Bioethical Issues Research Articles

Bioethical Issues in Contemporary Brazilian Culture

Bioethical Issues in Contemporary Brazilian Culture

Anthropomorphism as a methodological problem of animal ethics (in the memory of Sir Patrick Bateson)

Abstract The paper aims to highlight the serious methodological issue of contemporary bioethics (especially topics on the subject of animal ethics). In the discourse on the issue of the pain and suffering of animals and in derived questions, a certain form of anthropomorphism is manifested. Ethical applications of empirical research results that are relevant to humans (or humans as an anatomically and physiologically analogous animal species) are preferred. Subsequently, these extrapolations serve as a criterion for judging the qualitative level of the capabilities of all animals. Serious ethical conclusions are drawn from this reduction.

Biobanks: Will the Idea Change Indian Life?

Biobanks are an international phenomenon today and promise solutions to hitherto unanswered questions in biomedical research. However, though India may benefit from biobanking activities and output, the regulatory landscape for biobanks remains woefully inadequate. The Guidelines of the Indian Council of Medical Research, which prescribe the conditions for the operation of biobanks, do not adequately address the concerns that emerge in view of the socio-politico-economic backdrop peculiar to the Indian situation. The lack of awareness and understanding of the implications of bioethical issues and requirements on the part of research participants, and inadequate engagement with these issues and requirements on the part of interested personnel (including biobanking administrators, and review and regulatory bodies) could exacerbate growing concerns over effective scientific and ethical management of biobanks, especially commercial ones that have emerged. The role of the State is to be highlighted here as (a) facilitator of such research, mindful of the developmental and health-related needs of the Indian people, (b) regulator of such research, ensuring ethical and regulatory requirements are met, and (c) enabler of access to the productive outcomes of such research, keeping in mind the principles of egalitarian distribution of common resources for the good of all.

Ethics, health policy, and Zika: From emergency to global epidemic?

Zika virus was recognised in 2016 as an important vector-borne cause of congenital malformations and Guillain-Barré syndrome, during a major epidemic in Latin America, centred in Northeastern Brazil. The WHO...

Shiite Perspective on the Moral Status of the Early Human Embryo: A Critical Review.

According to Shiite perspective, the relative inviolability of the human embryo starts at the time of implantation and attains complete ethical status at ensoulment. Different paradigms of embryology have been influential on the understanding of Shiite jurists of the relevant Qur'anic verses. This paper provides a critical review of the process of issuing religious decrees on issues related to the early human life and concludes that Shiite jurisprudence needs to obtain consistency in its adopted account of embryology and adopt a proactive approach toward the bioethical new-emerging issues.

PSICOLOGIA, ÉTICA E BIOÉTICA

Este texto reproduz uma comunicação realizada em uma mesa-redonda intitulada “Psicologia e ética: quala relação entre a psicologia e o problema da bioética?”, que teve lugar na “Semana de Psicologia” promovidapela Universidade Federal de Santa Catarina em Novembro de 2003, e apresenta uma reflexão a respeito dasrelações entre a prática psicológica, as questões de ordem ética e a problemática contemporânea da bioética.Aponta as estreitas relações entre a ética médica e a da psicologia, destacando a centralidade de valoreshumanitários comuns à ética dos psicólogos e à bioética – normatividade oriunda dos domínios da medicinae da biologia – que estende aos animais e à própria natureza procedimentos e cuidados anteriormenteaplicados exclusivamente aos humanos.

Identifying bioethical issues in biostatistical consulting: findings from a US national pilot survey of biostatisticians

ObjectivesThe overall purposes of this first US national pilot study were to (1) test the feasibility of online administration of the Bioethical Issues in Biostatistical Consulting (BIBC) Questionnaire to a...

Bioethical Issues in Conducting Pediatric Dentistry Clinical Research.

Pediatric clinical research on new drugs and biomaterials involves children in order to create valid and generalizable knowledge. Research on vulnerable populations, such as children, is necessary but only admissible when researchers strictly follow methodological and ethical standards, together with the respect to human rights; and very especially when the investigation cannot be conducted with other population or when the potential benefits are specifically for that age group. Clinical research in Pediatric Dentistry is not an exception. The aim of the present article was to provide the bioethical principles (with respect to the child/parents' autonomy, benefit/risk analysis, and distributive justice), and recommendations, including informed consent, research ethics committees, conflict of interest, and the "equipoise" concept. Current and future worldwide oral health research in children and adolescents must be conducted incorporating their perspectives in the decision-making process as completely as possible. This concept must be carefully considered when a dental clinical study research is going to be planned and conducted, especially in the case of randomized controlled trials, in which children will be recruited as participants.

The oral cavity - potential source of stem cells.

The purpose of this review is to present the current knowledge regarding the hierarchy of stem cells originating from the oral cavity, which could have a potential value when applied to regenerative stomatology. It must be particularly emphasized that the heterogenous nature of its biology and function within oral compartment may predispose them to different types of applications. Stem cells can be perceived as immature, primitive and unspecialized types of cells with the ability to proliferate, self-renew and differentiate into specialized progeny according to the compartmental signaling. Their presence in tissue reservoirs was already discovered in many organs and tissues as well as in the stomatognathic system. The oral cavity appears to be an exceptionally attractive site to acquire stem cells. The common presence and easy access to these cells in dental and peridental tissues provides a real chance to apply them for therapeutic purposes. Such an opportunity would also be neutral to bioethical and moral issues, assuming autologous stem cells employment. Many authors suspect that stem cells have epigenetic memory, so some of their features can be inherited through generations. They are not connected, however, with DNA sequence modifications. It is, therefore, justified to apply the cells, which have the oral cavity as their natural reservoir, in interventions associated with tissue engineering within the stomatognathic system. An increasing number of clinical trials, among which the number of randomized studies with large group of patients is progressively carried out, allows for a prediction that shortly therapeutic methods based on stem cells of dental origin may be implemented to the routine repertoire of clinical practice.

A prospectus for ethical analysis of ageing individuals' responsibility to prevent cognitive decline.

As the world's population ages, governments and non-governmental organizations in developed countries are promoting healthy cognitive ageing to reduce the rate of age-related cognitive decline and sustain economic productivity in an ageing workforce. Recommendations from the Productivity Commission (Australia), Dementia Australia, Government Office for Science (UK), Presidential Commission for the Study of Bioethical Issues (USA), Institute of Medicine (USA), among others, are encouraging older adults to engage in mental, physical, and social activities. These lifestyle recommendations for healthy cognitive ageing are timely and well supported by scientific evidence but they make implicit normative judgments about the responsibility of ageing individuals to prevent cognitive decline. Ethical tensions arise when this individual responsibility collides with social and personal realities of ageing populations. First, we contextualize the priority given to healthy cognitive ageing within the current brain-based medical and social discourses. Second, we explore the individual responsibility by examining the economic considerations, medical evidence and individual interests that relate to the priority given to healthy cognitive ageing. Third, we identify three key ethical challenges for policymakers seeking to implement lifestyle recommendations as an effective population-level approach to healthy cognitive ageing. The result is a prospectus for future in-depth analysis of ethical tensions that arise from current policy discussions of healthy cognitive ageing.

Проблемы биоэтики как предмет исследований российской философии права

Проблемы биоэтики как предмет исследований российской философии права

Value pluralism, moral diversity, moral reasoning, and the foundations of bioethics

Summary This paper considers how matters concerning value pluralism and moral diversity bear on issues in bioethics, with particular attention to methodology, moral reasoning, and the possibility of intractable disagreements. Drawing on work in my recent book Moral Reasoning in a Pluralistic World, I examine what methodological implications value pluralism has for coherence reasoning, then articulate some practical implications. On the theoretical side, I argue that in contexts of value pluralism, a norm of “systematicity,” which says that the principles of a theory should be as few and as simple as possible, is epistemologically unsupported. Instead, coherence should be understood as “case consistency”: finding a principled way of prioritizing conflicting considerations from one case to another. On the practical side, adopting case consistency means that multiple internally coherent sets of moral beliefs are possible. So sometimes deep value-based disagreements cannot be resolved by reasoning alone. There are also implications for pedagogy: if moral reasoning accommodates various values and requires principled compromises that can take various forms, teaching about moral issues by first introducing a range of unified theories would not be the right approach. Instead, students ought to be encouraged to bring coherence to their own, possibly pluralistic, ways of valuing.

Reconciling female genital circumcision with universal human rights.

One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda.

Media portrayal of stem cell research: towards a normative model for science communication

As the field of science communication has matured over the past 50 years, there has been a significant move away from the conventional understanding that mass media’s role in the public communication of science is limited to reporting new scientific discoveries. Media have been increasingly viewed as important for the legitimation of science and scholars have recognized their agenda-setting effects and ability to facilitate interaction between the public, scientific community, policymakers, interest groups, and other social actors. This article draws on analyses of news media coverage of stem cell research between 1998 and 2013 to demonstrate the active role of mass media in validating scientific claims about discoveries in the field and shaping the public understanding of key bioethical and policy issues. It further assesses whether media, in their attempts to construct the “right” position, have instigated a rational-critical discourse on the controversy. I argue that media representations in different cultural contexts have largely failed to meet normative expectations about the democratization of public discussions on biomedical innovation, as set out in the public engagement with science and technology (PEST) model of science communication. Rather than deconstructing the major terms of science policy debates as framed by stem cell advocates and their opponents, media coverage has mostly replicated discussions in political and legislative arenas, presenting the controversy as a strict binary opposition. Media have rarely provided critical reflection on the hype surrounding breakthroughs in stem cell research, thus reinforcing the public’s unrealistic expectations about the future of this biomedical innovation.

Merging arts and bioethics: An interdisciplinary experiment in cultural and scientific mediation.

How to engage the public in a reflection on the most pressing ethical issues of our time? What if part of the solution lies in adopting an interdisciplinary and collaborative strategy to shed light on critical issues in bioethics? An example is Art + Bioéthique, an innovative project that brought together bioethicists, art historians and artists with the aim of expressing bioethics through arts in order to convey the "sensitive" aspect of many health ethics issues. The aim of this project was threefold: 1) to identify and characterize mechanisms for the meeting of arts and bioethics; 2) to experiment with and co-construct a dialogue between arts and bioethics; and 3) to initiate a public discussion on bioethical issues through the blending of arts and bioethics. In connection with an exhibition held in March 2016 at the Espace Projet, a non-profit art space in Montréal (Canada), the project developed a platform that combined artworks, essays and cultural & scientific mediation activities related to the work of six duos of young bioethics researchers and emerging artists. Each duo worked on a variety of issues, such as the social inclusion of disabled people, the challenges of practical applications of nanomedicine and regenerative medicine, and a holistic approach to contemporary diseases. This project, which succeeded in stimulating an interdisciplinary dialogue and collaboration between bioethics and arts, is an example of an innovative approach to knowledge transfer that can move bioethics reflection into the public space.

Performable Case Studies in Ethics Education.

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Maqasid al-Shariah as a Complementary Framework for Conventional Bioethics: Application in Malaysian Assisted Reproductive Technology (ART) Fatwa.

Rapid development in the area of assisted reproductive technology (ART), has benefited mankind by addressing reproductive problems. However, the emergence of new technologies and techniques raises various issues and discussions among physicians and the masses, especially on issues related to bioethics. Apart from solutions provided using conventional bioethics framework, solutions can also be derived via a complementary framework of bioethics based on the Higher Objectives of the Divine Law (Maqasid al-Shariah) in tackling these problems. This approach in the Islamic World has been applied and localised in the Malaysian context. Thus, this paper highlights a conceptual theoretical framework for solving current bioethical issues, with a special focus on ART in the Malaysian context, and compares this theory with conventional theories of bioethics.

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OBJECTIVES/SPECIFIC AIMS: Exposure to theatrical performances holds promise for addressing bioethical issues, but there has been little empirical examination of the impact of dramatic presentation on audiences’ attitudes. This study assessed the short-term impact of the play, Informed Consent, on perceptions of trust, willingness to donate biospecimens, attitudes toward harm and privacy among the general public and in faculty, medical and undergraduate students within an academic medical center in the intermountain west. METHODS/STUDY POPULATION: Surveys were administered before and after a staged reading of the play by professional actors. Pre and post survey responses were linked for each participant. Survey items included the short form Trust in Medical Researchers, and single item questions about group identity, of genetic testing in children, and willingness to donate biospecimens. In total, 3 additional questions about harm, consent, and ethical investigator behavior as represented in the play were asked in the post survey. In addition, respondents were given the option to answer open-ended questions through email. RESULTS/ANTICIPATED RESULTS: Out of the 481 who attended the play, 421 completed both the pre and post surveys, and 166 participants completed open-ended questions online ~1 week after the play. Across all participants, there were significant declines for Trust in Medical Researchers and for the survey item “is it ethical for genetic testing in children for adult onset conditions,” (p<0.001 for both) following the play. There was a significant increase in agreement to improve group identity protections (p<0.001) and no differences on willingness to donate biospecimens to research (p=0.777). When differences were analyzed by race of the participant, non-White participants (n=68) compared with White participants (n=344) were less willing to donate biospecimens in general (p<0.001). Further, non-White participants’ willingness to donate biospecimens decreased (p=0.049) after viewing the play while the white participants’ willingness to donate was unchanged. Qualitative data provided extensive contextual data supporting these perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This is one of the first studies to empirically examine the impact of a theatrical performance on both attitudes and behavioral intentions toward research and clinical research participation. Some attitudes changed following the play performance, but there were no significant differences on intention to donate biospecimens for research overall. Future research can further address the value and impact of theatrical performances and other creative arts as tools to engage the public and investigators in dialogue about the ethical issues and complexities in clinical research and further evaluation of the impact of performances on attitudes about research and ethics. Creative arts may be used to motivate investigators and study participants to confront fundamental questions about research participation and trust.

The Body as Gift, Commodity, or Something in Between: Ethical Implications of Advanced Kidney Donation.

An innovative program recently initiated at the University of California, Los Angeles (UCLA) Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to the meaning and moral salience of commodification. I first consider whether the literature on commercial markets in organs--a longstanding topic of bioethical debate--can meaningfully inform ethical analysis of kidney voucher programs. Specifically, I consider whether and to what extent common objections to the exchange of kidneys for cash also apply to the exchange of kidneys for "kidney vouchers." Second, I argue that the contrast between the ethical issues raised by these two practices highlights the need to understand commodification as existing on a continuum, with different degrees of commodification giving rise to different ethical issues. Doing so can help sharpen our understanding of commodification as a moral concept, as well as its relevance to broader debates about the moral limits of markets.

A Hospital-Based Committee of Moral Philosophy to Revive Ethics.

The Méditerranée Infection Foundation's primary goal is supporting a research hospital for the treatment of infectious diseases in Marseille. The main objective of this innovative center is to understand the mechanisms of contagion and face them. The Foundation will include a committee on moral philosophy that will accompany and supervise biomedical research. This is not a conventional ethics committee, frequently giving rise to a board's bureaucratic excesses, which might slow down creative biomedical clinical research without necessarily restricting abuses. Moral philosophy, however, can handle contemporary biomedical issues. In all its diversity, this discipline is able to enrich the debate on medical issues, thanks to many philosophical currents such as deontological ethics and consequentialism. The purpose of this committee is therefore to advance reflection on the bioethical issues encountered in biomedical research in infectious diseases, while respecting the precepts of moral philosophy.