermas’ “substantial” argument in the hope that philosophy and theology become allies in their struggle against an ever-more reifying lifeworld, which may create a “moral void” that would, at least from today’s perspective, be “unbearable”, and for upholding the conditions of human dignity, freedom, and justice. I will contextualize Habermas’ concerns in the broader discourse of bioethics, because only by doing this, his concerns are rescued from some misinterpretations.[1] Jürgen Habermas, The Future of Human Nature.[2] Ibid., 125, fn. 58. 8[3] Up to the present, no scientific publication of the exact procedure exists, but it is known that the scientist, Jiankui He, circumvented the existing national regulatory framework and may have misled the prospective parents about existing alternatives and the unprecedented nature of his conduct. Yuanwu Ma, Lianfeng Zhang, and Chuan Qin, "The First Genetically Gene‐Edited Babies: It's “Irresponsible and Too Early”," Animal Models and Experimental Medicine ; Matthias Braun, Meacham, Darian, "The Trust Game: Crispr for Human Germline Editing Unsettles Scientists and Society," EMBO reports 20, no. 2. (shrink)

In order to graduate, Florida's high school students by law must learn that Communism is evil, dangerous, and fallacious. All students must learn that the U.S. produces the highest standard of living and more freedom than any other economic system on earth. State universities in Florida are creating a curriculum to implement the Americanism versus Communism Act of 1961 and the Free Enterprise and Consumer Education Act of 1975. ;The Florida Department of Education says that ideology, noncritical thinking, is superior (...) to critical thinking and that the superiority of the U.S. political economy and the dignity of the individual rest in part on peoples' being able to express themselves freely. ;Florida's A.V.C. and F.E.C.E.A. proponents have a special way of convincing audiences that they will develop loyalty while at the same time imposing a set of ideas not open to question. ;This work argues that, intentionally or not, Florida's legislature and Department of Education have set up an official ideology and the mechanism to purvey it. This ideological approach defeats the aim of comparing systems objectively. While the stated aim is to promote critical thinking, the D.O.E.'s special philosophy underscoring words like "democracy" results in indoctrinating students with a questionable description of the U.S. system. (shrink)

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

In a prior issue of Developing World Bioethics, Cheryl Macpherson and Ruth Macklin critically engaged with an article of mine, where I articulated a moral theory grounded on indigenous values salient in the sub-Saharan region, and then applied it to four major issues in bioethics, comparing and contrasting its implications with those of the dominant Western moral theories, utilitarianism and Kantianism. In response to my essay, Macpherson and Macklin have posed questions about: whether philosophical justifications are something with (...) which bioethicists ought to be concerned; why something counts as ‘African’; how medicine is a moral enterprise; whether an individual right to informed consent is consistent with sub-Saharan values; and when thought experiments help to establish firm conclusions about moral status. These are important issues for the field, and I use this reply to take discussion of them a step or two farther, defending my initial article from Macpherson's and Macklin's critical questions and objections. (shrink)

The development of a code of ethics for a profession can be an indicator of the coherence and stability of a discipline as a unique and singular entity. Since “bioethics”, as a discipline, is not one profession but many, practiced by persons with not one but many varying responsibilities and training, it has been argued that no code of ethics is possible for the discipline(s) of bioethics. I argue that a code of ethics is possible for bioethics (...) by looking at the nature of the various disciplines and noting necessary overlap between them, and deriving the ethics from the nature of the discipline(s) themselves. I show how this can be done by arguing that strict rules about funding and conflict of interest are necessary for bioethicists. (shrink)

Bioethics journals have lagged behind medical and science journals in exploring the threat of conflict of interest (COI) to the integrity of publications. Some recent discussions of COI that have occurred in the bioethics literature are reviewed. Discussions of what has been termed the ?Healy affair? unintentionally demonstrate that the direct and indirect influence of undisclosed COI may come from those who call for protection from the undue influence of industry. Paradoxically, the nature and tone of current discussions (...) may serve to dull sensitivities to what is indeed a serious set of issues facing bioethics. Some proposals are presented to address COI and other challenges to the integrity of bioethics and its journals. COI is too important a topic to be left to ideologues, and there is no substitute for readers' caution and skepticism as tools in dealing with the full range of biases that exist in published papers. (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?

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)

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)

Although McMillan recognizes that moral theory has its place, he suggests that by setting bioethics up as a discipline whose predominant issues are to do with theory, not only are students insulated from the broadness of its scope and the diversity of its methods, but the subject comes across as largely inaccessible to those without some formal train- ing in normative ethics and of limited practical signifi- cance to those dealing with concrete issues.

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

Animal ethics has reached a new phase with the development of animal ethical thinking. Topics and problems previously discussed in terms of moral theories and ethical concepts are now being reformulated in terms of political theory and political action. This constitutes a paradigm shift for Animal Ethics. It indicates the transition from a field focused on relations between individuals (humans and animals) to a new viewpoint that incorporates the political dimensions of the relationships between human communities and non-human animals. Animals (...) are no longer seen as a heterogeneous group of sentient beings or simply as species, but as part of a common good that is simultaneously human and animal. In order to participate in this new phase, bioethics will have to face a series of challenges that have hindered the integration of animal ethics within its field. It will also need the development of a new theoretical framework based on relations between communities of individuals. This framework will be able to highlight the ethical and political dimensions that arise from interactions between human communities, non-human animals and the ecosystem. (shrink)

This article explores the institutionalization process of scientific organizations, with a focus on the case-study of the Laboratório Químico Municipal do Porto (LQMP). Within the context of Institutionalization Theory (IT) and framed by the history of chemistry, the LQMP’s lifecycle is examined to propose a new model for the institutionalization of scientific entities. The article reveals the dynamic interplay between historical developments in chemical science, micro-level scientific practices and macro-level societal changes, offering a comprehensive understanding of how scientific institutions influence (...) public policy and societal norms. Through the lens of IT, the article provides a nuanced exploration of the LQMP’s inception, development, and closure, shedding light on the broader implications of scientific institutionalization. This research addresses a gap in LQMP’s institutional understanding as a historical peripheral landmark in the emergence of science-based legislation. Its findings contribute to the theoretical discourse on the institutionalization of scientific practices, with implications for policy formulation on public health and food regulation. (shrink)

The advancement of and prospects for stem cell research raise a number of specific ethical issues. While navigating the ethical landscape of stem cell research is often challenging for biology researchers and biotechnology innovators, it is also difficult for the public and other persons of concern (from ethicists to policy-makers) to grasp the technicalities of a burgeoning field that develops in many directions. Organoids are one of these new biotechnological constructs that are currently eliciting a rich debate in bioethics. (...) In this guide, we argue that different types of organoids have different emerging properties with different ethical implications. Going from general properties to particular ones, we propose a typology of organoid technology and other associated biotechnology from a philosophical and ethical perspective. We point to relevant ethical issues and try to convey the sense of uncertainty peculiar to ongoing research and emerging technological objects. (shrink)

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

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.

The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)

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

Recent years have witnessed intensive efforts to specify which requirements ethical artificial intelligence (AI) must meet. General guidelines for ethical AI consider a varying number of principles important. A frequent novel element in these guidelines, that we have bundled together under the term explicability, aims to reduce the black-box character of machine learning algorithms. The centrality of this element invites reflection on the conceptual relation between explicability and the four bioethical principles. This is important because the application of general ethical (...) frameworks to clinical decision-making entails conceptual questions: Is explicability a free-standing principle? Is it already covered by the well-established four bioethical principles? Or is it an independent value that needs to be recognized as such in medical practice? We discuss these questions in a conceptual-ethical analysis, which builds upon the findings of an empirical document analysis. On the example of the medical specialty of radiology, we analyze the position of radiological associations on the ethical use of medical AI. We address three questions: Are there references to explicability or a similar concept? What are the reasons for such inclusion? Which ethical concepts are referred to? (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)

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)

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)

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)

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

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

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

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)

Blumenthal-Barby et al. (2022) present a nuanced and convincing case for the continued presence of moral and political philosophers in bioethics. We agree with the authors that philosophers should have a role in bioethical inquiry. However, we partly disagree on what that role should be. We assess the case taking our clues from a concern the authors mention – and another one that they do not directly address.

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)

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

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)

When many people think of bioethics, they think of gripping issues in clinical medicine such as end-of-life decision-making, controversies in biomedical research such as that over work with stem cells, or issues in allocating scarce health-care resources such as organs or money. The term “bioethics” may evoke images of moral controversies being discussed on news programs and talk shows. But this “controversy of the day” focus often treats ethical issues in medicine superficially, for it addresses them as if (...) they could be examined and discussed in isolation from the context in which they are situated. Such a focus on the latest controversies fails to take into account that medicine is a social institution and that the controversies in bioethics often reflect deeper social and moral issues that transcend the boundaries of medicine and ethics. If one moves beyond the issue-of-the-day approach to bioethics, one can see that the field must address these deeper issues. (shrink)

In this article, I will explore how the underlying research values of ‘openness’ and ‘mutual responsiveness’, which are central to open science practices, can be integrated into a new ethos of science. Firstly, I will revisit Robert Merton's early contribution to this issue, examining whether the ethos of science should be understood as a set of norms for scientists to practice ‘good’ science or as a set of research values as a functional requirement of the scientific system to produce knowledge, (...) irrespective of individual adherence to these norms. Secondly, I will analyse the recent codification of scientific practice in terms of ‘scientific integrity’, a framework that Merton did not pursue. Based on this analysis, and illustrated on the case of COVID-19 as a case in which the institution of science was challenged to deliver urgently on societal desirable outcomes, I will argue that promoting open science and its core norms of collaboration and openness requires broader governance of the institution of science in its relationship with society at large, rather than relying solely on self-governance within the scientific community through a new ethos of science. This conclusion has implications for re-evaluating research assessments, suggesting that the evaluation of the scientific system should take precedence over evaluating individual researchers, and that incentives should be provided to encourage specific research behaviour rather than solely focusing on individual research outputs. This article is followed up by Commentaries of Carl Mitcham, Alfred Nordmann, Sabina Leonelli, Lukas Fuchs, Monica Edwards-Schachter. (shrink)

In 1975, The New England Journal of Medicine published James Rachels' article 'Active and Passive Euthanasia'. The argumentative method that Rachels introduced, the Bare Difference Argument (also known as the Contrast Strategy), became one of the most widely used tools in ethical reasoning. The argument, however, fails to show active euthanasia being morally permissible. It fails because Rachels takes the intuitions from the case where letting die is morally impermissible and applies the intuitions to cases where letting die is morally (...) permissible. While it is possible to create thought-experiments that are more analogous to euthanasia, in this respect, than Rachels' cases, they too are disanalogous to euthanasia with some of the relevant features. Creating the perfect analogy, however, would be a mistake too. Such a case would be too analogous; people would simply be divided on what kind of moral intuitions they would have. The problem thus highlights a methodological limit in philosophical bioethics and raises questions related to the roles of philosophical ethicists in the context of assisted dying. (shrink)

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)

The three target articles constitute a powerful and persuasive call for actively anti-racist bioethics and biomedicine. All three articles reject race as a biological category. Nevertheless, they share a common commitment to racial classification. At one point, Ruqaiijah Yearby writes that “social race, like biological race, is an illusion created to establish racial hierarchy,” but mostly she writes about “races” as though they were not an illusion, but a reality. In this commentary I critique the racial realism of the (...) target articles. I argue that the biomedical fight against racism is best served by a form of anti-realist reconstructionism about race, which says that there are no races, only racialized groups—groups misunderstood to be races. Note that I do not defend the color blindness that Clarence H. Braddock (2020) persuasively rejects. Because of the role of skin color in racialization and racism, color blindness is a misguided goal. One can reject color blindness, though, without accepting racial realism... (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)

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

The orphans of Romania were participants in what is sometimes called “the forbidden experiment”: depriving human infants of intimacy, affection, and human contact is an inhuman practice. It is an experiment which no ethical researcher would set out to do. This paper examines historical data, case histories, and research findings which deal with early deprivation and performs a phenomenological analysis of deprivation phenomena as they impact emotional and physical development. A key element of deprivation is the absence of intimate relationships (...) with other human beings. However, the absence of intimacy impacts not only the social/emotional abilities of infants, but their very ability to perceive the world. Philosophically and from a radically Merleau-Pontean perspective, the intimate face of the other appears to be a world opening event for the child. Its absence has a profound impact on the child’s experience of embodiment, coexistence, spatiality, temporality, and language. When seen through early deprivation, intimacy appears as a necessary foundation for establishing the transcendence of the world beyond perceptual presence, and it provides the possibility for language, culture, and history. (shrink)

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

This 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)

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

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.

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

The new phase of science evolution is characterized by totality of subject and object of cognition and technology (high-hume). As a result, forming of network structure in a disciplinary matrix modern are «human dimensional» natural sciences and two paradigmal «nuclei» (attraktors). As a result, the complication of structure of disciplinary matrix and forming a few paradigm nuclei in modern «human dimensional» natural sciences are observed. In the process of social verification integration of scientific theories into the existent system of mental (...) and valued options of spiritual culture takes place. The attribute of classical science – ethics neutrality of scientific knowledge becomes an unattainable ideal. One of the trends in the evolution of theoretical epistemology is the study of migration mechanisms of generation of scientific knowledge from the sphere of its own logic and methodology of science in the field of sociology - the consideration of this process, as the resulting system of interactions of social structures and institutions. Ensuing ideas and settings become the dominant worldview of philosophical and technological civilization. -/- . (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)