Bioethical Discourse Research Articles

Re/Thinking Bioethics: Reproduction and Non-Reproduction in an Intersectional Bioethics’ Perspective

The article begins by reconstructing the main feminist bioethics perspective as a “new discourse” within the official bioethical discussion. It illustrates how the moral discussion and juridification have contributed to remove reproduction and non-reproduction from the personal and intimate context, reinventing them as a “states business”. This process framed these issues in terms of “duties”, “rights”, “family planning”, “demography”, and “population policy”. In this manner, law and morality have helped to reinforce a specific construct of fertility, motherhood, and family. By comparing two interrelated forms of Cross Border Reproductive Care (CBRC), concerning abortion and surrogacy, the article analyses how bioethical and legal frameworks – through their polarized and dichotomic discussion between law and morality – confirm and strengthen gender injustice in reproductive life. That comparison of cross-border travels highlights that surrogacy and abortion restrictions stem from a shared social and legal paradigm that relies on traditional gender roles and reveals how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. Finally, the article introduces an intersectional bioethics point of view on reproductive health to re-read the phenomena of non-reproductive and reproductive tourism and to propose a critique of the main global Northern feminist bioethical discourses and ethical-philosophical paradigms.

Human heritable genome editing and its governance: views of scientists and governance professionals

Heritable human genome editing has garnered significant attention in scholarly and lay media, yet questions remain about whether, when, and how heritable genome editing ought to proceed. Drawing on interviews with scientists who use genome editing in their research and professionals engaged in human genome editing governance efforts, we examine their views on the permissibility of heritable genome editing and the governance strategies they see as necessary and realistic. For both issues, we found divergent views from respondents. We place the views of these scientists and governance professionals within the context of the larger bioethical discussion of heritable genome editing governance, along a continuum of hard to soft approaches. These respondents’ views highlight the challenges of various hard forms of governance and the potential virtues of soft governance approaches.

A rational exploration of personalist bioethics: understanding its foundations

The aim of this article is to elucidate the rational foundations upon which personalist bioethics is built, thereby enhancing understanding regarding its place within the broader discourse of secular bioethics. Personalist bioethics, as a dynamic pursuit, actively engages with scientific discoveries, periodically revisiting them and considering contemporary individuals' diverse perceptions of identity and values. It integrates two foundational trunks: personalism and Aristotelian-Thomistic theology with metaphysical reference. The method employed by personalist bioethics is illustrated through triangulation: the exposition of biomedical reality, an in-depth study of anthropological significance, and the identification of values at stake. Rooted in a substantialist concept of the human person, it follows a systematic interaction of various knowledge spheres, aiming not only to describe problematic relations but also to propose prescriptive solutions. Personalism maintains that the human person is valuable for who he is and not only for the choices he makes; he is a source from which the choices proceed. According to personalist ethics, the ethical value of an act will have to be considered under the subjective aspect of intentionality, but it will also have to be considered in terms of its objective content and its consequences. The natural moral law that urges every conscience to do good and avoid evil, therefore, becomes concrete in respect for the human person in all the fullness of his values, his essence, and ontological dignity.

Science and Islamic ethics: Navigating artificial womb technology through Quranic principles

This paper explores the complex interplay between scientific innovation and religious ethics, with a specific focus on the ethical implications of Artificial Womb Technology (AWT) as interpreted through the lens of Quranic teachings on the essence of life. The objective is to meld the burgeoning field of reproductive technologies with the foundational principles of Islamic theology through an examination of Islamic jurisprudential rulings, contemporary bioethical discourse and innovations in reproductive technology. In addition to attention given to the compatibility of AWT with Islamic teachings concerning the sanctity of life, there is also a focus on the concept of motherhood and the preservation of family structure. This study undertakes an extensive exploration of both historical and contemporary interpretations of Islamic precepts, culminating in the establishment of an ethical framework. This framework is designed to harmonise religious doctrines with the exigencies of reproductive science by proposing normative guidelines for the ethical implementation of AWT and similar technologies. This paper makes a substantial contribution to academic discourse on science and religion by integrating advancements in reproductive health technology with moral principles intrinsic to the Islamic faith.

Advanced human embryo research beyond the 14-day limit: A bioethical perspective from the Muslim world

Advancements in invitro human embryo research prompt a reconsideration of the 14-day rule, highlighting the integration of global religious perspectives, particularly Islam. Through analyzing classical Muslim scholars' perspectives and modern interdisciplinary Islamic bioethical discussions, we advocate extending the 14-day limit to at least 40days, with specified conditions.

MyBioethics: How Ed-Tech Enables Discovery-Driven Empirical Bioethics Research

Digital tools have granted new opportunities to engage people with bioethical discussion and rehearsed decision-making. The ongoing development of the MyBioethics mobile application links these together within a digital space designed to encourage deliberation and research participation by inviting users into the process of discovery. Besides educational purposes, this has enabled a unique way to gather real-world observations. A research procedure was designed to harness the functionality of a mobile application. Quantitative data was generated by dilemma scenarios and integrated surveys that measure and inform users about their psychological and epistemic tendencies. The resulting analysis enabled the possible influence of these factors on moral judgment formation to be investigated—leading to the preliminary identification of prospective relationships. The adopted methodology is crowdsourced and explorative. We seek to generate hypotheses as well as facilitate ethical reflection among users. This work is a proof-of-concept. The main finding is the tentative confirmation of the approach. A digital teaching tool can function to advance empirical bioethics research. The gathered data unveiled prospective areas of academic interest and yielded observations that may contain valuable reflective insights for individual end users. Digital bioethics brings along new opportunities to engage a diverse user base in a way that provides educational resources, challenges ethical preconceptions and intuitions, allows inclusion in research efforts, and encourages autonomous decision-making. Ed-tech applications appear suitable for investigating personal tendencies that are influencing our moral judgments. Digital environments could be designed to surface unarticulated factors behind our held positions and challenge unquestioned moral notions.

Toward a Theology of Compassionate Release: Orthodox Christianity and the Dilemma of Assisted Dying. Confronting End-of-Life Realities with Faith and Compassion

This article examines the subtle interconnection between the sanctity of life and individual autonomy within the context of assisted dying, as seen through the lens of Orthodox Christianity. It seeks to unravel the complex theological, ethical, and pastoral considerations that inform the Orthodox stance on end-of-life issues, particularly the nuanced understanding of suffering, death, and the redemptive potential encapsulated within them. Orthodox theology, with its profound veneration for life as a divine gift, offers a counter-narrative to contemporary discourses that often prioritize personal autonomy and the alleviation of suffering above all. This tradition emphasizes the transformative power of suffering when united with Christ’s own redemptive suffering, proposing a vision of end-of-life care that is rooted in compassion, dignity, and hope for resurrection. The exploration begins with a historical and theological examination of the Orthodox perspective on life’s sanctity, engaging with the teachings of Church Fathers and contemporary theological and bioethical discussions. It highlights the foundational concepts of Orthodox anthropology, which perceives human beings as an indivisible unity of body and soul, reflecting the imago Dei. This anthropological understanding challenges reductionist views of human existence and informs the Orthodox approach to medical ethics, palliative care, and the spiritual accompaniment of the dying. By critically evaluating arguments for and against assisted dying, the article presents a balanced discourse that respects the depth of individual suffering while upholding the intrinsic value of life. It argues that Orthodox Christianity, through its rich theological heritage and pastoral practice, provides a compassionate and ethically nuanced framework for navigating the moral complexities of assisted dying. This framework advocates for an end-of-life care that honors the fullness of the human person, supports the spiritual journey toward eternal life, and fosters a communal embrace of life’s sacred threshold, offering a dignified passage that aligns with the faith’s deepest convictions about human destiny and divine grace.

Social vulnerability in the context of the COVID-19 pandemic: a bioethical discussion

To analyze, from a bioethical perspective, social vulnerability in relation to health during the context of the COVID-19 pandemic. Methods: The study included peer-reviewed publications from January 1st until December 31st 2020, identified in Pubmed, SciELO and LILACS data basis. Mesh terms were utilized for research in Pubmed as follows: “COVID-19” conjugated with the terms: “vulnerable population”, “population groups”, “social determinants of health”, “health equity”. Portuguese and Spanish equivalents DECS terms were used for searching in the other two databases. Results: a total of 132 articles were found. After applied inclusion and exclusion criteria, were 21 eligible articles. The most recurrent themes were: racial, ethnic and social-economics, gender, age, disability and chronic health conditions. Articles addressing more than one theme were observed, integrating different aspects of vulnerable populations. A bioethical discussion with focus in vulnerability based in the data retrieved took place and connections with discrimination and social determinants of health were made. Conclusion: Results point to the violation of rights explained in the Universal Declaration of Bioethics and Human Rights. By increasing the disparity in morbidity and mortality from COVID-19 of population groups already impacted by the social determination of health, there is a violation of the right to health, indicating that governments and societies fail to respect the vulnerability of social groups in the pandemic context. Submission: 08/01/23| Review: 09/15/23| Approval: 09/18/23

Social vulnerability in the context of the COVID-19 pandemic: a bioethical discussion

To analyze, from a bioethical perspective, social vulnerability in relation to health during the context of the COVID-19 pandemic. Methods: The study included peer-reviewed publications from January 1st until December 31st 2020, identified in Pubmed, SciELO and LILACS data basis. Mesh terms were utilized for research in Pubmed as follows: “COVID-19” conjugated with the terms: “vulnerable population”, “population groups”, “social determinants of health”, “health equity”. Portuguese and Spanish equivalents DECS terms were used for searching in the other two databases. Results: a total of 132 articles were found. After applied inclusion and exclusion criteria, were 21 eligible articles. The most recurrent themes were: racial, ethnic and social-economics, gender, age, disability and chronic health conditions. Articles addressing more than one theme were observed, integrating different aspects of vulnerable populations. A bioethical discussion with focus in vulnerability based in the data retrieved took place and connections with discrimination and social determinants of health were made. Conclusion: Results point to the violation of rights explained in the Universal Declaration of Bioethics and Human Rights. By increasing the disparity in morbidity and mortality from COVID-19 of population groups already impacted by the social determination of health, there is a violation of the right to health, indicating that governments and societies fail to respect the vulnerability of social groups in the pandemic context. Submission: 08/01/23| Review: 09/15/23| Approval: 09/18/23

Bioethics-CSR Divide

Bioethics-CSR Divide

Competence or Experience

Competence or Experience

Applying the Concepts of Benefit and Harm in Malaysian Bioethical Discourse: Analysis of Malaysian Fatwa.

Rapid developments in science and technology have resulted in novel discoveries, leading to new questions particularly related to human values and ethics. Every discovery and technology has positive and negative implications and affects human lives either directly or indirectly, involving all walks of life. Bioethical discourse in Malaysia must consider the multiracial and multireligious background of Malaysia and especially the Islamic view as the majority of Malaysians are Muslims and Islam is the religion of the federation. This article discusses several selected bioethical issues in Malaysia by studying the application of maṣlaḥah (the public good) and mafsadah (evil and harms) in Malaysian Islamic rulings (fatwas). This article uses the critical interpretation approach, as this is an ethical, interpretive, textual, and contextual analysis. In a situation when there is a conflict between maṣlaḥah and avoidance of mafsadah, it is preferred to attempt to address both needs. However, if maṣlaḥah and avoidance of mafsadah are mutually exclusive, the decision to choose must be made by weighing (tarjīḥ) and choosing the one which is superior. The maṣlaḥah and mafsadah concepts play vital and significant roles in bioethical discourse to realize human essential interests, namely faith, life, lineage, intellect, and property, thus achieving maqāṣid al-sharī'ah (the ultimate goal of sharia). This concept helps in guiding bioethical discussions, especially in determining the priority between achieving benefits and avoiding harms. The application of this concept will also assist Malaysian authorities in formulating appropriate rulings, especially bioethical issues related to Malaysian Muslims' lives.

Public Reason Requirements in Bioethical Discourse.

This paper analyzes the use of public reason requirements in bioethical discourse and discusses when such requirements are warranted. By a "public reason requirement," I mean a requirement that those involved in a particular discourse or debate only use reasons that can properly be described as public reasons. The first part of the paper outlines the concept of public reasons as developed by John Rawls and others and discusses some of the general criticisms of the concept and its importance. The second part then distinguishes between two types of public reason requirements in bioethics. One type is what I will call the orthodox public reason requirement since it hews closely to the original Rawlsian conception. The second is what I will call the expansive public reason requirement, which departs quite radically from the Rawlsian conception and applies the requirement not to policy discourse or policymaking, but to the actions of individuals. Both types of requirements will be analyzed, and some problems in applying public reason requirements in bioethics will be identified. It will be argued that the expansive public reason requirement is misguided. The concluding part argues that requirements of civic civility and what Rawls terms an "inclusive view" of public reason should be important in bioethical discourse.

Saviour siblings in India: A reminder of our existing challenges and biases.

Saviour babies or saviour siblings are conceived specifically to be sources of biological materials - ranging from cord blood, stem cells or even organs - to save another child, usually an older sibling, who is suffering from a disease like thalassemia that can be cured with this biological material. In 2020, the media reported about the birth of India's first saviour baby, in the state of Gujarat [1]. In January 2023, there was a report of the birth of another saviour baby, in the state of Maharashtra [2]. Ethical concerns relating to saviour siblings find a place in the western bioethics discourse. However, it is little discussed in the Indian context.

Fostering Medical Students’ Commitment to Beneficence in Ethics Education

Fostering Medical Students’ Commitment to Beneficence in Ethics Education

Charity Scott, Bioethics, and Health Law.

As Steve Kaminshine said in his comments at the symposium honoring Charity Scott, I was recruited to come to Georgia State University as a "Law and Bioethics" scholar who had spent more than sixteen years shuttling between an office in a hospital and another in a law school. But when I first visited Georgia State Law, I did not know that more than ten years earlier Charity Scott had spent the better part of an academic year living and breathing clinical ethics at Grady Memorial Hospital.1 Because of her usual habit of immersion in all learning experiences, in that year Charity gained more insight into how hospitals work and how physicians behave when they are knee deep in their professional milieu of life and death decision-making than many full-time bioethics academics do in a career. For the rest of her career Charity kept one foot well planted in the medical context, as an advisor in problems of research ethics, as a teacher in her own medical-legal partnership structured around real-life clinical problems, and as an ethical analyst who could never be accused of mouthing a mantra of phrases, the "vacuous incantation of abstract principles"2 that might pass for bioethics discourse in some circles.

Conceptualising the Value of Life in Bioethical Discourse: Sanctity vs Quality of Life

The article deals with the problem of the value of life in the context of its understanding in bioethical discourse. Two different approaches are used to discuss the topic. The first approach demonstrates a set of imperatives of human behaviour associated with the dominance of the religious component defining the value of life. It is called the concept of the “sanctity of life” and considers human life as a sacred act of divine influence on the existence of the living. The second approach systematises bioethical views that promote the supreme value of freedom and autonomy in making decisions by each individual, including those related to their life and health. It is called the concept of “quality of life” and represents a set of ideas that suggest toconsciously influence the state of life of the individual if it is possible to improve it or if its further existence loses its rational meaning. Being in opposition to each other, these two main conceptual approaches create a problematic situation that stimulates scientific interdisciplinary research within the framework of bioethical discourse, forming its conceptual and categorical apparatus and expanding the worldview of the researcher and the reflective individual.

Access to infertility care in Brazil: validation of a questionnaire for a bioethical discussion

BackgroundThe World Health Organization characterizes infertility as a disease since 2009; however, in many countries, reproductive health is not prioritized. Characterizing a target population and knowing the barriers to accessing reproductive care may allow for a broadening of the discussion on how to provide equal opportunities. The objective of this study was to develop and validate a questionnaire that seeks to identify socioeconomic and cultural characteristics of Brazilian infertile couples to open the discussion on the principle of fair access to health.Methods(1) literature review in the main databases, (2) questionnaire elaboration by researchers within the areas of human reproduction and bioethics, concerned with content adequacy and comprehension, using the Google Forms online platform, (3) pilot study - the questionnaire was applied to 54 couples, over 18 years of age, that were seeking treatment for infertility and accepted to participate in the study and (4) statistical analysis - for continuous numerical variables, mean, standard deviation and 95% CI of the means were presented. For discrete numerical variables, median, interquartile range, minimum and maximum were presented.ResultsForty-four questionnaires were fully completed and with adequate answers. The questionnaire proved to be objective and easy to understand. It was possible to obtain information on education, race of the couple, the impact of infertility on the couple’s life, socioeconomic conditions, and the main difficulties in accessing medical care for treatment of infertility.ConclusionThe questionnaire proved to be feasible in collecting appropriate information to characterize a target population and the only limitation was that there was no academic expert evaluation prior to the pilot test.

The controlled Donation after Circulatory Death (cDCD): From bioethical discourse to ordinary speech

The controlled Donation after Circulatory Death (cDCD): From bioethical discourse to ordinary speech

Sanctity and quality as the conceptual basis of the value of life doctrine in the bioethical discourse

The article offers a study of the bioethical discourse regarding the value of life through the prism of conceptualizing the main approaches to the study of this phenomenon. It is noted that with all the diversity of approaches that demonstrate a wide range of views on the value of life, the modern bioethical discourse com-bines the ideas of scientific research, the dogmatics of religious doctrines and the basic principles of moral imperatives, which are interpreted in a civilized soci-ety in the context of medico-biological problems of life preservation and repro-duction, as well as determining its value. This combination is far from being ec-lectic. It synthesizes the main achievements of scientific, religious and ethical thought and extrapolates them to the problem of human life, which is a unique phenomenon that should be separated into a specific system of moral norms and imperatives of human activity. The article notes that in modern conditions the bioethical discourse is concentrated around the axiological paradigm in the study of living beings. All the diversity of viewpoints is proposed to be grouped into two main approaches: the ethics of the sacredness (sanctity) of life and the the quality of life ethics. The conceptualization of these two main approaches permits to consider all the diversity of views on the value of life in the context of bioethi-cal discourse as a systematized set of views, which contributes to the creation of an appropriate scientific research situation and will contribute to the deepening of scientific studies on the specified subject.