Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

This book focuses on informed consent in African Traditional Medicine (ATM). ATM forms a large portion of the healthcare systems in Africa. WHO statistics show that as much as 80% of the population in Africa uses traditional medicine for primary health care. With such a large constituency, it follows that ATM and its practices should receive more attention in bioethics. By comparing the ethics of care approach with the ATM approach to Relational Autonomy In Consent (RAIC), (...) the authors argue that the ATM focus on consent based on consensus constitutes a legitimate informed consent. This book is distinctive insofar as it employs the ethics of care as a hermeneutic to interpret ATM. The analysis examines the ethics of care movement in Western bioethics to explore its relational approach to informed consent. Additionally, this is the first known study that discusses healthcare ethics committees in ATM. (shrink)

Modern scientific medicine is increasingly challenged by complementary and alternative therapies. Reviewing policy options for contemporary healthcare development, the World Health Organization's first global strategy on traditional and alternative medicine, released in May 2002, advocates integration. However, experience in East Asia, the only part of the world where state of the art modern scientific facilities are commonly found alongside thriving traditional practices, reveals that medical integration can take several forms. To clarify the available policy options, this (...) article categorizes those forms, identifying three types of integration (unification, equalization and subjugation), plus one type of non-integration (marginalization). It marks out a zone of balanced healthcare development that cuts across two of the integrationist types, and comprises non-discriminatory state treatment of separate but linked sectors of traditional and modern medicine. The article closes by exploring arguments for and against locating state policy in this zone, and holds that policy should be situated here for medical practices that can meet broadly acceptable professional standards, demonstrate an existing social demand, and generate an adequate supply of medical practitioners, possibly through some state subsidy. (shrink)

For over two centuries, Western scholars have discussed African philosophy and culture, often in disparaging, condescending terms, and always from an alien European perspective. Many Africans now share this perspective, having been trained in the western, empirical tradition. Makinde argues that, particularly in view of the costs and failings of western style culture, Africans must now mold their own modern culture by blending useful western practices with valuable indigenous African elements. Specifically, Makinde demonstrates the potential for the development of African (...) philosophy and even African traditional medicine. Following the lead of a number of countries with government policies of incorporating indigenous medicine with orthodox Western medicine, Makinde argues that traditional African practices should be taken seriously, both medically and scientifically. Further, he charges African scholars with the responsibility of investigating these and other elements of traditional African culture in order to dispel their mystery and secrecy through modern research and useful publications. (shrink)

A study of the abnormal sex ratio at birth in China reveals that it is not an entirely new phenomenon that emerged since the 1980s, but is simply more visible at present. Deliberate intervention to determine the sex of children has existed in the past few decades, at least in certain groups. Apart from modern medical methods, traditional Chinese medical practice is shown to be highly accurate in identifying the sex of a fetus. This may lead to sex-selective abortion (...) and an abnormal sex ratio at birth. The possible causes of the abnormal sex ratio at birth include not only the real imbalance due to the disturbance of social factors, but also a spurious one attributable to the under-counting of female births. The real magnitude of the imbalance has been exaggerated by statistical error. The phenomenon is a complicated one reflecting the comprehensive socioeconomic setting. Among these factors, the stage of the fertility transition is one of the most decisive. (shrink)

I respond to this article agreeing with Nyika.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Healing Powers and Modernity: Traditional Medicine, Shamanism, and Science in Asian SocietiesE. N. AndersonHealing Powers and Modernity: Traditional Medicine, Shamanism, and Science in Asian Societies. Edited by Linda H. Connor and Geoffrey Samuel. Westport, CT: Bergin and Garvey, 2001. Pp. xiii + 283. Hardcover.Healing Powers and Modernity: Traditional Medicine, Shamanism, and Science in Asian Societies, edited by Linda H. Connor and Geoffrey (...) Samuel, consists of an Introduction, by the first editor, and eleven case studies. The latter are short ethnographic studies of particular communities or healers in East and South Asian countries. All of these are well-written, detailed accounts of particular healing contexts and behaviors. Several are by first-rate veteran ethnographers, such as Laurel Kendall (writing-as usual-on Korean shamans), Mark Nichter (India), Carol Laderman (Malaya), and Geoffrey Samuel (Tibet). Others are by younger scholars, such as Amanda Harris (the Iban of Sarawak), who are carrying on the great tradition. Other essays by Kalpana Ram (India), Marina Roseman (the Temiar of Malaya), Cynthia Hunter (Indonesia), Sydney White (the Naxi of China), Craig Janes (Tibet), and Vincanne Adams (Tibet) complete the picture. All are fine ethnographic sketches.The unifying theme is a classic anthropological one: traditional, small-scale, indigenous traditions meet international forces of change. Inevitably, the former must accommodate to the overwhelmingly greater wealth and power of the agents of the latter. In the medical arena, nations often push international biomedicine to the exclusion of other modes. In the nations under study here, things are a bit more complex; all have their own elite medical traditions, some much changed by contact with biomedicine (as in the case of China's "Traditional Chinese Medicine," with capital letters; it is a new invention, in spite of the name). So local indigenous healers have to accommodate not only to some much-altered form of biomedicine; they usually have to accommodate also to some much-altered form of their country's elite medicine. They improvise, often with striking success. The spirits of the forest are joined by the spirit of canned sardines (see Roseman's chapter), but spiritual healing practice continues.Naturally, this is confusing, and here the book begins to break down a bit. "Modernity" as a concept is taken over from the writings of Foucault, de Certeau, Homi Bhabha, and the like, which are by no means consistent or clear on its meaning. And the authors of this book are far too sophisticated to think of "modernity" as any one thing or as anything at all simple. They are, perforce, left to say that modernity-especially as written up at enormous length and vagueness in the works of the authorities cited-is too complex to address here. (Someone more irreverent might even suggest that "modernity," if indeed it cannot be tightly defined, is not a concept worthy of much attention.) This leaves the book rather undertheorized.Moreover, the authors follow the aforementioned authorities in leaving out bio-scientific considerations, even from descriptions of local modernizing discourses. One wishes for some biomedical diagnoses of cases, for example, for background data on disease incidence, infant and maternal mortality, nutrition, and other basic health concerns. [End Page 702]A reviewer usually should not complain about what is not treated in a book, but in some cases here, stories really need rounding out. Laurel Kendall speaks of Korean folkloristic interest in shamans, but does not mention the fascinating and hotly debated ideas about shamanism as the fount of Korean morality and fine art. Geoffrey Samuel puts discussion of China's brutal crushing of Tibetans and their culture "beyond the scope of this chapter" (p. 215), which deprives the reader of serious consideration of the most obtrusive force shaping Tibetan medical practice today.Such quibbles are minor. These compelling studies of local healers caught in global currents can stand on their own. [End Page 703]E. N. AndersonUniversity of California, RiversideCopyright © 2006 University of Hawai'i Press... (shrink)

ABSTRACTIt has been estimated that more than 80% of people in Africa use traditional medicine . With the HIV/AIDS epidemic claiming many lives in Africa, the majority of people affected rely on TM mainly because it is relatively affordable and available to the poor populations who cannot afford orthodox medicine. Whereas orthodox medicine is practiced under stringent regulations and ethical guidelines emanating from The Nuremburg Code,1 African TM seems to be exempt from such scrutiny. Although recently (...) there have been calls for TM to be incorporated into the health care system, less emphasis has been placed on ethical and regulatory issues.In this paper, an overview of the use of African TM in general, and for HIV/AIDS in particular, is given, followed by a look at: the relative laxity in the application of ethical standards and regulatory requirements with regards to TM; the importance of research on TM in order to improve and demystify its therapeutic qualities; the need to tailor‐make intellectual property laws to protect traditional knowledge and biodiversity. A framework of partnerships involving traditional healers’ associations, scientists, policy makers, patients, community leaders, members of the communities, and funding organizations is suggested as a possible method to tackle these issues. It is hoped that this paper will stimulate objective and constructive debate that could enhance the protection of patients’ welfare. (shrink)

ABSTRACTIn his commentary on Aceme Nyika’s paper ‘Ethical and Regulatory Issues Surrounding African Traditional Medicine in the Context of HIV/AIDS’,1 Godfrey B. Tangwa charges the author with inappropriately using expressions, terminology and criteria of evaluation appropriate in Western scientific medicine to judge African traditional medicine . He seriously frowns on Nyika’s suggestion that African TM needs to be incorporated into, and subjected to the canons of Western scientific medicine. Such a suggestion, he believes, is (...) a prescription for invasion, colonization and exploitation so characteristic of the relationship between Africa and the Western world. However, he thinks that African TM is quite compatible with Western scientific medicine. (shrink)

English translation by Glenn H. Shepard Jr. Revision by Matthew MeyerThis article reports on the recent “International Congress of Traditional Medicine, Interculturality, and Mental Health” held by the Takiwasi Center in Tarapoto in the Peruvian Amazon. The event united 218 researchers and indigenous and religious representatives from 22 countries to present results of scientific discussions and engage in political and ethical debates surrounding the increasingly globalized, transnational, and biomedicalized reach of indigenous medical practices, especially ayahuasca-based therapy and religious (...) practice. The author interviewed several key researchers and representatives present at the event, and presents several important controversies in the field of ayahuasca and traditional medicine. She also reports on the colorful and eclectic nonacademic sessions at the event which included Inca chiropractics, ayahuasca sessions, and various forms of indigenous medicine. The text also reflects on the tragic events that unfolded in nearby Bagua, Peru, on the evening of the meeting, bringing a special urgency to the event's focus on indigenous cultural heritage. (shrink)

This chapter contains sections titled: Hippocrates With and Against Philosophy Alexandrian Medicine and the Hellenistic Philosophical Schools The Theoretical Audacity of the Medical Schools Medicine and Skepticism Ethics and Medicine Bibliography.

In this article, I argue that distinguishing ‘evolutionary’ from ‘Darwinian’ medicine will help us assess the variety of roles that evolutionary explanations can play in a number of medical contexts. Because the boundaries of evolutionary and Darwinian medicine overlap to some extent, however, they are best described as distinct ‘research traditions’ rather than as competing paradigms. But while evolu- tionary medicine does not stand out as a new scientific field of its own, Darwinian medicine is united (...) by a number of distinctive theoretical and methodological claims. For example, evolutionary medicine and Darwinian medicine can be distinguished with respect to the styles of evolutionary explanations they employ. While the former primarily involves ‘forward looking’ explanations, the latter depends mostly on ‘backward looking’ explanations. A forward looking explanation tries to predict the effects of ongoing evolutionary processes on human health and disease in contem- porary environments (e.g., hospitals). In contrast, a backward looking explanation typically applies evolutionary principles from the vantage point of humans’ distant biological past in order to assess present states of health and disease. Both approaches, however, are concerned with the prevention and control of human diseases. In con- clusion, I raise some concerns about the claim that ‘nothing in medicine makes sense except in the light of evolution’. (shrink)

This book provides a systematic analysis of the ethical implications of traditional and complementary medicine, focusing on pragmatic solutions. The author uses a bioethical methodology called the “Ethical Matrix,” to consider the impact of T&CM use for animals and the environment as well as for humans. A systematic search of the literature reveals that most published ethical concerns are related to the safety of T&CM use for humans. However, application of the Ethical Matrix demonstrates that the ethical implications (...) for T&CM use are much broader. In this book, the author analyses the most serious implications, including adverse events related to homeopathy, the use of animals in T&CM products, and the impact of herbal medicine on the environment. Comparisons with the ethical implications of conventional biomedicine help readers to contextualise debate, and highlight aspects that may be unique to T&CM. Globally, many high-level health policy makers promote T&CM as an accessible and affordable healthcare option. However, their use is considered by some to be a waste of resources, unscientific, and unethical. Offering a frank analysis of this largely ignored field of healthcare ethics, this book is both timely and essential. It helps patients, policy makers, practitioners, researchers, and students gain the knowledge they need to make more informed decisions. (shrink)

This essay discusses the ethics of traditional Chinese medicine. After a brief remark on the history of traditional Chinese medical ethics, the author outlines the Confucian ethics which formed the cultural context in which traditional Chinese medicine was evolving and constituted the core of its ethics. Then he argued that how Chinese physicians applied the principles of Confucian ethics in medicine and prescribed the attitude a physician should take to himself, to patients and to (...) his colleagues. In the last part of the essay he discusses the characteristics of traditional Chinese medical ethics. Keywords: Confucian, China, humaneness, compassion, virtues CiteULike Connotea Del.icio.us What's this? (shrink)

Whereas bioethicists generally consider medicine a practice aimed at the individual good of each patient, in this paper I present an alternative conception of the goods of medicine. I first explain how modern liberal political theory gives rise to the predominant view of the medical good and then contrast this understanding of politics with that of Thomas Aquinas, informed by Aristotle. I then show how this Christian politics is implicit in certain aspects of contemporary medical practice and argue (...) that Christians ought to draw more attention to this point in order to direct medicine toward the common good. (shrink)

RESUMEN La medicina tradicional herbolaria desde su evolución hasta la contemporaneidad ha sido objeto de uso para la medicina convencional. Por eso el objetivo del trabajo es describir el comportamiento de la medicina tradicional herbolaria en los sistemas de salud convencionales. Se realizó la búsqueda y análisis documental de numerosas fuentes sobre la temática pertenecientes a las bases de datos SciELO Cuba, SciELO Regional, Science Direct, Clinical Key, Cumed, Lilacslo. Se concluye que la actualidad social registra manifestaciones alentadoras en el (...) campo de la aceptación de la herbolaria como medicina complementaria por el equipo de salud y un renovado interés en el ámbito mundial por estudiar los efectos que tienen las plantas sobre la salud. ABSTRACT The traditional herbalist medicine from its evolution to the contemporaneity has been an object use for the conventional medicine. That's why the objective of the work is to describe the behavior of the traditional herbalist medicine in the conventional health systems. A search and documentary analysis of numerous sources on the subject-matter belonging to the databases SciELO Cuba, SciELO Regional, Science Direct, Clinical Key, Cumed, Lilacslo was carried out. It is concluded that the social actuality registers encouraging declarations in the field of the acceptance of the herbalist as complementary medicine for the team of health and a renewed interest in the world ambience to study the effects that have the plants on the health. (shrink)

As science and religion researchers begin to engage questions of mental health, mindfulness may prove to be a fruitful area of investigation. However, quantifying the physical effects of mindfulness on the brain is difficult because mindfulness deals with the problem of mental and physical interaction or, the mind/body problem. One system of understanding which may aid science and religion scholars in the pursuit of mindfulness is traditional Chinese medicine (TCM). Within TCM, heart Qi manages the body's present connection (...) to time and space. If the “being in the moment” is disrupted, then the heart Qi is blocked and mental illness or various neurological disorders occur. Succinctly, within TCM, mindfulness is understood as a nonphysical phenomenon (Qi) which directly affects physical systems, resulting in empirical data. This is tracked and treated through the TCM understanding of Qi. The TCM view of Qi in mental health may therefore provide a helpful new paradigm to investigations concerning mindfulness and the human brain. (shrink)

In 2015, the Chinese pharmacologist, Tu Youyou, was awarded the Nobel Prize for Physiology or Medicine for the discovery of artemisinin. Traditional Chinese medicine (TCM) was the source of inspiration for Tu's discovery and provides an opportunity for the world to know more about TCM as a source of medical knowledge and practice. In this article, the value of TCM is evaluated from an ethical perspective. The characteristics of ‘jian, bian, yan, lian’ are explored in the way (...) they promote accessibility and economic efficiency for TCM. The article also examines how the increased use and prevalence of TCM reflects the scientific, cultural, and ethical values of TCM and their increasing attraction in meeting major challenges to medicine and health systems currently and in the future. The article discusses safety issues within TCM, which is a controversial area, and also comments on some shortcomings and challenges which pose difficulties for more widespread and greater uptake of TCM‐derived clinical or therapeutic interventions. The article concludes that TCM is generally safe if it is used according to TCM theory and where such applications are cognizant of the strengths and weaknesses of TCM. TCM has important bioethical values which may inform potential measures for meeting challenges facing global health care systems and the article argues that it can have an increasing role in improving human health. (shrink)

Se realizó una revisión bibliográfica de materiales disponibles en revistas electrónicas de la base SciELO con el objetivo de fundamentar la contribución de la Medicina Tradicional y Natural a la Salud Pública cubana y las interrelaciones ciencia-tecnología-sociedad. La perspectiva Ciencia, Tecnología y Sociedad contribuye a construir una cultura científica para que la población en general pueda llegar a sentirla como propia, lo cual requiere priorizar la aplicación de la Medicina Tradicional y Natural socialmente útil y culturalmente relevante con el compromiso (...) social basado en la erradicación de la pobreza, la armonía con la naturaleza y el desarrollo sustentable. Se enfatizó en la importancia de la medicina preventiva, además de poner en evidencia la necesidad de reconceptualizar la investigación en las ciencias médicas sobre la base de una visión interdisciplinaria que permita revelar fenómenos no explicados hasta el momento, aspecto que necesita del enfoque desde la perspectiva de la ciencia, tecnología y sociedad como complemento esencial. We conducted a bibliographic review of materials available in electronic journals in SciELO base aiming to substantiate the contribution of Natural and traditional medicine to the Cuban public health and the interrelationships of science-technology - society. Science, technology and society perspective contributes to build a scientific culture so the population can in general get to feel it as their own, which requires to prioritize the application of traditional medicine and Natural, socially useful and culturally relevant social commitment based on the eradication of poverty, the harmony with nature and sustainable development. Emphasized the importance of preventive medicine, as well as highlight the need to reconceptualize the research in the medical sciences on the basis of an interdisciplinary view that reveal phenomena not explained so far, issue that needs the approach from the perspective of science, technology and society as essential complement. (shrink)

One contested moral commitment shared by the American Medical Association and American Nurses Association has to do with the place of conscience in the practice of medicine. These organizations, each in their own way, urge their respective members to engage in careful moral discernment regarding their professional life, and they assert the existence of an obligation on the part of others to respect the conscientious objections of healthcare professionals and to accommodate objecting individuals. Yet despite the value that these (...) organizations place on conscience and objector rights, these organizations do not offer elaborate philosophical defenses of their positions. This shortcoming is exposed by the light of contemporary philosophical challenges to conscience-friendly policies. What such challenges demand is a philosophical defense of these organizations’ moral commitments and corresponding policy recommendations. The point of this article is to indicate how the Catholic philosophical tradition’s account of the nature and importance of conscience can philosophically underwrite these organizations’ conscience-related principles and practices. It can be seen, then, that the Catholic tradition is far from inimical to the contemporary practice of medicine and that, on the contrary, this tradition offers philosophically serious grounds on which to rest some of the most morally significant values and guidelines endorsed by these contemporary health-professional organizations and their members. (shrink)

The tradition of anthropological medicine in philosophy of medicine is analyzed in relation to the earlier interest in epistemological issues in medicine around the turn of the century as well as to the current interest in medical ethics. It is argued that there is a continuity between epistemological, anthropological and ethical approaches in philosophy of medicine. Three basic ideas of anthropologically-oriented medicine are discussed: the rejection of Cartesian dualism, the notion of medicine as science (...) of the human person, and the necessity of a comprehensive understanding of disease. Next, it is discussed why the anthropological movement has been superseded by the increasing interest in medical ethics. It is concluded that the present-day moral issues cannot be interpreted and resolved without clarification of the underlying anthropological images. (shrink)

This paper argues that it will be important for new genomic technologies to recognize the limits of traditional approaches to informed consent, so that other-regarding implications of genomic information can be properly contextualized and individual rights respected. Respect for individual autonomy will increasingly require dynamic consideration of the interrelated dimensions of individual and broader community interests, so that the interests of one do not undermine fundamental interests of the other. In this, protection of individual rights will be a complex (...) interplay between individual and community concerns. (shrink)

Gerald P. Mckenny; Critical Care Medicine and the Catholic Tradition: Reflections on the Consensus Statement, Christian bioethics: Non-Ecumenical Studies in Med.

The "people of knowledge" of traditional Mazatec medicine have preserved until today the ritual use of psilocybin mushrooms as part of their health care systems. The renewed interest in the effect of psilocybin on human consciousness for both therapeutic and recreational purposes usually obviates the historical and cultural background of indigenous peoples, as well as the legitimation of their practices and knowledge. In this article, through the case study of a foreign person who attended a Mazatec ritual specialist (...) to participate in a ritual night ceremony known as velada, we show the importance of approaching research on psychoactive plants and mushrooms from a transdisciplinary and intercultural perspective, so that we can appreciate the profound complexity of the healing processes that take place in traditional indigenous contexts, as well as the limits of recreational uses or exclusively neopositivist and clinical approaches. (shrink)

From the perspectives of Jewish tradition, particularly that of the Halakhah (Jewish law), this paper considers the policy problem of the balance in health care allocations between preventive and curative or crisis medicine. Since the value of human lives has a high degree of supremacy, and the duties to rescue imperiled life and to treat the sick are recognized, it might be argued that a basically curative policy should be favored. On the other hand, the duty of personal health (...) maintenance and safety would appear to argue in favor of a preventive policy. In balancing these considerations, it is suggested that the halakhic tradition can accommodate a preventive policy of health care because the duty to rescue is lessened or negatived by risk to the as-it-were rescuers. It is further suggested that Halakhah permits a non-divertable allocation of tax-generated funds to preventive health care. Keywords: Preventive medicine, curative medicine, value of human lives, duty to rescue, risk taking, Jewish law ( Halakhah ), charity tax CiteULike Connotea Del.icio.us What's this? (shrink)

1. At least since W.F. Edwards’ pioneering articles on medieval and renaissance interpretations of the prologue to Galen's Art of Medicine,1 it has often been maintained that Latin scholastics inte...