Controversial Ethical Issues Research Articles

Virtue ethics and the unsettled ethical questions in controlled human infection studies.

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID-19 pandemic, CHIs remain controversial, and there has been no in-depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful for addressing CHIs that present a constellation of controversial, unresolved, and/or under-regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models.

Powerful Knowledge as a Conceptual Frame for Teaching Controversial Issues in Ethics and Values Education in Social Studies Subjects

Much has recently been written about how teaching on “controversial issues” may be designed and developed in accordance with various pedagogical and didactic guidelines and based on a democratic ethos. In this article, I develop an analysis of the theoretical prerequisites for a tenable and solid teaching on controversial ethical issues in social-studies subjects. With reference to Diana Hess’s research, which identifies four pedagogical strategies in teaching on controversial issues in a general sense, I critically examine how these strategies can be conceived in a context where ethics and values education are taught in school. I make a claim for the importance of exploring an ethical meta-language for the establishment of a theoretical framework, defined with regard to the concept of powerful knowledge, where teachers may find support for teaching on controversial ethical issues. This claim is supported by a critical discussion of Michael Hand’s well-known defence of the “epistemic criterion”.

LEGAL SITUATION REGARDING ASSESSED REPRODUCTION TECHNOLOGIES IN MUSLIM COUNTRIES

Background. The assessed reproduction technologies (ART) often involve a range of controversial ethical and legal issues that are inspiring for research.
 Purpose. Comprehensive study on ways to use certain types of technologies.
 Materials. This paper provides with research of a legal framework of the ART based on the legislation of 13 Muslim countries: Oman, Saudi Arabia, Bahrain, Morocco, Jordan, the UAE, Malaysia, Iran, Lebanon, Egypt, Algeria, Tunisia and Turkey.
 Results. Due to a range of religious, ethical, legal and social reasons access to the ART was prohibited, but in recent decades mujtahids and fakihs have come to conclusion that for the sake of national prosperity and sustainable development of the ummah medically assisted reproduction may be permissible under certain conditions and must be regulated by laws and correspond to fatwas. The limits of usage of certain technologies have common tendency in gulf countries and the Northern Africa. Nevertheless, some other Muslim countries (e.g., Iran and Malaysia) address this issue in a more detailed and open-minded way.
 Conclusion. Although there’re legal mechanisms and tools for a broader interpretation and a wider interpretation despite critical opinion of theologies and restricted nature of so-called «gates of al-ijtihad», because they are based on established years ago institutes an, in fact, don’t contradict the foundations of Qur’an and Sunnah. However, features of Muslim law remain.

Stem cell-derived extracellular vesicles: A novel and potential remedy for primary ovarian insufficiency.

Primary ovarian insufficiency (POI) is an essential cause of young female fertility loss. At present, there are many treatments for primary ovarian insufficiency, but due to the complexity of the pathogenesis of primary ovarian insufficiency, the efficacy still could not be satisfactory. Stem cell transplantation is a feasible intervention protocol for primary ovarian insufficiency. However, its wide application in the clinic is limited by some defects such as tumorigenic and controversial ethical issues. Stem cell-derived extracellular vesicles (EVs) represent an important mode of intercellular communication attracting increasing interest. It is well documented that stem cell-derived extracellular vesicles for primary ovarian insufficiency with exciting therapeutic effects. Studies have found that stem cell-derived extracellular vesicles could improve ovarian reserve, increase the growth of follicles, reduce follicle atresia, and restore hormone levels of FSH and E2. Its mechanisms include inhibiting ovarian granulosa cells (GCs) apoptosis, reactive oxygen species, and inflammatory response and promoting granulosa cells proliferation and angiogenesis. Thus, stem cell-derived extracellular vesicles are a promising and potential method for primary ovarian insufficiency patients. However, stem cell-derived extracellular vesicles are still a long way from clinical translation. This review will provide an overview of the role and the mechanisms of stem cell-derived extracellular vesicles in primary ovarian insufficiency, and further elaborate on the current challenges. It may suggest new directions for future research.

Procena znanja, stavova i prakse medicinskih sestara u primeni mera fizičkog sputavanja pacijenata

Introduction: Physical restraint is a frequently debated procedure due to controversial ethical and legal issues related to patient autonomy and dignity. This study aimed to assess the level of knowledge, attitudes and practice of nurses regarding the use of physical restraint measures on patients and to determine whether there is a difference between the level of knowledge, attitudes and practice of nurses regarding the use of physical restraint measures to their sociodemographic and professional characteristics. Material and methods: This study was conducted as a cross-sectional study at three healthcare institutions of different medical care levels (n = 253). Instruments used in this research included a questionnaire to assess knowledge, attitude, intention, and practice and a sociodemographic questionnaire. Descriptive and inferential statistics were used for statistical analysis of the data, and statistical significance was determined at p < 0.05. Results: Nurses have a moderate level of knowledge, a positive attitude, and good practice in applying measures of physical restraint of patients. A significant difference in the level of knowledge regarding the application of measures of physical restraint of patients was determined by the age of the nurses, as well as that nurses with a positive attitude towards the application of measures of physical restraint of patients have a better practice. Conclusion: By implementing an appropriate educational pro-gram, which is certainly mandatory for all employees in the health sector, and creating a guide for the proper use of measures for physical restraint of patients, it is possible to influence the improvement of the quality of care and treatment of patients.

Legal initiative for Gestational Surrogacy in Portugal: an overview of the legal, regulatory, and ethical issues

Gestational surrogacy is a controversial ethical issue worldwide. In 2016, Portugal launched a second political attempt to legalize gestational surrogacy, proposing it as: being altruistic; forbidding a biological tie between the surrogate and the child; requiring a biological relationship between one of the legal parents and the child; and demanding a legal contract between the surrogate and the legal parents. The law was approved, regulated and entered into force. However, months later, the Constitutional Court ruled some of its norms unconstitutional, namely due to: the legal ambiguity of the surrogacy contracts; too short a deadline for the surrogate’s withdraw of consent; and the need to comply with the children’s right to know their biological origin. The law entered a complex political and legal process. It also caused a serious problem in assisted reproductive treatments, with the suspension of those treatments that entailed the anonymity of the donors. The law on surrogacy was, finally, enacted in November 2021, although the introduction of its regulation is still pending. This paper describes the legal process, within its political context, stressing the ethical issues at stake, and presenting the initiative for legalization of gestational surrogacy in Portugal as a valuable case study analysis: of how a top-down initiative, ideologically driven and politically rushed, and which ignores ethical advice, generates a troubled and penalizing legal process for the people involved.

European mechanisms for the protection of human rights in the field of artificial intelligence technologies (hereinafter - AI)

The article examines the main challenges, faced by scientists and lawmakers in development of a regulatory framework for such technologies. The article reflects on the analysis of basic approaches, principles and concepts of regulation of AI technologies. The analysis revealed that the development and application of AI has raised many controversial legal and ethical issues, as well as complex institutions of law and legislation, and possibly even new branches of law.
 Today, there is a lot of controversy among scientists in definition of a unified approach to the concept of "artificial intelligence". And this, in turn, affects the development of the legal framework, what requires a coordinated approach of specialists from different fields of research: technical, legal, ethical, etc. Also important and open to discussion is the ethical side of using such technologies. As it is seen, the concept of respect for human dignity has a high chance of being the basis for the legal regulation of AI. Because, even with differing views on the definition of AI, the goal of protecting human rights and ensuring their fundamental freedoms must remain paramount.
 Important is the fact, that the immediate subject of research is technology, which is characterized by unprecedented speed and scale of development and change. This threatens the emergence of a significant number of risks and challenges to human rights, freedoms and legitimate interests, due to new advances in AI development. Scientists point out that one of the main challenges is to increase the gap between the rapid level of development of AI technologies and their implementation in society on the one hand, and the lack or obsolescence of research and legislation.
 Another controversial issue addressed in the article is the uncertainty of the development of these technologies, which requires close cooperation of legal scholars with specialists involved in the development of AI systems to anticipate possible human rights violations that such technology may cause, as well as anticipation of the level and types of responsibility for the actions of AI systems.

Regulating Biobanks: An ethical analysis of the Spanish law and the new challenges of the big data-driven biomedical research

In the European landscape, Spain represents a positive reference point when it comes to biobank regulation. Indeed, at the beginning of XXI century, the Spanish legislation has promptly responded to challenges posed by new biotechnologies and advances in genomics in the field of biomedical research by enacting in 2007 the Ley de Investigación Biomédica in order to keep up with the paradigm shift. Over the past 10 years, this Spanish framework along with the Real Decreto 1716/2011 has hold the merit to tackle the most controversial ethical issues related to use of human samples and personal data in biomedical research and biobanking (e.g. broad consent, secondary uses, governance, etc.). However, today the regulation of biomedical research and biobanks has to deal with big data, artificial intelligence and data-intensive research which have brought a number of challenges and controversies. The aim of this paper is two-fold. First, I will analyse from an ethical point of view the merits of Spanish regulation on biobanking in order to draw some lessons for the still unregulated situation in other Member States. Secondly, I will discuss the big data paradigm shift in biomedical research and question if the ethical and legal framework introduced the Spanish law at the beginning of the century is still able to hold the ground with the new contextual and societal challenges. In this respect, I will identify some opportunities for implementation and suggest strategies to achieve them in the specific context of biobanks.

Making room for the 3Rs principles of animal use in ecology: potential issues identified through a survey

Research on animals is one of the most controversial ethical issues in our society. It is imperative that animal welfare is being considered and the harm and distress to animals used in research is minimized. This could be achieved through implementation of the so-called 3Rs principles for animal research, which are now implemented in many legislations worldwide. These principles serve as a basis for research without the use of animals (Replacement), with as few animals as possible (Reduction), and in which the animal’s welfare is as good as possible (Refinement). While there has been a lot of focus on implementation of these principles, only a few studies have documented the knowledge and adoption of the 3Rs among researchers. One field that has been particularly neglected is ecological research, which can involve many practices that affect animal welfare. Moreover, the knowledge, experience, and attitudes about animal use in ecological research and education has never been examined before. In order to close this gap, I conducted a survey among European ecologists. Responses from 107 respondents from 23 countries revealed that lethal and invasive research methods are prevalent, and that more than half of the respondents have never heard of the 3Rs principles for animal research. Major concerns are also the lack of calculation of the minimum sample size and widespread of dissection classes as part of education. Additionally, most respondents experienced ethical doubts about their research, and did not receive any training in animal welfare or ethics. These findings revealed that it is necessary to implement rigorous standards for ecological research and enforce the implementation of the 3Rs principles. Furthermore, the evaluation of current educational practices in ecology is urgently needed.

Digital bioethics: introducing new methods for the study of bioethical issues

The online space has become a digital public square, where individuals interact and share ideas on the most trivial to the most serious of matters, including discussions of controversial ethical...

Current status and future prospects of patient-derived induced pluripotent stem cells.

Induced pluripotent stem cells (iPSCs) are produced from adult somatic cells through reprogramming, which behave like embryonic stem cells (ESCs) but avoiding the controversial ethical issues from destruction of embryos. Since the first discovery in 2006 of four factors that are essential for maintaining the basic characteristics of ESC, global researches have rapidly improved the techniques for generating iPSCs. In this paper, we review new insights into patient-specific iPSC and summarize selected "disease-in-a-dish" examples that model the genetic and epigenetic variations of human diseases. Although more researches need to be done, studies have increasingly focused on the potential utility of iPSCs. The usability of iPSC technology is changing the fields of disease modeling and precision treatment. Aside from its potential use in regenerative cellular therapy for degenerative diseases, iPSC offers a range of new opportunities for the study of genetic human disorders, particularly, rare diseases. We believe that this rapidly moving field promises many more developments that will benefit modern medicine.

Abortion for minors: do they need parental consent? The case of Kazakhstan

The requirement for parental consent for conducting abortion for minors has always been a highly debatable and controversial ethical issue. In terms of ethical debate, there are manifolded ‘pros’ and ‘cons’ of liberal legislation on abortion for the underage girls. Worldwide experience has revealed that the variations in the laws as well as the arguments for and against abortion for teenagers differ depending on geographical location, ethnicity, religion, and cultural peculiarities. This paper juxtaposes arguments in favor for and against parental consent, as well as neutral arguments neither for nor against, narrowing down the issue to the context of Kazakhstan. At the same time, the paper also uses ethical stances of virtuous and utilitarian aspects for argumentative purposes and touching upon the aspects of morality. In conclusion, the paper argues in favor for mitigating the access for underage girls in Kazakhstan on a legislative level and suggests that Kazakhstan should reconsider as well as readapt its regulation and laws on abortion in order to maintain health, happiness, utility, and reproductive abilities of future-to-be mothers. Thus, a law mitigating the access to abortion for youngsters could make a huge positive impact for both underage girls as well as the society to reach an agreeable consensus between the two. Key words: abortion, Kazakhstan, minors, parental consent, ethics.

Survey for the Opinion of Medical Students and Medical Staff on a Financial Incentive System for Deceased Organ Donation in an Asian Country

BackgroundFinancial incentives for deceased organ donation are associated with many controversial ethical issues. This study examines the perspectives of medical students and staff members on financial incentives for the families of brain-dead organ donors. MethodologyA structured survey form was used between December 7, 2017 and January 28, 2018 to elicit opinions on financial incentives for the families of brain-dead organ donors. Forty-three medical staff members and 81 medical students participated in the survey voluntarily. The opinions on the financial incentive system and the relationship between willingness to give information about organ donation to families and a financial incentive system were assessed. ResultsThe majority of the participants (81.4%) had positive thoughts on organ donation. More than half of the participants (60.5%) thought that the financial incentive system did not erode the ethical purity of organ donation. As charge doctors, most respondents (84.6%) were willing to give information about organ donation to family members in the presence of financial incentives. However, the percentage decreased significantly to 60.5% when financial incentive was no longer factored into consideration (P < .001). LimitationThe study population is small, and the participants are not representative of the general population. ConclusionThe opinions of medical students and medical staff on financial incentives for deceased organ donation were generally positive. Financial incentives proved to be a potential influencing factor as an option of organ donation to be given to families.

Caregivers' Attitude and Perspective on Coercion and Restraint Practices on Psychiatric Inpatients from South India.

Background:Coercion and restraint practices in psychiatric care are common phenomena and often controversial and debatable ethical issue. Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients have received relatively less research attention till date.Aims:Caregivers’ attitude and perspective on coercion and restraint practices on psychiatric inpatients.Methodology:This is a hospital-based, a descriptive, cross-sectional study. A total of 200 (n = 200) consecutive patient and their caregivers were chosen between June 2013 and September 2014 through computer-generated random numbers sampling technique. We used a semi-structured interview questionnaire to capture caregivers’ attitude and perspective on coercion and restraint practices. Sociodemographic and coercion variable were analyzed using descriptive statistics. McNemar test was used to assess discrete variables.Results:The mean age was 43.8 (±14.9) years. About 67.5% of the caregivers were family members, 60.5% of them were male and 69.5% were from low-socioeconomic status. Caregivers used multiple methods were used to bring patients into the hospital. Threat (52.5%) was the most common method of coercion followed by persuasion (48.5%). Caregivers felt necessary and acceptable to use chemical restraint (82.5%), followed by physical restraint (71%) and electroconvulsive therapy (ECT) (56.5%) during acute and emergency psychiatric care to control imminent risk behavior of patients.Conclusion:Threat, persuasion and physical restraint were the common methods to bring patients to bring acutely disturbed patients to mental health care. Most patients caregivers felt the use of chemical restraint, physical restraint and ECT as necessary for acute and emergency care in patients with mental illness.

The Attitude of the Orthodox Parishioners Toward Euthanasia: Evidence From Georgia.

The right of euthanasia is the subject of worldwide discussion today, as it is one of the most controversial medical, religious, political, or ethical issues. This study aims to survey the attitudes of Orthodox parishioners toward the euthanasia. Methods: Within the quantitative study, the survey was conducted through a semistructured questionnaire. Respondents were the parishioners of the Orthodox Church. Within the qualitative study, the survey of the experts of the Orthodox Church, in particular the clergy, was conducted. During the survey of the experts, we used the snowball method. The majority of respondents (81%) were aware of euthanasia. The dominant opinion is that euthanasia is " the consent to life termination during the illness, when there is no way out and recovery is impossible" or " a terminally ill person voluntarily decides to end life painlessly." Those who disagree with euthanasia rely on the religious factors (why the church prohibits it). Those who agree with euthanasia action argue the legitimate human rights and free will of person. Most of the respondents (86%) have not heard about euthanasia practices in Georgia. Most of the respondents (71%) knew that the Orthodox Church prohibits euthanasia; 39% of the respondents believe that euthanasia is justified in medical terms. It is advisable to raise public awareness on euthanasia in religious, medical, cultural, social, and legal aspects.

A Scientist’s Oath

Data on the perceptions of scientists suggest a moderate public distrust of scientist's motivations. Bettridge etal. suggest scientist's reluctance to engage the public on controversial ethical issues may be a contributing factor. The authors propose a Scientist's Oath to send a clear message to the public about our ideals.

Enhancing Research Quality with Updated and Controversial Ethical Issues: Summary and Recommendations

Enhancing Research Quality with Updated and Controversial Ethical Issues: Summary and Recommendations

Practices and views of neurologists regarding the use of whole-genome sequencing in clinical settings: a web-based survey.

The use of Whole-Genome Sequencing (WGS) in clinical settings has brought up a number of controversial scientific and ethical issues. The application of WGS is of particular relevance in neurology, as many conditions are difficult to diagnose. We conducted a worldwide, web-based survey to explore neurologists' views on the benefits of, and concerns regarding, the clinical use of WGS, as well as the resources necessary to implement it. Almost half of the 204 neurologists in the study treated mostly adult patients (48%), while the rest mainly children (37.3%), or both (14.7%). Epilepsy (73%) and headaches (57.8%) were the predominant conditions treated. Factor analysis brought out two profiles: neurologists who would offer WGS to their patients, and those who would not, or were not sure in which circumstances it should be offered. Neurologists considering the use of WGS as bringing more benefits than drawbacks currently used targeted genetic testing (P<0.05) or treated mainly children (P<0.05). WGS' benefits were directed towards the patients, while its risks were of a financial and legal nature. Furthermore, there was a correlation between respondents' current use of genetic tests and an anticipation of increased use in the future (P<0.001). However, over half of respondents did not feel sufficiently informed to use WGS in their practice (53.5%). Our results highlight gaps in education, organization, and funding to support the use of WGS in neurology, and draw attention to the need for resources that could strongly contribute to more straightforward diagnoses and possibly better treatment of neurological conditions.

The Contribution of Teaching Logic to Ethical Decision Making

Everyone makes many important decisions in one's life and these decisions are the result of one's thinking. However, in many critical situations one cannot find a solution. The paper deals with the importance of teaching logic in mathematics for the human individual to be able to make ethically correct decisions. The mathematical formalism can simplify thinking and thus achieve the proper conclusion. Teaching logic can help humans learn the basic rules of logical reasoning. Mathematics is essentially a universal language of physics and technology but it can also be a language of communication in ethics. The unambiguity of mathematics could be used to solve many controversial ethical issues in the application of new scientific knowledge.

Protecting Student Intellectual Property in the Entrepreneurial Classroom

While universities are intensely protective of revenue streams related to intellectual property interests for the institution and professors, the financial and legal interests of students in the entrepreneurial process have largely been overlooked. This lack of attention, both in universities and in the literature, is intriguing given the mushrooming growth in entrepreneurial education courses in almost every U.S. university. This article builds and reflects on an original article by Katz, Harshman, and Lund Dean where the authors advocate for establishing classroom norms for promoting and protecting student intellectual property. We present research, insights, and reflections from Professor Katz regarding the controversial ethical and legal issues related to student intellectual property in university settings and provide suggested resources for faculty traversing these issues.