Bioethical Issues Research Articles

인격주의 생명윤리 교육 프로그램 효과검증

This study has been attempted to verify the effectiveness of the education program developed for improving nurses’ consciousness of bioethics. The education program is a Personalist Bioethics Education Program(PBEP) consisting of 2 hours a week for 4 weeks and a total of 8 hours in 4 sessions. Verification of the effectiveness of the bioethical consciousness training program was conducted under the approval of the relevant agency IRB. The design of the study was a mixed study method applied together with studies of non-equivalent experimental group and control group pre-test and post-test design and qualitative research to analyze the content of reflective writing of participants. The subjects of the study were nurses with clinical experience of more than one year and less than 10 years, and 26 were in an experimental group and 28 were in a control group. Kim Seung-ju's bioethics consciousness scale was used. The data collection ran from Sep. 25 to Dec. 10. 2019, and the experimental group was provided with a program to promote bioethical consciousness. The quantitative data collected were analyzed for the differences between the experimental group and the control group using the SPSS 21.0 program as analyses of covariance (ANCOVA), and the results showed that the experimental group participating in the bioethical consciousness training program significantly increased the consciousness of bioethics (F=12.184, p=.001, ηp2= .193). In conclusion, the Personalist Bioethics Education Program can be presented as a strategic practice to firmly establish values related to bioethics so that nurses can make the right decisions at clinical sites that face complex and diverse bioethics issues.

Mitochondrial Replacement Therapy: An Islamic Perspective.

Mitochondrial replacement technology (MRT) is an emerging and complex bioethical issue. This treatment aims to eliminate maternal inherited mitochondrial DNA (mtDNA) disorders. For Muslims, its introduction affects every aspect of human life, especially the five essential interests of human beings-namely, religion, life, lineage, intellect, and property. Thus, this technology must be assessed using a comprehensive and holistic approach addressing these human essential interests. Consequently, this article analyses and assesses tri-parent baby technology from the perspective of Maqasidic bioethics-that is, Islamic bioethics based on the framework of Maqasid al-Shariah. Using this analysis, this article suggests that tri-parent baby technology should not be permitted for Muslims due to the existence of third-party cell gametes which lead to lineage mixing and due to the uncertain safety of the therapy itself and because the major aim of the technology is to fulfil the affected couples interest to conceive their own genetically healthy child, not to treat and cure mtDNA disorders sufferers.

Connecting historical events to contemporary issues in bioethics and medical humanities teaching

Introduction: Didactic pedagogy and passive learning in bioethics and medical humanities teaching are ineffective in engaging students and gauging learning interests. As a result, medical students are unaware of why and how bioethics and medical humanities relate to their learning and thus prioritising acquiring clinical knowledge in their medical education. Methods: This project involves a teacher-student collaboration to develop a teaching approach, which bridges historical events and contemporary issues, acknowledging how ethics and humanities are interwoven in clinical and everyday life. The objectives are to (1) highlight landmark historical events in bioethics and medical humanities and (2) recognise the evolving nature of values and social norms that inform current practice. Results: The three activities include the use of historical narratives, annual newsletter publications, and social media to augment didactic classroom teaching and learning. Video narratives of landmark events in bioethics were developed to strengthen historical knowledge and encourage self-reflection. The newsletter invited students to write about any topic in bioethics and medical humanities and enabled them to experience a peer-review process. It allowed students to critically appraise everyday issues. Social media engagement via Instagram offered a flexible and informal medium to diversify the traditional bioethics content taught in the classroom. The advantages and obstacles of each element are discussed. Conclusion: A holistic approach using historical narratives, newsletters, and social media engages students’ learning and allows students to become conscious of how past events shape the present.

Animals: Who Gave You the Right to Experiment with My Body?

The Science Fiction genre has been a means for humans to comprehend reality. A major part of the fantasies in the genre is cross-species beings of human and animal DNA. Recent studies show that in some countries the legislative framework accepts research and experimentation with guinea pigs to create cross-species beings with transhumanistic purposes. According to Bokota the umbrella term to refer to the results of the above phenomenon is Chimeras. The results of this technological process are unquestionably impressive but, who has gotten permission from these animals to use their bodies and take their genetic material for the possibility of humans to survive a bit longer than expected? This study focuses on the definition of the human, the monster, and their bodies, on bio-ethical issues that highlight the fragile equality of beings and answers to the question of whether Chimeras can be an alternative term to refer to Posthumans.

Euthanasia in the practice of the european court of human rights

The paper aims to shed light on the interpretation of mercy killing, i.e., euthanasia, in European Court of Human Rights cases. This controversial phenomenon has a specific legal status. More specifically, due to the complexity of euthanasia, it is impossible to create universally accepted international standards. On the other hand, modern society creates a need to expand the legal boundaries regarding bioethical issues related to the compassionate endof-life care. The European Court of Human Rights is a unique international organization that interprets universal legal documents, especially the European Convention on Human Rights, in the context of euthanasia. Bearing this in mind, it is important to collect and analyze the information resulting from the specific decision-making process of the European Court of Human Rights. The Court’s past and future similar cases will certainly affect the future legal status of euthanasia both internationally and at the level of member states.

Medical Aid in Dying: How Might U.S. Policy Prevent Suffering at the End of Life?

ABSTRACT Medical aid in dying refers to policies that allow terminally ill patients to seek assistance from their medical providers to obtain medications to hasten death. In this paper, we used a 7-point policy analysis model to examine the diversity of medical aid in dying policies that exist in jurisdictions (states and territories) in the U.S. and the implications of these policies for suffering at end of life. As of this writing, these practices are available in 12 jurisdictions, including 11 states and the District of Columbia. Legalization has occurred via statutory approaches in 10 jurisdictions and permissive approaches in two jurisdictions. We discuss the structures of these laws, the requirements for participation, and the limitations created by having jurisdiction-specific policies on such broad, bioethical issues. Existing laws appear to relieve suffering in patients at end of life. Jurisdictional differences create barriers to comprehensive expansion but provide insights into practice in different contexts.

ISLAM AND FOUR PRINCIPLES OF BIOMEDICAL ETHICS: FROM THEORY TO PRACTICE

Unfortunately, many clinicians still lack a sufficient understanding of the concepts behind the ethical structure of Islam implemented in everyday clinical circumstances, allowing them to provide care insensitive to the religion's culture. Several aspects of Islamic Biomedical ethics have been discussed. This study explores Islamic Bioethics and its tenets. The importance of appreciating and respecting Islamic Bioethics becomes clear. The nature of Islamic bioethics is also illuminated. Also, the theory of the Islamic bioethical framework for protecting human life, including how it is shaped by the Quran, the Sunnah, ijtihad, and the field as a whole, has been discussed. Islam proposes four bioethical principles: beneficence, nonmaleficence, autonomy, and justice, which are also part of the study. Finally, the relevance of an Islamic approach to bioethical issues is discussed. The Islamic faith places a premium on both preventative healthcare and the therapeutic management of illness. Treatment, genetic engineering, and abortion regulations are a few of the major life issues covered. Concerning the final stages of life, topics like suicide will be considered. Last but not least, is the Islamic perspective on exhumation and organ transplants. Keeping in mind the value of life in Islam, it is obligatory for the patient to seek proper and timely treatment. Also, it is healthcare providers' religious and ethical obligation to be very honest with their duties.

Teaching bioethical issues of COVID-19 pandemic through cinemeducation: A pilot study

In the last two years, the COVID-19 pandemic has presented new bioethical challenges for humanity. Cinemeducation uses movies and television series to enhance understanding of complex concepts. The present study assessed the effectiveness of cinemeducation in teaching bioethical issues related to the COVID-19 pandemic to students of health sciences and humanities. Participants were recruited from two classes of fourth-year undergraduate students: those enrolled in a bioethics course in the Human Biology degree program (n=34) and in a course on social transformation in the Humanities degree program (n=29). The two classes watched clips from the TV medical dramas Grey’s Anatomy, The Good Doctor, and Chicago Med in a guided two-hour classroom activity. Participation in the study was voluntary. To measure the activity’s effects on learning, a 10-question multiple-choice questionnaire was administered before and after the activity. To measure students’ satisfaction, a survey about the usefulness of the activity was also administered. A total of 45 out of 63 (71.4%) students completed the questionnaires. Scores in both groups were higher after the activity (p< 0.05); mean improvements were 0.607 (95% CI: 1.16–0.45) for Human Biology students and 3.00 (95% CI: 3.87–2.12) for Humanities students. The improvement was higher in Humanities students (p < 0.05). Students’ satisfaction was high in both groups. The findings imply that cinemeducation can be effective for teaching some complex bioethics concepts in relation to the COVID-19 pandemic.

Comparative Analysis of the Social Concept of the Russian Orthodox Church and the Social Doctrine of Islam on BIoethics

Relevance. Religion permeates all spheres of human life: politics, economics, education, culture, medicine. There is no sphere of influence where religion would not leave its mark. In this regard, the consideration of the social doctrines of various prevailing confessions in the social life of a person is an urgent topic. Religion cares about the spiritual and physical well-being of a person, therefore, in the modern realities of the development of biomedical technologies, the moral aspect of human activity in the field of bioethics causes discussions in relation to such manipulations with the human body as IVF, surrogacy, abortion and transplantation. This leads to the need to consider these medical interventions from the point of view of the prevailing confessions in Russia.The purpose is to conduct a comparative analysis of the social concepts of Islam and Orthodoxy concerning bioethics issues.Objectives. To examine the existing approaches of Orthodoxy and Islam to bioethics; to identify the specifics of the doctrines of Islam and Orthodoxy in matters of surrogacy, IVF, abortion and transplantation; to compare the religious views of these denominations with regard to bioethics.Methodology. The study was conducted on the basis of a systematic approach within the framework of structural functionalism using universal scientific methods such as analysis, synthesis and generalization. Results. In the course of studying the doctrines of Islam and Orthodoxy in the field of bioethics, a comparative analysis of views on surrogacy, IVF, abortion and transplantation was carried out; similarities and differences of views of Orthodoxy and Islam on bioethics issues were revealed.Conclusions. The work identified similarities between Orthodox concepts and Muslim doctrines in relation to abortion, IVF, surrogacy and transplantation, differences are observed in relation to traditions.

To Resuscitate or Not to Resuscitate – The Crossroads of Ethical Decision-Making in Resuscitation in the Emergency Department

Emergency physicians (EPs) working in low-resource settings, where patients mainly bear healthcare delivery, face many challenges. Emergency care is patient-centered and ethical challenges are numerous in situations where patient autonomy and beneficence are fragile. This review discusses some of the common bioethical issues in the resuscitation and post-resuscitation phases of treatment, it proposes solutions and emphasizes the necessity for evidence-based ethics and unanimity on ethical standards. After consensus was reached on the article's structure, smaller groups of authors (2-3) wrote narrative reviews of ethical issues like patient autonomy and honesty, beneficence/nonmaleficence and dignity, justice, and specific practices/circumstances like family presence during resuscitation after having discussions with senior EPs. Ethical dilemmas were discussed, and solutions were proposed. The cases related to medical decision-making by proxies, financial constraints in management, and resuscitation in the face of medical futility have been discussed. Solutions proposed include involving hospital ethics committees early on, having financial mechanisms in place beforehand, and allowing some leverage on a case-to-case basis when care is futile. We recommend developing evidence-based national ethical guidelines and incorporating societal and cultural norms with autonomy, beneficence, non-maleficence, honesty, and justice principles.

The European Convention on Human Rights and the Practice of the ECtHR in the Field of Gestational Surrogacy

Background. The article focuses on the analysis of the case law of the European Court of Human Rights regarding gestational surrogate motherhood and the development of the bioethics issue in this area. It was established that the notion of "private life," regulated by Article 8 of the European Convention on Human Rights, guarantees everyone the ability to demand the establishment of their identity, providing for the possibility of establishing family relationships. It is highlighted that, despite the legal ban on the implementation of surrogate motherhood technology, to confirm the child’s identity, there is a need for official recognition of this kind of family relationship as indicated by other relevant relationships. In particular, the peculiarities of establishing parent-child relationships in the case of individuals applying for gestational surrogacy to exercise their reproductive rights are disclosed. The problem of legal regulation unification in the technological application of gestational surrogate motherhood is considered. A conclusion set regards the need to create an international legislative and regulatory framework useful for national governments, particularly in gradually banning the use of surrogate motherhood technologies. Attention is placed on international efforts focused to create an international legislative and regulatory framework that will provide recommendations useful to national governments, particularly in the gradual prohibition of surrogacy. The authors believe that the corresponding international agreement will constitute a legal framework for ensuring individual rights, freedoms, and health, the limitation to gestational surrogate motherhood services, and the observance of a uniform policy in this area. Methods: The methodological framework of the study incorporated a range of philosophical, general, and legal methods. The worldview-dialectical method of cognition made it possible to investigate the problem's social content and legal form, then to conduct a systematic theoretical and legal analysis of the practice by applying the judgments of the European Court of Human Rights. The diversity of legal certainty of the surrogate motherhood system’s legality in Europe, particularly in France, Italy, Iceland, Poland, and Norway, was investigated using the comparative method. With the help of a formal-legal approach, it analysed the content and peculiarities of applying the ECtHR practice. Results and Conclusions: We comprehensively considered the ECtHR legal positions on gestational surrogate motherhood and the bioethics development in this area. International efforts should be concentrated on establishing an international regulatory framework that will provide recommendations practical to national governments, particularly in the gradual prohibition of surrogacy.

Bioethics of childbirth for another (surrogate motherhood) in the Civil Code of Kosovo

Transformations in the biological, medical and legal processes of infertility, substantial modifications in family structure and the advancement of methods and techniques of reproductive technology will affect the next step in both legal and medical terms to address the regulation of bioethics and law in Kosovo. There is a need to establish perspectives in both ethical and professional terms, since the Republic of Kosovo is in the process of drafting a Civil Code. Many of these issues have been raised and addressed during the review and evaluation of family law in the context of harmonisation and inclusion of this law in the Civil Code of the Republic of Kosovo. During the several meetings of official members with different interest groups regarding family law, the need has been raised to regulate family law to be included in the Civil Code for motherhood and fatherhood in the case of reproduction with biomedical assistance, as well as for the birth contract as a donation for another person (so-called surrogate motherhood). These bioethical and legal issues indicate the urgent need for legal harmonisation of a multidimensional platform specifically based on the principles of public health and universal human rights Conclusion. These bio-ethical and legal interferences indicate the urgent need for legal harmonization of a multidimensional platform specifically designed based on the principles of public health and universal human rights.

«Библиотека биоэтики»: вклад в развитие образования (рецензия на многотомное издание) М.: Вече, 2019–2022; Тома 1–10

The published review is devoted to ten-volume edition entitled Bioethics Library published by Veche publishing house. The series was edited by Academician Chuchalin AG. It consisted of various works related to bioethical issues. The edition is mainly intended for students and teachers of bioethics of Russian medical universities. The series has a wide historical framework. It examines the works by Avicenna and Immanuel Kant, translated books by Sweden researchers Johansson I and Lynøe N. Texts by Russian physicians and thinkers (Berdyayev NA, Veresayev VV, Uglov FG, Botkin ES, Voyno-Yasenetsky VF (St. Luka Krymsky), Pirogov NI, Pavlov IP, Koni AF, Ilyin IA, Metropolitan Antony Surozhsky, etc.) are published as well. A collection of official documents on bioethical regulation is presented as a separate volume. The edition comprises self-evaluation questions. The texts included into the Bioethics Library make the readers familiar with the history of bioethics building and formation as an anthropologic project. Bioethics is based on the value of life and human integrity, it protects the human being and society, and, as a result, possesses regulatory functions. In the edition, special attention is paid to Russian authors and their view of bioethical issues. It is assumed that examination, popularization and content analysis of the series are particularly relevant within the context of national bioethics development.

Ethicizing history. Bioethical representations of Nazi medicine.

The article presents and analyzes different approaches of U.S. bioethicists in comprehending the Nazi medical crimes after 1945. The account is divided into two sections: one dealing with discussions on research ethics and the Nuremberg Code up until the 1970s and the other ranging from the 1970s to the present and highlighting bioethics' engagement with Nazi analogies. The portrayal of different bioethical scholars, institutions, and documents-most notably Henry K. Beecher, Jay Katz, the Belmont Report, the Hastings Center, Arthur L. Caplan, and Robert M. Veatch-provides a nuanced interpretation of the motives that bioethicists held and the strategies that they applied to establish an understanding of the Nazi medical crimes and their relation to contemporary bioethical issues. In this, the different approaches shared a common goal: To integrate the Nazi medical crimes into an ethical framework by means of selective acknowledgments and representation of their history.

Withdrawing Assisted Nutrition in Neonates: A Survey on Attitudes and Insights in Argentina.

This study aimed to assess beliefs and attitudes of Argentinean neonatologists and neonatal nurses regarding end-of-life care of newborn infants, including withdrawal of clinically assisted nutrition and hydration (CANH). A five-domain survey was sent to 465 neonatal health care workers, which included demographic data, general ethical concepts, participation in end-of-life decisions, beliefs about end-of-life care practices, and presentation of four clinical scenarios. Standard statistical tests were used, and a multivariable analysis was done to evaluate variables independently associated with rejecting the withdrawal of CANH. A total of 227 questionnaires were anonymously completed, 60% by physicians and 40% by nurses. More respondents agreed to withdraw mechanical ventilation in comparison to CANH in patients under certain circumstances (88 vs. 62%, p < 0.01). The most accepted variables when deciding to withdraw care were the quality of life perceived by parents (86%) and their religious beliefs (73%). A total of 93% agreed that parents should be included in the decision, but only 74% acknowledged they are included in real practice. Considering the scenario of a newborn with severe and irreversible neurological compromise, 46% of respondents were opposed to suspending enteral nutrition. No independent variables were found to be associated with opposing the withdrawal of CANH. Of those agreeing to withdraw enteral feeds under certain circumstances, for the severely neurologically affected neonate 58% would either refuse to limit enteral feeds or consult with an ethics committee before doing so. When given the scenario of their own severe and irreversible neurological compromise, 68% agreed to have enteral feeds withdrawn to themselves, and they were more likely to agree with withdrawing feeds for the severely compromised neonate (odds ratio: 7.2; 95% confidence interval: 2.7-24.1). While most health care providers agreed to withdraw life-sustaining support under certain conditions, many were reluctant to suspend CANH. Many responses differed when being asked as general statements versus actual clinical scenarios. · Withdrawal of assisted nutrition is supported by the American Academy of Pediatrics in certain scenarios.. · Many neonatal intensive care units health care providers from Argentina are reluctant to suspend assisted nutrition.. · There is a need to learn how to deal with complex bioethical issues..

The Promise of Artificial Intelligence in Digestive Healthcare and the Bioethics Challenges It Presents.

With modern society well entrenched in the digital area, the use of Artificial Intelligence (AI) to extract useful information from big data has become more commonplace in our daily lives than we perhaps realize. Medical specialties that rely heavily on imaging techniques have become a strong focus for the incorporation of AI tools to aid disease diagnosis and monitoring, yet AI-based tools that can be employed in the clinic are only now beginning to become a reality. However, the potential introduction of these applications raises a number of ethical issues that must be addressed before they can be implemented, among the most important of which are issues related to privacy, data protection, data bias, explainability and responsibility. In this short review, we aim to highlight some of the most important bioethical issues that will have to be addressed if AI solutions are to be successfully incorporated into healthcare protocols, and ideally, before they are put in place. In particular, we contemplate the use of these aids in the field of gastroenterology, focusing particularly on capsule endoscopy and highlighting efforts aimed at resolving the issues associated with their use when available.

The SARS-CoV-2 pandemic as a source of unprecedented bioethical and biolaw issues: lessons for intensivists

The following article presents the relevant and unprecedented bioethical and biolaw issues posed by the SARS-COV-2 pandemic and summarizes the initiatives adopted by the Italian Society of Anesthesia and Resuscitation (SIAARTI) as well as by the Veneto Region ICU Network. Since the initial phase of the pandemic, in March 2020, there has been a strong appeal from both SIAARTI and the Veneto Region ICU Network to consider “the appropriate intensive treatment.” During the pandemic, the principle of proportionality must be applied, in compliance with the main principle in bioethics. This encompasses the concept of clinical appropriateness, based on the efficacy of the treatment in specific case and context, as well as the concept of ethical appropriateness, which refers to ethical and juridical principles of acceptance of health care. The “appropriate treatment” must never interfere with the withdrawal of patients, who are not eligible for intensive treatments since they would not benefit from them and who are eligible for ordinary treatments that must be maintained, and, where necessary, palliative treatments were initiated. On the other hand, it must not encroach on unreasonable obstinacy. At the end of 2020, the SIAARTI-SIMLA (Italian Society of Insurance and Legal Medicine) document provides healthcare professionals with a tool for responding appropriately to the emergency of the pandemic, in the event of an imbalance between healthcare demand and available resources. The document states that the ICU triage should be based on global evaluation of each patient, taking into account well-defined parameters and stresses that each person potentially eligible for intensive care should have a shared care planning (SCP) stipulated, and, when necessary, a proxy should be nominated. This has illustrated how the biolaw issues encountered by intensivists during the pandemic, such as those relating to consent and refusal to medical treatment, even when it is lifesaving, as well as requests for treatment of unproven clinical efficacy, were subject to appropriate guidelines and solutions through the application of Law 219/2017 (provisions for informed consent and advance directives treatment). Communication with family members and the management of sensitive personal data; the evaluation of “legal capacity” of comprehension and informed decision-making regarding the proposed treatment plan; and the need for emergency medical intervention in the absence of consent are all addressed in light of the relevant regulations and the particular conditions of social isolation induced by the pandemic. The collaborative ICUs network sustained by the Veneto Region has given great prominence to clinical bioethics issues, and as a result, multidisciplinary integration with the help of legal and juridical experts was developed. This has led to an increase in skills in the bioethical field, as well as providing a valuable lesson for the improvement of therapeutic relationships with critically ill patients and their families.

Editorial

The Foundation for Scientific and Technological Development (FUNDECIT), in partnership with the Center for Advanced Studies in Education and Medical Training (CEDUMED) of the Faculty of Medicine of Agostinho Neto University (FMUAN), took the initiative to organize the Workshop on Integrity and Ethics in Scientific Research. The event brought together professionals from various fields with the aim of promoting dialogue on ethical and bioethical issues related to scientific research. These topics were intended to cover different lines of research coexisting in this area, revealing the epistemological heterogeneity in the field of science and technology, leading to interdisciplinary analysis, both theoretical and methodological. The event allowed researchers to reassess their actions and practices within their institutions and scientific projects with ethical and moral implications. As the first event with this focus and with guiding themes for good functioning, academics, researchers, and scientists from various countries such as Angola, South Africa, Argentina, Brazil, Mozambique, and Portugal were present. The event allowed for an examination of different realities and to verify if the path that the country is following is the most appropriate. Held in a hybrid format (in-person and remote) on March 30 and 31, 2023, at the Epic Sana Hotel, the workshop was aimed at managers of higher education institutions and the entire scientific community in general. The event consisted of two days of lectures and constructive debates between renowned national and foreign guests and participants, where contributions led to reflection on professional teaching practice with an ethical character, aiming to describe the stages of building a scientific project that focuses on addressing the problems and aspirations of the population. Respecting its morality (habits and customs), so that it can be feasible in various dimensions. Along with all these issues, it became clear that each country needs an ethical regulatory instrument to guide research in its territory because international devices cannot cover all the issues inherent in its culture. Hence, in some communications, it was evident that the creation of an entity that would create the same devices and another that would control the investigations carried out (National Ethics Committee and a National Bioethics Advisory Council), with one being deliberative and the other advisory in character. The event also brought to light the need to conform academic and research institutions to the best international practices and recommendations regarding ethical issues in science, technology, and innovation. Without forgetting the Universal Declaration on Bioethics and Human Rights (UDBHR), which is a significant document for the analysis of scientific research protocols. The results presented point to the importance of paying close attention to double standards of research protocol for clinical trials in developing or peripheral countries. Consequently, the speakers raised the urgent need for South-South cooperation to discuss ethical and bioethical problems in the face of the common reality of peripheral countries. Institutional contexts may be definitive and timely in the analysis of the works published by these researchers. By discussing science, technology, and innovation as a parameter for discussion, which will contribute to the realization of paradigm shifts in this area of socio-discursive production (Ethics and Bioethics), this meeting also allowed for networking among speakers from various national and foreign institutions and event participants.

Sources for Christian Bioethics: The Orthodox Discourse on Sin

AbstractThe article discusses ways of developing bioethical guidance in the Orthodox Christian discourse. Here, “ethical” refers to what contributes to holiness, “un-ethical” refers to sin as what hinders man’s foundational calling to holiness. To explore the development of guidance for emerging bioethical issues, we use the “therapeutic” understanding of treatment for sin in two senses. (1) It refers to the spiritual means provided by the “hospital” of the Orthodox Church for healing the fallenness of human nature in general; and (2) it helps identify in particular cases both what counts as transgression of unconditional boundaries (defining what is illicit for everyone) and what is advisable in order to help particular persons to choose rightly within the area of the “more or less licit” (or “permissible”). Sources of the Orthodox faith that frame the general understanding of the boundaries between the permissible and the impermissible reflect the work of the Holy Spirit in the Church framing her Sacred (Holy) Tradition. In Holy Tradition, prayers, as communion with God, occupy a central position. This is why Orthodox moral reasoning, and thus also Orthodox bioethics, takes the form of liturgical bioethics. Penalties of excommunication determine hard boundaries that believers should not overstep: when crossing such boundaries, they enter on a spiritually dangerous path that completely distracts them away from God. Many minor sins, by contrast, have not been codified in Canons. They are not taken to remove the sinner completely from contact with the Lord. Within this realm of actions, it depends on a person’s spiritual maturity whether such actions are classified as sinful. Thus, an act can be counted merely as a small offense if committed by a beginner, while that same act can become a grave sin for an advanced believer. Due to acceleration of the technological progress, Orthodox recourse to Holy Tradition encounters ever-new challenges. There are bioethical issues that had not surfaced at the time of the Fathers of the Church. Today, Bishops gathered at a local council can supply the guidance lacking on a newly emerging bioethical problem. Even if ratified only by such local councils, the resulting decrees can also be regarded as the expression of the Holy Spirit working within a local Church and conveying His guidance. The article illustrates this source of Christian bioethics by reference to how the Russian Orthodox Church orients and develops its position on the ethics of reproductive technologies.

Assessing the Awareness of the Staff of a University of Medical Sciences about Organ Donation Following Brain Death

Background: Organ donation is fast becoming an important bioethical issue from a social perspective, because it is a humanitarian act with the goal of saving human lives and deliverance from suffering. Donation may be for research or, more often, healthy transplantable organs and tissues may be donated to be transplanted into another person. Organ donors are usually dead at the time of donation, though sometimes may be alive. The purpose of this study is to assess the awareness of the employees of a university of medical sciences, Tehran- Iran, about organ donation following brain death. Methods: A questionnaire containing ten questions regarding participant's knowledge about “organ donation” was filled. To evaluate the reliability of the questionnaire Cronbach's alpha method test was used. SPSS software was used for statistical analysis of the data. Findings: Out of 70 participants (those who answered the questionnaire), 61 were male (87.1%) and 9 were female (12.9%). Based on the education, most of the participants (36 people) were general practitioner with MBBS degree, masters and medical student (51.4%). Analyses of the collected data indicate that 60% of the 70participants are "familiar" with organ donation (P&gt; 0.05). 72.9% of the participants expressed interest in having more information about organ donation. Conclusion: Motivating people to donate organ is a multi-approach task. It involves applying effective methods of teaching and learning, social network interventions and exposing educational content about organ donation for social media users.