The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people’s beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. In this paper, we (...) discuss some of the main approaches to death determination that have been theoretically proposed or currently put into practice and propose a new approach to death determination called "weak pluralism" as a reasonable ethical and political alternative to respect diversity in death determination. (shrink)

Background: This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation. Materials and Methods: A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018. Results: Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have (...) expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain. Conclusion: Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain. (shrink)

El presente artículo tiene como objeto llevar a cabo un estudio pragmático y analítico sobre la acción de valoración, el valor y los valores a la luz de la ciencia semiótica y de la ciencia cibernética. Por ello, se desarrollará un proceso axiológico que ilustre cómo sucede el ingreso, la transición y la salida de códigos morales en función de un esquema cognitivo. Así pues, el proceso axiológico se postula, primero, en fundamento de tres sistemas: de mentalidad, de valores y (...) de biomoralidad y, segundo, conforme a la teoría de la información y de la teoría general de sistemas. (shrink)

Los conceptos de percepción y corporalidad en la obra de Maurice Merleau-Ponty han influido los estudios sobre filosofía del teatro. La idea de la conciencia encarnada es relevante para comprender la experiencia corporal y expresiva en el contexto teatral, especialmente, para indagar en la relación que se presenta entre el espectador y la obra. Así, el obejtivo de este artículo es evidenciar cómo se configura el campo fenomenal en una obra teatral en dos momentos: primero, la comprensión del escenario como (...) núcleo articulador de la experiencia en la que intervienen espacio, tiempo y movimiento; segundo, la relación entre el actor y el espectador en términos de la gestualidad y la palabra. Se demuestra que en el teatro hay una configuración generativa de sentidos colectivos conforme a la modulación del campo fenomenal. (shrink)

El escritor keniata Ngũgĩ wa Thiong'o a través de su libro Descolonizar la mente (1986) ha invitado a sus colegas de origen africano a abandonar las lenguas europeas, recuperando las africanas en su gesto escriturístico. La intención de este ensayo estriba en leer este libro desde la reflexión elaborada por varios filósofos del lenguaje y pensadores decoloniales, para cuestionarnos por los alcances que tiene el lenguaje mismo para la colonización y descolonización de conciencias, para el establecimiento violento de centrismos euronorteamericanos (...) o para su dislocamiento en pos de la reafirmación poscolonial de los valores africanos. Existen diferentes medios por los cuales se predispone el pensamiento lingüísticamente; el Occidente imperialista se ha encargado de entronizarse como canon único de razonamiento. ¿Será posible, entonces, asumir una contra-postura mediante la lengua? (shrink)

There has been little investigation of male adolescent violence against women as acknowledged by boys themselves, and even less on such violence in different contexts with comparative studies of behavior between those who perpetrate this violence and the population at large. This study used cluster analysis to establish a male adolescent typology based on boys’ self-reporting of violence against women in three contexts. The participants were 3,132 Spanish teenage boys aged 14–18 with experience of relationships with girls. Three discrete, identifiable (...) types were obtained: the first group, of non-violent boys; the second group, more involved in sexual harassment online outside a relationship but with a low incidence of dating violence offline; the third group, with abuse in the three contexts but less involved in sexual harassment online than the second group. The logistic regression analysis showed that justification of male dominance and violence was the main risk condition for inclusion in the second and third groups, followed by low self-esteem and risky sexual behaviors online. The findings based on these results are important for preventing male adolescent dating violence against women in the three male types detected. (shrink)

This article presents the results of the research “Philosophical Attitude and Childhood: Teachers’ Formation and Transformation”, developed at the Universidad Pedagógica y Tecnológica de Colombia UPTC Kindergarten, by using the Community of Inquiry as a strategy to foster a philosophical attitude. It is divided in three descriptive moments, the first one, previous considerations, contains: philosophy as a tool to think, philosophical attitude as a life style, philosophy for kids as a theoretical and methodological perspective; the second one includes methodological perspectives; (...) and the third one, the experience as a transformation, covers: the Community of Inquiry and ludic, the Community of Inquiry with kids, teacher’s formation and transformation, childhood’s discovery, critical, creative and ethic thinking in childhood, and from the Community of Inquiry to a life style. (shrink)

El presente artículo tiene como objeto llevar a cabo un estudio pragmático y analítico sobre la acción de valoración, el valor y los valores a la luz de la ciencia semiótica y de la ciencia cibernética. Por ello, se desarrollará un proceso axiológico que ilustre cómo sucede el ingreso, la transición y la salida de códigos morales en función de un esquema cognitivo. Así pues, el proceso axiológico se postula, primero, en fundamento de tres sistemas: de mentalidad, de valores y (...) de biomoralidad y, segundo, conforme a la teoría de la información y de la teoría general de sistemas. (shrink)

Understanding the mechanisms of early embryonic patterning and the timely allocation of specific cells to embryonic regions and fates as well as their development into tissues and organs, is a fundamental problem in Developmental Biology. The classical explanation for this process had been built around the notion of positional information. Accordingly the programmed appearance of sources of Morphogens at localized positions within a field of cells directs their differentiation. Recently, the development of organs and tissues from unpatterned and initially identical (...) stem cells (adult and embryonic) has challenged the need for positional information and even the integrity of the embryo, for pattern formation. Here we review the emerging area of organoid biology from the perspective of Developmental Biology. We argue that the events underlying the development of these systems are not purely linked to “self‐organization,” as often suggested, but rather to a process of genetically encoded self‐assembly where genetic programs encode and control the emergence of biological structures. (shrink)

Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR (...) is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death. (shrink)

Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality. In the present report, we extend this line of research by examining how medical students and professionals (N = 184) and laypeople (N = 122) describe physicians’ behaviour in end‐of‐life scenarios. (...) We show that the distinction between ‘ending’ a patient’s life and ‘allowing’ it to end arises from morally motivated causal selection. That is, when a patient wishes to die, her illness is treated as the cause of death and the doctor is seen as merely allowing her life to end. In contrast, when a patient does not wish to die, the doctor’s behaviour is treated as the cause of death and, consequently, the doctor is described as ending the patient’s life. This effect emerged regardless of whether the doctor’s behaviour was omissive (as in withholding treatment) or commissive (as in applying a lethal injection). In other words, patient consent shapes causal selection in end‐of‐life situations, and in turn determines whether physicians are seen as ‘killing’ patients, or merely as ‘enabling’ their death. (shrink)

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of societies-- as a (...) scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when (...) organs are procured remains problematic for the New York City protocol and, indeed, for all uDCDD protocols. In the United States, two amendments to the legal criteria of death have been suggested to avoid a formal violation of the dead donor rule in DCDD protocols: first, replacing the requirement “irreversible” with the weaker term “permanent,” and second, using the term “circulatory” instead of “cardiac” to identify the key function that must be lost to declare death. While intended to facilitate controlled DCDD, these modifications create a problem for uDCDD protocols: if extracorporeal membrane oxygenation is introduced to preserve the organs, then circulation is restored after death is declared. In this issue of the Hastings Center Report, Kevin Munjal and colleagues call for a new ethical construct and policy so that uncontrolled and controlled DCDD can coexist. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

El presente artículo tiene como propósito criticar y reformular la teoría de valores del autor y filósofo argentino Risieri Frondizi. Para ello, se someterán a falsacionismo las tesis según las cuales la cualidad estructural es, primero, estructuralista y no analítica y, segundo, empírica, de acuerdo con la metodología holista de la ciencia. La crítica, así, se desarrollará a partir de los siguientes interrogantes. Inicialmente, ¿el autor acude al holismo o al reduccionismo como enfoques metodológicos de desarrollo? Finalmente, ¿cuál es la (...) distinción lógica entre el valor como cualidad sui géneris y el valor como cualidad estructural? (shrink)

Since the 1960s, organ procurement policies have relied on the boundary of death—advertised as though it were a factual, value‐free, and unobjectionable event—to foster organ donation while minimizing controversy. Death determination, however, involves both discoveries of facts and events and decisions about their meaning (whether the facts and events are relevant to establish a vital status), the latter being subjected to legitimate disagreements requiring deliberation. By revisiting the historical origin of the dead donor rule, including some events that took place (...) in France prior to the report by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, I want to recall that those who first promoted the DDR did not take into account any scientific rationale to support the new proposed criteria to determine death. Rather, through a process of factual re‐semantization, they authorized themselves to decide about the meaning of death in order to implicitly prioritize the interests of organ recipients over those of dying people. (shrink)

En el presente escrito, se da a conocer una interpretación _“personal”_, no por ello arbitraria, del texto _Sobre el concepto de historia _o _Tesis de filosofía de la historia_, _Über den Begriff der Geschichte_ de Walter Benjamín, leído de manera situada, una lectura cuya óptica pretende ser _desde_ América Latina. Se insistirá en la excepcionalidad crítica de la obra de Benjamín, sugiriendo que su propuesta alcanza una re-definición y transvaloración del concepto de historia, aquel que de manera habitual nos determina, (...) y que impide todo actuar, toda praxis revolucionaria, que para un tiempo como el nuestro, y que es ahora, se requiere más que nunca. (shrink)

In this issue of the Report, James L. Bernat proposes an innovative and sophisticated distinction to justify the introduction of permanent cessation as a valid substitute standard for irreversible cessation in death determination. He differentiates two approaches to conceptualizing and determining death: the biological concept and the prevailing medical practice standard. While irreversibility is required by the biological concept, the weaker criterion of permanence, he claims, has always sufficed in the accepted standard medical practice to declare death. Bernat argues that (...) the medical practice standard may be acceptable on the ground that proving circulatory or brain permanence is sufficient to assure complete accuracy for death diagnosis. -/- The topic requires public deliberation: processes to survey people's opinions and mechanisms to channel their opinions into policy-making. What is at stake is the nature of our society. Do we want an expertocracy, in which an enlightened few design policies for the greater good of the majority and exploit the lack of public knowledge to achieve compliance? (shrink)

A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer’s disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies (...) and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page W4-W6, August 2011.

This book offers a theoretical and practical overview of the specific ethical and legal issues in pediatric organ transplantation. Written by a team of leading experts, Ethical Issues in Pediatric Organ Transplantation addresses those difficult ethical questions concerning clinical, organizational, legal and policy issues including donor, recipient and allocation issues. Challenging topics, including children as donors, donation after cardiac death, misattributed paternity, familial conflicts of interest, developmental disability as a listing criteria, small bowel transplant, and considerations in navigating the media (...) are discussed. It serves as a fundamental handbook and resource for pediatricians, transplant health care professionals, trainees, graduate students, scholars, practitioners of bioethics and health policy makers. (shrink)

Several studies have explored differences between North American and European doctor patient relationships. They have focused primarily on differences in philosophical traditions and historic and socioeconomic factors between these two regions that might lead to differences in behaviour, as well as divergent concepts in and justifications of medical practice. However, few empirical intercultural studies have been carried out to identify in practice these cultural differences. This lack of standard comparative empirical studies led us to compare differences between France and the (...) USA regarding end-of-life decision-making. We tested certain assertions put forward by bioethicists concerning the impact of culture on the acceptance of advance directives in such decisions. In particular, we compared North American and French intensive care professional's attitudes toward: advance directives, and the role of the family in decisions to withhold or withdraw life-support. (shrink)

The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowledge that accuracy is cardinal from outcome-oriented justice because it helps (...) to maximize patients’ benefits and optimizes limited resources. However, we claim that the opaqueness of the algorithmic black box and its absence of explainability threatens core commitments of procedural fairness such as accountability, avoidance of bias, and transparency. To illustrate this, we discuss liver transplantation as a case of critical medical resources in which the lack of explainability in AI-based allocation algorithms is procedurally unfair. Finally, we provide a number of ethical recommendations for when considering the use of unexplainable algorithms in the distribution of health-related resources. (shrink)

Este análisis teórico busca analizar, por una parte, en la inmersión de la obra del pensador galés Raymond Williams y, por otro lado, el acercamiento a lo que podemos denominar como Estudios Culturales Británicos, una propuesta metodológica y política plausible en virtud de pensar nuestro presente con una mirada y una sensibilidad diferente a lo que ampliamente se ha caracterizado como «presentismo» o futuros cancelados. Para ello, retomar la obra de un pensador parcialmente olvidado en las últimas décadas, no solo (...) nos permitirá atisbar posibilidades de pensar futuros diversos, sino que nos obligará a tomar en consideración una caja de herramientas, sugerente, que terminó defendiendo con matices, contradicciones e incorporaciones hasta el final de su vida en 1988. (shrink)

Cano, Germán (2023)Mark Fisher: Los espectros del tardocapitalismoBarcelona: Gedisa, 149 p.ISBN 978-84-19406-00-2.

En este artículo se discute acerca de la existencia y la consistencia de un concepto de naturaleza humana en la obra de Nietzsche que no recaería en los extremos de las lecturas biologicistas ni historicistas de la misma. Para ello se lleva a cabo una interpretación que aúna la consideración nietzscheana de la naturaleza y de la historia alrededor del concepto-matriz de lo ahistórico, lo que conducirá la reflexión inicial sobre la cultura a un análisis en términos ontológico-formales de la (...) naturaleza del hombre y de su anclaje en la del mundo. (shrink)

Este ensayo muestra las semejanzas inconfesables entre el neoliberalismo y la religióna partir de las raíces religiosas de la modernidad. Decisivas en este sentido son las aseveraciones de los pensadores Durkheim, Marx y Weber acerca de las abstracciones religiosas clásicas y las necesarias determinaciones desde los hombres “modernos”. Para identificar estas raíces el texto emplea tanto las reflexiones de Nietzsche como de las aportaciones decisivas de Foucault y Bourdieu en sus diferentes composiciones intelectuales.

We study 944 shareholder proposals submitted to 343 U.S. firms on climate change issues during 2009–2022. We use logistic and two-stage regression to estimate the propensity for a firm to be targeted or subjected to a vote at the annual general meeting and, for voted proposals, the determinants of that vote. We also examine whether climate-related proposals affect investor returns and how they relate to firms’ future environmental performance and greenhouse gas emissions. Compared to a matched sample, we first find (...) that activists target larger, more carbon-intensive, and less R&D-active firms. Second, voting likelihood is higher for firms with repeated and operations-related proposals and lower pre-proposal environmental ratings. By contrast, disclosure-related proposals are likelier to be negotiated and withdrawn. Third, repeated and operations-related proposals receive higher votes in favor, whereas votes on carbon-intensive firms do not. Fourth, building on the theory that investors act as if they distinguish among the different shareholder proposals based on the expected cost to the firm, we find evidence to support this idea. We find that investors respond negatively to ex-ante costlier proposals, such as those that relate to emissions reduction and target carbon-intensive firms. Fifth, targets’ future environmental performance rating is almost twenty percent higher after a proposal than before compared to the matched sample, whereas emissions do not budge appreciably. (shrink)

The development of information and communication technologies offers innovative opportunities to establish business strategies focused on customer value co-creation. This situation is especially notable in the banking industry. e-Banking activities can support competitive advantages. However, the adoption of e-banking is not yet well-established among consumers. In this sense, the technology acceptance model is considered essential in studying consumer behavior applied to adopt a particular technology. According to the TAM model, this study analyses the factors which influence bank customers to adopt (...) e-banking to facilitate their banking services and support the process of value co-creation. Consequently, the authors examine five main aspects of the technology adoption model to provide a broad understanding of bank customers’ consumption of e-banking. A partial least squares structural equation modeling analysis is conducted to evaluate proposed relationships between factors and customers’ e-banking adoption. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 15-17, June 2012.

Negar el libre albedrío implica que el ser humano no es libre por naturaleza, sino que puede llegar a serlo mediante un uso adecuado de su inteligencia; libertad que solo la consiguen los “sabios”. Por eso, cuando Spinoza entiende la democracia como la forma de gobierno que mejor defiende la libertad, esto vale para los “sabios”, pero no para el vulgo, que solo mediante el miedo y la esperanza es conducido a obrar según los dictados de la razón. ¿No será (...) esta indeseable consecuencia la que le impidió terminar su Tratado Político, precisamente cuando se aprestaba a estudiar la democracia? (shrink)

Ray and Cooper (2024) argue for the need to incorporate the fight for environmental justice into the bioethics agenda. While they convincingly argue that the principle of justice involves environme...