Respect for bioethical principles and human rights in prisons: a systematic review on the state of the art.

BACKGROUND: Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. METHODS: A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. RESULTS: Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners' access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. CONCLUSIONS: Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.

Proxy failure in social policies as one of the main causes of persistent sexism and racism.

One example of proxy failure is current antisexist and antiracist policies. One of the most popular proxy in them is the number of representatives of marginalized groups - women and nonwhite people - in power structures. Here I show that such measures do not lead to combating sexism and racism, which flourish despite their application.

The evolution of puritanical morality has not always served to strengthen cooperation, but to reinforce male dominance and exclude women.

Puritanical morality regulates a range of seemingly insignificant behaviors, including those involving human sexuality. A sizable portion of the latter particularly burdens women, who are held responsible for the moral conduct of men. In my paper, I show that these norms have not necessarily served to evolve cooperation, but to subjugate and eliminate women from public life.

The final frontier: what is distinctive about the bioethics of space missions? The cases of human enhancement and human reproduction.

We examine the bioethical issues that arise from long-duration space missions, asking what there is that is distinctive about such issues. We pay particular attention to the possibility that such space missions, certainly if they lead to self-sustaining space settlements, may require human enhancement, and examine the significance of reproduction in space for bioethics. We conclude that while space bioethics raises important issues to do with human survival and reproduction in very hazardous environments, it raises no issues that are distinct from those in terrestrial bioethics. Rather, space bioethics raises extreme versions of bioethical issues that are already found in the military, when working in extreme environments (such as Antarctica), or when living in circumstances (such as in prison) where one's autonomy is severely curtailed.

The "staying alive" theory reinforces stereotypes and shows women's lower quality of life.

Staying alive theory explains why women have more effective self-protective mechanisms in terms of woman's role as a mother and caregiver. This theory reinforces stereotypes and the relationship of oppression and submission to men. Somewhat paradoxically, it also points to women's lower quality of life, which may be explained by their greater fear of threats caused by men's power.

Why catastrophic events, human enhancement and progress in robotics may limit individual health rights.

Despite the fact that people usually believe that individual health rights have an intrinsic value, they have, in fact, only extrinsic value. They are context dependent. While in normal conditions the current societies try to guarantee individual health rights, the challenge arises in emergency situations. Ones of them are pandemics including current covid-19 pandemic. Emergency situations challenge individual health rights due to insufficient medical resources and non-random criteria of selection of patients. However, there are some reasons to assume that societal and technological processes in the near future will threaten permanently individual health rights in normal conditions. Such processes include progress in commonly available human enhancement technologies, and progress in robotics and automation. In this paper I show how individual health rights will be challenged in both scenarios including catastrophic events and future technological progress. In both cases, the idea of assisted dying is discussed as possibly the unique healthcare principle available for people whose individual health rights will be limited or canceled due to catastrophes or technological and financial exclusion. The special case of future space missions is also discussed as an example of an extreme environment affecting the way moral norms are viewed in health care ethics.

Space bioethics: Why we need it and why it should be a feminist space bioethics.

Space philosophy offers rich insights in the future and is already well-developed new branch of philosophy. However, space philosophers still do not pay much attention to a number of bioethical issues that may occur in space. This paper aims to introduce space bioethics, as a new branch in space philosophy, space ethics and space policy, to the philosophical and bioethical discourse. The basic issues discussed in space bioethics include-but are not limited to-human reproduction in space and human enhancement for space. This paper concludes that the new space bioethics should be a feminist new bioethics that is free from many of the historical biases associated with a male-centred perspective in philosophy and bioethics. Bioethical issues in space have also impact on future political decisions related to objectives and nature of space missions.

Ethical Challenges in Human Space Missions: A Space Refuge, Scientific Value, and Human Gene Editing for Space.

This article examines some selected ethical issues in human space missions including human missions to Mars, particularly the idea of a space refuge, the scientific value of space exploration, and the possibility of human gene editing for deep-space travel. Each of these issues may be used either to support or to criticize human space missions. We conclude that while these issues are complex and context-dependent, there appear to be no overwhelming obstacles such as cost effectiveness, threats to human life or protection of pristine space objects, to sending humans to space and to colonize space. The article argues for the rationality of the idea of a space refuge and the defensibility of the idea of human enhancement applied to future deep-space astronauts.

Is Human Enhancement in Space a Moral Duty? Missions to Mars, Advanced AI and Genome Editing in Space.

Any space program involving long-term human missions will have to cope with serious risks to human health and life. Because currently available countermeasures are insufficient in the long term, there is a need for new, more radical solutions. One possibility is a program of human enhancement for future deep space mission astronauts. This paper discusses the challenges for long-term human missions of a space environment, opening the possibility of serious consideration of human enhancement and a fully automated space exploration, based on highly advanced AI. The author argues that for such projects, there are strong reasons to consider human enhancement, including gene editing of germ line and somatic cells, as a moral duty.

Why Human Enhancement is Necessary for Successful Human Deep-space Missions.

While humans have made enormous progress in the exploration and exploitation of Earth, exploration of outer space remains beyond current human capabilities. The principal challenges lie in current space technology and engineering which includes the protection of astronauts from the hazards of working and living in the space environment. These challenges may lead to a paradoxical situation where progress in space technology and the ability to ensure acceptable risk/benefit for human space exploration becomes dissociated and the rate of scientific discovery declines. In this paper, we discuss the predominant challenges of the space environment for human health and argue that development and deployment of a human enhancement policy, initially confined to astronauts - for the purpose of future human space programmes is a rational solution to these challenges.