Modern Bioethics Research Articles

Христианские основы Bio-Ethik Фрица Яра и центрально-европейская перспектива восприятия его концепций

The article presents the concept of Bio-Ethik by the German theologian Fritz Jahr (1895–1953) and discusses the reasons of the interest to his legacy in Central Europe. The popularity of Fritz Jahr’s works fits into the specific context of a complex development of bioethics in Central Europe at the turn of the twenty-first century. The appeal to Fritz Jahr’s ideas in the field of bioethics allows us to assess the contribution of Christian thinkers to the articulation of bioethical issues and to raise the question of why in modern bioethics, which is trying to draw upon universal, non-religious values, there was a demand for theological works of a Protestant pastor. The article describes the attitude to bioethics in Germany at the turn of the 1980s–90s, the ideological conflict of the “anti-bioethics” movement and the context of the new reception of Fritz Jahr’s works.

From mere urbanity to urban bioethical standards

An interest in research, deliberation, and reflection on urbanity has been present for a long time. Due to rapid urbanisation in the last few decades, such interest has intensified, attracting scholars from different disciplines and creating new platforms for discussion. The first indicators of a ‘bioethical’ interest in urban life are already present in Van Rensselaer Potter’s early papers (urban ethics. However, more extensive research into urban bioethics remained on hold until recently, mainly due to the dominance of the biomedical paradigm within modern mainstream bioethics. In 2017, the European Bioethics in Action project (funded by the Croatian Science Foundation) ended, resulting in a list of general bioethical standards related to animals, plants, and human health. The aim of this paper is to present the rationale for developing bioethical standards in a specific urban context.

ВПЛИВ ДЕРЖАВИ НА ВИХОВАННЯ ЕТИЧНИХ ЦІННОСТЕЙ МЕДИЧНОГО ПЕРСОНАЛУ

А study of national normatively-legal acts that regulate activity of organizations and medical personnel in the system of health care and also international documents, about ethics allowed to us to come to the following. Influence of the state on education of high ethic relations in the environment of medical personnel is provided by normatively-legal, by acts, that form official ethics it is possible to include to that,: Law of Ukraine of «Basis of legislation on a health protection Ukraine», Oath of doctor, Ethic code of doctor of Ukraine, Ethic code of medical sister of Ukraine, Ethic code of pharmaceutical workers of Ukraine. Also in this circle normatively-legal acts that form the special medical legislation after different directions of medical activity are included: Laws of Ukraine «On the donor ship of blood of ї of her components», «About transplantation of organs and other anatomic materials of man», «About a psychiatric help», «About prohibition of the reproductive cloning of man», «About medicinal facilities» et al. Exactly the state tries normatively-legal acts to carry out influence on education of ethical behavior of medical personnel. All operating in the state documents that regulate mental and ethical relations in a medical environment are based on the confessed international acts, in particular on the International code of medical ethics and International oath of doctors that on maintenance are the modern release of «Oath» of Hippocrates, and on General declaration about bioethics and human rights, and also other international documents. In these documents behavior of medical workers is regulated at the grant of medical care, that always must restrain temper ethic values and rules of justice, goodwill, sympathy and respect to the man, professional competence, identical attitude toward all patients regardless of their social state and other features, inhibition of medical secret and other. All ethic rules are identically important, both for the transmitter of certain behavior and for his social environment. Mutual relations between people from old times are regulated by ethic norms and rules. A modern medical ethics that purchased the name of bioethics cannot do without application in everyday life by the medical personnel of the formed four models of ethical behavior (after Hippocrates, after Paracelsus, after Petrov and modern bioethics), that was produced by human practice and medical public in the world during many centuries. In present tense bioethics is examined as ethics of future life. Values and principles of bioethics are the modern moral system for a medical personnel and functioning of the system of health protection. Among basic and major principles of bioethics for medical workers experts consider four: respect and autonomy of man and to the patient in particular. On this principle independence of patient stands in made decision about possibility of realization of treatments by a doctor, or medical a sister, informed consent to surgical interference, or other manipulations. A justice is identical attitude and sympathy of medical personnel toward somebody regardless of his social status and financial possibilities. Benefaction is unselfish attitude toward a patient and sincere attempt to help. On this principle it follows to offer hand of help and improve the state of patient, regardless of circumstances. And also principle not to harm the actions, after that it follows always at accepted medical decisions of diagnostic and curative character, to think a sick man and weigh possible consequences and quality of life of man after the given help. In present tense it is considered that medical care is valuable then, when medical personnel restrain temper all ethic norms and rules, but not only correctly and adequately uses curatively-diagnostic technology. The prominent representatives of medical profession always marked humane essence of medicine, required mercy, honest and selfless implementation by the physicians of the professional duties according to calling and conscience.

Bioethics - A component of culture: development tendencies and basic features

This article discusses the role of bioethics in the cultural system. The development of modern bioethics as a science and the stages of its formation have been analyzed.

Bioethics - A component of culture: development tendencies and basic features

This article discusses the role of bioethics in the cultural system. The development of modern bioethics as a science and the stages of its formation have been analyzed.

Systematic analysis of severity in a widely used cognitive depression model for mice.

Animal models in psychiatric research are indispensable for insights into mechanisms of behaviour and mental disorders. Distress is an important aetiological factor in psychiatric diseases, especially depression, and is often used to mimic the human condition. Modern bioethics requires balancing scientific progress with animal welfare concerns. Therefore, scientifically based severity assessment of procedures is a prerequisite for choosing the least compromising paradigm according to the 3Rs principle. Evidence-based severity assessment in psychiatric animal models is scarce, particularly in depression research. Here, we assessed severity in a cognitive depression model by analysing indicators of stress and well-being, including physiological (body weight and corticosterone metabolite concentrations) and behavioural (nesting and burrowing behaviour) parameters. Additionally, a novel approach for objective individualised severity grading was employed using clustering of voluntary wheel running (VWR) behaviour. Exposure to the paradigm evoked a transient elevation of corticosterone, but neither affected body weight, nesting or burrowing behaviour. However, the performance in VWR was impaired after recurrent stress exposure, and the individual severity level increased, indicating that this method is more sensitive in detecting compromised welfare. Interestingly, the direct comparison to a somatic, chemically induced colitis model indicates less distress in the depression model. Further objective severity assessment studies are needed to classify the severity of psychiatric animal models in order to balance validity and welfare, reduce the stress load and thus promote refinement.

Islam, ethics and bioethics

The article discusses the influence of Sharia, as mandatory rules of behavior of Muslims, on ethical and bioethical norms of life. Based on the sources of Islam, the Koran and the Sunnah, rather than their various interpretations, the article deals with a number of problems of medical bioethics. It is noted that, despite the influence of modern biomedical technologies on modern world cultures, their moral and ethical comprehension is the least in Islam. All of these issues are considered solely on the basis of the provisions of the Koran and the Sunnah. From the various ethical positions that contain the Qur'an and the Sunnah, it can be concluded that the physician, as a true Muslim, must demonstrate the qualities prescribed by Islam to the individual. It is shown that discussions in Islamic countries in a number of areas of modern bioethics do not conflict with the sources of Islam. It is concluded that in the Islamic world the norms of medical bioethics are determined by religious beliefs, which are the dominant of all social life.

On the idea of person and the Japanese notion of ningen and its relation to organ transplantation

It is not possible to talk about bioethics without recognizing the plurality inherent in it. In this sense, the notion of person is important due to its multiplicity of possible interpretations depending on its cultural context. This fact is highlighted in the case of organ transplantation in Japan. While there are many critiques against this procedure from scholars in various fields, those that deal with the problem of brain death are especially problematic. This is because the definition of person that is invoked in such debates does not seem to coincide with how the notion of person has been understood in the Japanese tradition. Hence, investigating the Japanese concept of ningen could be helpful in not only partially clarifying some of the attitudes that exist in Japan towards the notion of brain death, but also to illustrate the need to recognize the plurality of views in modern bioethics.

Ethical, Socio-Cultural and Religious Issues in Organ Donation

Brain death and cadaveric organ donation for transplantation present many challenges to society and even to the medical community; therefore, an ethical and legal framework is mandatory. Social values, death taboo, ignorance and procrastination are often issues that can influence the act of organ donation. This article sets out the close link between modern bioethics principles, legal framework, social and cultural value and cadaveric organ donation in the Romanian society. Organ donation, brain death and transplantation will continue to present challening questions for laws and bioethics and it is crucial that medical comunity and society members understand the involved principles, so that they can contibute to increasing the rate of organ donation and maintaining public confidence.

Reconceiving bioethical proceduralism: an ontological perspective.

This year marks the 40th anniversary of the Belmont Report that formally ushered in an era of principlism and proceduralism in the field of bioethics, an era which shaped the form of bioethical debate according to the combination of Enlightenment-inspired dualism and Liberal pragmatism characteristic of the United States. While ostensibly seeking to protect the vulnerable in a pluralistic society, in reality, recent critiques have argued, the development of bioethics has been directed at legitimizing the bureaucratization of ethics into a self-referential and isolated instrument for socio-political control. As a result, bioethical proceduralism often subverts the very values it is supposed to defend. These critiques, while valuable, do not reach the heart of the problem, which is rooted in the ontological level. The philosophical heritage of modern bioethics -the ontological presuppositions about human nature, freedom and the supposed ″neutrality″ towards any claims about the good, among others- must be rectified so bioethics may better achieve its stated goals and uphold its own principles. While recounting the entire ontological vision that would undergird such a renewal is beyond the scope of this paper, reconceiving the presuppositions behind the notions of freedom, consensus, and autonomy through an understanding of the human being as a person-in-community constitutively related to others opens a path through which principles and procedures can be preserved, not subverted, within bioethics today.

Transitioning from Urban to Rural: Challenges Seen through the Eyes of a Recent Bioethics Doctoral Graduate.

Transitioning from Urban to Rural: Challenges Seen through the Eyes of a Recent Bioethics Doctoral Graduate Daniel J. Hurst In my bioethics doctoral program in a mid-sized, urban American city, I undertook coursework in end of life issues, emerging technologies, [End Page 91] global bioethics, and multiple clinical ethics rotations that were largely focused on decision-making and treatment issues near the end of a patient’s life. My dissertation focused on the notion of corporate social responsibility applied to the pharmaceutical and biotechnology industry, a fascinating and timely subject that I was and remain passionate about. I even had the opportunity to work for a year as a bioethics consultant with a major European-based pharmaceutical company. And then, as that job fizzled out, I began my first faculty appointment, at a rural family medicine residency program in a central Alabama town—population: less than 3,000. I was hired to aid in managing the residents and fellows, develop and oversee curriculum, teach on various topics, and direct healthcare research for the residency and our ambulatory clinic system. While I was prepared for encountering bioethical issues and the precipitous medical learning curve that was ahead of me, I was not prepared for the multiple issues surrounding healthcare disparities. These issues are less characterized by conversations of emerging technologies and end-of-life topics that so readily exemplify modern bioethics, and are more characterized by issues of access to care and access to resources, which is broadly construed here. It is these “less glamorous issues,” that are nonetheless significant and deserve attention, which are the focus of this account. In doctoral work, healthcare disparities were, predominantly, what happened in other places— low- or middle-income countries (LMICs) whose healthcare systems are not nearly as robust and sophisticated as ours in the US. Access to health-care, lack of secure funding, scarcity of indigenous research, and barriers to care caused by simple inequality were prevalent in the literature I read on LMICs. Yet, disparities within the US healthcare system that was dependent upon context, such as rural vs. urban, was not on the radar. This umbrella term “access” can signal a variety of conditions, including access to care and access to various resources. Access to care is a genuine concern in many rural settings. My doctoral curriculum taught me plenty about the bioethical concept of justice, applied mainly in a global health framework. To say that I was naïve of inequalities in regards to healthcare in my own country would not be accurate, yet I was uninformed of the scale of these inequalities and the many systemic issues that feed them. For example, in the rural community, access to prenatal and obstetrical care can be a major challenge. In 2010, 49% of the 3,143 U.S. counties lacked an ObGyn. These counties are predominantly rural, situated in places such as areas of the rural south, midwest, and mountain states. Very curiously, Alabama has the highest infant mortality rate, on a state-by-state basis, in the country—9.1 deaths per 1,000 live births. Some individual counties rival low-income countries. This is of note because access to local maternity care is firmly established as a necessary, though an insufficient component of optimal maternal-child outcomes. If it were not for our rural community hospital having re-opened their labor & delivery (L&D) department a few years ago, expectant mothers would have had to drive more than 40 minutes to the nearest urban L&D department to receive obstetric care. Access to care in my context also means significant transportation issues for patients. Even if a patient has insurance or can afford our sliding fee schedule, simply getting to our out-patient clinic can be a challenge. In a town of 3,000, we have no city buses, and a taxi or Uber service is simply impractical due to financial hardships that many rural patients face. Our family medicine residents make regular home visits, but even with these ardent strides to ensure patients are seen, the challenge of transportation is ever-present. Having lived and worked in urban settings, access to care is not something I...

Humanism, Humanitarian Values and the Search for the Foundations of Modern Bioethics

The article discusses the relationship of the axiological foundations of modern bioethics with casual and even incidental effects of the activity of scholars in the late Middle Ages and the Renaissance. The author examine the ability of humanists to influence the formation of values system as well as the possibility of instrumentalizing these values in social practices. The study determines the entire causal complex that led to the formation of a special tradition of non-religious substantiation of values associated with the teaching and study of ancient languages in the context of the functioning of political and legal institutions and cultural and historical traditions of European states. The author considers the origins and meaning of humanism and the gradual change of its content as well as the transformation of humanistic experience into a tool of constructing ideals and values and an element of social technology. A special place is given to the analysis of attempts to form meta-ethics and bioethics within the framework of the value system of post-Soviet Russian society and the role of humanistic ideas in this process. On the example of the development of modern European philosophical thought, the controversial and problematic nature of various interpretations of humanism is shown, and the thesis of the historical conditionality of the ideals of humanism and its connection with some certain paradigms of metaphysic is confirmed. The central theme of the article is the problem of the relationship between the historical and conceptual, conditional and unconditional, contextual and universal in the heritage of the late medieval humanism. Technologization paths and contexts for the interpretation of humanistic ideas in modern Russia are outlined. The paper determines the ways of harmonization of humanitarian values and the system of their social and legal legitimation. On the example of the educational policy of higher education in recent decades, achievements and failures in the process of forming a new value system are analyzed. This value system could be used as a basis for legislative practice and state policy that would allow determining the basis of modern bioethics, which is of great importance for the development of Russian society and further improvement of the moral and legal foundations of its existence.

Ethical Considerations in Exploiting, Culturing and Killing Fish towards Animal Rights in Islam

Human show cruelty to fish during exploiting, culturing, killing, experimentation and amusement. Presently, overexploitation of marine fishes is a serious problem worldwide. More than 50% of total fish production is now raised in aquafarms where many fish suffer from parasitic infections, diseases, and debilitating injuries in culture systems. Every year, millions of fish are caught in nets and on hooks. Many of them are tortured just for sports. Fishes are also regularly used for scientific experiments. Many of them are killed by unethical ways. Among all animals, human is the main culprits in causing harms to animals including fishes by damaging their ecosystems. To secure animal rights, modern bio-ethics started to be developed in the last century. The principle of modern bio-ethics is very similar to the principle of Islamic bio-ethics. Therefore, modern bio-ethics might be guided by Islamic bio-ethics, which was well established in the 7th century. According to Islam, God gave the human being responsibility to look after animals, to protect them, and not to abuse or threaten them. Human is not permitted to kill animals just for sports or amusements. God created the universe in a perfect balance and human should not disturb this. Therefore, human may exploit and culture food (fish and other organisms) and ornaments without destroying aquatic ecosystems. Islam prescribes a set of rules to treat animals with the utmost kindness and compassion. However, Islamic direction can be integrated with science to ensure minimum stress, pain and suffering when killing animals including fishes.

Ethics of esthetic procedures in pregnancy.

Ethical dilemmas arise when clinicians are faced with conflicting and mutually exclusive courses of action that create moral uncertainties (Beauchamp and Childress, 2001). Four ethical principles (respect for patient autonomy [i.e., respect patient’s preferences in medical care], beneficence [i.e., act in the best interests of the patient], nonmaleficence [i.e., do no harm; minimize risk to the patient], and justice [i.e., clinical intervention results in fair distribution of clinical benefits and burdens in a population]) form the foundation of modern bioethics (Beauchamp and Childress, 2001). In a systematic review of ethical principles in plastic surgery, autonomy was the most common theme (Chung et al., 2009). Cosmetic care is considered to be based on an individual’s autonomous right to seek to become more beautiful (Nejadsarvari et al., 2016). A resolution of ethical conflicts often requires prioritizing moral obligations through a process of shared decision making, negotiation, and thoughtful compromise (Mahowald, 2006). The aim of this article is to discuss ethical dilemmas related to esthetic procedures during pregnancy on the basis of evidence in support of the safety of such procedures during pregnancy. Ethical principles as applicable to mother and fetus and the concept of the fetus as a patient are discussed. Through the analysis of case scenarios, the article highlights reasons for ethical conflicts related to esthetic procedures during pregnancy, such as a lack of high-quality evidence.

Redefining Autonomy, Dignity and Intimacy in a Postmodern Society

From a traditional perspective, ethics is a part of philosophy. Also traditionally, we have become accustomed to having a profoundly philosophical discourse on autonomy, dignity and, more recently, intimacy of the individual. On the historical axis of human knowledge, just recently concepts have been claimed, recontextualized and redesigned by domains extraneous to philosophy. Especially in the medical field, along with the emergence of the modern bioethics, there is a need to correlate the traditional theories with the trends of a postmodern society, characterized by effervescence: in reactions, in thinking, in change, in adaptation.

Bioethics In Neurospinal Patient Care

Neurosurgery is among the newest of surgical disciplines, appearing in its modern incarnation at the dawn of twentieth century with the work of Harvey Cushing and contemporaries. Neurosurgical ethics involves challenges of manipulating anatomical locus of human identity and concerns of surgeons and patients who find themselves bound together in that venture.In recent years, neurosurgery ethics has taken on greater relevance as changes in society and technology have brought novel questions into sharp focus. Change of expanded armamentarium of techniques for interfacing with the human brain and spine— demand that we use philosophical reasoning to assess merits of technical innovations.Bioethics can be defined as systematic study of moral challenges in medicine, including moral vision, decisions, conduct, and policies related to medicine. Every surgeon should still take the Hippocratic Oath seriously and consider it a basic guide to follow good medical ethics in medical practice. It is simple and embodies three of the four modern bioethics principles – Respecting autonomy, beneficence, nonmaleficence, and justice.Spinal cord injury (SCI) is a devastating condition often affecting young and healthy individuals around the world. Currently, scientists are pressured on many fronts to develop an all-encompassing “cure” for paralysis. While scientific understanding of central nervous system (CNS) regeneration has advanced greatly in the past years, there are still many unknowns with regard to inducing successful regeneration. A more realistic approach is required if we are interested in improving the quality of life of a large proportion of the paralyzed population in a more expedient time frame.

The Ethnic Plots of Bioethics

Bioethics of the ethnos has meanings that reflect the history and culture of a particular people. At the same time, the ethnos in its existence realizes the general bioethical principles and norms that integrate into ethnic bioethics. The ratio of these modifications of bioethics can ensure the self-preserving behavior of the ethnos and help maintain the genetic diversity of mankind. The assessment and standards in modern bioethics cannot be exactly the same for all countries and peoples; they must match the ethnic age of this particular ethnic group. Thus, scientifically-invariant biomedical ethics always functionally acts as a cultural reflection of the national model of medicine. On the other hand, the normative bioethical regulation allows adapting the National standards of medicine as a cultural complex to international requirements. The article shows the options for the ethical support of various ethnic parameters in medicine.

The Nazi Physicians as Leaders in Eugenics and "Euthanasia": Lessons for Today.

This article, in commemoration of the 70th anniversary of the Doctors' Trial at Nuremberg, reflects on the Nazi eugenics and "euthanasia" programs and their relevance for today. The Nazi doctors used eugenic ideals to justify sterilizations, child and adult "euthanasia," and, ultimately, genocide. Contemporary euthanasia has experienced a progression from voluntary to nonvoluntary and from passive to active killing. Modern eugenics has included both positive and negative selective activities. The 70th anniversary of the Doctors' Trial at Nuremberg provides an important opportunity to reflect on the implications of the Nazi eugenics and "euthanasia" programs for contemporary health law, bioethics, and human rights. In this article, we will examine the role that health practitioners played in the promotion and implementation of State-sponsored eugenics and "euthanasia" in Nazi Germany, followed by an exploration of contemporary parallels and debates in modern bioethics. 1.

Биоэтика: возвращение к истокам

<p class="Default">В статье рассматривается влияние постгуманизма на развитие современной биоэтики. Постгуманизм — новый, неантропоцентричный научный подход. Автор показывает, что ответом на вызовы современного мира, в том числе стоящие перед биоэтикой, может быть просто возвращение к тем ее определениям, которые появились в период ее становления как научной дисциплины. </p><p class="Default">Представляется история и специфика развития биоэтики как научной дисциплины, упоминается ее несколько забытый ранний теоретик Фриц Яр, автор «биоэтического императива», требующего уважительного отношения ко всему живому. В связи с развитием науки и технологии, которые все чаще и все успешнее перечеркивают межвидовые границы, а также расширяют наше знание о других живых существах, биоэтика стоит сегодня перед аналогичными вызовами, как и в период своего становления в качестве научной дисциплины в 1960 гг. Новые научные знания, указывающие на нашу близость с миром живого, и постепенный уход от антропоцентризма как новая философская формация требуют изменений в самой биоэтике.</p><p class="Default">На данный момент можно говорить о двух значениях биоэтики: в узком значении она регулирует проблемы, связанные со здоровьем чело­века, спорные ситуации во взаимодействии врача и пациента, ученого и подопытного, а также прочие проблемы, вытекающие из развития медицины и биотехноло­гии, а в широком значении она рефлектирует проблемы экологического характера, вопросы цен­ности биоразнообразия и понимается как этика жизни. Сегодня растет понимание того, что уважение к жизни не может ограничиваться только одним биологическим видом. Современные достижения науки и технологий втягивают в терапевтическую практику также другие виды, из-за чего появилась потребность применения более широкого значения биоэтики в биоэтической рефлексии.</p><p class="Default">Выражается убеждение, что этот новый и необходимый поворот на самом деле является возвращением к корням этой дисциплины, заложенными Ф. Яром и В. Р. Поттером. </p>

The "Human Subject," "Vulnerable Populations," and Medical History: The Problem of Presentism and the Discourse of Bioethics.

This discussion considers recent historical works of eugenics and sterilization in Canada, but it is not an historiographic review essay or critique per se of this literature. Rather, by focussing on the topic of historic diagnostic categories such as "feeble-minded," "idiot," and "moron," methodological issues such as historical presentism and its possible interactions with the discourse of modern bioethics are examined. The conclusions derived are meant only to be cautionary, and are neither prescriptive nor proscriptive. Medical historians undertaking analyses of currently contentious topics that may directly involve or indirectly allude to "human subjects" or "vulnerable populations" perhaps ought to reflect on the degree, if any, they may be anachronistically writing contemporary bioethical categories into bygone eras.