Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in (...) reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics. (shrink)

ABSTRACT:This article presents a case for transforming traditional bioethics into "Bios-ethics." This exposition relies on three propositions: (1) the climate emergency is the "Bios emergency"; (2) in the Bios emergency, bioethics must be replaced by Bios-ethics; and (3) the top and overwhelming priority of Bios-ethics is to address the Bios emergency. Biocentrism, habitat, and environmental ethics are discussed in light of their contribution to the development of Bios-ethics, and potential lines of research in Bios-ethics (...) are outlined. The urgency of undertaking substantive conceptual and practical innovations in response to our current danger is emphasized throughout. (shrink)

Organoids, in general, have become an established theme in bioethics. However, brain organoids are almost unique due to the vital and symbolic nature of the organ they reproduce, albeit partially,...

Transmodern ethics establishes moral norms on liberal, pluralist and pragmatic principles. We see a comeback of the negation morals, however not of ontology-anchored morals, as is the case of the God who picks favourites or of the jealous God paradigm, and not even of morals anchored in a contractualist perspective, as is the case in the modern period. The preferred focus is on the value of positivism, of cooperation as a source of efficiency, of personal enrichment, be it cultural, (...) spiritual, or moral, derived from the access to alterity. Tolerance as an ethical value is legitimised by a new, utilitarian humanism. The ethical construction of identity revolves around the value of loyalty to a tradition, a dogma, a mentality, and by extension to any coherent system liable to generate a sense of belonging. Postindustrial ethics uses for instance the value of loyalty as a strategy in marketing, organisational development, political propaganda etc. The policies used in order to increase the loyalty of a shop's customers, the employee's loyalty for the company she works for, the supporter's loyalty to his team, are the translation in layman terms of the loyalty ethics that in spiritual terms was one of the foundations of orthodoxy as loyalty to the tradition of the holy fathers. The values of equality, liberty and fraternity have been more than that, as they have laid the foundations of the modern society. (shrink)

Lectures from experts in scientific research, law, insurance, philosophy, ethics, theology and public policy.

John McCumber; The Threshold of Bio-Ethics: Philosophical Warrant in the Thought of Stephen Erickson, Christian bioethics: Non-Ecumenical Studies in Medical Mor.

Holocaust education is important for learning how healthcare has been leveraged to influence social change in the past and how it can be used to advocate for ethical social change in the future. By understanding how medical professionals became the social and political leaders of Nazi Germany, today’s health professionals can learn how to avoid unethical politicization. By understanding how early twentieth century discourse on medico-social issues used terms and language that are similar, if not the same, as today’s debates, (...) proponents of different sides of these debates can understand the troubling subtexts and potential consequences of their – and the opposing side’s – positions. (shrink)

Drawing on postmodernist analyses, Leaky Bodies and Boundaries presents a feminist investigation into the marginalization of women within western discourse that denies both female moral agency and bodylines. With reference to contemporary and historical issues in biomedicine, the book argues that the boundaries of both the subject and the body are no longer secure. The aim is both to valorize women and to suggest that "leakiness" may be the very ground for a postmodern feminist ethic. The contribution made by Margrit (...) Shildrick is to go beyond modernist feminisms to radically displace the mechanisms by which women are devalued. The anxiety that postmodernism cannot yield an ethics, nor advance feminist concerns is addressed. (shrink)

In this essay I consider whether the political perspective of third wave science studies – ‘elective modernism’ – offers a suitable framework for understanding the policy-making contributions that (bio)ethical experts might make. The question arises as a consequence of the fact that I have taken inspiration from the third wave in order to develop an account of (bio)ethical expertise. I offer a précis of this work and a brief summary of elective modernism before considering their relation. The view I set (...) out suggests that elective modernism is a political philosophy and that although its use in relation to the use of scientific expertise in political and policy-making process has implications for the role of (bio)ethical expertise it does not, in the final analysis, provide an account that is appropriate for this latter form of specialist expertise. Nevertheless, it is an informative perspective, and one that can help us make sense of the political uses of (bio)ethical expertise. (shrink)

Drawing on case studies from the modern era of pharmaceutical regulation in the UK, US and Europe, I examine how the extent and distribution of trust between regulators, the pharmaceutical industry, and the medical profession about drug testing and monitoring influences knowledge and regulatory judgements about the efficacy and safety of prescription drugs. Introducing the concepts of ‘acquiescent’ and ‘investigative’ norms of regulatory trust, I demonstrate how investigative norms of regulatory trust—which deter pharmaceutical companies from assuming that their data analyses (...) will be accepted without independent de-construction—drive up bioethical and regulatory standards of drug assessment in the interests of health. By contrast, acquiescent norms of regulatory trust, which are associated with industrial capture and professional closure of interests, promote permissive standards allowing patients to take pharmaceuticals with greater risks to health and less evidence of therapeutic efficacy. (shrink)

The issue of the significance and importance of moral theory to moral reasoning and moral decisions also accompanies ethical discourse between ethics and bioethics, especially in recent decades, as the issue itself is of a theoretical nature. The presence and functionality of moral theory when reasoning in dilemma situations does not only provide the apparatus for decision-making, but even a deeper understanding of responsibility and commitment when anticipating and preventing such situations. Ethics, however, is not a matter of (...) science, but primarily it is a matter of a human view, which in real life must be promoted while dealing with real "human" dilemmas and conflicts. Bioethics education encounters all the pitfalls of current theory and practice, science and ethics. The issues of bioethics are a very topical phenomenon of real life, which has brought about complex issues that man faces and whose solutions have neither theoretical nor empirical parallels with the past. This refers to current and pressing questions that are directly related to life and its intimate sphere. (shrink)

The use of qualitative research in empirical bioethics is becoming increasingly popular, but its implementation comes with several challenges, such as difficulties in aligning moral epistemology and methods. In this paper, we describe some problems that empirical bioethics researchers may face; these problems are related to a tension between the different poles on the spectrum of scientific paradigms, namely a positivist and interpretive stance. We explore the ideas of narrative construction, ‘genres’ in medicine and dominant discourses in relation to empirical (...) research. We also reflect on the loss of depth and context that may occur with thematic or content analyses of interviews, and discuss the need for transparency about methodologies in empirical bioethics. Drawing on insights from narrative approaches in the social sciences and the clinical-educational discipline of Narrative Medicine, we further clarify these problems and suggest a narrative approach to qualitative interviewing in empirical bioethics that enables researchers to ‘listen (and read) in new ways’. We then show how this approach was applied in the first author’s research project about euthanasia decision-making. In addition, we stress the important ethical task of scrutinizing methodologies and meta-ethical standpoints, as they inevitably impact empirical outcomes and corresponding ethical judgments. Finally, we raise the question whether a ‘diagnostic’, rather than a ‘problem-solving’, mindset could and should be foregrounded in empirical ethics, albeit without losing a commitment to ethics’ normative task, and suggest further avenues for theorizing about listening and epistemic (in)justice in relation to empirical (bio)ethics. (shrink)

Review of Margit Shildrick, Leaky Bodies and Boundaries: Feminism, Postmodernism and (Bio)Ethics.

Amid the controversies surrounding physician-assisted suicides, euthanasia, and long-term care for the elderly, a major component in the ethics of medicine is notably absent: the rights and welfare of the survivor's family, for whom serious illness and death can be emotionally and financially devastating. In this collection of eight provocative and timely essays, John Hardwig sets forth his views on the need to replace patient-centered bioethics with family-centered bioethics. Starting with a critique of the awkward language with which philosphers (...) argue the ethics of personal relationships, Hardwig goes on to present a general statement on the necessity of family-centered bioethics. He reflects on proxy decisions, the effects of elder care on the family, the financial and lifestyle consequences of long-term care, and physician-assisted suicide from the perspective of the family. His penultimate essay, "Is There a Duty to Die?" carries the idea of family-centered ethics to its logical, controversial, conclusion; comments upon this essay from Daniel Callahan, Larry Churchill, Joanne Lynn, and journalist Nat Hentoff offer differing views on this highly charged subject. As advances in medicine prolong patient's lives, the welfare of those ultimately responsible for medical care-the family-must be addressed. Hardwig's courageous and illuminating essays set forth a new direction in bioethics: one that considers the welfare of everyone concerned. (shrink)

In 1977 John Money published the first modern case histories of what he called ‘apotemnophilia’, literally meaning ‘amputation love’ [Money et al., The Journal of Sex Research, 13(2):115–12523, 1977], thus from its inception as a clinically authorized phenomenon, the desire for the amputation of a healthy limb or limbs was constituted as a sexual perversion conceptually related to other so-called paraphilias. This paper engages with sex-based accounts of amputation-related desires and practices, not in order to substantiate the paraphilic model, but (...) rather, because the conception of these (no doubt) heterogeneous desires and practices as symptoms of a paraphilic condition (or conditions) highlights some interesting cultural assumptions about ‘disability’ and ‘normalcy’, their seemingly inherent (un)desirability, and their relation to sexuality. In critically interrogating the socio-political conditions that structure particular desires and practices such that they are lived as improper, distressing and/or disabling, the paper constitutes an exercise in what Margrit Shildrick [Beyond the body of bioethics: Challenging the conventions. In M. Shildrick and R. Mykitiuk (Eds.), Ethics of the body: Postconventional challenges (pp. 1–26). New York: MIT Press, 2005] refers to as “postconventional ethics”. (shrink)

Given the recent developments in biotechnology and genetic engineering, the ability to eliminate genetic diseases from the human genome seems more and more possible each day. Being able to do so would mean a better quality of life for those who would otherwise suffer from incurable genetic diseases. However, even though the success of such a procedure would bring benefits that cannot be obtained by other means, the consequences for humans are still unknown. As such, the people involved should be (...) held responsible. The responsibility needs to be collective, not individual, because the decisions leading to the edition of a human genome and someone being born as a result of it are not made by a single individual, but several people, from the prospective parents interested in the intervention for their future child to the ones in charge of performing said intervention. The addition of the human genome can bring significant benefits, and it seems to be the only way to avoid certain genetic diseases; however, collective responsibility should be taken by those involved in the decisions that lead to a person being born with a modified genome. (shrink)

We tend to think that the difficulties in bioethics spring from the novel and alarming issues that arise due to discoveries in the new biosciences and biotechnologies. But many of the crucial difficulties in bioethics arise from the assumptions we make about ethics. This paper offers a brief overview of bioethics, and relates ethical ‘principlism’ to ‘ethical fundamentalism’. It then reviews some alternative approaches that have emerged during the second phase of bioethics, and argues for a neo-Aristotelian approach. Misconceptions (...) about ethical principles and ethical reasoning not only distort our views of the business of bioethics, but they also prevent us from facing up to the formidable problems posed by ethical pluralism in so-called liberal societies. (shrink)

As a scientific, materialist worldview becomes increasingly difficult to repudiate, and as philosophers increasingly uncover and articulate the conceptual nature of morality and distinctively moral normativity, the threat of moral anti-realism becomes more and more real. This perspective is argued in Chapter One. Chapter Two discusses how laws and bioethical trends that pertain to the clinical management of patients in a vegetative coma differ from country to country and continue to give rise to unresolved legal debates and scientific controversy. Chapter (...) Three covers how caregivers in palliative care must be supported to better understand patients hopes and needs, making them comfortable to decide when or how much they want to eat. Chapter Four synthesises findings from four empirical studies conducted in Western Africa (Togo) on topics related to the autonomy (end of life decision-making among terminally-ill patients), benevolence and non-malevolence (breaking bad news to elderly patients and their families), and justice (informal payments to physicians, criminal prosecution in cases of HIV transmission) principles of bioethics. Finally, Chapter Five argues that expert members in Ethics committees have an unfair upper-hand, with their decisions trumping other debates in committee deliberations. Qualitative research is brought to bear which illustrates this and which also notes how expertise dilutes the training given to newly appointed ethics committee members. (shrink)

Review of Margrit Shildrick, Leaky Bodies and Boundaries.

연명치료에 대해 보통의 사람들이 가진 가장 일반적인 견해는 ‘연명의료의 중단은 환자를 죽이는 것이라기보다는 죽도록 내버려두는 것이다‘라는 주장으로 표현될 수 있을 것이다. 이러한 일반적인 신념은 소위 웰다잉법으로 알려진 연명의료결정법이 근본전제로서 가정하고 있는 사실이기도 하다. 즉, 이러한 (표준)견해에서 보면, 연명치료의 중단은 반윤리적이라고 보기 어렵고, 따라서 연명의료의 중단은 일정한 조건 하에서 법으로 허용된다는 것이다. 그러나 이러한 연명의료에 대한 표준견해나 주장에는 여러 비판이 있을 수 있다. 즉 연명치료의 중단은 살인일 수 있다는 견해가 가능하다.BR 본 논문은 연명치료중단 행위가 지닌 함의를 생명의료윤리의 측면에서 분석함으로써 연명치료중단이 살인이 (...) 아니라 죽게 내버려 두는 것이라는 표준견해를 이론적으로 옹호하였다.BR 이를 위해 우리는 ‘차이를 만듦’ 그리고 ‘행함’과 ‘허용함’이란 개념 틀을 사용하여 인과관계에서의 ‘원인으로서 야기함(causing)’이란 개념을 검토하였다. 그렇게 함으로써 우리는 표준견해에 포함된 ‘죽음을 (원인으로서) 야기함’이란 개념은 ‘행함’보다는 ‘허용함’에 해당한다고 보는 것이 보다 합리적이고 타당하다는 사실을 주장했다. 끝으로 우리는 표준견해에 대한 이런 방식의 이해를 통해 표준견해에 대해 제기되는 전형적이고 대표적인 몇몇 비판을 논박함으로써 표준견해가 참이거나 혹은 최소한 참일 가능성이 크다는 사실을 보여주고자 하였다. (shrink)

In responding to perceived crises—such as the COVID-19 pandemic—in routinized ways, contemporary bioethics can make us prisoners of the proximate. Rather, we need bioethics to recognize and engage with complex configurations of global ecosystem degradation and collapse, thereby showing us paths toward co-inhabiting the planet securely and sustainably. Such a planetary health ethics might draw rewardingly on Indigenous knowledge practices or Indigenous philosophical ecologies. It will require ethicists, with other health professionals, to step up and become public advocates for (...) environmental sustainability. The COVID-19 pandemic should be seen as opening a portal to planetary health ethics or ecologized bioethics. (shrink)

The diagnosis of Fetal Alcohol Spectrum Disorders is embedded in a matrix of biological, social and ethical processes, making it an important topic for crossdisciplinary social and ethical research. This article reviews different branches of research relevant to understanding how FASD is identified and defined and outlines a framework for future social and ethical research in this area. We outline the character of scientific research into FASD, epidemiological discrepancies between reported patterns of maternal alcohol consumption during pregnancy and the incidence (...) of FASD, and the social and ethical considerations that may impact on who is, and is not, diagnosed. We highlight what further research investigating FASD diagnostic processes, as well as the multi-generational impacts of FASD, is needed. Important research priorities are to: 1) enumerate the variety of stakeholders involved in seeking FASD diagnoses; 2) understand the experiences and perspectives of mothers from different backgrounds who have consumed alcohol during pregnancy and their affected children; and 3) collect health histories of maternal alcohol consumption in families to determine the effect of FASD at sub-cultural and cultural levels. (shrink)

ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent models for understanding psychedelics' effects—specifically, neurobiological, psychological, and spiritual frameworks. Following our review, the implications of each (...) framework for ethics and professional competencies in the implementation of psychedelics as medicines are explored. We suggest that interdisciplinary education may be necessary to improve communication between researchers, develop models that effectively incorporate multiple levels of analysis, and facilitate collaboration between professionals with diverse backgrounds in the implementation of psychedelic medicines. We also address pitfalls associated with overemphasis on neuro-mechanisms, risks associated with instigating vulnerable states of consciousness, and hurdles associated with the integration of spiritual frameworks in medicine. Ultimately, as psychedelics push the boundaries of explanatory frameworks focused on one level of analysis, developing new and more useful models to reflect knowledge being produced in this field should be a central aim of psychedelic science going forward. (shrink)

Volume 2 spells out the implications of this ethical theory, and Cauthen takes forthright and controversial positions on a wide variety of contemporary topics.

Questions concerning moral problems caused by the lifesciences and concerning the adequate methods and instruments to solve these are timely and urgent; especially in the face of intense debates on the acceptability of research on human embryonic stem cells and preimplantation diagnostics, to name only two applications developed from research in the life-sciences. Unfortunately, the constant and accusing demand that life-scientists must behave morally does not give us a clue on how ethics may help in establishing guidelines for moral (...) behaviour. In this heated situation the foundation of ethics-committees seems to be the motto of the day. But instead of functioning as necessary and fruitful scientific advisory boards, these committees run the risk of being misused as a fashionable (and soon forgotten) weapon in the battle for political opinion-leadership. In the following article, the view is defended that ethics is a scientific enterprise and has an important role to play in political decision making on lifesciences issues. Content Type Journal Article Pages 29-31 Authors Felix Thiele, Bad Neuenahr-Ahrweiler GmbH, Wilhelmstrasse 56, D-53474 Bad Neuenahr-Ahrweiler, Germany Journal Human Reproduction & Genetic Ethics Online ISSN 2043-0469 Print ISSN 1028-7825 Journal Volume Volume 8 Journal Issue Volume 8, Number 2 / 2002. (shrink)

Risk analysis and regulatory systems are usually evaluated according to utilitarian frameworks, as they are viewed to operate “objectively” by considering the health, environmental, and economic impacts of technological applications. Yet, the estimation of impacts during risk analysis and the decisions in regulatory review are affected by value choices of actors and stakeholders; attention to principles such as autonomy, justice, and integrity; and power relationships. In this article, case studies of biotechnology are used to illustrate how non-utilitarian principles are prominent (...) in risk analysis and regulatory review and to argue that these relationships should be carefully considered as we consider nanotechnology oversight systems for its products. We argue that there are not distinct separations between “science-based” review systems, in which evaluations of the consequences of technological products are primarily considered, and principles of integrity, justice, non-maleficence, and autonomy. It should further be expected that, given research into fair treatment during decision-making processes, attention to ethics will affect how citizens assess emerging technologies. Finally, a more holistic approach for evaluating oversight systems for the products of nanotechnology is suggested, one which does not draw a sharp distinction between risk analysis, regulation, and respect for non-utilitarian values. (shrink)

In order to take ethical considerations of patenting biological material into account, the so-called “ordre public or morality clause” was implemented as Article 6 in the EC directive on the legal protection of biotechnological inventions, 98/44/EC. At first glance, this seems to provide a significant advantage to the European patent system with respect to ethics. The thesis of this paper argues that the ordre public or morality clause does not provide sufficient protection against ethically problematic uses of the patent (...) system within the area of life. On the contrary, there are worrisome obstacles to any effective and comprehensive critical analysis of the ethical aspects of bio-patenting, especially in the field of agriculture. These obstacles can be seen as indirect consequences of the implementation of ethical considerations in form of the ordre public and morality clause in the EC Directive. Therefore, Article 6 of the EC Directive on the legal protection of biotechnological inventions seems to ultimately weaken the position of ethics in the debate concerning bio-patenting because the ordre public and morality clause is usually interpreted in an exclusively bio-ethical way in the sense of an “intrinsic ethics,” which is primarily interested in questions regarding the moral status of particular entities. It is argued that an important cause of this phenomenon is that the decisive reasons against bio-patenting are concerns of social ethics, and not bio-ethics. (shrink)

Increasing awareness of the importance of the biodiversity of the whole global biosphere has led to further awareness that the problems which arise in connection with preservation and exploitation of our planet’s biodiversity are best tackled from a global perspective. The ‘Biodiversity Convention’ and the ‘Human Genome Project’ are some of the concrete attempts at such globalisation. But, while these efforts are certainly very good at the intentional level and on paper, there is, at the practical level of implementation, the (...) danger that globalisation may simply translate into westernisation, given the Western world’s dominance and will to dominate the rest of the globe. How is ‘global bioethics’ to be possible in a world inhabited by different cultural groups whose material situation, powers, ideas, experiences and attitudes differ rather markedly and who are not, in any case, equally represented in globalisation efforts and fora? One index of the pertinence of this question is that talk about biodiversity, biotechnology, biotrade etc. is being increasingly matched by talk about biopiracy, biorade, biocolonialism etc. In this paper, I attempt to explore and develop these very general concerns. (shrink)