Bioethics: 50 Puzzles, Problems, and Thought Experiments collects 50 cases—both real and imaginary—that have been, or should be, of special interest and importance to philosophical bioethics. Cases are collected together under topical headings in a natural order for an introductory course in bioethics. Each case is described in a few pages, which includes bioethical context, a concise narrative of the case itself, and a discussion of its importance, both for broader philosophical issues and for practical problems in clinical ethics and (...) health policy. Each entry also contains a brief, annotated, list of suggested readings. In addition to the classic cases in bioethics, the book contains discussion of cases that involve several emerging bioethical issues: especially, issues around disability, social justice, and the practice of medicine in a diverse and globalized world. (shrink)
Authors: Joseph M. Eble, John A. Di Camillo, Peter J. Colosi. --- NEWS RELEASE For Immediate Release February 27, 2024 Contact: Joseph M. Eble, MD Corresponding author 919-667-5206 -/- The statement, Catholics United on Brain Death and Organ Donation: A Call to Action (HTML), was published on February 27, 2024. It was prepared by Joseph Eble, a physician and President of the Tulsa Guild of the Catholic Medical Association; John Di Camillo, an ethicist of The National Catholic Bioethics Center; and (...) Peter Colosi, a philosophy professor at Salve Regina University. -/- Catholic United explains that the criteria for brain death establish only partial loss of brain function. This is now abundantly clear based on scientific studies, a recent effort to lower the legal standard for death, and updated brain death guidelines issued in October 2023. -/- Catholics United bridges a divide among faithful Catholics about whether the concept of brain death aligns with Church teaching. Some Catholics hold that brain death represents true death when there is complete and irreversible cessation of all brain activity, often called whole brain death. Others hold that brain death does not represent true death. Since the existing criteria establish only partial loss of brain function, all the endorsers—whether they accept or reject whole brain death as true death—agree that “the current brain death criteria in widespread use do not provide moral (prudential) certainty of death.” -/- Catholics United calls on health care professionals and institutions to cease organ harvesting that relies on the inadequate criteria, noting that 70% of all donors are declared dead using brain death criteria. “Given the lack of moral certainty of death whenever the current brain death criteria are used,” the statement affirms, “a clear majority of vital organ donors can be presumed alive at the time of organ harvesting.” Since the Catholic Church forbids removing vital organs when this would kill the patient, “it is therefore wrong to remove organs from patients declared dead using these inadequate criteria.” . (shrink)
Secular Health Care Ethics.Barry Hoffmaster - 2006 - In Joan Anderson, Arthur Blue, Michael Burgess, Harold Coward, Robert Florida, Barry Glickman, Barry Hoffmaster, Edwin Hui, Edward Keyserlingk, Michael McDonald, Pinit Ratanakul, Sheryl Reimer Kirkham, Patricia Rodney, Rosalie Starzomski, Peter Stephenson, Khannika Suwonnakote & Sumana Tangkanasingh (eds.), A Cross-Cultural Dialogue on Health Care Ethics. Wilfrid Laurier Press. pp. 139-145.details
Chinese Health Care Ethics.Edwin Hui - 2006 - In Joan Anderson, Arthur Blue, Michael Burgess, Harold Coward, Robert Florida, Barry Glickman, Barry Hoffmaster, Edwin Hui, Edward Keyserlingk, Michael McDonald, Pinit Ratanakul, Sheryl Reimer Kirkham, Patricia Rodney, Rosalie Starzomski, Peter Stephenson, Khannika Suwonnakote & Sumana Tangkanasingh (eds.), A Cross-Cultural Dialogue on Health Care Ethics. Wilfrid Laurier Press. pp. 128-138.details
Buddhist Health Care Ethics.Pinit Ratanakul - 2006 - In Joan Anderson, Arthur Blue, Michael Burgess, Harold Coward, Robert Florida, Barry Glickman, Barry Hoffmaster, Edwin Hui, Edward Keyserlingk, Michael McDonald, Pinit Ratanakul, Sheryl Reimer Kirkham, Patricia Rodney, Rosalie Starzomski, Peter Stephenson, Khannika Suwonnakote & Sumana Tangkanasingh (eds.), A Cross-Cultural Dialogue on Health Care Ethics. Wilfrid Laurier Press. pp. 119-127.details
This study examines the ethical and legal issues faced by girls/women requesting abortions who were victims of rape, aspects which have received little attention to date. This is a retrospective study using an approach and legal issues relating to incidents of unwanted pregnancy resulting from rape as reported in Turkish newspapers from 2010 to 2018. A total of 95 articles were discovered and categorized. These were then evaluated for content and analyzed in terms of the ethical issues related to the (...) cases. Of the articles,14 involved rape-related pregnancy cases. The six cases chosen for analysis in this study were carefully selected from newspaper reports between 2010-2018. The victims who requested abortions were between 9 and 26 weeks pregnant and aged 14-26 years old. Turkish courts approved only two of the victims' requests. The cases in this study were evaluated by the authorities solely on legal grounds. The stress experienced by victims of rape is exacerbated by compulsory pregnancy; the fact that these victims were not allowed to terminate their pregnancies resulted in their further punishment. Requests for abortions should be assessed not only in terms of legality but also based on medical and especially ethical issues. (shrink)
In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading the host’s body. Like a (...) disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease. (shrink)
Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)
This chapter examines whether high prices for gene therapies are justified and whether the problems associated with high prices can be solved by the "pay for performance" (P4P) reimbursement model. To this end, we first describe how prices for new drugs, including gene therapies, are set in Germany (section 2.). P4P is then presented as an example of a reimbursement model (section 3.). The subsequent ethical analysis (section 4.) first examines whether P4P models can sustainably guarantee the right to health (...) and healthcare for all people (section 4.1; cf. on the "sustainable right to health" already Alex, 2021). It is then shown that cost-benefit analyses for setting prices for new gene therapies must be viewed critically from an ethical perspective and pose a problem for equity of access and thus also for the sustainable guarantee of a right to health (section 4.2). The final question is whether P4P is compatible with the idea of human dignity (Article 1 I 1 of the German Basic Law) (section 4.3; cf. already König et al., 2020). -/- Alex, K. (2021): Ethical conceptualization of a sustainable right to health(care). In: Schildmann, J. et al. (eds.): Defining the value of medical interventions. Normative and empirical challenges. Kohlhammer, Stuttgart: 29-48. PMID: 36256802 König, J. et al. (2020): Am individuellen Therapieergebnis orientierte Erstattungsverfahren in der Onkologie: ethische Implikationen am Beispiel der CAR-T-Zelltherapie. In: Ethik Med 32: 85–92. doi: 10.1007/s00481-020-00565-3. (shrink)
Una vez que se desarrollen vacunas efectivas contra la enfermedad del coronavirus 2019 (COVID-19), estas serán escasas. Esto plantea la cuestión de cómo distribuirlas equitativamente entre países. La asignación de vacunas entre países plantea cuestiones complejas y controvertidas que involucran la opinión pública, la diplomacia, la economía, la salud pública y otras consideraciones. Sin embargo, muchos líderes nacionales, organizaciones internacionales y productores de vacunas reconocen que un factor central en esta toma de decisiones es la ética [1, 2]. No obstante, (...) se ha avanzado poco en la definición de lo que constituye una distribución internacional equitativa de vacunas. Muchos han respaldado la “distribución equitativa de la vacuna contra el COVID-19” sin describir un marco o sin ofrecer recomendaciones [3, 4]. Se han presentado dos propuestas sustantivas para la asignación internacional de una vacuna contra la COVID19, pero presentan graves fallas. Ofrecemos una propuesta más éticamente defendible y práctica para la distribución equitativa de la vacuna COVID19: el Modelo de la Prioridad Equitativa. El Modelo de la Prioridad Justa está orientado principalmente a tres grupos. Una es la alianza COVAX, encabezada por GAVI (por sus siglas en inglés), la Organización Mundial de la Salud (OMS) y la Coalición para Innovaciones en Preparación para Epidemias (CEPI por sus siglas en inglés), que tiene la intención de comprar vacunas para distribuirlas equitativamente entre países [5]. Un segundo grupo son los productores de vacunas. Afortunadamente, muchos productores se han comprometido públicamente con una distribución internacional de vacunas “amplia y equitativa” [2]. El último grupo son los gobiernos nacionales, algunos de los cuales también se han comprometido públicamente con una distribución equitativa [1]. Estos grupos necesitan un marco claro para reconciliar valores en competencia, uno que ellos y otros aceptarán legítimamente como ético y no solo como una afirmación de poder. El Modelo de la Prioridad Justa especifica lo que implica una distribución equitativa de vacunas, dando contenido a sus compromisos. Además, la aceptación de este marco ético común reducirá la duplicación y el desperdicio, lo que facilitará los esfuerzos por lograr una distribución equitativa. Eso, a su vez, promoverá la confianza de los productores en que las vacunas se asignarán de manera equitativa para beneficiar a las personas, lo que motivará un aumento en el suministro de vacunas para distribución internacional. (shrink)
Es probable que las vacunas contra COVID-19 sean escasas en los próximos años. Muchos países, desde la India hasta el Reino Unido, han adoptado el nacionalismo de las vacunas. ¿Cuáles son los límites éticos de este nacionalismo de vacunas? Ni el nacionalismo extremo ni el cosmopolitismo extremo son éticamente justificables. En cambio, proponemos el marco de prioridad justa para quienes residen en un país (PJR, por sus siglas en español), en el que los gobiernos pueden retener las dosis de la (...) vacuna COVID-19 para quienes residen en el país solo en la medida en que sean necesarias para mantener un nivel de mortalidad que no sea de crisis mientras están implementando intervenciones razonables de salud pública. En la práctica, un nivel de mortalidad sin crisis es el experimentado durante una mala temporada de gripe, el cual la sociedad considera un riesgo de fondo aceptable. Los gobiernos toman medidas para limitar la mortalidad por influenza, pero no existe una emergencia que incluya confinamientos severos. Este "estándar de riesgo de gripe" es una heurística no arbitraria y generalmente aceptada. La mortalidad por encima del estándar de riesgo de gripe justifica mayores intervenciones gubernamentales, incluida la retención de vacunas para quienes residen en un país por sobre la necesidad global. El nivel preciso de vacunación necesario para cumplir con el estándar de riesgo de influenza dependerá de factores empíricos relacionados con la pandemia. Esto vincula los principios éticos a los datos científicos que surgen de la emergencia. Por lo tanto, el marco PJR reconoce que los gobiernos deben priorizar la adquisición de vacunas para su país cuando sea necesario para reducir la mortalidad a niveles similares a los de la gripe sin crisis. Pero después de eso, un gobierno está obligado a hacer su parte para compartir vacunas para reducir los riesgos de mortalidad de las personas en otros países. Consideramos y rechazamos las objeciones al marco PJR basadas en que un país (1) haya desarrollado una vacuna, (2) haya aumentado los impuestos para pagar la investigación y compra de vacunas, (3) quiera eliminar las cargas económicas y sociales, y (4) sea ineficaz para combatir el COVID-19 a través de intervenciones de salud pública. (shrink)
Este número de acceso abierto tiene como objetivo resaltar los puntos de vista de los países latinoamericanos sobre la justicia en un contexto de pandemia y contribuir al diálogo entre estos y con la comunidad científica global. Explora los desafíos globales de la pandemia de COVID-19, las diferencias relevantes entre las medidas de salud pública y su impacto en los países de ingresos altos versus los países de ingresos bajos o medios, y cómo la injusticia global se profundizó debido a (...) la pandemia de COVID-19. También llama la atención sobre las experiencias, los resultados y las respuestas del norte global a la pandemia con respecto a poblaciones vulnerables y trayectorias de exposición que se reproducen en América Latina. (shrink)
This open-access issue aims to highlight views about justice in a pandemic context from Latin American countries and to contribute to the dialogue between them as well as with the global scientific community. It explores the global challenges of the COVID-19 pandemic, relevant differences between public health measures and their impact on high-income countries versus low- or middle-income countries, and how global injustice deepened because of the COVID-19 pandemic. It also draws attention to experiences, outcomes, and responses to the pandemic (...) from the global north regarding vulnerable populations and exposure paths that are also present in Latin America. (shrink)
Is it wrong to create a blind child, for example by in vitro fertilization, if you could create a sighted child instead? Intuitively many people believe it is wrong, but this belief is difficult to justify. When there is a possibility to create and select either ‘blind’ or ‘sighted’ embryos choosing a set of ‘blind’ embryos seems to harm no-one since choosing ‘sighted’ embryos would create a different child altogether. So when the parents choose ‘blind’ embryos, they give some specific (...) individual a life that is the only option for her. Because her life is worth living (as blind peoples’ lives are), the parents have not wronged the child by creating her. This is the reasoning behind the famous non-identity problem. I suggest that the non-identity problem is based on a misunderstanding. I claim that when choosing a ‘blind’ embryo, prospective parents harm ‘their child’, whoever she or he will be. Put another way: parents harm their child in the de dicto sense and that is morally wrong. (shrink)
Bartha and DesRoches (2021) and Steel and Bartha (2023) argue that we should understand the precautionary principle as the injunction to maximise lexical utilities. They show that the lexical utility model has important pragmatic advantages. Moreover, the model has the theoretical advantage of satisfying all axioms of expected utility theory except continuity. In this paper I raise a trilemma for any attempt at modelling the precautionary principle with lexical utilities: it permits choice cycles or leads to paralysis or implies that (...) the smallest value difference that is possible in a context has extreme axiological implications. (shrink)
Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)
Xenotransplant patient selection recommendations restrict clinical trial participation to seriously ill patients for whom alternative therapies are unavailable or who will likely die while waiting for an allotransplant. Despite a scholarly consensus that this is advisable, we propose to examine this restriction. We offer three lines of criticism: (1) The risk–benefit calculation may well be unfavorable for seriously ill patients and society; (2) the guidelines conflict with criteria for equitable patient selection; and (3) the selection of seriously ill patients may (...) compromise informed consent. We conclude by highlighting how the current guidance reveals a tension between the societal values of justice and beneficence. (shrink)
In this paper, I consider an example of fast science produced in the early stages of the pandemic and the lasting effects of the study on public safety and trust in science. Due to pressures intrinsic to contemporary science and from the pandemic to produce research on COVID quickly, studies on COVID-19 that did not meet rigorous scientific standards were used to form public health policies and recommendations. I argue that the fast science produced for COVID-19, which caused many public (...) health policies and recommendations to change throughout the pandemic, confuses the publics and erodes their trust in science. (shrink)
This article applies the tools of experimental philosophy to the ongoing debate about both the theoretical viability and the practical import of partially aggregative moral theories in distributive ethics. We conduct a series of three experiments (N=383): First, we document the widespread occurrence of the intuitions that motivate this position. Our study then moves beyond establishing the existence of partially aggregative intuitions in two dimensions: First, we extend experimental work in such a way as to ascertain which amongst existing versions (...) of partial aggregation (localised vs. global) chimes more fully with moral common sense. Specifically, we document how, in tie-breaking cases, ‘irrelevant goods’ judgments (Kamm) are just as robust as the original aggregative/non-aggregative pair of judgments that constitute partial aggregation. Second, by pairing laypeople’s moral judgments in standard cases with their intuitions about the limits of permissible self-prioritisation, we investigate whether one prominent explanation of why irrelevant claims may not be aggregated (Voorhoeve’s ‘personal prerogative’ argument) can be said to underpin people’s intuitions about the (ir)relevance relation of claims in conflict cases. We close with a discussion of our findings’ practical and theoretical import and highlight avenues for future research. (shrink)
One of the lessons of the COVID-19 pandemic is that the lay public relies immensely on the knowledge of public health officials. At every phase of the pandemic, the testimony of public health officials has been crucial for guiding public policy and individual behavior. The reason is simple: public health officials know a lot more than you and I do about public health. As lay people, we rely on experts. This seems straightforward. But the COVID-19 pandemic has shown that public (...) health officials seem undecided as to what, precisely, their role is; are they providing the public information as it presents itself, or are they informing the public in a way that produces a desired or optimal outcome? In this article, I answer the following question: what are public health officials morally obligated to tell the public? As I see it, these are the main options: (1) public health officials should tell the full truth, regardless of outcome; or (2) they should tell partial truths or lies that are aimed to promote a socially optimal outcome. My answer to this question is that public health officials are only allowed to lie under very narrow and rare conditions. -/- . (shrink)
This article argues that non-consensual vaccination is morally impermissible, for the same reasons for which sexual assault is not permissible. Likewise, mandatory vaccination is morally akin to sexual harassment, and therefore is not to be allowed.
This chapter provides a high-level overview of key ethical issues raised by the use of surveillance technologies, such as digital contact tracing, disease surveillance, and vaccine passports, to combat the COVID-19 pandemic. To some extent, these issues are entirely familiar. I argue that they raise old questions in new form and with new urgency, at the intersection of information ethics, research ethics, and public health. Whenever we deal with data-driven technologies, we have to ask how they fare in relation to (...) important values like privacy, fairness, transparency, and accountability—values emphasized by information ethics scholars. Likewise, when such technologies put individuals at risk in order to drive scientific research and knowledge construction, we have to ask how they implicate values such as autonomy, beneficence and non-maleficence, and justice—values central to research ethics. And as researchers focusing on health information have long argued, when the data collected by these technologies pertain to individuals and public health, these ethical issues take on a special cast. -/- It is also true, however, that the pandemic has placed these questions in a new and revealing light. I highlight three insights from information ethics and research ethics that can help us navigate this difficult terrain. First, the value of privacy is instrumental, not absolute—there is nothing wrong with asking how to balance privacy against other important values. Second, privacy has both individual and social importance. Weighing privacy, on one hand, and public health, on the other, is not, therefore, a contest between individual and collective interests. Rather, it is an attempt to balance disparate public goods. Third, we ought to put these kinds of ethical decisions in the hands of third parties, rather than leaving them up to those who directly stand to benefit from them. In the case of pandemic surveillance technologies, this should mean more public, democratic oversight. (shrink)
Recent progress in geroscience holds the promise of significantly slowing down or even reversing ageing and age-related diseases, and thus increasing our healthspans. In this paper, I offer a novel argument in favour of developing such technology and making it unconditionally available to everyone. In particular, I argue that justice requires that each person be provided with sufficient opportunities to have a ‘complete life’, that many people currently lack such opportunities, and that we would substantially improve the status quo by (...) giving them access to anti-ageing technology. (shrink)
Normative political theorists have been growing more and more aware of the many difficult questions raised by the discretionary power inevitably left to public administrators. This article aims to advance a novel normative principle, called ‘principle of restraint’, regulating reform of established administrative agencies. I argue that the ability of public administrators to exercise their power in accordance with the requirements of public reason is protected by an attitude of restraint on the part of potential reformers. Specifically, they should refrain (...) from any reform of an administrative agency that involves a switch to a considerably more loosely interconnected system of values underlying the work of that agency. To illustrate the importance of the principle of restraint, I examine a case from British health policy, showing that a recent reform of the National Institute for Health and Care Excellence well exemplifies the serious problems brought by any violation of that principle. (shrink)
This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates. The paper argues for two main claims of general interest in favour of these mandates. First, mask wearing mandates provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against mask wearing mandates may justify some (...) exemptions for specific categories of individuals, but do not cast doubt on the justifiability of these mandates. Hence, unless some novel decisive objections are put forward against mask wearing mandates, governments should adopt such mandates. (shrink)
El artículo analiza el Vacunagate: escándalo suscitado en el Perú a inicios de 2021 por la inoculación de la vacuna Sinopharm cuando aún se encontraba en fase experimental. Se analiza la moralidad del caso para iluminar la discusión pública sobre políticas de conducción y supervisión de ensayos clínicos en un contexto de pandemia. Se evalúa si eran moralmente justificables dos acciones: primero, la utilización de la candidata a vacuna por fuera de un ensayo clínico y, segundo, priorizar algunos grupos en (...) aquella inusual inoculación. Tales grupos son (i) el personal de investigación del ensayo clínico, (ii) los funcionarios de la salud pública que dirigían la lucha contra la pandemia, (iii) el entorno humano inmediato de los dos grupos anteriores y (iv) otros. El artículo corresponde a la ética aplicada por lo que sigue su metodología: se define el marco moral o filosófico que, luego, se aplica al caso en cuestión. Aquel marco ético para el análisis lo constituyen dos tipos de principios morales: democráticos y utilitaristas. Primero, se abordan dos principios comunes a las democracias contemporáneas: el igual valor de los seres humanos y la necesaria deliberación pública sobre asuntos de interés común. Segundo, y sin contradecir aquellos principios democráticos, se evalúan las acciones bajo la aplicación de un razonamiento utilitarista. Finalmente, con base en la guía MEURI de la OMS y en el marco ético señalado, se describen las condiciones faltantes bajo las cuáles ambas acciones pudieron haber sido moralmente justificables. (shrink)
In this article, we analyse how researchers use the categories of race and ethnicity with reference to genetics and genomics. We show that there is still considerable conceptual “messiness” (despite the wide-ranging and popular debate on the subject) when it comes to the use of ethnoracial categories in genetics and genomics that among other things makes it difficult to properly compare and interpret research using ethnoracial categories, as well as draw conclusions from them. Finally, we briefly reconstruct some of the (...) biases of reductionism to which geneticists (as well as other researchers referring to genetic methods and explanations) are particularly exposed to, and we analyse the problem in the context of the biologization of ethnoracial categories. Our work constitutes a novel, in-depth contribution to the debate about reporting race and ethnicity in biomedical and health research. First, we reconstruct the theoretical background assumptions about racial ontology which researchers implicitly presume in their studies with the aid of a sample of recent papers published in medical journals about COVID-19. Secondly, we use the typology of the biases of reductionism to the problem of biologization of ethnoracial categories with reference to genetics and genomics. (shrink)
Two challenges have faced policymakers during the Covid-19 pandemic: First, they must determine the reliability of expert testimony in the face of uncertainty; second, they must determine the relevance of different kinds of expertise with regard to particular decisions. I argue that both these problems can be fruitfully analyzed through the lens of trust by introducing an in-depth case study of Iceland’s handling of the first wave of the Covid-19 pandemic. I contend that the problem of relevance highlights the limited (...) appeal of a thoroughly technocratic society. Value judgments, best realized through democratic processes, are always lurking in the background. (shrink)
To clarify the proper role of values in science, focusing on controversial expert responses to Covid-19, this article examines the status of (in)convenient hypotheses. Polarizing cases like health experts downplaying mask efficacy to save resources for healthcare workers, or scientists dismissing “accidental lab leak” hypotheses in view of potential xenophobia, plausibly involve modifying evidential standards for (in)convenient claims. Societies could accept that scientists handle (in)convenient claims just like nonscientists, and give experts less political power. Or societies could hold scientists to (...) a higher bar, by expecting them not to modify evidential standards to avoid costs only incidentally tied to error. (shrink)
On 24 July 2022, the landmark decision Roe v. Wade (1973), that secured a right to abortion for decades, was overruled by the US Supreme Court. The Court decision in Dobbs v. Jackson Women’s Health Organisation severely restricts access to legal abortion care in the USA, since it will give the states the power to ban abortion. It has been claimed that overruling Roe will have disproportionate impacts on women of color and that restricting access to abortion contributes to or (...) amounts to structural racism. In this paper, we consider whether restricting abortion access as a consequence of overruling Roe could be understood as discrimination against women of color (and women in general). We argue that banning abortion is indirectly discriminatory against women of color and directly (but neither indirectly, nor structurally) discriminatory against women in general. (shrink)
The dissemination of information in times of crisis or emergency is distinctive since the affected individuals may take, process, and act on information differently. As the Centers for Disease Control and Prevention noted “the right message at the right time from the right person can save lives.” This study elaborates on the principles of crisis and emergency risk communication (CERC) in the realistic narrative, and notes that a successful CERC should be prompt, accurate, veracious, empathetic, respectful, and promote meaningful action. (...) Since pandemics are not only biomedical but also social, political, economic, and cultural incidents, critical communication in the time of a pandemic is of crucial significance. Hence, the Coronavirus (COVID-19) pandemic is assessed as a recent and important case study. This pandemic had four chief challenges; including that since the disease is caused by the novel SARS-CoV-2 virus the assumptions about the disease have been revised numerously and rapidly. In addition, the cumulative scale and scope of COVID-19 which is in excess of 627 million confirmed cases, and approximately 6.58 million deaths worldwide remained a strain. Another concern was the overwhelming uncertainty and evolving trajectory of the pandemic about how and when it ends or enters the endemic stage of the outbreak. Finally, the overabundance of amplification and dissemination of both accurate and inaccurate information led to an infodemic. Long before the COVID-19 pandemic, many individuals used the internet as an important resource for seeking health-related information. However, the infodemic and the other aforementioned challenges made distinguishing up-to-date accurate information a more arduous task, and CERC and pandemic-related communication are even more crucial. Hence, a multi-dimensional set of skills is required to overcome these challenges whether amidst or after the pandemic. Therefore, a multi-stakeholder approach towards an overarching and comprehensive metaliteracy that “provides an integrated and inclusive framework to cultivate critical thinking and proficiency in comprehending data, information, visuals and the media” is essential. This study recommends and elaborates on how to incorporate metaliteracy into crisis and risk communication at governmental, organizational, and individual levels. (shrink)
Wie jedes Krankenhaus hat Charité ihre Geschichte, die mit dem Erlaß des preußischen Königs Friedrich I. vom 14. November 1709 zur Gründung von Lazareth-Häusern anfing, um der Ausbreitung der Pest entgegenzuwirken, wozu es allerdings in Berlin nie gekommen ist. Am 9. Januar 1727 verfügte König Friedrich Wilhelm I. die Umwandlung des vor dem Spandowischen Tor errichteten Lazareth in ein Hospital und nannte es „das Haus die Charité“ nach dem Vorbild von Hôpital de la Charité in Paris. -/- Das Wort und (...) der Begriff Charité ist wesentlich älter als das Krankenhaus. Das Französische charité ist äquivalent dem Englischen charity und dem Deutschen Barmherzigkeit, während ihre Ursprünge im Griechischen zu finden sind: χάρις bedeutet Gnade, Gunst, χαριτόω Gnade oder Gunst zeigen oder empfangen, favorisieren oder favorisiert werden, gnädig oder begnadet sein. Das Krankenhaus ist ein Ort der Gnade, welche den Kranken und Bedürftigen zusteht aufgrund allgemeiner Verpflichtung, seinen Nächsten so zu lieben wie sich selbst. Die Gunst und die Gnade zu erweisen heißt auch, sich zu erbarmen und mitleidig sein, eigenes Herz für fremdes Leid zu offnen. -/- Seit ihrer Gründung weichte Charité von diesem Grundgedanke mehrmals ab, was bisher in ihrer Geschichtsschreibung mehr oder weniger wahrheitsgetreu festgehalten wurde. Dieser Tradition des Festhaltens und der Wiedergabe der Wahrheit bin ich verpflichtet, weil offizielle Geschichtsschreibung erneut beginnt, von der Realität abzuweichen und die Tatsachen zu leugnen, die sowohl unzweifelhaft sind als auch unzweifelhaft würdig sind, erzählt zu werden, weil es dabei um die Frage des Auftrags der Charité geht. -/- Charité wurde gegründet, um das Unheil abzuwenden, dennoch war ihre Geschichte keine Heilsgeschichte, wie ich bereits feststellte. Das Unheil setzte sich im 21. Jahrhundert fort, was ich zu unterbinden suche. Einziges Heilmittel dagegen ist die Wahrheit, daran besteht kein Zweifel, und der Weg, um die Wahrheit zu erkennen, ist die Barmherzigkeit. (shrink)
On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the same, (...) schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)
The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)
In this position paper, we have used Alan Cooper’s persona technique to illustrate the utility of audio- and video-based AAL technologies. Therefore, two primary examples of potential audio- and video-based AAL users, Anna and Irakli, serve as reference points for describing salient ethical, legal and social challenges related to use of AAL. These challenges are presented on three levels: individual, societal, and regulatory. For each challenge, a set of policy recommendations is suggested.
Moralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of ‘mismoralization’, which is when moralization is metaethically (...) unjustified. In order to identify mismoralization, we argue that one must engage in metaethical analysis of moralization processes while paying close attention to the relevant facts. We briefly discuss one historical example and two contemporary cases related to COVID-19 that we contend to have been mismoralized in public health. We propose a remedy of de-moralization that begins by identifying mismoralization and that proceeds by neutralizing inapt moral content. De-moralization calls for epistemic and moral humility. It should lead us to pull away from our tendency to moralize—as individuals and as social groups—whenever and wherever moralization is unjustified. (shrink)
Theory of health care ethics -- Principles of health care ethics -- The moral status of gametes and embryos : storage and surrogacy -- The ethical challenges of the new reproductive technology -- Ethics and aging in America -- -- Healthcare ethics committees : roles, memberships, structure, and difficulties -- Ethics in the management of health information systems -- Technological advances in health care : blessing or ethics nightmare? -- Ethics and safe patient handling and mobility -- Spirituality and healthcare (...) organizations -- A new era of health care : the ethics of healthcare reform -- Health inequalities and health inequities -- The ethics of epidemics -- Ethics of disasters : planning and response -- Domestic violence : changing theory, changing practice -- Looking toward the future. (shrink)
Completely updated and revised, the third edition of Catholic Health Care Ethics: A Manual for Practitioners sets the standard for Catholic bioethicists, physicians, nurses, and other health care workers. In thirty-nine chapters (many with subchapters), leading authors in their fields discuss a wide range of topics relevant to medicine and health care. The book has six parts covering foundational principles, health care ethics services, beginning-of-life issues, end-of-life issues, selected clinical issues, and institutional issues. Some highlights from the third edition include (...) new entries on the Ethical and Religious Directives for Catholic Health Care Services, certitude in moral decision-making, the principle of double effect, clinical ethics consultation, natural family planning, prenatal testing and diagnosis, care of fetal remains, challenges to neurological criteria, the use of ventilators, POLST, alkaline hydrolysis, opportunistic salpingectomy, so-called lethal prenatal diagnoses, transgenderism, and new age medicine. The volume continues to provide insightful information on the topics previously covered in the second edition, but with significant updates throughout. (shrink)
La pandemia mundial del coronavirus ha supuesto una de las mayores conmociones de nuestra historia reciente y, como tal, parece obligarnos a repensar nuestros modos de organización y formas de vida e, incluso, como se propone aquí, a plantearnos cómo podríamos habitar el colapso. En este escenario incierto y desconocido, la filosofía, con sus múltiples enfoques y subdisciplinas, se presenta como un lugar privilegiado para analizar las vertiginosas transformaciones que han dado lugar a esta “nueva normalidad”. El presente monográfico aglutina (...) una serie de contribuciones realizadas por distintos investigadores e investigadoras de la Universidad de Oviedo, que han tratado de abordar la crisis sanitaria global desde diversas perspectivas filosóficas y humanísticas. Entre los temas que se estudian en estas páginas, figuran los relativos a la gestión de la pandemia y la comunicación científica sobre la misma, las relaciones entre pobreza, salud mental y suicidio o el alcance de la revalorización del mundo rural. También se utilizan las herramientas del análisis biopolítico para examinar la gestión de los cuerpos durante la pandemia a partir de tres ejes distintos: el tratamiento de los enfermos, los nuevos dispositivos de control y la gestión de la pandemia en las instituciones de encierro. Además, varios de los capítulos se ocupan explícitamente de un tema inherente a la mayoría de las reflexiones que componen este volumen: a saber, el de la necesidad de un cuestionamiento profundo de la sociedad occidental contemporánea y la insostenibilidad de su forma de vida. (shrink)
When considering the social valuation of a life-year, there is a conflict between two basic intuitions: on the one hand, the intuition of universality, according to which the value of an additional life-year should be universal, and, as such, should be invariant to the context considered; on the other hand, the intuition of complementarity, according to which the value of a life-year should depend on what this extra-life-year allows for, and, hence, on the quality of that life-year, because the quantity (...) of life and the quality of life are complement to each other. This paper proposes three distinct accounts of the intuition of universality, and shows that those accounts either conflict with a basic monotonicity property, or lead to indifference with respect to how life-years are distributed within the population. Those results support the abandon of the intuition of universality. But abandoning the intuition of universality does not prevent a social evaluator from giving priority, when allocating life-years, to individuals with the lowest quality of life. (shrink)