The purpose of this paper is to evaluate the significance of the existential notion of authenticity for medical ethics. This is done by analyzing authenticity and examining its implications for the patient-professional relationship and for ethical decision-making in medical situations. It is argued that while authenticity implies important demand for individual responsibility, which has therapeutic significance, it perpetuates ideas which are antithetical both to authentic interaction between patients and professionals and to fruitful deliberation of moral dilemmas. In order to counteract (...) these consequences, an alternative idea of authenticity is introduced. According to this idea, authenticity is not regarded primarily as individual sovereignty, but as an ability to participate in a dialogue in which the subjectivity of both partners is respected. Such practice, based on mutual trust and responsibility, would enhance common decision-making and overcome the alienation between patients and professionals. (shrink)

Abstract:This article deals with the question as to what makes bioethics a critical discipline. It considers different senses of criticism and evaluates their strengths and weaknesses. A primary method in bioethics as a philosophical discipline is critical thinking, which implies critical evaluation of concepts, positions, and arguments. It is argued that the type of analytical criticism that restricts its critical role to critical thinking of this type often suffers from other intellectual flaws. Three examples are taken to demonstrate this: premature (...) criticism, uncritical self-understanding of theoretical assumptions, and narrow framing of bioethical issues. Such flaws can lead both to unfair treatment of authors and to uncritical discussion of topics. In this context, the article makes use of Häyry’s analysis of different rationalities in bioethical approaches and argues for the need to recognize the importance of communicative rationality for critical bioethics. A radically different critical approach in bioethics, rooted in social theory, focuses on analyses of power relations neglected in mainstream critical thinking. It is argued that, although this kind of criticism provides an important alternative in bioethics, it suffers from other shortcomings that are rooted in a lack of normative dimensions. In order to complement these approaches and counter their shortcomings, there is a need for a bioethics enlightened by critical hermeneutics. Such hermeneutic bioethics is aware of its own assumptions, places the issues in a wide context, and reflects critically on the power relations that stand in the way of understanding them. Moreover, such an approach is dialogical, which provides both a critical exercise of speech and a normative dimension implied in the free exchange of reasons and arguments. This discussion is framed by Hedgecoe’s argument that critical bioethics needs four elements: to be empirically rooted, theory challenging, reflexive, and politely skeptical. (shrink)

In his seminal work, Truth and Method, theGerman philosopher Hans-Georg Gadamer distinguishesbetween three types of what he calls the experience ofthe `Thou'. In this paper, Gadamer's analysis of thisexperience is explained in terms of his philosophicalhermeneutics and brought to bear upon thepatient-professional relationship. It is argued thatwhile Gadamer's analysis implies fruitful insights fora dialogical account of the patient-professionalinteraction, it harbours elements which are conduciveto paternalistic practice of medicine. The strongattribution of value to tradition and the respect forauthority emphasized in his (...) theory result in a lack ofsensitivity for individual self-determination which isneeded for a successful account of thepatient-professional relationship. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.The themes covered in the section so far include dignity, (...) naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected]. (shrink)

Three arguments of Habermas against “liberal eugenics”—the arguments from consent, responsibility, and instrumentalization—are critically evaluated and explicated in the light of his discourse ethics and social theory. It is argued that these arguments move partly at a too deep level and are in part too individualistic and psychological to sufficiently counter the liberal position that he sets out to criticize. This is also due to limitations that prevent discourse ethics from connecting effectively to the moral and political domains, e.g., through (...) a discussion of justice. In spite of these weaknesses, Habermas’s thesis is of major relevance and brings up neglected issues in the discussion about eugenic reproductive practices. This relevance has not been duly recognized in bioethics, largely because of the depth of his speculations of philosophical anthropology. It is argued that Habermas’s notion of the colonization of the lifeworld could provide the analytical tool needed to build that bridge to the moral and political domain. (shrink)

ABSTRACT A major moral problem in relation to the deCODE genetics database project in Iceland is that the heavy emphasis placed on technical security of healthcare information has precluded discussion about the issue of consent for participation in the database. On the other hand, critics who have emphasised the issue of consent have most often demanded that informed consent for participation in research be obtained. While I think that individual consent is of major significance, I argue that this demand for (...) informed consent is neither suitable nor desirable in this case. I distinguish between three aspects of the database and show that different types of consent are appropriate for each. In particular, I describe the idea of a written authorisation based on general information about the database as an alternative to informed consent and presumed consent in database research. (shrink)

This study attempts to situate ethical discourse within descriptions of a moral context which do justice both to concrete individual moral experiences and to the socio-historical framework within which they are lived. In light of these descriptions it is argued that an adequate theory of morality must focus on the essential continuity between the individual moral life and the communal practices and institutions which constitute our ethical substance. ;In Chapter One it is shown how the existentialist liberation of the moral (...) subject centers ethical concerns around the concrete living individual, who, for the most part, had no place in traditional ethics. ;In Chapter Two it is argued that the existentialist revolt in morals is incomplete and misguided, insofar as the power of individual freedom is overemphasized and the weight of socio-historical reality is neglected. On the basis of hermeneutical analysis of human existence, it is shown how the cultural fabric of interpretations and practices sustains and gives meaning to the moral life. On the basis of Sartre's Marxism, it is shown how the social field of classes and violence alienates and frustrates our individual moral projects. ;In Chapter Three it is asked what implications for ethical theory and conduct emerge from these descriptions of the moral context. It is argued that while Heidegger's thought provides an important criticism of the history of ethics, it escapes all concrete applications to ethical discourse. In this respect Gadamer's hermeneutics is found more fruitful, although his Aristotelian account of the situated moral life underestimates the ideological distortions of the moral context as well as the power of moral consciousness to reject tradition and project its freedom. In order to abet such a critical account of morality, Habermas' analysis of the moral consciousness and its development within the socialization process is introduced. But it is argued that Habermas' emphasis on a theoretical grounding of ethical discourse loses touch with the concrete existential/historical dimension of the moral life. It is proposed that only by moving out from descriptions of individual experiences of injustices and wrongs will it be possible to successfully combine moral and social considerations in a critical theory with practical intent. (shrink)

This paper defends human dignity in two ways. First, by confronting the criticism that human dignity does not serve an important function in contemporary moral discourse and that its function can be sufficiently performed by other moral terms. It is argued that this criticism invites a danger of moral reductionism, which impoverishes moral discourse. The authority of moral philosophy to correct widely shared moral intuitions, rooted in experiences of grave injustices and wrongs, is questioned. Secondly, dignity is defended by showing (...) what is needed to uphold it, both in theory and practice. It is argued, and demonstrated through examples, that human dignity as a universal value ascribed to human beings and the virtue of dignified action are intimately related. This is fleshed out in terms of Kant’s analysis of respect in the practical sense and of virtue as a commitment to the value of dignity as a constitutive end of our moral order. It is furthermore argued that theoretical attempts to ground respect for dignity in human capacities lead to a moral impasse. It is necessary to act as if every human being is worthy of respect. This practical approach requires institutions and specified moral obligations that are integral to the democratic ethos and the rule of law, which guarantees the equal status of human beings. This practical task requires that we consistently tease out and act on the implications of these principles rather than seek deeper justification for the equal worth of humans, articulated in the term human dignity. (shrink)

_This article reflects on the central themes of Vilhjálmur Árnason's work, particularly his focus on contextualized morality and dialogical ethics. Vilhjálmur emphasizes the importance of balancing individual freedom and responsibility with an understanding of social and political contexts. By examining relational ethics across healthcare, research, and public health, the article highlights his contributions to bioethics, including concepts like informed consent, scientific citizenship, and authorization in biobank research. Vilhjálmur 1 advocates for communicative reasoning and authentic dialogue as essential tools for ethical (...) analysis, situational decision-making, and fostering trust in research and healthcare practices. The work underscores the importance of trustworthiness, veracity, and participatory engagement in addressing modern ethical challenges, particularly in rapidly advancing biotechnologies. _ _Keywords: _Contextual ethics, dialogical ethics, relational autonomy, informed consent, authorization, bioethics, trustworthiness, communicative reasoning, healthcare ethics, public health ethics, scientific citizenship, biobank research. (shrink)

It is argued that the ethical questions and challenges raised by the project of personalizing medicine are not sufficiently addressed without considering the possible effects thereof on our system of healthcare. I argue that the framing of ethical issues in light of the main principles of bioethics, such as autonomy, welfare and even justice, tends to be too narrow and the larger social implications thus tend to be neglected. Among the possible unintended consequences of the project to increase personal responsibility (...) for health is a reduced emphasis on it’s social determinants, for which we are jointly responsible.This presents important challenges for bioethics, and calls in turn for closer attention to be paid to biopolitics and the social context of bioethical discourse. The conclusion is that the benefits or damage that might result from personalizing medicine will depend no less upon political and policy decisions than on pharmacogenomic developments. (shrink)

Rationality and the Genetic Challenge by Matti Häyry is a well-written and thoughtful book about important issues in the contemporary ethical discussion of genetics. The book is well structured around seven practical themes that the author takes to exemplify “the genetic challenge.” He also refers to them as “seven ways of making people better,” which the subtitle of the book already puts into question form: Making People Better? In the first chapter of the book, Häyry introduces these seven themes and (...) he discusses each of them in Chapters 3–9. In the remaining two chapters, 2 and 10, he describes the main normative positions analyzed in the book and clarifies his own methodology and position. He chooses six authors, or three pairs of authors, whom he takes to “represent the three normative doctrines of Western Moral philosophy” in order to demonstrate six “divergent rationalities” or “methods of genethics.” In this way, Häyry both summarizes the main prescriptive positions in contemporary bioethical debate and contrasts them with his own “nonconfrontational notion of rationality,” which aims to show that there is a variety of divergent, not mutually exclusive normative views, the justification of which “depends ultimately on the choice of worldviews, attitudes, and ideas about the foundation of moral worth”. (shrink)

In this paper, I discuss how a Working group on ethics dealt with the question whether the collapse of the Icelandic banks and related financial setbacks can to some extent be explained by morality and work practice. I describe how the Working group delineated its subject matter by evaluating practice in the financial sector, the administration, the political sector and the social or cultural sector. I demonstrate the approach used by the Working group by discussing some important examples which throw (...) light on some aspects of its manifold analyses. The examples show how different aspects of morality are of importance in an analysis of the events that took place. (shrink)

Recent bioethics discussion and research in Iceland has been greatly affected by the fact that one of the world’s largest genetics research companies is based there and has been in the forefront of creating a population database resource for its research projects. Consequently, a large part of this article is centered around the bioethical discussion engendered by these projects, but other recent bioethical developments related to issues at the beginning and the end of life will also be discussed.

In the present paper, we focus on the role that the concept of geneticization has played in the discussion about health care, bioethics and society. The concept is discussed and examples from the evolving discourse about geneticization are critically analyzed. The relationship between geneticization, medicalization and biomedicalization is described, emphasizing how debates about the latter concepts can inspire future research on geneticization. It is shown how recurrent themes from the media coverage of genetics portray typical traits of geneticization and thus (...) contribute to the process. We look at examples of small-scale studies from the literature where geneticization of medical practice has been demonstrated. Methodological disputes about the relevance of empirical evidence for the geneticization thesis and the normative status of the concept are discussed. We consider arguments to the effect that ideas from mainstream bioethics have facilitated geneticization by emphasizing individualistic notions of autonomy and responsibility while ignoring the role of genetics in the wider social context. It is shown how a concept like geneticization, which can be used to draw the attention of philosophers, social scientists and others to challenges that tend to be neglected by mainstream bioethics, also has the potential to move people’s attention away from other pertinent issues. This may happen if researchers become preoccupied with the transformative effects of genetics, and we argue that a wider reading of geneticization should inspire critical analysis of the sociocultural preconditions under which genetics is currently evolving. (shrink)

A hallmark of good antenatal care is to respect prospective parent’s choices and provide information in a way that encourages their autonomy and informed decision making. In this paper, we analyse the meaning of autonomous and informed decision making from the theoretical perspective and attempt to show how those concepts are described among prospective parents in early pregnancy and in the public media in a society where NT screening is almost a norm. We use interviews with Icelandic prospective parents in (...) early pregnancy (N = 40) and material covering the discourse around prenatal screening in the media over 5 years period. Our analysis indicates that both prospective parents and the public media include ethical terms in their rhetoric around prenatal screening although those concepts differ in their expression. We conclude that the context in which these decisions are taken does not encourage moral reflection. Prospective parents describe that there is a lack of dialogue with professionals when decisions are made about screening. With routine offer of screening the conceptualization of bioethical concepts finds its own way through a mainstream discourse which has limited connections to the theoretical notions. This has been neglected in the implementation of screening, as limited effort has been subject to audit with reference to explore how the offer of screening and informed choice is experienced among prospective parents. (shrink)

_This article explores Vilhjálmur Árnason’s critique of contemporary bioethics, particularly its limited focus on individualistic principles, and its neglect of the broader social implications of emerging technologies. Vilhjálmur 1 argues that the commonly used “four principles approach”—respect for autonomy, beneficence, non-maleficence, and justice—is inadequate for addressing the complex ethical and societal impacts of new technologies. He suggests that ethical evaluations must extend beyond immediate individual risks to consider broader societal consequences._ _In critiquing overly individual-centered bioethical frameworks, Vilhjálmur raises a critical (...) theoretical question: what kind of ethical theory does bioethics truly require? This examination considers whether Vilhjálmur’s critique of the four-principles approach is justified and whether a more expansive ethical framework or theory of value is needed to specify and rank bioethical principles. By scrutinizing collective values like solidarity and the notion that “the personal is political” this paper suggests that new layers of disagreement arise, moving beyond traditional debates over moral theories. In a diverse society with conflicting values, such conflicts may be unavoidable. However, by highlighting the interconnection between individual moral agency and socio-political context, Vilhjálmur underscores the importance of self-reflection on personal values and the need to seek understanding across differing viewpoints in bioethical discussions_. _Keywords_: bioethics, personalized medicine, genetic database, four-principles approach, principlism, pluralism, value, ethical theory, personal is political, socio-political context. (shrink)

The editorial introduces the rationale for putting together the special issue on the works of Vilhjalmur Arnason, discusses some of the main themes of his corpus and gives and overview of the published commentaries.

_This paper will explore two strands of Vilhjálmur Árnason’s extensive body of work: his analysis of dialogue ethics within medical ethics and his analysis of ethics in the Icelandic sagas. The central thesis is that combining these two strands, bioethics and literary analysis, can provide valuable insights to further the discussion of ethics among citizens in multicultural communities. _ _Vilhjálmur’s 1 analysis of the Icelandic sagas shows that the sagas have a specific value foundation, specific virtues as well as narrative (...) in how to present the ethical aspects. In the field of bioethics, he has developed the study of dialogue ethics in several aspects, such as between patient and professional, in interdisciplinary research, and in public deliberation. By integrating insights from historic literary studies with contemporary bioethical research we gain an interesting platform for a discussion on Western assumptions of what constitutes a good dialogue. One of the core aspects in dialogue ethics is how to develop the procedure for a fair, open-minded, and oppression-free discussion in ethical issues. Vilhjálmur’s contributions are summarized here, but could they also be extended beyond the Icelandic and Western horizon?_ _I will compare his ethical framework to a recent parallel discussion on the claims of indigenous peoples for a fair dialogue. That is, a dialogue that must be inclusive with a carefulness about deciding the foundation of inherent values and the procedure of how to perform the dialogue. Finally, I draw conclusions on what dialogue ethics will gain from this explorative work._ _Keywords: _dialogue ethics, one health approaches, Indigenous peoples, bioethics, interdisciplinarity, ethics in the Icelandic sagas, medical ethics, literary analysis, multicultural communities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Principles and Theory in BioethicsPat Milmoe McCarrick (bio)The following citations were selected from BIOETHICSLINE, the online database prepared at the Kennedy Institute of Ethics for the National Library of Medicine's MEDLARS system. Searching the keywords autonomy, beneficence, casuistry, justice, and virtues, as well as the text word principlism produced more than 400 citations. Only the citations concerned with theory and principle in the practice of bioethics are included here—e.g., (...) works about justice in resource allocation have been deleted.Arkes, Hadley V. When Bungling Practice Is Joined to Absurd Theory: Doctors, Philosophers, and the Right to Die. In Set No Limits: A Rebuttal to Daniel Callahan's Proposal to Limit Health Care for the Elderly, ed. Robert L. Barry and Gerard V. Bradley, pp. 31-44. Urbana: University of Illinois Press, 1991.Arnason, Vilhjalmur. Towards Authentic Conversations: Authenticity in the Patient-Professional Relationship. Theoretical Medicine 15 (3): 227-42, September 1994.Arras, John D. Getting Down to Cases: The Revival of Casuistry in Bioethics. Journal of Medicine and Philosophy 16 (1): 29-51, February 1991.Arras, John D. Principles and Particularity: The Role of Cases in Bioethics. Indiana Law Journal 69 (4): 983-1014, Fall 1994.Beauchamp, Tom L. Principles and Other Emerging Paradigms in Bioethics. Indiana Law Journal 69 (4): 955-71, Fall 1994.Beauchamp, Tom L. The Principles Approach. Hastings Center Report 23 (6): S9, November-December 1993.Beauchamp, Tom L., and Childress, [End Page 279] James F. Principles of Biomedical Ethics. 4th ed. New York: Oxford University Press, 1994. 752 p.Beauchamp, Tom L., and Walters, LeRoy. Ethical Theory and Bioethics. In their Contemporary Issues in Bioethics. 4th ed., pp. 1-38. Belmont, CA: Wadsworth, 1994.Beldecos, Athena, and Arnold, Robert M. Gathering Information and Casuistic Analysis. [Commentary]. Journal of Clinical Ethics 4 (3): 241-45, Fall 1993.Bole, Thomas J. The Rhetoric of Rights and Justice in Health Care. In Rights to Health Care, ed. Thomas J. Bole and William B. Bondeson, pp. 1-19. Boston: Kluwer Academic, 1991.Broome, John. Fairness Versus Doing the Most Good. [Commentary]. Hastings Center Report 24 (4): 36-39, July-August 1994.Campbell, Courtney S. Gifts and Caring Duties in Medicine. In Duties to Others, ed. Courtney S. Campbell and B. Andrew Lustig, pp. 181-97. Boston: Kluwer Academic, 1994.Carson, Ronald A.; Callahan, Sidney; Ross, Judith Wilson; and May, William F. Spirit, Emotion, and Meaning: The Many Voices of Bioethics. Hastings Center Report 24 (3): 26-27, May-June 1994.Charlesworth, Max. Bioethics in a Liberal Society. New York: Cambridge University Press, 1993. 172 p.Cherbas, Peter. Paradigms and Our Shrinking Bioethics. Indiana Law Journal 69 (4): 1105-13, Fall 1994.Childress, James F. Ethical Theories, Principles, and Casuistry in Bioethics: An Interpretation and Defense of Principlism. In Religious Methods and Resources in Bioethics, ed. Paul F. Camenisch, pp. 181-201. Boston: Kluwer Academic, 1994.Childress, James F., and Fletcher, John C. Individualism and Community: The Contested Terrain of Respect for Autonomy. Hastings Center Report 24 (3): 34-35, May-June 1994.Clouser, K. Danner, and Gert, Bernard. A Critique of Principlism. Journal of Medicine and Philosophy 15 (2): 219-36, April 1990.Devettere, Raymond J. Clinical Ethics and Happiness. Journal of Medicine and Philosophy 18 (1): 71-89, February 1993.DeGrazia, David. Moving Forward in Bioethical Theory: Theories, Cases, and Specified Principlism. Journal of Medicine and Philosophy 17 (5): 511-39, October 1992.Donnelly, William J. From Principles to Principals: The New Direction in Medical Ethics. [Commentary]. Theoretical Medicine 15 (2): 141-48, June 1994.Downie, Robin. Health Care Ethics and Casuistry. [Editorial]. Journal of Medical Ethics 18 (2): 61-62, 66, June 1992. [End Page 280]DuBose, Edwin R.; Hamel, Ronald P.; and O'Connell, Laurence J., eds. A Matter of Principles? Ferment in U.S. Bioethics. Valley Forge, PA: Trinity Press International, 1994. 381 p.Fox, Renée C. The Entry of U.S. Bioethics into the 1990s: A Sociological Analysis, pp. 21-71.Gudorf, Christine E. A Feminist Critique of Biomedical Principlism, pp.164-81.Campbell, Courtney S. Principlism and Religion: The Law and the Prophets, pp. 182-208.Charon, Rita. Narrative Contributions to Medical Ethics: Recognition, Formulation, Interpretation, and Validation... (shrink)

_The turn from traditional paternalism and towards patient autonomy has made informed consent a key concept for medical ethics and health legislation. However, informed consent has been attacked for a wide range of shortcomings, both conceptually and theoretically, as well as practically. Vilhjálmur Árnason has suggested an alternative to informed consent, i.e., to give authorizations. Vilhjálmur 1 has been supported by other researchers, but the authorization approach has not been elaborated in any greater detail or come to widespread use in (...) bioethics. This article describes and discusses Vilhjálmur’s and other scholars’ approach to authorizations and reflects on why this approach deserves more attention than previously given, especially for addressing the extended challenges emerging from biological sciences generating a wide range of person-related biological entities._ _Keywords:_ informed consent, authorization, bioethics, medical ethics, patient autonomy, biobank research, dynamic consent, broad consent, genetic research ethics, ethical challenges in biobanking,, PeRBEs, AI/ML. (shrink)

Over the last four decades, Vilhjálmur Árnason professor emeritus in philosophy, has been at the forefront in the academic fields of moral and political philosophy, and medical – and bioethics in Iceland. His research and in-depth understanding of the ethical aspects of medicine and life sciences in Icelandic society are demonstrated by his extensive written work on these issues. In 1993, the first edition of his book _Ethics of life and death_ was published in Iceland, a comprehensive book on ethical (...) issues related to healthcare, research, and public health. A second and improved edition of the book was published in 2003, and a German version in 2004. The third and latest edition was published in August 2023, which takes into account developments in the aforementioned fields in recent years, and as before with a particular focus on Iceland. The contents of this influential book will be discussed in this article, with special emphasis on comparing current subjects with previous editions. Moreover, it will be addressed if and how Árnason‘s thinking and perspective have changed over the years. (shrink)

Introduction to the Ethical Perspectives Theme Issue (19/1) on Genetics and Justice, with contributions by Greg Bognar, David Hunter, Michele Loi, Oliver Feeney, Vilhjálmur Arnason, Durnin et al.

This paper discusses the formation of Castoriadis’s concept of imaginary significations and relates it to his changing readings of Marx and Weber. Castoriadis’s reflections on modern capitalism took off from the Marxian understanding of its internal contradictions, but he always had reservations about the orthodox version of this idea. His writings in the late 1950s, already critical of basic assumptions in Marx’s work, located the central contradiction in the very relationship between capital and wage labour. Labour power was not simply (...) transformed into a commodity, as Marx had argued; rather, the instituted attempt to treat it as a commodity was a contradiction in itself, between the subjectivity and the objectification of labour. Castoriadis then moved on to link this claim to Weber’s analysis of the interconnections between capitalism and bureaucracy. The main contradiction of modern capitalism, whether wholly bureaucratised as in the Soviet model or increasingly bureaucratised as in the West, now seemed to be a matter of incompatible systemic imperatives: the need to control and to mobilise the workforce. Finally, difficulties with this model – and with the revolutionary expectations based on it – led to a more decisive break with classical theories and to the formulation of a bipolar image of modernity, where the vision of an autonomous society is opposed to the logic of calculation and domination, embodied in capitalist development. On both sides there is an imaginary component, irreducible to empirical givens or systemic principles. In this regard, Castoriadis remained closer to Weber than to Marx, but he also anticipated, in a distinctive way, later emphasis on the cultural dimension of modernity, and more specifi cally the notion of modernity as a new civilisation. (shrink)

One of the most controversial areas of animal research is the use of nonhuman primates for fundamental research. At the centre of the controversy is the question of whether the benefits of research outweigh the harms. We argue that the evaluation of harms and benefits is highly problematic. We describe some common procedures in neurological research using nonhuman primates and the difficulties in evaluating the harm involved. Even if the harm could be quantified, it is unlikely that it could be (...) meaningfully aggregated over different procedures, let alone different animals. A similar problem arises for evaluating benefits. It is not clear how benefits could be quantified, and even if they could be, values for different aspects of expected benefits cannot be simply added up. Sorting harms and benefits in three or four categories cannot avoid the charge of arbitrariness and runs the risk of imposing its structure on the moral decision. The metaphor of weighing or balancing harms and benefits is inappropriate for the moral decision about whether to use nonhuman primates for research. Arguing that the harms and benefits in this context are incommensurable, we suggest describing the moral consideration of harms and benefits as a coherent trade-off. Such a decision does not require commensurability. It must be well-informed about the suffering involved and the potential benefits, it must be consistent with the legal, regulatory and institutional framework within which it is made, and it must cohere with other judgments in relevant areas. (shrink)

This article discusses successive positions of the Frankfurt School, contrasts them to the unfolding ideas of Castoriadis and argues for a critical theory centred on a concept of autonomy, but aware of the obstacles and complications inherent in social–historical reality and its modern configuration. To clarify this perspective, we need a concept of society that distances itself from the Parsonian paradigm, more so than recent theorists of the Frankfurt School have done. The critique of over-integrated images of society, developed by (...) various sociologists in the 1970s and 1980s but not properly assimilated by the mainstream of the discipline and never taken on board by Frankfurt theorists, is an important source of reference, and it can be taken further in the light of Castoriadis’s reflections on the social–historical. The result is a definition of autonomy as a capacity of explicit and unlimited interrogation, confronted with its own hubristic temptations in the context of a multidimensional social world. (shrink)

This important new book by a major voice in the Social Imaginaries movement offers the most systematic attempt to establish conceptual and historical links between the idea of modernity as a new civilization and the notion of multiple modernities. Arnason demonstrates a theory of globalization that is still compatible with the emphasis on unity and diversity of modernity as a civilization.

Prematurely born children who have underdeveloped lungs may suffer a potentially fatal condition called respiratory distress syndrome. A U.S. company developed a drug, called Surfaxin, to treat such poorly functioning lungs. A placebo-controlled study was planned in four Latin American countries. At the time, in 2001, four treatments were already on the market, although not available to the research populations used in the study. This case is usually discussed as part of the standard of care debate or offered as an (...) example of exploitation. However, what concerns us in this case is rather the choice given to the parents of a prematurely born child under these circumstances: “You can give consent for your child's participation in this study. Half of the babies enrolled will receive sham air and are as likely to die as if they had not enrolled. The other half will receive an active treatment and are more likely to survive.” The parents can vastly increase their baby's chances of survival by participating in the study. Can the consent be voluntary? Do the parents have any meaningful choice? (shrink)

The ethics of using nonhuman animals in biomedical research is usually seen as a subfield of animal ethics. In recent years, however, the ethics of animal research has increasingly become a subfield within research ethics under the term “animal research ethics”. Consequently, ethical issues have become prominent that are familiar in the context of human research ethics, such as autonomy or self-determination, harms and benefits, justice, and vulnerability. After a brief overview of the development of the field and a discussion (...) of relevant theoretical ethical frameworks, I consider two of these issues, namely autonomy and self-determination on the one hand, and harms and benefits on the other hand. My concern is with philosophical and ethical issues, rather than animal research oversight. I focus my discussion on nonhuman primates, as the most plausible nonhuman candidates for this approach. I conclude that the approach, although promising, depends strongly on the moral status of nonhuman research subjects. (shrink)

Este artículo está dividido en dos partes. En la primera identifico los objetivos de la comunicación ¿tica en la asistencia sanitaria con el tratamiento del paciente como persona. Me propongo explicar el contenido de esta demanda moral y analizar los principales factores en juego. En la segunda parte presento tres modelos de relación entre pacientes y profesionales, y los examino críticamente a la luz de los fines morales de la comunicación en la asistencia a personas en los estadios terminales de (...) su enfermedad. Deseo mostrar que tratar al paciente como persona es el objetivo ético de la asistencia sanitaria, y que sólo puede alcanzarse mediante un diálogo veraz y considerado entre pacientes y cuidadores. Para ello, examinare brevemente las principales características de ese diálogo, sus condiciones previas y algunos de los obstáculos que pueden impedirlo. A modo de ejemplo, estudiaré cómo pueden funcionar esos tres modelos en los cuidados paliativos, para así proporcionar una ilustración de cómo este argumento puede llevarse a la práctica sanitaria real. (shrink)

The recognition of capitalism as a core component of modernity has often led to conflation of the two categories; this happens to critics as well as defenders of capitalism, and it reflects their shared but only partly acknowledged premises. A tendency to interpret capitalism as a self-contained system has strongly affected the debate on its historical significance; this reductionistic approach could be adapted to different ideological stances as well as to changing views of capitalism's long-term trajectory. The notion of a (...) `spirit of capitalism', in the sense of cultural sources essential to the constitution (and arguably also to the continuity) of the capitalist order, has been one of the most important correctives to economic determinism and reductionism, but it has proved difficult to link this dimension to other aspects of the problematic. The article surveys the contributions of Weber, Sombart, Castoriadis and - most recently - Luc Boltanski and Eve Chiapello to this debate. The last section then discusses the work of Fernand Braudel and suggests that it could serve to reformulate the problematic of capitalism in more multidimensional terms. (shrink)