Bioethical Issues Research Articles

Responsibility for Structural Racism in Medicine: Reflections and Recommendations from One Institution

In this article, we draw upon recent ethical arguments by Zheng and Young to explain our experience applying the social connection model of responsibility to structural racism in medicine. We propose that taking responsibility for structural racism must begin with acknowledging, studying, and learning from localized, particular instances of racism. Such practices raise personal and institutional consciousness about racism and injustice, creating a knowledge base from which effective action is possible. We describe our experiences engaging with responsibility for structural racism as a small group of scholars dedicated to learning more about our institution’s history and our own agency in altering its future trajectory. Our learning and introspection were developed over multiple sessions in the 2019–2020 academic year when the authors participated in a Medical Ethics Forum Fellowship. The Medical Ethics Forum Fellowship (the Forum) of the Medical University of South Carolina (MUSC) is composed of a diverse group of interdisciplinary faculty members, students, and practicing health professionals. The precise membership of the group changes every year, with a number of members continuing for multiple years. Each academic year the Forum focuses on a specific bioethical issue of current interest. Our focus for the academic year 2019–2020 was race and ethnicity in 21st century health care. This paper is the result of our year-long deliberations based on study of the relevant literature, monthly discussions, as well as personal presentations and discussions with nationally known scholars in this field.

Modern bioethical issues: Euthanasia, physician assisted suicide and abortion. Comparative study of attitudes between physicians and law professionals.

We aimed to examine and compare the attitudes of physicians and law professionals on modern bioethical issues. Euthanasia, physician assisted suicide and abortion were selected for this study, as they underline the conflict between human life as a fundamental value, and the individual's right to self-determination. The demand of euthanasia and physician assisted suicide services reflects each person's right to decide on the way their life will end, while the legalization of abortion determines the individual's right to self-determination. These are complex issues with moral, religious and social implications, and as such tend to divide public opinion. In order to investigate their attitudes, physicians of all specialties, as well as law professionals from all over Greece, were invited to participate in the study. In total, 220 professionals responded to the call and participated in the survey. The professionals involved showed fairly high rates of agreement in all the issues studied, but a significant difference in results was found when the occupation of participants was set as a criterion, with physicians being more negative to euthanasia, physician assisted suicide and abortion than lawyers. Religiousness, age and male sex were negatively correlated with "positive" attitudes towards euthanasia, physician assisted suicide and abortion. Moreover, participants' attitudes towards euthanasia and physician assisted suicide were found to predict their attitudes towards abortion, indicating a single ideological direction of agreement or disagreement, accordingly. Individuals' attitudes and opinions are complicated issues, not easy to be categorized. However, it is of scientific interest to shape a legislative framework that is close to the social consensus, ideological evolution and moral needs. This study tried to pave the way for a modern approach to the issues of euthanasia, physician assisted suicide and abortion.

Humanity in a New Reality: Global Biotechnological Challenges

An overview of the international scientific conference which was held at the Institute of Philosophy of the Russian Academy of Sciences in November 2020 as a part of the XX Readings in the Memory of Academician Ivan Timofeevich Frolov (1929–1999) is presented. The conference was dedicated to the global changes in the socio-anthropological reality associated with the use of the latest biotechnologies and the consequences of the pandemic of the coronavirus COVID-19 in the modern world. During the conference the following issues were discussed: interaction between man and technology, the upgrading of the economic structure of the world in terms of biotechnological stage of the scientific and technical revolution, anthropogenic challenges of the global ecosystem, the consequences and lessons of the coronavirus pandemic, bioethical issues of experiments on human subjects and editing of the human genome, the ethical challenges of genetic technologies in clinical practice, the problem of the status of the human embryo in embryology and genetics, state of the world in the era of global imbalances, the responsibility of modern man to the future of the planet and of the human race. At the conference three new books were presented. The book “Philosophical Conversations with Academician I.T. Frolov” includes transcripts of TV programs of the series “Philosophical Conversations” which Academician I.T. Frolov conducted on Central Television in 1986–1990. The project “Philosophical Conversations” caused a great response in the media and was recognized not only by the philosophical community but also by the general public. The other book is a second edition of I.T. Frolov's monograph “On Man and Humanism” which at the time became a kind of encyclopedia of human studies. The monograph in a concentrated form contains the main results of the Soviet philosophy of man in the 1960s and 1990s. In the book “Man in the Global World: Risks and Prospects” which is based on the results of the XIX Frolov readings man and his future are thought of as the main global problem. The scientific essence, ethical grounds and global consequences of the use of the latest NBICS technologies are considered as well as the way the collisions of global economic, environmental, and geopolitical crises affect the daily life of each person.

Toward an Africanized Bioethics Curriculum

AbstractAlthough many bioethicists have given attention to the special health issues of Africa and to the ethics of research on the continent, only a handful have considered these issues through the lens of African moral thought. The question has been for the most part neglected as to what a distinctively African moral perspective would be for the analysis and teaching of bioethics issues. To address the oversight, the authors of this paper describe embarking on a project aimed at incorporating African moral perspective, values and philosophy into a teaching curriculum. The authors clarify the rationale for the project and discuss the strategies employed in Africanizing the bioethics curriculum.

Mental illness in some Sub Saharan African communities: the perspective of Bioethics and transcultural nursing

In this paper, transcultural nursing is reviewed in light of bioethical issues arising from the interpretation of mental illness in some Western Sub-Saharan African communities. Four field studies were carried out by the authors of this paper in Sub-Saharan Africa (from 2016 to 2019), during which the traditional “treatment” of enchaining people considered “crazy” by local cultures was explored. These inhuman practices raise the attention of bioethics, which investigate ways to overcome this traditional practice not violating the cultural identity of the peoples who practice it. The model of Gregoire Ahongbonon and of his Association, “Saint Camille de Lellis”, is reported as an example of negotiation between the respect for traditions and the guarantee of human rights. The care practice in force in the Saint Camille is related to transcultural nursing as an adequate form of treatment and strategy for restoring patients’ dignity and rights.

Speech-Language Pathologists in Pediatric Palliative Care: An International Study of Perceptions and Experiences.

Purpose The purpose of this study is to gather qualitative data regarding the experiences and perceptions of speech-language pathologists (SLPs) practicing in pediatric palliative care (PPC) and investigate their approaches for working with patients, families, and the multidisciplinary team. Method Ten participants from Australia, Canada, and the United States were recruited from a previous survey study. In-depth interviews were conducted via videoconferencing. Two coders used NVivo software to record and organize the data into themes. Interrater reliability of the coding was established with a third coder. The COnsolidated criteria for REporting Qualitative research 32-item checklist has been used for reporting the research. Results Interrater coding reliability (using weighted kappa) was .81, indicating "almost perfect" agreement on the selection of themes from the code frame. Emerging themes included clinical interventions, unique SLP skills in PPC, multidisciplinary team relationships, workforce issues, education and training, governance, medicolegal considerations, bioethical issues, and holistic care. Additional subthemes are also noted. In the absence of research evidence and practice recommendations, SLPs rely on client perspectives and clinical experience to guide their professional practice in PPC. Conclusions Qualitative survey analysis of the perceptions and experiences of SLP clinicians from three postindustrial countries identified nine major themes regarding PPC. Results expand on limited literature to date in the area of PPC. Future research using larger samples is needed to provide clinicians with best practice recommendations for working with patients, families, and the broader care team.

“Shadowy objects in the test tubes”: Biocitizenship, Disposable Bodies, and Wasted Lives in Hanif Kureishi’s “The Body” and Kazuo Ishiguro’s Never Let Me Go

The paper aims to explore Hanif Kureishi’s (2002) “The Body” and Kazuo Ishiguro’s (2005) Never Let Me Go in order to throw light on the bioethical issues related to ageing, biocitizenship, organ transplantation, wasted lives and disposable bodies by extending the discussion from a human to a dystopian posthuman world where affluent sections of society replenish their aged degenerating organic body by incorporating biomatter from non-citizens and clones. The paper draws on and extends Nikolas Rose and Carlos Novas’s concept of biocitizenship, Zygmunt Bauman’s notion of wasted lives, Giorgio Agamben’s explanation of bare life and Julia Kristeva’s theory of abjection in the context of literary studies in order to analyze the socio-political status of the engineered lives who are classified as biomedical fodders.

Healthcare System Innovation: the vital systemic approach for new healthcare professionals

In light of the requirements associated with the Health goals set in the National Health Plan or in Regional HealthPlans and by the consequential creation of the new health professions, there has been an enlargement of the NationalHealth System network in recent years.Growing focus testified by the reform of ordinances enacted by Law 3 of 2018 (Lorenzin Law), and the clear newtopics related to bioethics, ethics and professional deontology issues put up new questions which need answers andsolutions. Innovation in the Italian Healthcare system therefore takes on a central role in scientific debates demanding new solutions which, necessarily, must first of all aim to protect individual and collective health, in order tosubsequently focus upon the governance of new professional healthcare workers.The systematic complexity of establishing new healthcare professionals in the three afferent areas: Care Techniqueand Diagnostic Technique, Rehabilitation and Prevention, generates of course many new opportunities, requiringrapid detection and set up rapidly the organic structure of the wider Healthcare System. This is the framework withinWHO’s Project “ Healthcare System Innovation: the vital systemic approach for new healthcare professionals”, seeking specific solutions and suggestions in order to contribute to the innovation and governance of the new healthcareprofessionals

Healthcare System Innovation: the vital systemic approach for new healthcare professionals

In light of the requirements associated with the Health goals set in the National Health Plan or in Regional Health Plans and by the consequential creation of the new health professions, there has been an enlargement of the National Health System network in recent years. Growing focus testified by the reform of ordinances enacted by Law 3 of 2018 (Lorenzin Law), and the clear new topics related to bioethics, ethics and professional deontology issues put up new questions which need answers and solutions. Innovation in the Italian Healthcare system therefore takes on a central role in scientific debates demanding new solutions which, necessarily, must first of all aim to protect individual and collective health, in order to subsequently focus upon the governance of new professional healthcare workers. The systematic complexity of establishing new healthcare professionals in the three afferent areas: Care Technique and Diagnostic Technique, Rehabilitation and Prevention, generates of course many new opportunities, requiring rapid detection and set up rapidly the organic structure of the wider Healthcare System. This is the framework within WHO's Project " Healthcare System Innovation: the vital systemic approach for new healthcare professionals", seeking specific solutions and suggestions in order to contribute to the innovation and governance of the new healthcare professionals.

Bioethical and Anthropological Issues Concerning Galenic Reminescences in Romanian Folk Medicine

Bioethical and Anthropological Issues Concerning Galenic Reminescences in Romanian Folk Medicine

Awareness and Perceptions on Bioethical Issues among Pre-Service Science Teachers

This study aims to investigate the awareness and perception level of bioethical issues among pre-service science teachers at one of the Malaysian Education Institutions. A total of 67 respondents studying science major and science elective were involved. A questionnaire based survey with an alpha Cronbach of approximately 0.93 was used. Data were analysed using SPSS version 22. The results showed that the average awareness and perception level were =4.218±0.758 (very high level) and =3.991±0.923 (high level), respectively. There was a statistically significant difference according to religion and course. Cloning showed the highest awareness level followed by organ donation, genetic modification, stem cells, abortion, gene therapy, gene screening and euthanasia. Overall, the findings indicated that pre-service science teachers were aware of the existence of bioethical issues. However, the authorities may implement bioethical issues more firmly in the future to increase pre-service science teachers’ awareness and perception level.

Le conseguenze bioetiche dell’emergenza sanitaria e la biopolitica della pandemia

AbstractThe essay briefly addresses the bioethical and biopolitical issues that have arisen following the health emergency due to the Convid-19 epidemic. In particular, the opinion of the CNB on the pandemic emergency isexamined and the debate opened by the biopolitical reflection of the philosopher Giorgio Agamben regarding the limitation of fundamental freedoms and the distribution of health resources is taken into account. Finally, the pandemic is examined as a historical social event that can generate a renewed consideration of the bioethics of care based on the vulnerability of the human being

Knowledge and Attitudes Towards Abortion and Euthanasia Among Health Students in Papua New Guinea.

PurposeThe purpose of this study was to explore knowledge and attitudes of health program students towards ethical issues pertaining to the beginning and the end of human life, and associations between these attitudes and demographic variables.Participants and MethodsThe study took a mixed-method approach with self-administered survey questionnaires and in-depth interviews. A total of 88 students participated in the survey, and 10 students participated in interviews. The study was conducted among students in the Health Extension Program at a Christian university in Papua New Guinea.ResultsStudents showed a higher acceptance of abortion than euthanasia. More year-4 students presented significantly deeper knowledge of euthanasia and abortion compared to year-1 students. There were no gender differences regarding knowledge and attitude towards these two bioethical issues. The majority of students opposed the idea of women’s right to abortion, which is attributed mainly to socio-cultural reasons. The qualitative analysis indicated a very strong perception that having children ‘defines’ womanhood and also revealed general disapproval of any form of euthanasia. A low level of acceptance of various forms of euthanasia is associated with a respect for older people in Melanesian society and beliefs that ancestors’ support is required for achieving prosperity in life.ConclusionThe study offered a comprehensive description and analysis of students’ knowledge and attitudes towards ethical issues pertaining to the beginning and the end of human life. Presented a low level of knowledge towards bioethical issues, together with a small proportion of the knowledge gained from lectures and tutorials, indicated inadequate teaching of bioethics and calls for further improvement. In the perspective of rapid social and cultural changes in the Papua New Guinea society, further studies on changing attitudes towards bioethics issues would be valuable.

Cryopreservation of oocytes (egg freezing): Bioethical issues

Cryopreservation of oocytes (egg freezing): Bioethical issues

(Bio)ética e população em situação de rua: entre Agamben e Derrida

Resumo Neste artigo pretende-se analisar problemas bioéticos relativos às populações em situação de rua a partir dos conceitos de homo sacer, de Giorgio Agamben, e de hospitalidade incondicional, de Jacques Derrida. Como elementos-chave destacam-se a invisibilidade dessas populações e o reconhecimento de que profissionais e instituições de saúde devem operar em lógica de cultura hospitaleira, que considere o cuidado às pessoas em situação de rua como significativa ação ética.

Yu.E. Veltischev. An outstanding pediatrician ahead of his time

The article is devoted to the outstanding pediatrician — Professor Yu.E. Veltischev, the head of Moscow Research Institute of Pediatrics and Pediatric Surgery (now — Scientific Research Clinical Institute of Pediatrics, bearing his name) for many years. All achievements of Yuri Evgenievich were aimed at the future: genetics, immunology, preventive medicine, age physiology, molecular and cellular biology, homeostasis and enzymology, environmental pediatrics, telemedicine etc. Yu.E. Veltischev paid great attention to the anatomical and physiological characteristics of children, he emphasized that the pediatrics should be aimed not only at a sick child, but, above all, at a healthy child, its growth and development, biological and social adaptation, and the state of immunity. Yuri Evgenievich paid great attention to the issues of ethics, deontology and bioethics in pediatrics, pointing out that during the outstanding achievements of biotechnology, the preservation of the moral and ethical foundations of society, the protection of human values, primarily culture, science, education remains the issue of the day.

THE UZBEK MODEL OF BIOETHICS: HISTORY AND MODERNITY

Modern biomedical ethics is based on a rich tradition of systematic moral thought, both philosophical and religious. In the XXI century, the interaction and synthesis of natural and humanitarian disciplines are of paramount importance in the system of biomedical education. One of the ways to solve this problem for future specialists is to study the foundations of biomedical ethics, the formation of a bioethical culture of future doctors. Among the ancient scientists of Central Asia who became famous in the field of medicine and pharmacy, a prominent place is occupied by Abuali Ibn Sino (Avicenna), whose life and work can serve as an example of national and historical identity, patriotic education of the youth of Uzbekistan. The emergence of such a phenomenon as the "Muslim Renaissance" and in this context the life and work of Avicenna, his role in the history of the development of medicine in Uzbekistan, are devoted to many, which, like others, were included in the materials of this study. A kind of bridge from ancient medicine to the medicine of the Renaissance and further to modern medicine was the legacy of doctors in Central Asia and Arab physicians. At present, the social, legal and economic aspects of ethical problems of key issues of bioethics in the field of health, medicine and biomedical technologies in the context of the Islamic faith continue to be studied.

Quem salva quem? Saviour siblings e seus aspectos bioéticos

INTRODUÇÃO: A ideia do artigo surgiu durante uma disciplina na qual os alunos foram organizados em grupo para a discussão de um assunto dentro da temática da bioética, sendo o assunto escolhido "saviour siblings". O “saviour sibling” é uma criança concebida na esperança de que ela seja geneticamente compatível com um irmão mais velho que possui alguma patologia cujo tratamento consista na doação de tecidos. OBJETIVO: Debater a concepção de irmãos doadores e a delicadeza e complexidade do tema na perspectiva bioética. METODOLOGIA: Revisão bibliográfica realizada em agosto de 2019, na base de dados PubMed, utilizando o descritor “saviour siblings.” O material obtido foi utilizado para discussão e elaboração de um caso clínico. RESULTADOS: Foram encontrados 40 artigos, nove excluídos pelo resumo por divergirem do tema. O caso clínico foi desenvolvido coletivamente e os autores incumbidos de se colocarem no lugar dos envolvidos nesta decisão e narrar os possíveis pensamentos e sentimentos em cada um deles. Em seguida, utilizaram-se as referências bibliográficas para discutir o caso clínico construído, sob a perspectiva bioética. CONCLUSÃO: São delicadas e complexas as questões bioéticas relacionadas ao tema saviour siblings. Por um lado, há o benefício de se salvar uma criança doente e trazer alívio a seus pais. Por outro, esta técnica pode remeter a práticas eugênicas como a seleção de indivíduos a partir de sua genética. A perda de autonomia do irmão salvador precisa ser enfoque de futuras discussões éticas a fim de proteger seus direitos. É imprescindível o ensino de Bioética para a formação de profissionais da saúde.

The teaching of Medical Law in Brasil.

To provide a brief overview of the teaching of medical law in Brazilian law schools, proposing a syllabus if needed. Survey the curricula of the best-ranked Law Schools in the country and reference Law Schools in the USA and Europe. Analyze the disciplines offered and their relation to the actual demands of the industry. The offer of medical law disciplines in Brasil is very scarce and concentrated in one city (São Paulo). Most of the few existing disciplines focus on bioethical issues rather than law and lawsuits. There is a need to reformulate the teaching of medical law in Brasil by including new disciplines and broadening the subjects approached.

Materials in the U.S. National Archives and Records Administration Related to the Kyushu University Vivisection Case, and their Significance

Aim: I investigated materials related to this case that were held in the U.S., and I explored reconsidering the case as a bioethical issue. Methods: For a 2012 Scientific Research Project (Theme: Research on Historical Documents at Kyushu University School of Medicine (Theme No.23650563) ), I conducted an overseas investigation of the Kyushu University Vivisection Case in December 2014 after completing a preliminary study in Japan. Results: On 25 December 2014, in the abovementioned U.S archives, I discovered unpublished materials written by Fukujiro Ishiyama,“Professor” in the First Department of Surgery of Kyushu Imperial University. These materials have since been published in a textbook and utilized for bioethics education. Conclusion: The Great Fukuoka Air Raid occurred in 1945, at the end of the Pacific War. Eight POWs who had been on board a U.S. Army B-29 bomber were subjected to “experimental surgeries” under the Japanese Western District Army at the Department of Anatomy of the Kyushu University School of Medicine. This resulted in the deaths of all the POWs in the so-called “Kyushu University Vivisection Case.” For a long time, the university has regarded this case as negative history and as taboo. The incident seemed to have been planned by Dr. H. Komori, an army physician, who held the key to the case and is said to have committed “a horrible and inhumane act.” The discovery of the new materials, however, has made the case a bioethics issue that involves the Code of Conduct for Medical Professionals. Significantly, the discovery has presented an opportunity for the issue to be reconsidered from an interdisciplinary perspective.