The extent of government intervention in the public health system and individual freedoms during the Covid-19 pandemic: a theoretical analysis.

The concept of individual freedom has complex and multifaceted dimensions that significantly affect the limits of permissible government interventions aimed at restricting such freedoms and maintaining public health. Therefore, the boundary between individual freedom and the social obligations of the government must be carefully clarified. During the Covid-19 pandemic, the need for such clarifications clearly increased. This study intended to investigate the concept of freedom according to major theories and to observe their application in analyzing the relations between individuals and the government in the health system, particularly during public health emergencies. The findings revealed that "justice-based", "development-based" and "accountability-based" conceptions of freedom provide a more appropriate rationale for implementation of public health restrictive measures by health authorities during infectious disease outbreaks including pandemics such as COVID-19. Even in minimal governments that are built upon a free-market system and unrestricted conception of individuals' freedom, such public health interventions are justifiable in the light of the 'Catastrophic Moral Horror' where there is an extreme risk to the health of citizens.

The rationale for detention in the Jordanian Code of criminal procedure: A comparative study with French law.

Amendments to the Jordanian Code of Criminal Procedure (JCCP) concerning the rationale for detention have narrowed its scope of application and provided for alternatives. However, although these amendments are important, their drafting has not achieved the stated objectives. To address this issue, the laws of Jordan and France are reviewed. The study's novelty lies in the justification for detention in the JCCP, which takes advantage of the long experience of French law and justice. It is recommended that the Public Prosecutor and the competent court justify an extension to a period of detention or a denial of release based on Article 114(1) of the JCCP. It is also suggested that a detention warrant is only issued or extended when grounded on the details of the specific case; that is, detention must only be effected when an alternative cannot achieve one or more of the goals of detention.

Individual Freedom in the Initial Response to Covid-19.

The COVID-19 pandemic has been a phenomenal challenge to global health care and will continue to be so in the upcoming months. Beyond its medical toll, COVID-19 has also exacerbated pre-existing social issues and created new inequalities. This has generated a series of ethical problems that will need to be carefully analyzed to avoid repeating similar mistakes in the context of other crises. Among those, we discuss here the bioethical implications of preserving individual freedom in the context of the early response to a pandemic and propose a global approach to the issue that could be applied in future health challenges.

Ley Orgánica 3/2021 sobre regulación de la eutanasia: ¿una ley deshumanizadora? / Organic Law 3/2021 on regulation of Euthanasia: A dehumanizing law?

El Congreso de los Diputados español ha aprobado la ley de regulación de la eutanasia. Precisamente,este artículo trata sobre las declaraciones más importantes realizadas por los defensores de la misma. Estasgiran en torno a los siguientes conceptos: dignidad, derecho, libertad, y dolor-sufrimiento. La dignidadhumana es el principio individual y social por excelencia, y del que se derivan los otros tres. Por esta razón,por defender la dignidad, que el ser humano posee por el hecho de serlo, se está en contra de esta nuevaLey. La dignidad humana no es destruida por la enfermedad terminal, ni por la dependencia, ni el sufri-miento, ni la debilidad o la fragilidad. Cada vida humana tiene valor en sí misma, que se debe respetar yque la hace innegociable en toda situación y condición. El valor innegociable de la vida sustenta cualquiersistema democrático. Sin embargo, el supuesto derecho a la eutanasia es propio de una visión individualis-ta y reduccionista del ser humano y de su vida; y de una libertad desvinculada tanto de la bondad o maldadde la elección y acción realizadas, como de la responsabilidad hacia la vida de los demás. Frente a ofrecerla eutanasia, como única solución al dolor y al sufrimiento de las personas en la última etapa de su vida,deben proponerse unos cuidados paliativos de calidad. Estos son la única opción ética acorde con el respetoa la dignidad humana. Respetar, valorar, cuidar, y atender a la vida humana vulnerable y frágil suponenprogresar en humanidad.(AU)

The Spanish Congress of Deputies has approved the law regulating euthanasia. Precisely, the articledeals at the statements made by its defenders. These revolve around the following concepts: dignity, right,freedom and, finally, pain-suffering. Human dignity is the individual and social principle par excellence andfrom which the other three are derived. For this reason, by defending the dignity that the human beingpossesses, simply, by the fact of being it, it is against said Law. Human dignity is not destroyed by terminalillness, or by dependency, suffering, weakness or frailty. Each human life has value in itself, which must besafeguarded and which makes it non-negotiable in all situations and conditions. That the non-negotiablevalue of life sustains any democratic system. However, the supposed right to euthanasia is typical of an in-dividualistic and reductionist vision of the human being and his life; and of a freedom detached both from the goodness or badness of the choice and action carried out, and from the responsibility towards the livesof others. Faced with offering euthanasia, as the only solution to the suffering of people in the last stageof their life, quality palliative care should be proposed. These are the only ethical option, consistent withrespect for human dignity. Respecting, valuing, caring for, and attending to vulnerable and fragile humanlife means progress in humanity.(AU)

Face masks in the general healthy population. Scientific and ethical issues.

In most European countries, facemasks use is recommended or mandatory in enclosed spaces where physical distancing is not possible. In Spain, this measure was first extended to open public spaces and later made mandatory regardless of whether or not the interpersonal safety distance can be kept. At present, there is no evidence on the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses, including SARS-CoV-2. The mandatory use of masks poses some ethical questions. Firstly, it entails a paternalistic action. Secondly, application of the principle of precaution becomes questionable when there is no clear benefit-risk relationship. Thirdly, compulsoriness can interfere with equity of public health actions. Fourthly, it can result in social stigma and discrimination against those who do not wear one, even though they well may have good reasons for doing so. Lastly, this measure may generate confusion in the population, along with an altered perception of the risk. The World Health Organization recommends its use in public places with a high potential risk of transmission and where other prevention measures, such as physical distancing, are not possible. Mandatory use of masks in public open spaces, regardless of the risk of transmission or of whether or not the interpersonal safety distance can be kept, is an intrusive measure that restricts individual freedoms, and would not appear to be justified on the basis of available scientific evidence. What we need are recommendations explaining where, when, how and what type of mask to wear.

Liberdade e desejo de constituir família: percepções de jovens adultos / Freedom and the desire to constitute a family: perceptions of young adults / Libertad y deseo de constituir una familia: percepciones de jóvenes adultos

Neste estudo, são examinadas as repercussões do individualismo na família contemporânea a partir de resultados de uma pesquisa qualitativa, por meio da qual se investigou como os planos de constituir uma família se inserem nos projetos de vida de indivíduos pertencentes a segmentos médios da população carioca de duas gerações. Para este trabalho, foram selecionados resultados das análises dos discursos de dez entrevistados da geração mais jovem, homens e mulheres, com idades entre 27 e 34 anos. Concluiu-se que a valorização da individualidade e da liberdade pessoal nas relações amorosas, a atribuição de fragilidade às relações amorosas e a visão de casamento como algo que limita a liberdade individual são reflexos do individualismo que influenciam diretamente a forma como a família é concebida nos projetos dos indivíduos. Com isso, o casamento vem deixando de ser o foco nos planos de constituir família, e os filhos passam a ocupar um lugar mais central para os indivíduos(AU)

In this study we examine the repercussions of individualism in the contemporary family from the results of a qualitative research, which investigated how the plans for constituting a family are inserted in the life projects of individuals from two generations. For this work we selected results from the discourse analysis of ten interviewees from a younger generation, men and women, aging from 27 to 34 years-old. We concluded that the appreciation of both individuality and personal freedom in loving relationships, the character of fragility attributed to loving relationships, and the perspective of marriage as constraining individuals are reflections of individualism that directly influence the way family is conceived in individuals' projects. Therefore, marriage is not anymore the focus when planning a family, and children are now central to the individuals(AU)

En este estudio se examinaron las repercusiones del individualismo en la familia contemporánea a partir de resultados de una investigación cualitativa, en la cual se investigó cómo los planes de constituir una familia se insieren en los proyectos de vida de individuos que pertenecen a segmentos medios de la población de Rio de Janeiro de dos generaciones. Para este trabajo se seleccionaron resultados de los análisis de discursos de diez encuestados de la generación más joven, hombres y mujeres, con edades entre 27 y 34 años. Se concluyó que la valoración de la individualidad y de la libertad personal en las relaciones amorosas, la atribución de fragilidad a las relaciones amorosas y la percepción del matrimonio como algo inhibidor del individuo, son reflejos del individualismo que influyen directamente en la forma cómo la familia se concibe en los proyectos de los individuos. Por lo tanto, el matrimonio ha dejado de ser el foco en los planes de construir una familia, y los hijos pasan a ocupar un lugar más central para los individuos(AU)

Liberdade e desejo de constituir família: percepções de jovens adultos / Freedom and the desire to constitute a family: perceptions of young adults / Libertad y deseo de constituir una familia: percepciones de jóvenes adultos

Neste estudo, são examinadas as repercussões do individualismo na família contemporânea a partir de resultados de uma pesquisa qualitativa, por meio da qual se investigou como os planos de constituir uma família se inserem nos projetos de vida de indivíduos pertencentes a segmentos médios da população carioca de duas gerações. Para este trabalho, foram selecionados resultados das análises dos discursos de dez entrevistados da geração mais jovem, homens e mulheres, com idades entre 27 e 34 anos. Concluiu-se que a valorização da individualidade e da liberdade pessoal nas relações amorosas, a atribuição de fragilidade às relações amorosas e a visão de casamento como algo que limita a liberdade individual são reflexos do individualismo que influenciam diretamente a forma como a família é concebida nos projetos dos indivíduos. Com isso, o casamento vem deixando de ser o foco nos planos de constituir família, e os filhos passam a ocupar um lugar mais central para os indivíduos...

In this study we examine the repercussions of individualism in the contemporary family from the results of a qualitative research, which investigated how the plans for constituting a family are inserted in the life projects of individuals from two generations. For this work we selected results from the discourse analysis of ten interviewees from a younger generation, men and women, aging from 27 to 34 years-old. We concluded that the appreciation of both individuality and personal freedom in loving relationships, the character of fragility attributed to loving relationships, and the perspective of marriage as constraining individuals are reflections of individualism that directly influence the way family is conceived in individuals' projects. Therefore, marriage is not anymore the focus when planning a family, and children are now central to the individuals...

En este estudio se examinaron las repercusiones del individualismo en la familia contemporánea a partir de resultados de una investigación cualitativa, en la cual se investigó cómo los planes de constituir una familia se insieren en los proyectos de vida de individuos que pertenecen a segmentos medios de la población de Rio de Janeiro de dos generaciones. Para este trabajo se seleccionaron resultados de los análisis de discursos de diez encuestados de la generación más joven, hombres y mujeres, con edades entre 27 y 34 años. Se concluyó que la valoración de la individualidad y de la libertad personal en las relaciones amorosas, la atribución de fragilidad a las relaciones amorosas y la percepción del matrimonio como algo inhibidor del individuo, son reflejos del individualismo que influyen directamente en la forma cómo la familia se concibe en los proyectos de los individuos. Por lo tanto, el matrimonio ha dejado de ser el foco en los planes de construir una familia, y los hijos pasan a ocupar un lugar más central para los individuos...

America, guns, and freedom. Part I: A recapitulation of liberty.

The role of gun violence and street crime in the United States and the world is currently a subject of great debate among national and international organizations, including the United Nations. Because the Second Amendment to the U.S. Constitution protects the individual right of American citizens to own private firearms, availability of firearms is greater in the U.S. than the rest of the world, except perhaps in Israel and Switzerland. Indeed, although the American people continue to purchase and possess more firearms, homicides and violent crimes have continued to diminish for several decades because guns in the hands of the law-abiding citizens does not translate into more crime. As neurosurgeons, we can be compassionate and still be honest and have the moral courage to pursue the truth and find viable solutions through the use of sound, scholarly research in the area of guns and violence. We have an obligation to reach our conclusions based on objective data and scientific information rather than on ideology, emotionalism or partisan politics.

Dignidade e autodeterminação física como fundamento do estatuto do paciente / Dignity and physical self determination as basis of patient status / Dignidad y autodeterminación física como fundamento del estatuto del paciente

Este trabajo contiene una reflexión sobre el estatuto del paciente. Tanto el Derecho de los Estados como el Derecho internacional y supranacional han respondido a los cambios operados en el ámbito de ciencias de la salud, incorporando normas específicas en relación con los derechos de las personas. Se analizan los conceptos de dignidad y libertad individual como fundamentos necesarios del estatuto del paciente y se defiende que la libertad de la persona se manifiesta en el ámbito biomédico a través de un nuevo derecho: el derecho de autodeterminación física, que define un ámbito de agere licere, un haz de facultades, de libertad decisoria, que debe estar protegida por el Derecho, y que permite a la persona decidir, optar o seleccionar qué hacer o no hacer respecto de aquellas cuestiones y situaciones que afecten su realidad física, su sustrato corporal. Complementariamente, se explica la posición transversal del principio de igualdad en la interpretación y aplicación de los derechos incluidos en el estatuto del paciente...

This study reflects on patient status. Both States Laws and international and supranational laws have respond to changes operated in health sciences, incorporating specific norms related to human rights. Dignity and individual freedom concepts are analyzed as necessary basis for patient status and personal freedom manifested in the field of biomedicine is defended by a new right: the right to physical self determination, which defines the field to improve decision making faculties, protected by law and that allows the person to decide, choose and select what to do or not to do with respect to questions and situations that affect his/her physical reality, his/her corporeity...

Este trabalho contém uma reflexão sobre o estatuto do paciente. Tanto o Direito dos Estados como o Direito internacional e supranacional têm respondido aos câmbios operados no âmbito das ciências da saúde, incorporando normas específicas em relação aos direitos das pessoas. São analisados os conceitos de dignidade e liberdade individual como fundamentos necessários do estatuto do paciente e se defende que a liberdade da pessoa se manifesta no âmbito biomédico através de um novo direito: o direito de autodeterminação física, que define um âmbito de agir livre, um feixe de faculdades, de liberdade decisória, que deve estar protegida pelo Direito, e que permite à pessoa decidir, optar ou selecionar o que fazer ou não fazer a respeito daquelas questões e situações que afetam sua realidade física, seu substrato corporal. Complementariamente, se explica a posição transversal do princípio de igualdade na interpretação e aplicação dos direitos incluidos no estatuto do paciente...

Ronald Dworkin on abortion and assisted suicide.

In the first part of this article, I raise questions about Dworkin's theory of the intrinsic value of life and about the adequacy of his proposal to understand abortion in terms of different ways of valuing life. In the second part of the article, I consider his argument in "The Philosophers' Brief on Assisted Suicide", which claims that the distinction between killing and letting die is morally irrelevant, the distinction between intending and foreseeing death can be morally relevant but is not always so. I argue that the killing/letting die distinction can be relevant in the context of assisted suicide, but also show when it is not. Then I consider why the intention/foresight distinction can be morally irrelevant and conclude by presenting an alternative argument for physician-assisted suicide.

Abortion, value and the sanctity of life.

In Life's Dominion Dworkin argues that the debate about abortion is habitually misconstrued. Substantial areas of agreement are overlooked, while areas of disagreement are, mistakenly, seen as central. If we uncover a truer picture, then hope of a certain accord may no longer seem vain. I dispute many of these claims. Dworkin argues that both sides in the debate are united in believing that life is sacred, or intrinsically valuable. I disagree. I maintain that only in a very attenuated sense of intrinsic value will this be agreed upon. I consider how an account of such value might be further fleshed out, but suggest, if this is done on any plausible lines, agreement will fall away. Dworkin argues, also, that the issue of personhood, does not, contrary to widespread belief, keep the parties apart. Again I disagree. We need to distinguish the question of whether there is in fact dispute over this issue from that of whether there is, in truth, good reason for dispute. And I argue that, rightly or wrongly, the issue of personhood remains central. Dworkin suggests that the purported proximity between the two sides offers some hope of an eventual reconciliation. At least, they will agree to differ, accepting that in this area freedom of choice is paramount. I am sceptical. Even this measure of reconciliation depends upon conservatives giving up positions which, I argue, they will continue to maintain. There is a further point. Dworkin appears to be, in many ways, cautiously optimistic. I appear, in contrast, to be pessimistic. I argue, however, that only so long as we do disagree over matters of substance is there much hope that our differences might be resolved.

The values of life.

In Life's Dominion Dworkin aims at defusing the controversy about abortion and euthanasia by redefining its terms. Basically it is not a dispute about the right to life, but about its value. Liberals should grant that human life has not only a personal, but also an intrinsic value; conservatives should accept the principle of toleration which requires to let people decide for themselves about matters of intrinsic value. Dworkin fails, however, to distinguish between two kinds of personal value: (1) the value of something to a person, when he actually or dispositionally desires it, or finds it pleasant; and (2) the value of something to a person, when it's objectively contributes to his well-being, as defined by reference to his personal point of view, whether or not he ever perceives it as so contributing. He also fails to distinguish between two meanings of the concept of 'intrinsic value': (3) ultimate, i.e. non-instrumental personal value of kind (2); (4) the impersonal value of something which is not good-for-anybody, but simply good, i.e. not a constituent of someone's well-being. Dworkin argues that the human fetus from conception onwards has a value, that it is not a personal value of kind (1), and therefore must be an intrinsic value. But the value of the life of the fetus is not a personal value of kind (2) either and therefore not an intrinsic value of kind (3): it is normally a constituent of the well-being of the pregnant woman, but that doesn't constitute its value, and it is not good 'for' the fetus itself in the relevant sense, because it doesn't have a personal point of view. If, however, the fetus' life is allowed to have an intrinsic value of kind (4), the conservative cannot be refuted by appeal to the principle of toleration, for this only concerns intrinsic value of kind (3). The liberal, indeed, should recognize that the fetus' life has a value, but it is neither a personal value (1) or (2), nor an impersonal value (4), but rather a relational value which gradually develops from some point substantially later than conception.

Embryos created for research purposes.

The creation of embryos for research use has drawn a great deal of criticism. It is difficult to defend an ethical distinction between what one can do to "spare" embryos and what one can do to "research" embryos. The strongest ground on which to argue against the creation of embryos for research is a symbolic one, having to do with respect for human life. Ronald Dworkin's work in Life's Dominion on the symbolic meaning of the abortion debate throws a helpful light on this dispute. By understanding the basic question to be, Does the creation of research embryos weaken or insult our communal respect for the sanctity of human life in some way that in vitro fertilization (IVF) or the experimental use of "spare" embryos does not?, the debate can move in a more constructive direction.