Bioethical Problems Research Articles

Medizinethik - auch ein Thema für Afrika?

Abstract The fundamental bioethical problems of medical progress, i.e. the gap between new medical technologies on the one hand and the inherited moral code as well as limited economic resources on the other, and of social change and cultural pluralism are even more urgent in Africa than in industrialised nations. Several characteristic conflicts result from these tensions: a superior position ofhealth care professionals without the corresponding checks and balances, the allocation of extremely scarce resources in the public sector and within health care, the relationship between biomedicine and 'traditional' healing, and the difference between individualistic and communalistic ethics, e.g. regarding informed consent

DIMENSIONES BIOÉTICAS DE LA INVESTIGACIÓN SOBRE EL GENOMA HUMANO

The elucidation of the human genome constitutes a major paradigm. Besides its impact on our biological knowledge, the elucidation of the human genome will certainly exert a driving force on both medical research and practice in the future. As a paradigmatic discovery impacting medical research, the human genome has also increased public awareness concerning the risks and ethical problems associated with this advancement. Questions such as whether it is ethical to reveal to a patient that he may be suffering an incurable disease, that this information may negatively impact his quality of life are among the many concerns. From the beginning of the race to elucidate the human genome, it was agreed upon that it is necessary to assure the privacy of an individual genetic information. Therefore, it is critical to focus the discussion in a wide scope and integrative perspective, since myths appear that may produce distortions in the analysis. It is also important to trust that the scientific community, together with other public sectors of the society, will promote a debate associated with the positive and negative aspects of any new technology arising from the discoveries around human genome. It is not the scientific advances that cause bioethical problems, it is the decisions that society takes in terms of how this technology will be used.

Individualization of Society and Religionization of the Individual

The theoretical strategy of sociologists like Ulrich Beck and Zygmunt Bauman employing “individualization” as a key concept to understand the “second modernity” or postmodernity is effective to understand the recent transformation of religiosity in the world. The problematic arises when trying to understand in a coherent way how this individualization and the rise of new religiosity and religion's new role in the public space. This paper attempts to find clues to this problematic by taking up (1) the rise of spirituality concerning death and dying and (2) the growth of spiritual networks through self-help movements. Since the late 1980s, spiritual networks for those facing the crises of death and loss, and for those suffering from addiction and handicap, have increased conspicuously in Japan. This indicates that there is a trend of religionization of individuals who are living in an individualized society. If we broaden our perspective to the whole world, we can also observe the spread of salvation religions in such forms of “fundamentalism” and “cults.” They are proposing to participate in the public space advocating collective religious ties. However, in less distinct ways, those sympathetic with more individualized spirituality are also raising their voices in such agenda as environmental issues and bioethical problems. Individualization of society generates religionization of individuals that is in some manner related to the new forms of participation of religiosity in the public space.

The Place of Civil Law in Biotechnology

Biolaw is an autonomous interdisciplinary legal discipline, with great theoretical and practical relevance because of its possible social effects. This contribution deal with the most relevant different approaches to bioethical problems according to the main juridical systems, as they are civil law and common law. A main topic is also the relation between Biolaw, Bioethics and Biopolitics

Bioethical Problems related with the Use of Human Tissues for Scientific Research

Bioethical Problems related with the Use of Human Tissues for Scientific Research

Research ethics and the principle of Justice as Fairness – A restatement

In my recent article, I addressed the question of whether a potential categorical exclusion of decisionally impaired patients from non-therapeutic medical research would be inaccordance with the Principle of Justice as Fairness. I came to the conclusion that a categorical exclusion of decisionally impaired persons from relevant research projects may collide with Rawls’s understanding of Justice as Fairness. Derek Bell has criticized my paper by denying that it is legitimate to apply Rawls to this bioethical problem. In my restatement I try to show that an extrapolation of John Rawls’s thought to such bioethical cases is possible, because Rawls himself has written that his orientation towards decisionally non-impaired persons is an idealized situation that allows extrapolations. In a second part I try to show that Bell hasroughly misunderstood my concept of “presumed consent” which I make a prerequisite for the legitimisation of research on decisionally impaired persons. In using advance consent as a proposal for resolving the problem, Bell has indirectly confirmed my approach because he is using a similar construct of consent, which operates with similar hypotheses and probabilities of error. I see here no categorical difference between Bell’s conclusion and my discussion. Thus, Bell’s reply does not represent a refutation of my thoughts, but rather it is a para phrased confirmation of my central theses. I conclude by showing the relevance of Rawls, pointing out that the discussion between Bell and me illustrates how Rawls’s concept of reflective equilibrium is an appropriate approach to finding a solution to this bioethical problem.

¿Qué hay de malo en la eugenesia?

Eugenics, deprived of its pejorative sense, can be viewed as a way favoured by biotechnology to serve therapeutical purposes which cannot be condemned for what they are. It concerns to philosophy to make clear the different meanings of eugenics, to put a limit to the increasing fascination produced by genetic determinism, and to show that the distinction between therapy and non therapy is not an static but a dynamic distinction. The aim is to requiere more accuracy in facing the ethical problems derived from bioechnological development. Nevertheless, philosophers have been always looking for a firm ontological basis to deal with problems as that of eugenics. The last book of Habermas is an example of it being a rejection of “liberal eugenesics” since it is seen as a threat to the integrity of persons and to their selfunderstanding as free beings. This article brings into question that the ontological resource provides the best method to face bioethical problems, whose solution does’nt depend so much on a precise conception of human species, as on the capacity of humans to use their freedom in a responsible way.

農業倫理・環境倫理・生命倫理 : 農業倫理学の論点は何か

It is aim of paper is to make major issues of clear by comparing them with ones of and bioethics. The main topics in this paper are following. 1. The major issues of debate over are (1) threats to public health and safety; (2) government responsibility for controlling resource depletion; (3) contributions to ecological disturbance; (4) government responsibility for preserving family farm; (5) problems with factory farming and animal husbandry; and (6) monopolistic control of food production by agribusiness industries (Schrader=Frechette [1992] : pp.30-31). 2. The most important thoughts in are the rights of nature, intergenerational ethics and environmental justice. When we make an issue of ethics, we need to consider these thoughts. 3. Agriculture is fundamental to if is of biosciences. The problems of agricultural bioethics arise from (prospective) application of modern biotechnologies. So we also need to discuss about issues of from bioethical point of view.

The ground of dialogical bioethics.

Dialogical ethics are a procedural alternative to substantive ethics such as consequentialism, deontology, principlism, casuistry, virtue ethics and care ethics. Dialogical ethics are procedural in that they do not establish goods in advance, unlike substantive ethics, but rather determine goods through a procedure enacted by the actual parties involved (although some substantive notion of justice may still be required); and they are dialogical in that the procedure is that of dialogue, involving both empathic critical discussion and negotiation. A fundamental tenet of dialogical ethics may be the use of appropriate rules of order regulating dialogue among the parties involved. Some of the central characteristics of such rules of order are that they are reciprocally regulated by dialogue, that they override other ethical considerations, and that they institute empathic critical discussion and negotiation within the ethical dialogue. Dialogical bioethics are the application of dialogical ethics to ethical problems in medicine. The approach of dialogical bioethics has proven fruitful for resolving bioethical problems such as that of medical futility, where approaches of substantive ethics have reached an impasse. There is room for further study of special challengeswithin dialogical bioethics, such as the incompetence of some involved parties, conflicts of interests of third parties, and the cost-effectiveness of this ethical approach.

Bioethics, semiotics of life, and global communication

Ethical problems connected with biological and medical discoveries in genetic engineering, neurobiology and pharmaceutical research, reach a unified and critical point of view in bioethics as a specific discipline. But even before reaching this stage, ethical problems already belong to two totalities: the semiobiosphere. and the current social form of global communication. Coherently with its philosophical orientation, bioethics must necessarily keep accountof this double contextualisation. The semiobiosphere is the object of study of global semiotics or the semiotics of life. Global semiotics is of particular interest to bioethics not only because of the broad context it provides for the problems treated by bioethics, but also because it provides bioethics with an adequate contextualisation both in terms of extension, of quantity, as well as of quality. From this point of view, "contextualisation" also means critical reformulation. We are now alluding to the need of viewing bioethical problems in the light of today's socio-economic context, that is, in the context of globalcommunication-production. These contextualisations are closely related from the viewpoint of ethics. Semiotics as global semiotics or semiotics of life must accept the responsibility of denouncing incongruencies in the global system, any threats to life over the entire planet inherent in this system.

Solving Ethical Problems in Medical Settings During Psychological Assessment: A Decisional Model

The unique culture of medical settings impacts the style, pace, and quality of psychological consultation provided in that setting. Matters of life and death and other health emergencies, relationships with the courts, and contact with severely impaired patients are typical events. Medical psychologists (MPs) share many, but not all, of the ethical values that guide provision of services by other medical professionals under such circumstances. This generates the need to develop an interdependent but independent ethical orientation on the part of MPs in all professional activities, including psychological assessment. In this article, background information is presented on values that frequently drive medical treatment that may conflict with the MPs' ethical standards. A model appropriate for use in situations requiring complex decisional processes is reviewed, and vignettes are presented as examples of bioethical problem solving under this systematic decisional framework.

Setting the agenda for urban bioethics.

Urban bioethics has two goals. First, it aims to focus attention on neglected bioethical problems that have particular salience in urban settings. Three problems are highlighted: socioeconomic inequality as a major determinant of health inequality, the foundations of an ethic for public health, and the impact of social context on the therapeutic alliance between patients and physicians. Second, urban bioethics serves as a vehicle for raising deep theoretical and methodological questions about the dominant assumptions and approaches of contemporary bioethics. Demands for cultural sensitivity, so pronounced in the urban context, compel us to reexamine the central commitment in bioethics to personal autonomy. The multiculturalism of urban life also argues for a dialogic approach to bioethical problem solving rather than the monologic approach that characterizes most bioethical thinking. Although my brief for redirecting bioethics will resonate with many critics who do not consider themselves urban bioethicists, I argue that there are special advantages in using urban bioethics to expose the limitations of contemporary bioethical paradigms.

Chaplain's Role in End of Life Care

score that what I am trying to argue for in my article is not so much further, fairly straightforward application of social scientific tactics to bioethical problems, important though that is. Rather, I'm calling for taking a particular perspective on bioethics and the social sciences as theoretical practices-a slant that foregrounds the assumptions, both normative and empirical, that both activities tend to harbor, in the interest of developing theories that are intellectually more supple and practically more useful.

Bioetyka a problemy metodologiczne etyki

The relation between bioethics and ethical methodology is the subject of this article. The author is of the opinion that bioethical considerations demand both medical and biological knowledge as well as some general ethical theory. As we know there is not one ethical theory. but many. The author asks whether we have any moral rational foundations for choosing one of the competing ethical systems, and, if this is not possible, whether normative ethics is at all necessary for the solution of practical conflicts. In other words, the author poses the question whether the cultivation of normative ethics. while one is aware of the pluralism of values and variety of ethical theories, has any scientific and practical sense. Still, according to the author methodological relativism need not necessarily imply the acceptance of an axiologically relativistic stand and need not necessarily lead to moral indifference. Beauchamp and Childress work shows a fine approach to bioethical problems.

An annotated bibliography for ethics training in consultation-liaison psychiatry.

The expanding field of bioethics has created a need in psychiatry for rapid access to the complex bioethics literature. This is especially true in consultation-liaison work. An annotated bibliography was created by a task force of the Academy of Psychosomatic Medicine charged with exploring how psychiatrists function on bioethics committees. The bibliography is organized into headings that reflect how bioethical problems came to the attention of psychiatrists. Introductory references allow the reader an overview of the history of bioethics and a selection of useful textbooks. References are provided explaining how ethical principles are used. References are also organized by areas of medical work frequently visited by consultation-liaison psychiatrists.

Foundations, frameworks, lenses: the role of theories in bioethics.

I explore the implications of the foundation metaphor for understanding the role of moral theories in ethics and bioethics and argue that its disadvantages outweigh its advantages. I then consider two other metaphors that might be used instead, those of frameworks and lenses. I propose that the metaphor of lenses is most promising in providing methodological guidance for drawing on moral theories when deliberating about bioethical problems.

Medical ethics from the Muslim perspective.

In view of everything written about freedom of religion in the national law of most European countries, international law and declarations of human rights, Muslims are free to take autonomous decisions about bio-ethical problems. However, autonomy as a right does not mean that Muslim individuals have the medical and ethical information at their disposal which could enable them to take the right decisions. The Universal Islamic Declaration of Human Rights states in its first article, Right to Life: Human life is sacred and inviolable and every effort shall be made to protect it. In particular no one shall be exposed to injury or death, except under the authority of the Law. Just as in life, so also after death, the sanctity of a person’s body is handled with due solemnity.KeywordsMedical EthicMuslim CommunityMuslim CountryHealth Care EthicMuslim ScholarThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

The utility of futility: the construction of bioethical problems.

The aim of this article is to analyse the contemporary 'futility discourse' from a constructivist perspective. I will argue that bioethics discourse typically disregards the context from which controversies emerge and the processes that inform and constrain such discourse. Constructivists have argued that scientific knowledge is expressive of the dominant paradigm within which a scientific community is working. I will outline an analysis of 'medical futility' as a construction of biomedical and bioethical communities (and their respective paradigms). I will trace the emergence and utilization of futility in the literature. My analysis of the context (i.e. the historical circumstances, the particular actors involved) within which the futility discourse emerged suggests that medical futility was constructed, in part, as a means of enhancing physician domination of a context wherein medical authority was threatened. The actors in this debate express widely divergent frameworks of 'the good', arguing from distinctive representations of moral agency. At times, this controversy has been argued from incommensurate moral horizons wherein the discussants debate incomparable problems. This discussion is related to a study of the 'practice' of futility in the clinical context. Further studies on the construction of bioethical problems are a necessary condition for supporting the truth claims of bioethical arguments.

The Utility of Futility: the construction of bioethical problems

The Utility of Futility: the construction of bioethical problems

Fragmentation and consensus: communitarian and casuist bioethics

Both communitarianism and casuistry have sought to restore ethics as a practical science - the former by incorporating various traditions into a shared definition of the common good, the latter by considering the circumstances of each situation through critical reasoning. Mark G. Kuczewski analyzes the origins and methods of these two approaches and forges from them a new unified approach. This approach takes the communitarian notion of the person as its starting point but also relies upon the narrative and analogical tools of case-based reasoning. He separates out the rhetoric that is incongruent with the Aristotelian aspirations of each method to show that the two are complementary, and that consensus can emerge from fragmentation. He then applies his resulting method to three major problems in bioethics: the difficulties that the issue of personal identity poses for advance directives, the role of the family in medical decision making, and the refusal of treatment because of religious beliefs. He analyzes the need to assume a communitarian notion of the person as a starting point for the application of casuistic insights. Combining theoretical, practical, and scholarly insights, this book will be of interest to philosophers, political and social scientists, and bioethicists.