Critically examining what most people take for granted is central to philosophical inquiry. Philosophers who accept positions on policy making commissions, tasks forces, or committees cannot, however, play the same uncompromisingly critical role in this capacity as they do in the classroom or in their personal research or writing. Still, philosophers have much to contribute to such bodies, and they can do so without compromising their integrity or betraying themselves as philosophers. Keywords: compromise, critical reflection, embryo research, integrity, organ transplantation, (...) policy development, Warnock Committee CiteULike Connotea Del.icio.us What's this? (shrink)

Predicting future trends in bioethics depends on the recognition of contemporary innovations. Because of the extraordinary challenges brought on by the HIV/AIDS pandemic, bioethics has had to undergo a critical examination of its own effectiveness. This essay examines 10 developments that have helped shape the future of bioethics in a time of HIV/AIDS.

Advancement in science may represent a headway in procreation, but ethicists and theologians have anxieties about the future uses of such procreative technologies. The procreative advancement often involves the use of a human embryo. There is widespread moral and theological disarray concerning the use of embryos. The Hindu ethics presented in this chapter presumes the sanctity of human life of all sentient beings. The Hindu belief does not recognize that a human embryonic formation is an inconsequential and hence (...) discardable tissue, nor is it a developed adult being. Destroying an embryo is said to incur karmic consequences in Hindu thought. This being so, Hindu ethics would object to the creation of embryos and foetuses for the sole purpose of experimentation. The chapter focuses on the ramifications of Hindu ethics with respect to its application to interventionist or intrusive embryonic research and of debates thereto. (shrink)

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.

The main trends of the bioethics development in Belarus have been analyzed on the basis of the materials collected by the Ethics Documentation Center (ISEU, Minsk, Belarus). A critical review of the most important publications in the field since 2000 suggests that development of bioethics in Belarus has occurred in two parallel directions distantly connected to each other: a theoretical direction and a practical one. Despite there are objective and subjective reasons for introducing bioethics in Belarus as (...) an institutionally-organized system based on liberal values such as individual rights and freedom, a range of essential problems could be identified. Non-equivalent regulation of ethical issues in health care and other fields of biomedical research has been emphasized, as well as the problem of unclear hierarchical relationships among institutions dealing with various aspects of bioethics in the country and low ethical and educational level of the social and professional groups involved in further expansion of bioethical knowledge. The contextual aspects of the development of bioethics in the country such as the consequences of the Chernobyl disaster, the prevalence of the authoritarian social morality and traditionally paternalistic nature of the relations between physicians and their patients are discussed. (shrink)

As in other countries, medical ethics in Mexico has rescued the world of philosophical ethics from oblivion. The needs of clinical medicine gave birth to Mexican bioethics. After the growth of scientific and technologic subjects in medical schools, the humanities, such as medical history, deontology, and medical philosophy, were replaced by such core subjects as radiology, pharmacology, and microbiology. Since the 1950s, graduates from Mexican medical schools have not been exposed to any courses in the medical humanities.

How do bioethics gatekeepers located in wealthy nations treat bioethics workers from developing countries? Can the policies of leading international bioethics journals—based on a concern for profit that effectively restricts access for most researchers from developing countries—be ethically justified? We examined these policies focusing on the way they influence the ability of researchers in resource-poor countries to participate in the development of the field of bioethics. Eight of the fourteen leading bioethics journals are published by (...) three transnational publishing houses, all of which are based in wealthy nations. None of these eight journals participates in the Health InterNetwork Access to Research Initiative of the World Health Organization, a program that provides free or very low-cost online access to the major journals by researchers in developing countries. Lack of access to these essential resources makes it extremely difficult, if not impossible, for bioethicists in developing countries to learn from, and engage in, the global bioethics dialogue. Thus, exclusionary practices of leading bioethics journals sustain the hegemony of Western bioethics, raising serious questions about professed aspirations to create a truly “global” bioethics. This phenomenon indicates lack of empathy and moral imagination of bioethicists in developed countries, raises serious questions about the ethics of bioethics, and highlights the urgent need for creative solutions to remedy this social injustice. (shrink)

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

What is 'legal' about bioethics? What are the ideas and artefacts that bioethics encompasses, and how are they related to law? What is the role of law in bioethics? In this work, Calvin Ho attempts to address these questions in the context of the governance of human pluripotent stem cell research. In essence, he argues that the hybridization of law, through processes, devices and techniques of juridification, has helped to constitute bioethics as a public sphere and (...) an emergent civic epistemology. Drawing on his multi-sited ethnographic fieldwork and on Actor-Network-Theory, Ho explains how the law has, through bioethics, contributed to the scientific and public understanding of human pluripotent stem cell research and its artefacts, particularly the embryo and human-animal combinations. Although the focus of his work is on bioethical developments in Singapore over a period of more than 15 years, parallel developments in key jurisdictions (especially the United States of America and the United Kingdom) and in international science policy are also evaluated. It is through appreciating how it has progressed that bioethics will be better able to engage with future challenges presented by advances in human embryo research and gene editing techniques, among others. (shrink)

This paper examines the case of a recent H5N1virus (avian influenza) outbreak in West Bengal, an eastern state of India, and argues that poorly executed pandemic management may be viewed as a moral lapse. It further argues that pandemic management initiatives are intimately related to the concept of health as a social 'good' and to the moral responsibility of protection from foreseeable social harm from an infectious disease. The initiatives, therefore, have to be guided by special moral obligations towards biorisk (...) reduction, obligations which remain unfulfilled when a public body entrusted with the responsibility fails to manage satisfactorily the prevention and control of the infection. The overall conclusion is that pandemic management has a moral dimension. The gravity of the threat that fatal infectious diseases pose for public health creates special moral obligations for public bodies in pandemic situations. However, the paper views the West Bengal case as a learning opportunity, and considers the lapses cited as challenges that better, more effectively conducted pandemic management can prepare for. It is hoped that this paper will provoke constructive bioethical deliberations, particularly pertinent to the developing world, on how to ensure that the obligations towards health are fulfilled ethically and more effectively. (shrink)

This paper will take as its starting point the premise that developing translational bioethics is a worthwhile endeavour. I will develop an account of translational bioethics and discuss what implications this would have for the wider discipline of bioethics and argue that this would be a useful development for bioethics. The paper will conduct a form of ‘translational meta‐bioethics analysis’, in the words of Bærøe. I will argue that if we are serious about instituting translational (...) bioethics, then it will need to look and be organised in a very different way from current bioethics research, this will be a radically different form of bioethics from what we currently have. In this paper I will sketch what translational bioethics might look like. My proposal here is not that translational bioethics should supplant existing ways of doing bioethics, but rather that it should be an addition to it, another subdiscipline of bioethics. (shrink)

: This paper provides an analysis of the first decade of bioethics development in Slovakia (1990-1999), together with an overview of the most important bioethical issues entering the scene of public debate and scholarly ethical analysis.

Bioethicists tend to focus on the individual as the relevant moral subject. Yet, in highly complex and socially differentiated healthcare systems a number of social groups, each committed to a common cause, are involved in medical decisions and sometimes even try to influence bioethical discourses according to their own agenda. We argue that the significance of these collective actors is unjustifiably neglected in bioethics. The growing influence of collective actors in the fields of biopolitics and bioethics leads us (...) to pursue the question as to how collective moral claims can be characterized and justified. We pay particular attention to elaborating the circumstances under which collective actors can claim ‘collective agency.’ Specifically, we develop four normative-practical criteria for collective agency in order to determine the conditions that must be given to reasonably speak of ‘collective autonomy’. For this purpose, we analyze patient organizations and families, which represent two quite different kinds of groups and can both be conceived as collective actors of high relevance for bioethical practice. Finally, we discuss some practical implications and explain why the existence of a shared practice of trust is of immediate normative relevance in this respect. (shrink)

Several prominent writers including Norman Daniels, James Sabin, Amy Gutmann, Dennis Thompson and Leonard Fleck advance a view of legitimacy according to which, roughly, policies are legitimate if and only if they result from democratic deliberation, which employs only public reasons that are publicised to stakeholders. Yet, the process described by this view contrasts with the actual processes involved in creating the Affordable Care Act (ACA) and in attempting to pass the Health Securities Act (HSA). Since the ACA seems to (...) be legitimate, as the HSA would have been had it passed, there seem to be counterexamples to this view. In this essay, I clarify the concept of legitimacy as employed in bioethics discourse. I then use that clarification to develop these examples into a criticism of the orthodox view–that it implies that legitimacy requires counterintuitively large sacrifices of justice in cases where important advancement of healthcare rights depends on violations of publicity. Finally, I reply to three responses to this challenge: (1) that some revision to the orthodox view salvages its core commitments, (2) that its views of publicity and substantive considerations do not have the implications that I claim and (3) that arguments for it are strong enough to support even counterintuitive results. My arguments suggest a greater role for substantive considerations than the orthodox view allows. (shrink)

In this short response to Peter Clarke's thorough and interesting tracing of the developments in Richard McCormick's approach to moral questions, I take a perspective external to the concerns of Clarke's paper. I propose to look at the developments in McCormick's approach not so much from the perspective of contemporary Catholic moral theology but from that of the impact on the practices and beliefs of the Catholic community. From that perspective, the really important events in McCormick's theological development (...) are his rejection of the received teaching on contraception and his closely connected embracing of a moral theory that implies that there are no moral absolutes, namely, proportionalism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics in Azerbaijan:History and Development of Bioethics in AzerbaijanAdelia Avaz gizi Namazova (bio) and Tarana Qadir gizi Taghi-Zada (bio)HistoryAzerbaijan is a unique country with a centuries-old culture and history; it is a country located at the junction of Europe and Western Asia, uniting economic and cultural relationships between two continents and harmoniously combining the elements of various civilisations and cultures. Peculiarities of the historical development of Azerbaijan (...) and its geographical location, as well as the ethnic composition of the population created an opportunity for the flourishing of various religions. Idolatry, fire worship, Zoroastrianism, Judaism, Christianity, Islam and other religions were spread in the country during different periods. The multinational and confessional state (also known as a multicultural state), with its unique cultural inheritance, provided the opportunity not only to adhere to traditions and customs of previous generations, but also to develop spiritual-moral values that created respect and tolerance towards other religions. As a result of this cultural synthesis throughout the centuries, universal ethical values such as respecting the dignity of all persons, veneration of elderly people by youth, and principals of mercy, care and love to those in need and in the closing stages of life evolved. Numerous sources of ancient manuscripts bear witness that poetry, philosophy and the ethics of medical practice have always been part of the searching and thinking in medicine.One of the ancient religions, Zoroastrianism, begins from fire worship and was revealed to the religious teacher and prophet Zoroaster (seventh century BC, Holy Book Zend-Avesta). According to the basic understandings of Zoroastrianism, there are two principles which are always contradictory—Kindness and Evil. [End Page 433] Zoroaster called upon people to be fair and pure, to fight any kind of unfairness and disgracefulness.The name of the healer Logman is covered with legends and is well known among different nations of the East. Across generations in Azerbaijan the name Logman has been used, inspiring the sharing of medical secrets and advice, cure of different illnesses and their prevention.1 This is witnessed by the Logman Covenants. The first covenant warns of excessive consumption of alcohol and food, educating people in hygienic practices and developing that culture. Another covenant is dedicated to the high mission of the medic: “Every kindness on this planet created people. The kind beginning is there where you have a doctor.”The basic principles of humanitarian behaviour of the doctor have also been described in an ancient manuscript of Azerbaijani literature, the national epic “Kitabi-Dede Qorqud” (seventh century), which provides advice on how to maintain one’s health in good condition, and the importance of spiritual purity, health and morals.Outstanding philosophers, poets and scientists of the ancient land of Azerbaijan, such as Bakhmaniyar ibn Marzaban (eleventh century), Omar Osmanoglu (eleventh century), Khatib Tabrizi (1030–1109), Khagani (1120–99), Nizami Ganjavi (1141–1209), Nakchivani (thirteenth century), Makhmud Shabustari (1287–1320), Seid YakhyaBakuvi (1410–62), Fizuli (1498–1556), Vagif (1717–97) and many others, described in their doctrines the difficult, selfless activities of doctors and the positive results and outcomes.6Back in the eleventh2 century, when madrasas or spiritual schools, where theology and medicine were taught and, ecclesiastics and tabibs (medics) were prepared and educated, a medical school was established in Azerbaijan’s old capital Shamakha. Here, under the guidance of the most famous doctor and pharmacologist in all the East, Omar Osman oglu, training and education of medical workers took place. Having been widely educated, Omar Osman oglu was an adherent of the moral principles declared by Logman and taught his students that the main goal of any doctor’s activities should be based on love towards the other person. His understanding of a medic’s behaviour was contrary to major customs of that time, saying: “Don’t deny your enemy. Heal him.” Omar Osman oglu inspired his students to undertake spiritual pureness, patriotism and service to the nation. “Bring benefit to the nation, even if it is contrary with your personal benefit”, “do not be egotistical”, “do not try to find your way to heaven and do not be afraid of hell” were his slogans.The famous poet Khagani (1120... (shrink)

Personalism is one of the philosophical perspectives which hold that the reality in person and the human person has the highest intrinsic value. This paper makes reference to Louis Janssens' eight criteria in adequate consideration of the human person but further argues that there is need to consider people as situated agents especially within gender relational perspectives. The paper identifies gender as an important social construction that shapes the consideration of the human persons within socio-spatial spheres. The main crux of (...) the paper is that there is a gender context of personalism and this has profound implications for bioethical agendas. Gender is part of the human condition, especially when we philosophically or sociologically engage the notion of equity and equality within the social system, because social realities in the relational perspective are not impartial, impersonal and equal. Gender does not determine morality but it plays a role in morality and expectations from moral agents. Women have been categorised as a sociological group because their integrity, freedom/autonomy and dignity (which are basic concerns of bioethics) are capable of being threatened. A gender perspective provides important incentives for moral theory which searches for possible conceptual imbalances or blind spots in ethical reflections. The paper refers to Sen's faces of gender inequality and expands on the notion that natality inequality is one of the fundamental levels of gender inequality, which in turn is the primary starting agenda in bioethics. The paper avers that the recognition of the fundamental importance of gender to the organization of social reality and the development of personal identities have important practical implications for bioethics. (shrink)

The Johns Hopkins‐Fogarty African Bioethics Training Program (FABTP) has offered a fully‐funded, one‐year, non‐degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub‐Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees.Our (...) data show that since 2001, the 28 former FABTP trainees have authored or co‐authored 105 new bioethics‐related publications; were awarded 33 bioethics‐related grants; played key roles on 78 bioethics‐related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post‐training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs. (shrink)

This volume tracks the development in the United States of the field of Bioethics, Ethics applied to the disciplines of medicine, nursing, and health care in general, including medical research and the complex economic and political problems surrounding the provision of medical and nursing care. It explains how the United States developed, case by case, the central rules and principles of ER ethics in the Health Care System. The discussion includes the controversies centering on birth, death, clinical research, experimental (...) procedures (cloning, reproductive technology, organ transplants), and ends with a substantial suggestion on the provision of health care for all. (shrink)

What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Second, we want to illustrate the added value of a novel method: in-depth analysis of a single article with the aim of deriving (...) quality criteria. The third and ultimate goal is to stimulate a broad and vivid debate on goodness in bioethics. An initial literature search reveals a range of diverse quality criteria. In order to expand on the realm of such quality criteria, we perform an in-depth analysis of an article that is acclaimed for being exemplary. The analysis results in eleven specific quality criteria for good bioethics in three categories: argumentative, empirical, and dialectic. Although we do not claim that the identified criteria are universal or absolute, we argue that they are fruitful for fueling a continuous constitutive debate on what is “good bioethics.” Identifying, debating, refining, and applying such criteria is an important part of defining and improving bioethics. (shrink)

JANET DELGADO RODRIGUEZ | : The concept of vulnerability is central to current developments in bioethics, not only because of its analytic nature, but also due to its capacity for criticism. However, this concept has not been sufficiently developed, neither in the area of moral philosophy nor in bioethics. For this reason, it is necessary to define and analyze the conceptual framework in which the notion of vulnerability has been developed within the scope of bioethics. Thus, (...) the purpose of this paper is to indicate how the concept of vulnerability in the field of bioethics has been developed and what the main problems that derive from this approach are. Secondly, the paper analyzes some of the main philosophical approaches that I consider should be articulated in the expansion of a critical bioethics approach focused on the notion of vulnerability. To address this issue, I analyze the reflections that we find in the work of Martha Fineman, emphasizing the main relevant aspects for bioethics. Finally, I highlight the main implications of a theory of vulnerability for bioethics. | : Le concept de vulnérabilité est au coeur des développements actuels de la bioéthique, non seulement en raison de sa nature analytique, mais aussi en raison de son potentiel critique. Cependant, ce concept n’a pas été suffisamment développé, que ce soit dans le domaine de la philosophie morale ou de la bioéthique. Pour cette raison, il est nécessaire de définir et d’analyser le cadre conceptuel dans lequel la notion de vulnérabilité a été développée en bioéthique. Ainsi, le but de cet article est d’indiquer comment le concept de vulnérabilité a été développé dans le domaine de la bioéthique et quels sont les principaux problèmes découlant de cette approche. Deuxièmement, l’article analyse certaines des principales approches philosophiques qui devraient selon moi être articulées à une approche bioéthique critique centrée sur la notion de vulnérabilité. Pour traiter ce problème, j’analyse la réflexion de Martha Fineman, en soulignant les principaux aspects pertinents pour la bioéthique. Enfin, je souligne les principales implications d’une théorie de la vulnérabilité pour la bioéthique. (shrink)

Explores contemporary controversies in bioethics from a Hindu perspective. S. Cromwell Crawford breaks new ground in this provocative study of Hindu bioethics in a Western setting. He provides a new moral and philosophical perspective on fascinating and controversial bioethical issues that are routinely in the news: cloning, genetic engineering, the human genome project, reproductive technologies, the end of life, and many more. This Hindu perspective is particularly noteworthy because of India's own indigenous medical system, which (...) is stronger than ever and drawing continued interest from the West. The Hindu bioethics presented in this book are philosophically pluralistic and ethically contextual, giving them that conceptual flexibility which is often missing in Western religions, but which is demanded by the twenty-first century's complex moral problems. Comprehensive in scope and passionate in nature, Crawford's study is an important resource for analyses of practical ethics, bioethics, and health care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Landmark Legal Cases in BioethicsSusan Cartier Poland (bio)Only a few decades old, the interdisciplinary field of bioethics has developed surrounded by centuries of legal tradition and moral philosophy. Bioethics and the law have weaved back and forth over time influencing each field. Sometimes ethics leads the debate on problematical issues; for example, the Recombinant DNA Advisory Committee at the National Institutes of Health established regulations prior to (...) initiating human gene therapy. At other times, law takes over; Roe v. Wade, for example, has polarized and closed public discussion on abortion. Most frequently, however, scientific developments initiate discussion in both fields, as when the announcement of the birth of Dolly—the first cloned mammal—sparked President Clinton to ask the National Bioethics Advisory Commission for a report on cloning.A back-and-forth pattern also exists within the law itself, this time between legislator and judge. Legislators enact statutes, which apply universally to regulate conduct in society. Judges, on the other hand, interpret statutes and apply them to particular cases to resolve disputes between parties. Case law, as judge-made law is called, that grows in the absence of legislation becomes the common law. Legislatures can change the course of common law development by enacting more law, usually as amendments, but sometimes as repeals. A judge who sees the facts of a case or the law differently may also change the common law. And so the counterpoint between legislator and judge goes.A legal case becomes a landmark in bioethics because of its historical or precedential value to the field. Historical cases reflect judicial reasoning or rationalization that lays the conceptual foundation for a bioethical principle. Perhaps the best known example of this is the focus on the right to self-determination in Schloendorff that led to the development of informed consent. The principle of autonomy in bioethics derives its legal impetus from this line of cases.A case that acquires landmark status because of its precedential value does so for one of two reasons based on legal precedents. First, the case may be one of “first impression.” In the legal sense, that means that the particular case with its [End Page 191] facts or issues is the first one that a particular court has confronted within that court’s jurisdiction or area of decision-making authority. To be a landmark in bioethics, however, the ordinary sense of “first impression” applies. The first time that a particular bioethical topic has appeared in court for legal resolution makes a case one of “first impression” for bioethics. The case of Baby M on surrogacy contracts illustrates this.The second way in which a case can achieve landmark status based on precedents involves legal precedent and the jurisdictional basis of the court system. Under the common law system, a preceding case that involves the same or similar facts or issues as a current case must be followed by lower—i.e., less authoritative—courts in the same jurisdiction. That judicial rule of decision making is called stare decisis. It creates an institution of continuity, yet allows for change due to differences in judicial interpretation of facts and issues, which is called distinguishing the case.All courts under United States jurisdiction must follow the U.S. Supreme Court. By its sheer power of authority, the Court issues opinions that, if they concern bioethical topics, make cases landmarks in bioethics. For example, Roe v. Wade made abortion legal and set off the debate between maternal and fetal rights. Casey later refined, or to some redefined with a discussion of stare decisis, the bioethical underpinnings of Roe by framing the debate as one between maternal rights and state interests.In law, precedents concern only appellate cases. Trial courts, like that in McFall v. Shimp, handle questions of both fact and law. Appellate courts, like that in Brotherton, hear appeals from the lower trial courts and address legal issues only. Trial judges apply the law to facts, and appellate judges reason about the trial judge’s legal interpretation.Appellate court decisions are the ones most frequently published, either in print or electronically online, for citation. Consequently they are the easiest to locate and retrieve. “Reporters” as... (shrink)

Human rights have increasingly been put forward as an important framework for bioethics. In this paper, it is argued that human rights offer a potentially fruitful approach to understanding the notion of Respect for Persons in bioethics. The idea that we are owed a certain kind of respect as persons is relatively common, but also quite often understood in terms of respecting people’s autonomous choices. Such accounts do however risk being too narrow, reducing some human beings to a (...) second-class moral status. This paper puts forward a political approach to our standing as persons and a strongly pluralistic account of human rights that lays the ground for a more broadly applicable conception of Respect for Persons. It is further argued that this model also provides an example of a more general approach to philosophical ethics, an approach which is here called taxonomical pluralism. When it comes to Respect for Persons specifically, this principle is developed in terms of five distinct core concerns. (shrink)

The Major Part Of The Study Is An Analysis Of The Development Of An Educational Theory And Praxis--A Practical Activity Shared By The Three Great Reformers, Tagore, Gandhi And Aurobindo. The Work Reveals That All Of Them Were Consistent In Their Self Under-Standing And In Their Articulation Of The Nature Of Man And The Building Of Future Humanity Through Education. The Three Reformers Offer A Challenge To Both East And West As We Enter A New Age In Both Religion And (...) Education With The Twenty-First Century Pressing Upon Us. (shrink)

Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a conceptual publication in bioethics. Authorship in conceptual research should (...) be based on contributing substantially to: (1) identifying a topic, problem, or issue to study; (2) reviewing and interpreting the relevant literature; (3) formulating, analyzing, and evaluating arguments that support one or more theses; (4) responding to objections and counterarguments; and (5) drafting the manuscript and approving the final version. Authors of conceptual publications should participate substantially in at least two of areas (1)?(5). (shrink)

Empirical research in bioethics has developed rapidly over the past decade, but has largely eschewed the use of technology-driven methodologies. We propose “design bioethics” as an area of conjoined theoretical and methodological innovation in the field, working across bioethics, health sciences and human-centred technological design. We demonstrate the potential of digital tools, particularly purpose-built digital games, to align with theoretical frameworks in bioethics for empirical research, integrating context, narrative and embodiment in moral decision-making. Purpose-built digital tools (...) can engender situated engagement with bioethical questions; can achieve such engagement at scale; and can access groups traditionally under-represented in bioethics research and theory. If developed and used with appropriate rigor, tools motivated by “design bioethics” could offer unique insights into new and familiar normative and empirical issues in the field. (shrink)

What are the resources and needs, the strengths and the vulnerabilities of patients, of society, or of nature? How do we evaluate the societal potential of scientific discovery? It is fairly well assured that we are influencing the terms of existence of many inhabitants of this planet, from flora to fauna to humans. Moreover, history has shown that while technologies can be used neutrally, they can be (and have been) used to the great benefit – or the great detriment – (...) of human life and the fate of the world as a whole. How various types of knowledge and technological ability will be deployed is up to us, individually and collectively. How such information and ability should be deployed, and for what reasons, are questions at the core of bioethical inquiry. These are the "expanding horizons in bioethics" to which this volume refers. This volume is comprised of fourteen essays. It is a rare gathering of scholarly opinion, featuring well-known experts from a diversity of disciplines. The topics addressed are of immediate concern to the public. The essays ask questions about human nature, genetic technologies, reproductive rights, human subjects research, and environmental issues – all in provocative and challenging new ways. Yet the themes that emerge throughout the volume are of enduring interest to anyone concerned about the interactions of scientific development, ethics, and society. This volume is of interest to students and teachers of bioethics and related topics, as well as to professionals working in these disciplines. (shrink)

In the context of clinical and non-clinical biomedical practices, negligence is usually understood as a lapse of a specific professional duty by a healthcare worker or by a medical facility. This paper tries to delineate systemic negligence as another kind of negligence in the context of health systems, particularly in developing countries, that needs to be recognized and addressed. Systemic negligence is not just a mere collection of stray incidences of medical errors and system failures in a health system, but (...) is proposed in this paper as a more pervasive kind of neglect. Several non-medical factors, such as lack of social and political will, also contribute to it and hence is more difficult to address in a health system. This paper argues that recognizing systemic negligence and including it research agenda have special moral importance for researchers in developing world bioethics, public health ethics and for health activists in the developing world. For, it can be a potent health system barrier, and can seriously impair efforts to ensure patient safety, particularly in the weaker health systems. As it erodes accountability in a health system, addressing it is also important for the twin goals of ensuring patient safety and improving health system performance. Above all, it needs to be addressed because the tolerance of its persistence in a health system seems to undervalue health as a social good. (shrink)

The last twenty-five years of published literature and curriculum development in bioethics suggest that the field enjoys a successful and stable marriage to philosophical ethical theory. However, the next twenty-five years could be very different. I believe the marriage is troubled. Divorce is conceivable and perhaps likely. The most philosophical parts of bioethics may retreat to philosophy departments, while bioethics continues on its current course toward a more interdisciplinary and practical field.I make no presumption that bioethics (...) is integrally linked to philosophical ethical theory. Indeed, I assume that the connection is contingent and fragile. Many individuals in law, theological ethics, political theory, the social and behavioral sciences, and the health professions carefully address mainstream issues of bioethics without finding ethical theory essential or breathtakingly attractive. This is not surprising. Moral philosophers have traditionally formulated theories of the right, the good, and the virtuous in the most general terms. (shrink)

The advocates of Integrative Bioethics have insisted that this recently emerging project aspires to become a new stage of bioethical development, surpassing both biomedically oriented bioethics and global bioethics. We claim in this paper that if the project wants to successfully replace the two existing paradigms, it at least needs to properly address and surmount the lack of common moral vocabulary problem. This problem points to a semantic incommensurability due to cross-language communication in moral terms. This paper (...) proceeds as follows. In the first part, we provide an overview of Integrative Bioethics and its conceptual building blocks: mutlidisciplinarity, interdisciplinarity, and transdisciplinarity. In the second part, we disclose the problem of semantic incommensurability. The third part gives an overview of various positions on the understanding of interdisciplinarity and integration in interdisciplinary communication, and corresponding attempts at solving the lack of common moral vocabulary problem. Here we lean mostly on Holbrook’s three theses regarding the character of interdisciplinary communication. Finally, in the fourth part, we discuss a particular bioethical case—that of euthanasia—to demonstrate the challenge semantic incommensurability poses to dialogues in Integrative Bioethics. We conclude that Integrative Bioethics does not offer a methodological toolset that would warrant optimism in its advocates’ predictions of surpassing current modes of doing bioethics. Since Integrative Bioethics leaves controversial methodological questions unresolved on almost all counts and shows no attempts at overcoming the critical stumbling points, we argue for its rejection. (shrink)

BackgroundA different ethos with respect to the perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which makes it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing the awareness of bioethics.MethodsFollowing a rigorous review of (...) relevant literature by a panel of experts, a 13-item instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach’s alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored.ResultsThe EFA of the OBMLA questionnaire resulted in three well-loading factors: (1) Physicians’ bioethics practice subscale (2) incentive related bioethics subscale and (3) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73–0.8. Of the total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of the bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. The majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice.ConclusionThe study provides an insight into the practice of bioethics, and the awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess a physician’s awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores on the indices which measure practice and awareness of bioethics and medical law. (shrink)

Human embryonic moral status in the embryo debate in the Indian religious school of thoughts is a challenging issue. The paper tries to figure out whether ontological status implies moral status of embryo. Consciousness is an important determinant of animation of human embryo. In this paper an attempt had been made to understand the concept of man and soul in the Hindu philosophical thought. In the process we would also make a critical review of embryology in the Hindu (...) philosophical thought. The study would adopt a conceptual elucidation of morality. The paper made an elaborative study of Puruṣa as found in the Saṃkhya Philosophy and the study of consciousness and animation would try to resolve the related question, when does life begin to have that value? Embryo-protectionist regards embryos as a potential person. The Gita says the human person is individual self-called āttmā, whose nature is of pure consciousness, Brahman/Puruṣa. Consciousness constitutes the essentiality of individual Self. Human embryo developments are elaborately studied in the Yajñavalkya Smṛti, Garbha Upaniṣad, and Suśruta Saṃhitā. The self that remain latent in the embryo gets impetus with the association of consciousness until then it cannot be a human personality. In Hinduism sanctity of life gets combined with autonomy and self-determination. The sanctity of life applies both to the fetus as well as to the overall welfare of the society. The embryo being in an interim stage and the soul not being destroyed upon body annihilation, it may be claimed that since destruction or annihilation of the physical form does not destroy the soul, beneficial embryo research should thus not be abhorrent. The Hindu ethics as examined here precludes the consideration of the situation at hand, and causing the least harm and work according to one’s dharma. (shrink)

The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has offered a fully-funded, one-year, non-degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub-Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees.Our (...) data show that since 2001, the 28 former FABTP trainees have authored or co-authored 105 new bioethics-related publications; were awarded 33 bioethics-related grants; played key roles on 78 bioethics-related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post-training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs. (shrink)

In this paper, I discuss exploitative transactions in bioethics. Examples of this kind of transactions allegedly include, among others, commercial surrogacy, organ selling, and research with human subjects in developing countries. The most problematic kind of exploitation is what Allan Wertheimer calls “mutually advantageous exploitation:” the weak party’s consent for the transaction is an effective and rational consent. Moreover, W does not suffer any harm by the transaction; on the contrary, the transaction benefits W. My aim in this paper (...) is twofold. From the perspective of individual ethics, I offer a model to understand the nature of the wrongfulness of the strong party’s action. And from the perspective of legal ethics, I suggest some reasons to believe that the prohibition of beneficial exploitative contracts is problematic and can only be justified in very exceptional cases. (shrink)