Ethical aspects in oncology.

Decisions related to the treatment of oncological diseases bring various ethical dilemmas to healthcare providers caring for cancer patients. Along with the development of medicine and new therapeutic methods, there are also increased demands on the appropriate selection of eligible patients for allocation to a particular treatment method, which causes a number of ethical connotations. The paper deals with ethical issues in the course of oncology treatment, with theoretical bases for ethical decision-making and with ethical aspects of communication with patients suffering from oncological diseases. The paper also contains results of studies that dealt with methods of ethical reasoning of health professionals in relation with the Do Not Resuscitate (DNR) decision in oncology, and with understanding of the concept of ethical competence of health professionals in order to make, or be involved in, DNR decisions, and how relevant skills can be developed. Among others, the results of the studies pointed out that in order to make ethically based DNR decisions in oncology, physicians and nurses need to improve their knowledge of ethical theories.

Consent and consensus-ethical perspectives on obtaining bodies for anatomical dissection.

Biomedical research and education benefit from the use of human cadavers. These are usually acquired from donors who have willed their body to science during their lifetime. This concept of donation through "informed consent" respects the personal autonomy of the donor and the dignity of the dead body (extended from the dignity of the living person). The concept of informed consent is taken from research on living human subjects regulated in the Helsinki Declaration. This transfer to the domain of anatomical donation, however, has several problems. For example, the dead cannot speak for themselves and the ethical status of the human cadaver remains ambiguous. It is therefore suggested that an element of consensus is added to the concept of consent, a consensus between donors, relatives, anatomists, and the wider community. A consensus can give difficult decisions surrounding body donation and dissection a broader basis and can help bridge the gap between donors and families on the one side and anatomists, researchers and students on the other side. This approach can help to establish relationships of trust with local communities, on which body donation programs depend.

Undergraduate healthcare ethics education, moral resilience, and the role of ethical theories.

BACKGROUND: This article combines foundational and empirical aspects of healthcare education and develops a framework for teaching ethical theories inspired by pragmatist learning theory and recent work on the concept of moral resilience. It describes an exemplary implementation and presents data from student evaluation. OBJECTIVES: After a pilot implementation in a regular ethics module, the feasibility and acceptance of the novel framework by students were evaluated. RESEARCH DESIGN: In addition to the regular online module evaluation, specific questions referring to the teaching of ethical theories were added using simple (yes/no) and Likert rating answer formats. PARTICIPANTS AND RESEARCH CONTEXT: At the Bern University of Applied Sciences, a total of 93 students from 2 parallel sub-cohorts of the bachelor's program in nursing science were sent the online survey link after having been exposed to the same modular contents. A total of 62% of all students participated in the survey. ETHICAL CONSIDERATIONS: The survey was voluntary and anonymous. Students were free to write their name and additional comments. FINDINGS: Students consider ethical theories-as taught within the proposed framework-as practically applicable, useful, and transferable into practice. DISCUSSION: Teaching ethical theories within the proposed framework overcomes the shortcomings described by current research. Students do not consider the mutually exclusive character of ethical theories as an insurmountable problem. CONCLUSION: The proposed framework is likely to promote the effectiveness of healthcare ethics education. Inspired by pragmatist learning theory, it enables students to consider ethical theories as educative playgrounds that help them to "frame" and "name" the ethical issues they encounter in daily practice, which is seen as an expression of moral resilience. Since it does not advocate a single ethical theory, but is open to the diversity of traditions that shape ethical thinking, it promotes a culturally sensitive, ethically reflected healthcare practice.

Towards an understanding of global brain data governance: ethical positions that underpin global brain data governance discourse.

Introduction: The study of the brain continues to generate substantial volumes of data, commonly referred to as "big brain data," which serves various purposes such as the treatment of brain-related diseases, the development of neurotechnological devices, and the training of algorithms. This big brain data, generated in different jurisdictions, is subject to distinct ethical and legal principles, giving rise to various ethical and legal concerns during collaborative efforts. Understanding these ethical and legal principles and concerns is crucial, as it catalyzes the development of a global governance framework, currently lacking in this field. While prior research has advocated for a contextual examination of brain data governance, such studies have been limited. Additionally, numerous challenges, issues, and concerns surround the development of a contextually informed brain data governance framework. Therefore, this study aims to bridge these gaps by exploring the ethical foundations that underlie contextual stakeholder discussions on brain data governance. Method: In this study we conducted a secondary analysis of interviews with 21 neuroscientists drafted from the International Brain Initiative (IBI), LATBrain Initiative and the Society of Neuroscientists of Africa (SONA) who are involved in various brain projects globally and employing ethical theories. Ethical theories provide the philosophical frameworks and principles that inform the development and implementation of data governance policies and practices. Results: The results of the study revealed various contextual ethical positions that underscore the ethical perspectives of neuroscientists engaged in brain data research globally. Discussion: This research highlights the multitude of challenges and deliberations inherent in the pursuit of a globally informed framework for governing brain data. Furthermore, it sheds light on several critical considerations that require thorough examination in advancing global brain data governance.

Corrigendum: Towards an understanding of global brain data governance: ethical positions that underpin global brain data governance discourse.

[This corrects the article DOI: 10.3389/fdata.2023.1240660.].

A survey of AI ethics in business literature: Maps and trends between 2000 and 2021.

Artificial intelligence is spreading rapidly in business products and processes, with innovations that bring great benefits to society; however, significant risks also arise. AI-enabled systems make decisions autonomously and influence users and the environment, presenting multiple ethical issues. This work focuses on the ethics of AI use in business. We conduct a survey of business journal articles published between 2000 and mid-2021 to identify the most influential journals, articles, and authors, the most influential ethical schools, and the main ethical issues of AI in business. It describes the state-of-the-art in the field and identifies trends in ethical issues arising from AI. Thus, we present maps and trends of the ethics in AI in business literature.

Applying ethical theories to the Iranian health system governance: a critical empirical assessment.

The policies of health systems are inspired by ethical priorities. A critical review of policies can reveal the ethical theories/justice schools behind them. This study aimed to identify the ethical theory(ies) underpinning the Iranian health system governance over the past 50 years. This was a qualitative study conducted in two stages during 2019. First, we identified and constructed the key concepts and distinctive notions of prominent ethical theories/justice schools. Then, we spotted and selected 24 strategic laws and policy documents in the Iranian health system governance during the past 50 years and analyzed their content to surmise their underlying ethical theory. The results showed that the dominant theory affecting the policies of the Iranian health system governance over the past 50 years was egalitarian liberalism and then objective utilitarianism and relativist communitarianism. Retrospective empirical application of ethical theories to health system governance is methodologically doable, and this application reveals the mood or priorities of the politics. Also, highlighting the underpinning ethical theories of health system governance as well as the gap between ambitions versus realization are insightful and may prospectively empower and strengthen egalitarianism.

The Use of Chemotherapy to Prolong the Life of Dogs Suffering from Cancer: The Ethical Dilemma.

Despite the emergence some years ago of oncology as a veterinary specialty, there has been very little in the way of ethical debate on the use of chemotherapy in dogs. The purpose of this article is to undertake an ethical analysis to critically examine the use of chemotherapy to prolong the life of dogs suffering from cancer. If dogs have no concept of the future and are likely to suffer at least some adverse effects with such treatments, consideration should be given as to whether it is ethical and in the animal's best interests to use chemotherapy. Chemotherapeutic drugs are mutagenic, carcinogenic, teratogenic and may be irritant. Furthermore, chemotherapy may involve multiple trips to the veterinarian, multiple procedures and periods in isolation. Cancer-associated pain has been shown to be under-diagnosed and pet owners overestimate the effects of chemotherapy on treatment survival time. Of additional concern is the public health risks associated with chemotherapeutic drugs. As chemotherapy is not generally considered curative, it is in effect palliative care. However, palliative care may not be in the best interests of a terminally ill animal. As the specialty of veterinary oncology continues to grow and as the use of chemotherapy becomes more commonplace in the treatment of animals with cancer, it is imperative that there is an ongoing ethical debate on the use of chemotherapy in animals.

Ética de los sentimientos, desarrollo de capacidades, memoria histórica y reconciliación: la fragilidad del personal de salud en el conflicto armado colombiano / Ètica dels sentiments, desenvolupament de capacitats, memòria històrica i reconciliació: la fragilitat del personal de salut al conflicte armat colombià / Ethics of feelings, capacity building, historical memory, and reconciliation: the fragility of health personnel in the Colombian armed conflict

Objetivo: analizar la forma en que los sentimientos y la recuperación de la memoria colectiva, posibilitan la disminución de la fragilidad social y política de los integrantes de la Misión Médica, haciendo factible nuevas maneras de participación, mediante el desarrollo de capacidades deliberativas desde la perspectiva bioética. Metodología: estudio exploratorio con enfoque cualitativo, que toma en cuenta la subjetividad e intersubjetividad de los participantes. Con fuentes de información heterogénea: grupos focales, entrevistas semiestructuradas y cartillas de campo, se constituyó un marco de factores relevantes, que permitieron procesar la información, mediante relaciones y categorizaciones conceptuales,para su posterior triangulación. Resultados: los sentimientos con mayor impacto ético en Misión Médica: incertidumbre, inseguridad ante el trabajo, ansiedad por los hechos de violencia, tristeza, temor, miedo e impotencia; producen efectos emocionales relacionados con el principio de maleficencia. La resiliencia, ha impedido realizar ejercicios de memoria colectiva, a causa del negacionismo y temor a recordar los hechos más significativos, esto les ha impedido el acceso a los mecanismos de Justicia Restaurativa. La ausencia de capacidades para afrontar la situación compromete la autonomía individual, la salud laboral y genera carencias legales no resueltas. Conclusiones: los sentimientos colectivos en el ámbito público del personal sanitario prevalecen sobre los sentimientos individuales basados en vivencias, que afectan la capacidad de deliberación, esto implica promover ejercicios de memoria colectiva, sobre los hechos del conflicto, mediante el desarrollo de capacidades que fortalezcan la legitima defensade su autonomía y el desarrollo de un ejercicio profesional beneficiente, ante situaciones limítrofes de confrontación.(AU)

Objectiu: analitzar la manera com els sentiments i la recuperació de la memòria col·lectiva, possibiliten la disminució de la fragilitat social i política dels integrants de la Missió Mèdica, fent factible noves maneres de participació, mitjançant el desenvolupament de capacitats deliberatives des de la perspectiva bioètica. Metodologia: estudi exploratori amb enfocament qualitatiu, que té en compte la subjectivitat i la intersubjectivitat dels participants. Amb fonts d'informació heterogènia: grups focals, entrevistes semiestructurades i cartilles de camp, es va constituir un marc de factors rellevants, que van permetre processar la informació, mitjançant relacions i categoritzacions conceptuals, per triangular-les posteriorment. Resultats: els sentiments amb més impacte ètic a Missió Mèdica: incertesa, inseguretat davant la feina, ansietat pels fets de violència, tristesa, temor, por i impotència; produeixen efectes emocionals relacionats amb el principi de maleficència. La resiliència, ha impedit fer exercicis de memòria col·lectiva, a causa del negacionisme i temor de recordar els fets més significatius, això els ha impedit l'accés als mecanismes de Justícia Restaurativa. L'absència de capacitats per fer fronta la situació compromet l'autonomia individual, la salut laboral i genera mancances legals no resoltes. Conclusions: els sentiments col·lectius en l'àmbit públic del personal sanitari prevalen sobre els sentiments individuals basats en vivències, que afecten la capacitat de deliberació, això implica promoure exercicis de memòria col·lectiva, sobre els fets del conflicte, mitjançant el desenvolupament de capacitats que enforteixin la legítima defensa de la seva autonomia i el desenvolupament d'un exercici professional beneficient, davant de situacions limítrofes de confrontació.(AU)

Objective: to analyze the way in which feelings and the recovery of collective memory make it possible to reduce the social and political fragility of the members of the Medical Mission, making new ways of participation feasible, through the development ofdeliberative capacities from a bioethical perspective. Methodology: exploratory study with qualitative approach, which considers the subjectivity and intersubjectivity of the participants. With heterogeneous sources of information: focus groups, semi-structured interviews and field primers, a framework of relevant factors was constituted, which allowed processing the information, through conceptual relationships and categorizations, for its subsequent triangulation. Results: the feelings with the greatest ethical impact in Mission Medical: uncertainty, insecurity at work, anxiety due to acts of violence, sadness, fear, fear, and impotence; produce emotional effects related to the principle of maleficence. Resilience has prevented them from carrying out collective memory exercises, due to denial and fear of remembering the most significant events, which has prevented them from accessing Restorative Justice mechanisms. The absence of capacities to face the situation compromises individual autonomy, occupational health and generates unresolved legal shortcomings. Conclusions: collective feelings in the public sphere of health personnel prevail over individual feelings based on experiences, which affect the capacity for deliberation, this implies promoting exercises of historical memory on the facts of the conflict, through the development of capacities that strengthen the legitimate defense of their autonomy and the development of a beneficial professional exercise, in the face of borderline situations of confrontation.(AU)

A importância das teorias éticas na prática da bioética / The importance of ethical theories in the bioethics' practice

A busca sem limites do conhecimento e a preocupação com o cometimento de abusos e exageros nascidos da curiosidade dividem a conduta do homem. A teoria ética nasce da necessidade de justificar racionalmente as condutas morais, diante da própria consciência e diante dos demais. Por ser a teoria um complexo integrado de princípios éticos, coerentes e fundamentais, o conhecimento das teorias éticas é essencial para reflexão, especialmente quando parece impossível cumprir todas as exigências de moralidade. A bioética, originalmente considerada fonte de normas e regras gerais para disciplinar eticamente a investigação científica, constitui-se uma espécie de código de ética profissional para os cientistas e pesquisadores, tornando-se um conjunto de reflexões filosóficas e morais sobre a vida em geral e sobre as práticas médicas em particular. Neste artigo, através de uma revisão da literatura, buscou-se descrever e discutir a importância das teorias éticas na prática da bioética.

The knowledge search without limits and the concern of practicing abuses and exaggerations as a result of curiosity divide the human behavior. The ethical theory comes from the need for rational justification of moral actions, toward the own human conscience and other people. As the theory consists of an integrated complex of ethical, coherent and fundamental principles, the ethical theories knowledge is essential for the reflection, especially when is not possible to fulfill all moral requests. The bioethics, originally considered source of general norms and rules for disciplining ethically the scientific investigation, can be regard as a sort of professional ethical code to scientists and researchers, being a group of moral and philosophical reflection concerning life in general and medical practices in particular. In this article, by a literature review, it was aimed to describe and discuss the importance of ethical theories in the bioethics' practice.