Euthanasia, consensual homicide, and refusal of treatment.

Consensual homicide remains a crime in jurisdictions where active voluntary euthanasia has been legalized. At the same time, both jurisdictions, in which euthanasia is legal and those in which it is not, recognize that all patients (whether severely ill or not) have the right to refuse or withdraw medical treatment (including life-saving treatment). In this paper, I focus on the tensions between these three norms (the permission of active euthanasia, the permission to reject life-saving treatment, and the prohibition of consensual homicide), assuming a justification of euthanasia based on the right to (personal) autonomy. I argue that the best way to provide a coherent account of these norms is to claim that patients have two distinct rights: the right to autonomy and the right to bodily integrity. This solution has some relevant implications for the discussion of the legalization of active euthanasia.

Propuesta para la elaboración de un protocolo de triaje en el contexto de la pandemia de COVID-19 / Proposal for the elaboration of a triage guideline in the context of the COVID-19 pandemic / Proposta per a l'elaboració d'un protocol de prova en el context de la pandèmia de COVID-19

Este documento ofrece una propuesta desde la perspectiva de la bioética para la elaboración de un protocolo de triaje en el contexto de la pandemia de COVID-19. Dicha propuesta incluye recomendaciones sobre las normas procedimentales y normas sustantivas que deben regir la asignación y reasignación de recursos terapéuticos en condiciones de escasez extrema

This document offers a proposal for the elaboration of a triage guideline in the context of the COVID-19 pandemic. This proposal includes recommendations on the procedural norms and substantive norms that should govern the allocation and reallocation of therapeutic resources in conditions of extreme scarcity

Aquest document ofereix una proposta des de la perspectiva de la bioètica per a l'elaboració d'un protocol de triatge en el context de la pandèmia de COVID-19. L'esmentada proposta inclou recomanacions sobre les normes procedimentals I normes substantives que han de regir l'assignació I reassignació de recursos terapèutics en condicions d'escassetat extrema

El papel de las ciencias empíricas en el derecho: el estatus del embrión humano / The role of empirical sciences in the law: the status of the human embryo / El paper de les ciències empíriques en el dret: l'estatus de l'embrió humà

Se analizan dos sentencias Ajudiciales antagónicas en relación con el estatus jurídico del embrión humano: el fallo "Portal de Belén", de la Corte Suprema de Justicia de la Argentina, y "Artavia Murillo", de la Corte Interamericana de Derechos Humanos. Mi propósito es mostrar que, a pesar de sostener posiciones contrarias, ambas sentencias cometen el mismo tipo de error conceptual: justificar su tesis acerca del estatus del embrión humano en consideraciones biológicas acerca del desarrollo embrionario. Detectar este tipo de falencia argumentativa puede ser útil para el análisis de muchas decisiones judiciales sobre temas bioéticos

In this paper, I consider two opposite judicial decisions concerning the legal status of the human embryo: "Portal de Belén" by the Argentine Supreme Court, and "Artavia Murillo" by the Inter-American Court of Human Rights. My purpose is to show that, although both decisions defend opposite positions, they commit the same kind of mistake. Both seek to ground a position about the legal status of the human embryo on biological considerations on embryo development. Highlighting this kind of argumentative failure can be useful for the analysis of judicial decisions with bioethical import

S'analitzen dues sentències judicials antagòniques en relació amb l'estatus jurídic de l'embrió humà: la sentència "Portal de Belém", de la Cort Suprema de Justícia de l'Argentina, i la sentència "Artavia Murillo", de la Cort Interamericana de Drets Humans. El meu propòsit és mostrar que, malgrat sostenir posicions contràries, ambdues sentències cometen el mateix tipus d'error conceptual: basar la seva tesi sobre l'estatus de l'embrió humà en consideracions biològiques sobre el desenvolupament embrionari. Detectar aquest tipus de fal·làcia argumentativa pot ser útil per a l'anàlisi de moltes decisions judicials sobre temes bioètics

Explotación y bioética. Ética individual y regulación jurídica / Exploitation and bioethics. Individual ethics and legal regulation

En este artículo discuto los contratos o transacciones explotativas en bioética. El caso más problemático teóricamente parece ser el de lo que Allan Wertheimer llama explotación «mutuamente ventajosa»: el consentimiento de la parte débil (D) para realizar la transacción es un consentimiento efectivo y racional. Además, D no sufre un daño mediante la transacción, sino que, por el contrario, esta transacción lo beneficia en comparación con no realizar la transacción. Mi objetivo en este trabajo es, por un lado, presentar, desde el punto de vista de la ética individual, un modelo para pensar la naturaleza de la incorrección que podemos asignarle a la conducta de la parte fuerte al contratar con D en forma explotativa. En segundo lugar, ofrezco algunas razones por las cuales, en el plano de la ética jurídica, la prohibición jurídica de este tipo de conductas explotativas es problemática y sólo podría ser justificada en casos muy excepcionales

In this paper, I discuss exploitative transactions in bioethics. The most problematic case is what Allan Wertheimer calls «mutually advantageous» exploitation: the weak party’s (W’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 conceive the nature of the wrongfulness of strong party’s action. 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

Is medically assisted death a special obligation?

Several distinct arguments conclude that terminally ill patients have a right to a medically assisted death; two are especially influential: the autonomy argument and the non-harm argument. Both have proven convincing to many, but not to those who view the duty not to kill as an (almost) absolute constraint. Some philosophers see the source of such a constraint in general (deontological) moral principles, other in the nature of the medical profession. My aim in this paper is not to add one further argument in favour of medically assisted death. Rather, I want to shed light on a kind of reason that, to my mind, has not been previously highlighted or defended, and that might shake the principled conviction that doctors are never allowed to actively assist their patients to die. Specifically, my purpose is to show that doctors (as members of the medical profession) have a special duty to provide medically assisted death to consenting terminally ill patients, because (and insofar as) they have been participants in the process leading to the situation in which a patient can reasonably ask to die. In some specific ways (to be explained), they are involved in the tragic fate of those patients and, therefore, are not morally allowed to straightforwardly refuse to assist them to die.

Organ sales and moral distress.

The possibility that organ sales by living adults might be made legal is morally distressing to many of us. However, powerful arguments have been provided recently supporting legalisation (I consider two of those arguments: the Consequentialist Argument and the Autonomy Argument). Is our instinctive reaction against a market of organs irrational then? The aim of this paper is not to prove that legalization would be immoral, all things considered, but rather to show, first, that there are some kinds of arguments, offered in favour of legalisation, that are, in an important sense, illegitimate, and second, that even if legalisation might not be wrong all things considered, there are good reasons for our negative moral intuitions. Moreover, identifying these reasons will help highlight some features of moral decisions in non-ideal situations, which in turn might be relevant to some other moral or policy choices.

Ethics and genetics in Latin America.

Genetic research in human beings poses deep ethical problems, one being the problem of distributive justice. If we suppose that genetic technologies are able to produce visible benefits for the well being of people, and that these benefits are affordable to only a favored portion of society, then the consequence is obvious. We are introducing a new source of inequality. In the first section of this paper, I attempt to justify some concern for the distributive consequences of applying genetics to human beings. This concern transcends a mere preoccupation for material equality. I argue that genetic inequality can undermine the very basis of social cooperation, at least regarding health care. The second section is more practical. My aim is to defend how, at least in some legal and cultural frameworks (such as those clearly apparent in some Latin American countries), the undesired distributive consequences of genetics are more likely to arise and more difficult to avoid.