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1.
Health Policy ; 142: 105031, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38428058

RESUMO

What do we owe other persons? Are we as much obliged to promote their wellbeing as we are to reduce their suffering? This question is crucial for a range of social institutions and welfare services, and especially for the health services. To address this question the article investigates prominent positions and arguments in moral philosophy. It finds that while classical utilitarianism claims that there is symmetry in the moral obligation with respect to peoples' wellbeing and their suffering, a wide range of other positions and perspectives argue for an asymmetric relationship with stronger moral obligations towards other persons' suffering than towards their wellbeing. This difference in obligations is supported ontologically by basic differences inherent in wellbeing and suffering and axiologically by a relative (gradual) difference in value. The many well-founded arguments for stronger moral obligations towards other persons' suffering than towards their wellbeing has important implications for health policy; especially for priority setting. Avoiding and reducing suffering should have priority to the promotion and enhancement of wellbeing.


Assuntos
Obrigações Morais , Princípios Morais , Humanos , Filosofia , Teoria Ética
2.
Hastings Cent Rep ; 54(1): 34-41, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38390681

RESUMO

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive-compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post-trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post-trial access as a means to achieve social reintegration through this neurotechnological accommodation.


Assuntos
Estimulação Encefálica Profunda , Transtorno Obsessivo-Compulsivo , Humanos , Estimulação Encefálica Profunda/métodos , Transtorno Obsessivo-Compulsivo/terapia , Dever de Recontatar , Assistência ao Convalescente , Obrigações Morais
3.
Hastings Cent Rep ; 54(1): 24-33, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38390679

RESUMO

We argue that in implanted neurotechnology research, participants and researchers experience what Henry Richardson has called "moral entanglement." Participants partially entrust researchers with access to their brains and thus to information that would otherwise be private, leading to created intimacies and special obligations of beneficence for researchers and research funding agencies. One of these obligations, we argue, is about continued access to beneficial technology once a trial ends. We make the case for moral entanglement in this context through exploration of participants' vulnerability, uncompensated risks and burdens, depth of relationship with the research team, and dependence on researchers in implanted neurotechnology trials.


Assuntos
Encéfalo , Obrigações Morais , Humanos , Beneficência
4.
Am J Bioeth ; 24(1): 27-29, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38236867
6.
Med Health Care Philos ; 27(1): 37-48, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37902931

RESUMO

Recent advancements in developmental biology enable the creation of embryo-like structures from human stem cells, which we refer to as human embryo-like structures (hELS). These structures provide promising tools to complement-and perhaps ultimately replace-the use of human embryos in clinical and fundamental research. But what if these hELS-when further improved-also have a claim to moral status? What would that imply for their research use? In this paper, we explore these questions in relation to the traditional answer as to why human embryos should be given greater protection than other (non-)human cells: the so-called Argument from Potential (AfP). According to the AfP, human embryos deserve special moral status because they have the unique potential to develop into persons. While some take the development of hELS to challenge the very foundations of the AfP, the ongoing debate suggests that its dismissal would be premature. Since the AfP is a spectrum of views with different moral implications, it does not need to imply that research with human embryos or hELS that (may) have 'active' potential should be completely off-limits. However, the problem with determining active potential in hELS is that this depends on development passing through 'potentiality switches' about the precise coordinates of which we are still in the dark. As long as this epistemic uncertainty persists, extending embryo research regulations to research with specific types of hELS would amount to a form of regulative precaution that as such would require further justification.


Assuntos
Início da Vida Humana , Pesquisas com Embriões , Humanos , Incerteza , alfa-Fetoproteínas , Obrigações Morais , Embrião de Mamíferos
7.
Med Health Care Philos ; 27(1): 15-30, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37851211

RESUMO

In this paper, I assess the role responsibility argument that claims suicidal agents have obligations to specific people not to kill themselves due to their roles. Since the plausibility of the role responsibility argument is clearest in the parent-child relationship, I assess parental obligations. I defend a view that says that normative roles, such as those of a parent, are contractual and voluntary. I then suggest that the normative parameters for some roles preclude permissible suicide because the role-related contract includes a promise to provide continuing care and emotional support. I propose that as we have established criteria for morally acceptable reasons for cancelling, voiding, or amending a contract, we can apply these to the role responsibility argument to establish grounds for releasing a parent from his role-related and contractual obligations. Failure to fulfil one's contractual roles may not be blameworthy, depending upon the circumstances. I propose the factors determining culpability in failure to fulfil one's role-related obligations are: intention, voluntariness, diminished responsibility, mental capacity, and foreseeability.


Assuntos
Obrigações Morais , Suicídio , Humanos , Ideação Suicida , Pais , Dissidências e Disputas , Responsabilidade Social
8.
Pain Manag Nurs ; 25(1): 29-33, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37926633

RESUMO

In addition to a physical and emotional experience, pain is also a morally infused experience with deep, often subconscious, meaning for many sufferers. Whether justified or not, for many people, pain may represent loss, judgement, unworthiness, abandonment, punishment, and even existential suffering and thoughts of death. The moral meaning of pain is what influences the associated experiences of stigma, loneliness, and guilt that contribute to suffering. It is why nurses and other healthcare practitioners have long adhered to a moral obligation to treat those with pain, implying a duty to attempt to make right the wrong of undeserved suffering. Yet the moral meaning of pain is rarely discussed and is often overlooked when establishing a relationship with and a treatment plan for a person with pain. It is the unattended moral meaning of pain that may contribute to unnecessary suffering, futile treatment, and even moral dilemmas in establishing care. In this paper, I explore the definition of morality itself, the moral meaning of pain, and its implications for care. I discuss how moral pluralism in contemporary society contributes to various moral perceptions that influence a person's pain experience and how their pain is treated. Finally, I make the case that using a narrative approach to intentionally look for moral meaning in an individual's pain story may reveal opportunities for more effective pain management options.


Assuntos
Princípios Morais , Dor , Humanos , Manejo da Dor , Obrigações Morais , Emoções
9.
Am J Bioeth ; 24(1): 3-12, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36635972

RESUMO

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then draw conclusions about what we do (or do not) owe them. This paper argues that at best the concept of "personhood" is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood.


Assuntos
Aborto Induzido , Bioética , Gravidez , Feminino , Animais , Humanos , Pessoalidade , Inteligência Artificial , Obrigações Morais
10.
Cognition ; 243: 105692, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38101081

RESUMO

Despite the importance of uncertainty in decision-making, few published studies have examined how individuals make moral judgments under uncertainty. Across four experiments (N = 445), we examined whether a relatively small shift in probability affected participants' judgments of both moral acceptability and choice. Overall, reading dilemmas where the characters were either certain or likely to die, the probability of the sacrificed individual and the group at risk dying both had independent effects on participants' responses. That is, participants were more accepting of sacrificing the individual if they were not certain to die, but less accepting if the group was only likely to die when the individual was not sacrificed. Furthermore, a number of participants made acceptability ratings that did not match the action they endorsed, either finding the sacrificial decision more acceptable but refusing to make it, or choosing the sacrificial decision while viewing it as less acceptable. Many participants also stated that this was because they recognised a crucial difference between what they viewed as morally acceptable in a dilemma and what they were actually willing to do. Such mismatches may reflect the sensitivity and complexity of the moral principles that individuals employ during their moral decision-making.


Assuntos
Tomada de Decisões , Julgamento , Humanos , Tomada de Decisões/fisiologia , Incerteza , Julgamento/fisiologia , Princípios Morais , Obrigações Morais
12.
Hastings Cent Rep ; 53(6): 35-37, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38131492

RESUMO

Mass incarceration is an ethical crisis. Yet it is not only the magnitude of the system that is troubling. Mass incarceration has been created and sustained by racism, classism, and ableism, and the problems of the criminal legal system will not be solved without meaningfully intervening upon these forms of oppression. Beyond that, incarceration itself-whether of one person or 2 million-represents a moral failing. To punish and control, rather than invest in community and healing, is antithetical to the values of the field of bioethics. This commentary, which responds to the article "Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics," by Sean Valles, considers abolition as a crucial form of justice that must be centered in the work of bioethics. Abolition is both an antiracist intervention and a means of considering the ways health care broadly and bioethics specifically have allowed for the perpetuation of carcerality in the United States.


Assuntos
Bioética , Obrigações Morais , Humanos , Estados Unidos , Prisões , Atenção à Saúde
13.
Philos Ethics Humanit Med ; 18(1): 20, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38115053

RESUMO

BACKGROUND: In 1926, Fritz Jahr described bio-ethics (German: bio-ethik) as "the assumption of moral obligations not only towards humans, but towards all forms of life." Jahr summarized his philosophy by declaring, "Respect every living being on principle as an end in itself and treat it, if possible, as such!." Bioethics was thus originally an ethical system concerned with the "problems of interference with other living beings… and generally everything related to the balance of the ecosystem" according to the 1978 Encyclopedia of Bioethics. This definition was predicated on the work of Fritz Jahr, Menico Torchio, and Van Rensselaer Potter. METHODS: In order to proceed with depthful analysis of the origin and major bioethical flare up, we will use critical analysis of existing literature, followed by a study trip to relevant bioethical localities (collecting photo and other documentations regarding Menico Torchio). RESULTS: While Jahr and Potter are typically given intellectual credit for developing the field of bioethics, the eco-ethical contributions of Menico Torchio have been forgotten.This article will first trace the origins of "bioethics" - now commonly bifurcated into "biomedical ethics" and "environmental bioethics." The former was developed by Tom Beauchamp from the Philosophy Department and James Childress of the Religious Studies department at Georgetown University and is based on principlism, with a narrow focus on medical settings. The latter addresses the environmental impact of the medical industry and climate change health hazards. Second, we will present a panorama of Torchio's significant intellectual contribution to bioethics. Menico Torchio's concept of bioethics synthesized work of both Jahr and Potter, advocating "the need to expand our ethical obligations and embrace the most developed groups of animals, not only physically but also psychologically." Third, we will reflect on the lasting legacy of "bioethics" on biomedical and environmental bioethics today. Thematic elements such as interconnectedness of planetary health and human health, dedication to living in harmony with nature, and emphasis on systems and symbiosis remain unchanged from the legacy of Tochio onward. CONCLUSION: Our conclusion will underscore the necessity of understanding the connections between planetary, environmental, and human health.


Assuntos
Bioética , Ecossistema , Animais , Humanos , Bioética/história , Obrigações Morais , Princípios Morais , Filosofia , Ética Baseada em Princípios , História do Século XX
20.
Inn Med (Heidelb) ; 64(11): 1072-1076, 2023 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-37801097

RESUMO

Hardly any other field of application of artificial intelligence (AI) needs more ethics by design than medicine; however, if a deep integration of ethical principles succeeds there is a chance of "deep healing", for each individual and also for medicine and the healthcare system itself. Thus, AI in medicine could also become a blueprint for how AI should enter society and culture.


Assuntos
Inteligência Artificial , Medicina , Obrigações Morais , Cicatrização
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