We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence (...) that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population. (shrink)

The traditional paradigm of medicine assumes that health is a natural given depending on a body's intrinsic teleology, and that medicine aims at restoring or preserving health, making a physician only an "assistant to nature." I argue that nowadays this paradigm is becoming obsolete, because the concept of health is no longer a "natural given" and interventions on the human body attempt not only to help nature's teleology, but also to change it whenever doing so can satisfy human needs and (...) wants. We should abandon the term "medicine" and adopt the term "health care" to mark such an epoch-making transition, analogous to that marking the passage from "alchemy" to "chemistry.". (shrink)

Purpose Recent research has found unrealistic optimism among patient-subjects in early-phase oncology trials. Our aim was to investigate the cognitive and motivational factors that evoke this bias in this context. We expected perceptions of control to be a strong correlate of unrealistic optimism. Methods A study of patient-subjects enrolled in early-phase oncology trials was conducted at two sites in the USA. Respondents completed questionnaires designed to assess unrealistic optimism and several risk attribute variables that have been found to evoke the (...) bias in other contexts. Results One hundred and seventy-one patient-subjects agreed to be interviewed for our study. Significant levels of perceived controllability were found with respect to all nine research-related questions. Perceptions of control were found to predict unrealistic optimism. Two other risk attribute variables, awareness of indicators and mental image, were correlated with unrealistic optimism. However, in multivariate regression analysis, awareness and mental image dropped out of the model and perceived controllability was the only factor independently associated with unrealistic optimism. Conclusion Patient-subjects reported that they can, at least partially, control the benefits they receive from participating in an early-phase oncology trial. This sense of control may underlie unrealistic optimism about benefiting personally from trial participation. Effective interventions to counteract unrealistic optimism may need to address the psychological factors that give rise to distorted risk/benefit processing. (shrink)

>Engelhardt’s After God gives a comprehensive perspective on the deepest and hardest issues in both moral philosophy and bioethics of our time. Although the book is an intelligent critique of contemporary moral philosophy in favor of a kind of traditionalism rooted in the perspective of the Orthodox Church, containing numerous forceful arguments, I ultimately disagree with Engelhardt on several main points stemming from his pessimistic view of our current culture and society. I have neither the pretense to open new perspectives, (...) nor to put forward new arguments, and I am aware that I might be wrong. I simply want to present a different position on the quest for meaning. (shrink)

The paper is mostly limited to an analysis of the main theses advanced by Engelhardt in his great book After God, compared with those elaborated in the first edition of The Foundation of Bioethics. The first part is devoted to a summary of Engelhardt’s proposals, and two of them are criticized in the second part. In particular, Engelhardt is doubtful that a morality after God is possible, while I argue that it is going to be produced and possibly will be (...) more adequate than traditional morality. In the same line, Engelhardt holds that without God everything is meaningless, while I argue that meanings are instilled by humans in our projects, and that even in our forthcoming post-history age people will continue to have meaningful ethical actions. (shrink)

Can happiness be achieved by means of human will and reason or does it depend on natural conditions which escape the control of man? Is it an expression of autonomy or of heteronomy? The Enlightenment gives manifold answers to this question. Sometimes -above all in England and France -happiness is defined in terms opf pleasure and thus heteronomy is stressed; in other cases -above all in Germany -happiness is conceived as perfection, hence it is rather autonomy that is emphasized. For (...) his part Kant neatly contrasts happiness with autonomy, both from the ethicalpractical standpoint and from the technical-practical one . Such a contrast, which still leaves room for happiness in Kant's view, is carried to extremes in the idealistic tradition that comes to drastically anti-eudemonic results, since the latter either completely rejects happiness as expressing heteronomy or deprives it of its sensitive constituents and embodies it into interior bliss. (shrink)

The functions and expression pattern of urea cycle enzymes have undergone considerable changes during the course of evolution. Sequence analyses shows that urea cycle enzymes from mammals are homologous to microbial enzymes of the arginine‐metabolic pathway. Recently, an unexpected relationship was found between argininosuccinate lyase (EC 4.3.2.1), the fourth enzyme of the cycle, and δ‐crystallin, a lens structural protein of birds and reptiles.

Sulla questione del libero filosofi, teologi e scienziati arbitrio si interrogano da più di due millenni: tuttavia essa conserva intatta tutta la sua problematicità. Già Kant sosteneva che la libertà, per quanto indispensabile sotto il profilo morale, non sia dimostrabile sul piano teorico. Nel volume il tema viene illustrato da studiosi di diversa formazione, intrecciando ricostruzione storica e analisi concettuale. I contributi mettono in luce le alternative teoriche e i nuclei tematici cruciali, emersi di volta in volta nei singoli autori (...) o periodi, con l'obiettivo di chiarire il senso complessivo di un dibattito che occupa ancora una posizione centrale sulla scena della riflessione filosofica contemporanea. (shrink)

INDICE -/- Note biografiche Introduzione, di Riccardo Faucci -/- Parte I - Da Verri a Toniolo 1. Jeremy Bentham: Contemporary Interpretations, di M.D.A. Freeman 2. Su Helvétius, Beccaria e Bentham, di Letizia Gianformaggio 3. L'etica utilitaristica di Pietro Veti, di Vincenzo Polignano 4. ll liberismo interventista di Vincenzo Emanuele Sergio, di Anna Li Donni 5. Il concetto di " felicità pubblica, nella << Genesi del diritto penale » di Romagnosi, e il rapporto Romagnosi-Bentham, di Robertino Ghiringhelli 6. « La più (...) grande felicità per il maggior numero » all'Accademia dei Georgofili ( 18)0-1850), di Gabriella Gioli 7. Una nota su Manzoni critico dell'utilitarismo, di Maurizio Mori 8. Sul concetto di utile in Francesco Ferrara e in Maffeo Pantaleoni, di Daniela Parisi Acquaviva 9. Sul pensiero sociale cristiano di fronte all'edonismo, di Luciano Avagliano 10. Giuseppe Toniolo e il recupero cattolico dell'utile e del valore, di Anna Camaiti -/- Parte II Aspetti di storia del pensiero economico nell’età classica -/- 1. La filosofia economica di Thomas Hobbes, di Marco Bertozzi 2. Ordinamento del sapere, modelli metodologici ed economia politica in Adam Smith, di Sergio Cremaschi 3. Elementi classici nel pensiero di Adam Smith: giurisprudenza romana e morale stoica, di Gloria Vivenza 4. Il “lusso” negli economisti italiani del Settecento, di Cosimo Perrotta 5. Prezzi naturali, prezzi di mercato e legge degli sbocchi nel dibattito fra Malthus e Ricardo, di Lilia Costabile 6. Marx e la moneta, di Roberto Petrini -/- . (shrink)