Bios-Ethics and the Bios Emergency: Finding the Real Work.

This article presents a case for transforming traditional bioethics into "Bios-ethics." This exposition relies on three propositions: (1) the climate emergency is the "Bios emergency"; (2) in the Bios emergency, bioethics must be replaced by Bios-ethics; and (3) the top and overwhelming priority of Bios-ethics is to address the Bios emergency. Biocentrism, habitat, and environmental ethics are discussed in light of their contribution to the development of Bios-ethics, and potential lines of research in Bios-ethics are outlined. The urgency of undertaking substantive conceptual and practical innovations in response to our current danger is emphasized throughout.

Does Bioethics Need Ethical Theories?

The relationship between philosophy and bioethics remains a matter of perennial debate, but there does appear to be a consensus on one issue: whatever bioethics might want to borrow from philosophical ethics, it won't be normative theories. This essay argues that theories can have an important role to play in bioethics, though it might not be the one traditionally assumed by philosophers.

The obligation of the physician to save the life of the detainee on a hunger strike: the opinion of the Italian National Bioethics Committee.

Abstract: The Cospito case has highlighted a widely debated bioethical issue regarding the need to choose between safeguarding the life of a detainee and their right to self-determination through the practice of a hunger strike. Recently, the Italian National Bioethics Committee has been called upon to give an opinion on this matter. On the other hand, the media resonance of this case has shed light on the need to pose an ethical and social question regarding such situations: does the physician have an obligation to protect the detainee's health at the expense of their free choice? To be able to answer, it is necessary to understand whether law no. 219/17 is applicable to this context.

La objeción de conciencia en el ámbito sanitario: un equilibrio entre derechos y deberes / L’objecció de consciència en l'àmbit sanitari: un equilibri entre drets i deures / Conscientious objection in the healthcare domain: A balance between rights and responsibilities

La entrada en vigor de la Ley Orgánica 3/2021 sobre eutanasia en España (2021), ha propiciado un debate de relevancia en el ámbito de la bioética, como es el de la objeción de conciencia (OC) de los profesionales de la salud. Ahora bien, a pesar de que la literatura científica ha abordado esta cuestión, lo cierto es que la comprensión de los motivos subyacentes que impulsan a los profesionales a objetar no está del todo clara. Diversos autores han destacado que la OC halla sus fundamentos en creencias personales, ética profesional, aspectos emocionales y dinámicas del propio sistema. A su vez, se ha observado cómo hay posiciones diversas sobre la legitimidad de la OC, generando debates sobre su validez.Los objetivos de este artículo son revisar el concepto objeción de conciencia en el ámbito sanitario; analizar los factores que motivan este derecho; examinar las consecuencias de la OC en la carga asistencial de los profesionales no objetores; y explorar su posible conflicto ético con la justicia distributiva en la atención sanitaria. Por último, se reflexionará sobre la posibilidad de la OC institucional y sus posibles consecuencias en los derechos de pacientes y trabajadores.(AU)

L'entrada en vigor de la Llei Orgànica 3/2021 sobre l'eutanàsia a Espanya (2021) ha suscitat un debat rellevant en l'àmbit de la bioètica, com és el de l’objecció de consciència(OC) dels professionals de la salut. Tanmateix, malgrat que la literatura científica ha abordat aquesta qüestió, és cert que la comprensió dels motius subjacents que impulsen els professionals a objectar no està del tot clara. Diversos autors han destacatque l’OC troba els seus fonaments en creences personals, ètica professional, aspectes emocionals i dinàmiques del propi sistema. Al seu torn, s'ha observat com hi ha posicions diverses sobre la legitimitat de l’OC, generant debats sobre la seva validesa. Els objectius d'aquest article són revisar el concepte d’objecció de consciència en l'àmbit sanitari; analitzar els factors que motiven aquest dret; examinar les repercussions de l’OC en la càrrega assistencial dels professionals no objectors; i explorar el seu possible conflicte ètic amb la justícia distributiva en l'atenció sanitària. Finalment, es reflexionarà sobre la possibilitat de l’OC institucional i les seves possibles repercussions en els drets dels pacients i treballadors.(AU)

The enactment of Organic Law 3/2021 on euthanasia in Spain has sparked a significant debate in the field of bioethics, namely the issue of conscientious objection (CO) among healthcare professionals. However, despite the scientific literature addressing this matter, the understanding of the underlying reasons that drive professionals to object is not entirely clear. Several authors have highlighted that CO is rooted in personal beliefs, professional ethics, emotional aspects, and dynamics within the healthcare system. Simultaneously, there have been varying stances on the legitimacy of CO, leading to debates regarding its validity.The objectives of this article are to review the concept of conscientious objection in the healthcare context, analyze the factors motivating this right, examine the consequences of CO on the workload of non-objecting professionals, and explore its potential ethical conflict with distributive justice in healthcare. Finally, we will reflect on the possibility of institutional CO and its potential implications for the rights of patients and healthcare workers.(AU)

Bioética y democracia en la sociedad digital / Bioètica i democràcia a la societat digital / Bioethics and democracy in digital society

La sociedad contemporánea vive la revolución digital y la necesidad de reflexionar sobre la interacción entre los seres humanos y las tecnologías digitales. El auge de las tecnologías de inteligencia artificial y la algoritmización social ha planteado interrogantes sobre la indispensabilidad de la supervisión y el análisis ético de la información y los datos en Internet. Así como la necesidad de verificar la influencia de las plataformas digitales en el ejercicio de la ciudadanía. La bioética posibilita la investigación sobre los principios que se deben respetar en una sociedad democrática y digital. Resaltamos los principios de responsabilidad social y no discriminación con la intención de que los beneficios del uso tecnológico promuevan el bienestar y la calidad de vida de los menos favorecidos. Su objetivo es garantizar la supervivencia de la especie humana y la mejora de la protección de la vida de todos los seres vivos, animales y plantas. La reflexión bioética sobre el uso de la inteligencia artificial podría establecer la brújula moral que oriente el análisis de los conflictos éticos y la defensa de que a todos los seres humanos se les debe garantizar la igualdad de oportunidades y las condiciones para realizar plenamente su proyecto de vida.(AU)

La societat contemporània viu la revolució digital i la necessitat de reflexionar sobre la interacció entre els éssers humans i les tecnologies digitals. L'auge de les tecnologies d'intel·ligència artificial i la algoritmització social ha plantejat interrogants sobre la indispensabilitat de la supervisió i l'anàlisi ètic de la informació i les dades a Internet. Així com la necessitat de verificar la influència de les plataformes digitals en l'exercici de la ciutadania. La bioètica possibilita la recerca sobre els principis que es deuen respectar en una societat democràtica i digital. Destaquem els principis de responsabilitat social i no discriminació amb la intenció que els beneficis de l'ús tecnològic promoguin el benestar i la qualitat de vida dels menys afavorits. El seu objectiu és garantir la supervivència de l'espècie humana i la millora de la protecció de la vida de tots els éssers vius, animals i plantes. La reflexió bioètica sobre l'ús de la intel·ligència artificial podria establir la brúixola moral que orienti l'anàlisi dels conflictes ètics i la defensa que a tots els éssers humans se'ls ha de garantir la igualtat d'oportunitats i les condicionsper realitzar plenament el seu projecte de vida.(AU)

Contemporary society is going through the digital revolution and the need to reflect on the interaction between human beings and digital technologies. The rise of artificial intelligence technologies and social algorithmization has raised questions about the need for ethical monitoring and analysis of information and data on the Internet. As well as the need to verify the influence of digital platforms in the exercise of citizenship. Bioethics enables research on the principles that must be respected in a democratic and digital society. We highlight the principles of social responsibility and non-discrimination with the intention that the benefits of technological use promote the well-being and quality of life of the less favored. Its objective is to guarantee the survival of the human species and the improvement of the protection of the life of all living beings, animals, and plants. Bioethical reflection on the use of artificial intelligence could establish the moral compass that guides the analysis of ethical conflicts and the defense that all human beings must be guaranteed equal opportunities and the conditions to fully carry out their project of life.(AU)

Reconfiguración del principio de dignidad humana. La visibilidad de nuevos sujetos de derecho en el interior del orden jurídico colombiano / Reconfiguració del principi de dignitat humana. La visibilitat de nous subjectes de dret a l'interior de l'ordre jurídic colombià / Reconfiguration of the principle of human dignity. Visibility of new subjects of law within the Colombian legal order

Este trabajo tiene por objeto identificar de qué manera el sistema normativo colombiano de los últimos años se ha estructurado a partir del concepto Dignidad. Para ello se hará una presentación del término en tres momentos histórico-jurídicos a través de los cuales resulta posible construir una noción del sistema normativo según principios y valores afincados en una cosmovisión propia al alcance del término y la transformación jurídica de su significado en el que se transita de la legalidad a la dignidad humana y posteriormente hacia la dignidad de los sujetos de derecho. Es un trabajo descriptivo, analítico y crítico que servirá para identificar la actualidad del marco interpretativo de la Constitución y el orden jurídico en Colombia a lo largo de los últimos treinta años de vigencia de nuestro sistema constitucional.(AU)

Aquest treball té com a objectiu identificar de quina manera el sistema normatiu colombià dels últims anys s'ha estructurat a partir del concepte Dignitat. Per fer-ho, es farà una presentació del terme en tres moments històrico-jurídics a través dels quals resulta possible construir una noció del sistema normatiu segons principis i valors arrelats en una cosmovisió pròpia al voltant del terme i la transformació jurídica del seu significat en el qual es transita de la legalitat a la dignitat humana i posteriorment cap a la dignitat dels subjectes de dret. És un treball descriptiu, analític i crític que servirà per identificar l'actualitat del marc interpretatiu de la Constitució i l'ordre jurídic a Colòmbia al llarg dels últims trenta anys de vigència del nostre sistema constitucional.(AU)

The purpose of this paper is to identify how the Colombian regulatory system in recent years has been structured based on the dignity concept. For this, a presentation of the term will be made in three historical-legal moments through which it is possible to build a notion of the normative system according to principles and values based on a worldview of its own within the scope of the term and the legal transformation of this meaning in which it movesfrom legality to human dignity and later to the dignity of legal subjects. It is a descriptive, analytical and critical work that will serve to identify the actuality of the interpretative framework of the Constitution and legal order in Colombia throughout the last thirty years of validity of our constitutional system.(AU)

El cadáver en los sistemas jurídicos colombiano y español: una discusión jurídica, ética y bioética / El cadàver en els sistemes jurídics colombià i espanyol: una discussió jurídica, ètica i bioètica / The corpse in the Colombian and Spanish legal systems: Alegal, ethical and bioethical discussion

El objeto de este trabajo es contribuir al desarrollo conceptual de la categoría jurídica del cadáver en razón a la dificultad que representa la dualidad de sujeto–objeto y que eventualmente puede generar una desprotección al mismo. El estudio se limita a las legislaciones de España y Colombia, cuya regulación, además de estar estrechamente relacionada en sus orígenes, es similar en muchos aspectos. La hipótesis sostenida es que el cadáver es una sustancia corpórea que contiene información personal y en virtud de ello, la bioética se convierte en una fuente útil para su tratamiento y regulación.(AU)

L'objecte d'aquest treball és contribuir al desenvolupament conceptual de la categoria jurídica del cadàver en raó a la dificultat que representa la dualitat de subjecte–objectei que, eventualment, pot generar una des protecció a aquest. L'estudi es limita a les legislacions d'Espanya i Colòmbia, que a més d'estar estretament relacionada en els seus orígens, és similar en molts aspectes. La hipòtesi sostinguda és que el cadàver és una substància corpòria que conté informació personal i en virtut d'això, la bioètica es converteix en una font útil per al seu tractament i regulació.(AU)

The purpose of this work is to contribute to the conceptual development of the legal category of the corpse because of the difficulty represented by the duality of subject–object, which can eventually generate a lack of protection for the corpse. The study is limited to the legislation of Spain and Colombia, whose regulations, in addition to being closely related in their origins, are similar in many aspects. The hypothesis sustained is that the corpse is a corporeal substance that contains personal informationand by this, bioethics becomes a useful source of bioethical principles for its treatment and regulation.(AU)

Hidden Ethical Challenges in Health Data Infrastructure.

Data infrastructure includes the bureaucratic, technical, and social mechanisms that assist in actions like data management, analysis, storage, and sharing. While issues like data sharing have been addressed in depth in bioethical literature, data infrastructure presents its own ethical considerations, apart from the actions (such as data sharing and data analysis) that it enables. This essay outlines some of these considerations-namely, the ethics of efficiency, the visibility of infrastructure, the power of standards, and the impact of new technologies-in order to invite the bioethics community to participate in conversations about infrastructure, as their expertise is both needed and welcomed.

Interrupción del embarazo en nefritis lúpica: un análisis bioético desde el método integral / Termination of pregnancy in lupus nephritis: A bioethical analysis with the integrative method

Antecedentes y objetivo: La interrupción del embarazo en pacientes con enfermedades reumatológicas es controvertida y pocas veces se realiza un análisis bioético. En este estudio analizamos el caso de una paciente embarazada con nefritis lúpica sin respuesta a tratamiento a quien se le planteó la interrupción del embarazo. Métodos: Se aplicó el modelo integral, incluyendo distintos sistemas normativos para el análisis del dilema. Resultados: Desde el utilitarismo es justificable la interrupción del embarazo, buscando el mayor beneficio para la mayoría de las partes. La deontología justifica tanto continuar como interrumpir el embarazo, centrando la importancia en la acción misma y en la autonomía. Para la ética de la virtud, la importancia de las decisiones recae en la persona que realiza la acción buscando el florecimiento: la interrupción del embarazo sería justificable. Discusión y conclusiones: La interrupción del embarazo sería una solución adecuada según el modelo integral. El análisis bioético de casos paradigmáticos es fundamental para asegurar el mejor actuar posible en casos similares en reumatología.(AU)

Background and objective: Termination of pregnancy in patients with rheumatic diseases is controversial and a bioethical analysis is rarely performed. In this study we analysed the case of a pregnant patient with lupus nephritis unresponsive to treatment, for whom termination of pregnancy is considered. Methods: The integrative model was applied combining different normative ethical theories. Results: From a utilitarian perspective, termination of pregnancy is justifiable, seeking the greatest benefit for the greatest number of stakeholders. Deontology justifies both terminating and continuing the pregnancy, focusing on the action itself and on autonomy. In virtue ethics the importance of decisions rests with the person who performs the action seeking flourishing; termination of pregnancy would be justifiable. Discussion and conclusions: Interruption of pregnancy is a justifiable solution following the integrative model. Bioethical analysis of paradigmatic cases is essential to ensure the best possible action and as a precedent for future similar situations in rheumatology.(AU)

A Framework for Examining Bioethical Issues from a Sunni Perspective: Maslaha.

All religions should develop convincing responses to emerging bioethical problems stemming from medical and technological advancements. Additionally, believers need to know their faiths' interpretations of bioethical issues to be able to make medical decisions in line with their religious values. Therefore, Islamic bioethics should provide Muslims with conclusive and credible answers regarding newly rising problems in health care by revisiting the religious norms and decrees. However, the diversity in the Islamic denominations, the traditionalist aspect of the Sunni jurisprudence demanding strict compliance with the scriptural texts, the lack of unanimously accepted authority, and the limited number of academic works in Islamic bioethics (at least in English) complicate exploring new standards or rules for new ethical matters. In this view, the present paper aims to delineate two primary Islamic theological schools and propose al-Ghazali's maslaha as a general framework to analyze bioethical issues in the Sunni tradition. Maslaha allows exercising discretion in light of the protection of five fundamental values: religion, life, reason, lineage, and property. Maslaha has the potential to enable Sunni Muslims to appraise contemporary ethical questions, concerns, and dilemmas through an Islamic view and make more autonomous decisions by having religious guidelines.

The myth of translational bioethics.

In recent years, the case has been made for special attention to be paid to a branch of research in the field of bioethics called 'translational bioethics'. In this paper, we start by considering some of the assumptions that those advancing translational approaches to bioethics make about bioethics and compare them to the reality of bioethics as an academic field. We move on to explain how those who make this case, implicitly or explicitly, for translational bioethics go awry because of how they understand the 'gap' between bioethical inquiry and practical settings that requires bridging. We consider three interpretations of this 'translation gap' in bioethics: (i) the gap between theory and practice, (ii) the gap between the force of normative claims and practical contextual realities and (iii) the gap between relevance or applicability to practice and actual application or implementation in practice. In each case, we show how a proper understanding of the nature of the academic field of bioethics undermines how these gaps have been formulated, and how any need for talk of 'translational bioethics' is removed.

Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics.

Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term "social bioethics." Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare.

Lockdowns, Bioethics, and the Public: Policy-Making in a Liberal Democracy.

Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy-makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy-making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds-a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought to have on lockdown decision-making, including how policy-makers ought to handle misinformed or morally suspect viewpoints, and how policy-makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision-making, will be central to the field of bioethics as it increasingly focuses on policy and population-level issues and therefore ought to be priorities for future work.

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice.

The question of whether nursing ethics is a distinct entity within bioethics is an important and thought-provoking one. Though fundamental bioethical principles are appreciated and applied within the practice of nursing ethics, there exist distinct considerations which make nursing ethics a unique subfield of bioethics. In this article, we focus on the importance of relationships as a distinguishing feature of the foundation of nursing ethics, evidenced in its education, practice, and science. Next, we consider two objections to our claim of distinctiveness: first, that nursing ethics is merely an application of bioethical principles; second, that many bioethical subfields emphasize relationships. We respond by highlighting that throughout nursing education and generally in every career path that follows, the creation and nurturing of relationships is emphasized. Compassion and respect for the dignity of every patient is the framework upon which these therapeutic relationships are built. Much of the focus of nursing science rests on creating meaningful interpersonal experiences and human connection. After responding to each objection, we turn to the implications of this distinctiveness on clinical ethics practice, arguing that the strengths of our approach outweigh the limitations. The deep emphasis on creating meaningful interpersonal experiences and human connection supports a greater integration of relationships and social contexts into the evaluation of whether an action is ethically permissible, which is an important benefit in addressing the challenging human situations that patients face. Moreover, this perspective allows nurse ethicists to account for diverse and complex social structures and their influence in making ethical determinations. These strengths outweigh the limitations of potential inconsistencies between nurse and non-nurse clinical ethicists on the same service, a result we attribute to nursing ethics-and, in turn, the practice of the nurse ethicist-being framed by relationships to a larger extent than other bioethical subfields.

[Social participation in Chile's healthcare system: Reflective contributions from bioethics.] / Participación social en el sistema de salud de Chile: aportes reflexivos desde la bioética.

Social participation in health is related to the ability of collectives to intervene in the healthcare system. From a bioethical perspective, the relevance of social participation in health has been emphasized due to its positive effects at the level of social groups, the healthcare structure, and democratic political systems. To ensure social participation in health, bioethics advocates for the incorporation of deliberation as a tool for making binding decisions. The aim of this essay is to reflect on social participation in the history of Chile's healthcare system from a bioethical perspective. The main reflections indicate that participation is consultative in nature, lacking deliberation and, therefore, the distribution of power. Additionally, social participation has been redefined under the label of "citizen," promoting an instrumental, individual, and client-oriented character in healthcare. To subvert this situation, it is necessary to incorporate bioethical reflections into the healthcare structure to enable communities to consistently influence the healthcare system.

La participación social en salud se relaciona con la capacidad de intervención de los colectivos en el sistema sanitario. Desde la bioética, se ha enfatizado en la relevancia de la participación social en salud debido a los efectos positivos a nivel de los grupos sociales, de la estructura sanitaria y de los sistemas políticos democráticos. Para asegurar la participación social en salud, la bioética aboga por la incorporación de la deliberación como herramienta para la toma de decisiones vinculantes. El objetivo del presente ensayo es reflexionar sobre la participación social en la historia del sistema de salud de Chile desde la óptica de la bioética. Las principales reflexiones indican que la participación es de tipo consultiva, sin deliberación y, por tanto, sin distribución de poder. Asimismo, la participación social fue resignificada por la etiqueta de "ciudadana", potenciando el carácter instrumental, individual y clientelar en salud. Para subvertir esta situación, se requiere incluir reflexiones bioéticas en la estructura sanitaria con el propósito que las comunidades puedan incidir de manera consistente en el sistema de salud.

[Health care for trans people: a bioethical reflection]. / http://aebioetica.org/revistas/2023/34/112/309.pdf.

Health care for trans people has not been among the priorities of Bioethics, so that in most of the manuals of this discipline there is no reference to this issue, or it is covered in a rather simple or measured way. However, it is necessary to note that in the last decade the bioethical debate, on gender issues in general and on transsexualism in particular, has increased significantly. This work seeks to offer the transsexual person, the health professional or the student on the trans topic tools to articulate their particular bioethical reflection. It has two clearly differentiated parts. In the first, the aspects that are considered necessary to consider when assessing the ethics of a gender change intervention are presented. In the second part, a reflection is offered on the lines of argument that support the different bioethical currents..