The eco-ethical contribution of Menico Torchio - a forgotten pioneer of European Bioethics.

BACKGROUND: In 1926, Fritz Jahr described bio-ethics (German: bio-ethik) as "the assumption of moral obligations not only towards humans, but towards all forms of life." Jahr summarized his philosophy by declaring, "Respect every living being on principle as an end in itself and treat it, if possible, as such!." Bioethics was thus originally an ethical system concerned with the "problems of interference with other living beings… and generally everything related to the balance of the ecosystem" according to the 1978 Encyclopedia of Bioethics. This definition was predicated on the work of Fritz Jahr, Menico Torchio, and Van Rensselaer Potter. METHODS: In order to proceed with depthful analysis of the origin and major bioethical flare up, we will use critical analysis of existing literature, followed by a study trip to relevant bioethical localities (collecting photo and other documentations regarding Menico Torchio). RESULTS: While Jahr and Potter are typically given intellectual credit for developing the field of bioethics, the eco-ethical contributions of Menico Torchio have been forgotten.This article will first trace the origins of "bioethics" - now commonly bifurcated into "biomedical ethics" and "environmental bioethics." The former was developed by Tom Beauchamp from the Philosophy Department and James Childress of the Religious Studies department at Georgetown University and is based on principlism, with a narrow focus on medical settings. The latter addresses the environmental impact of the medical industry and climate change health hazards. Second, we will present a panorama of Torchio's significant intellectual contribution to bioethics. Menico Torchio's concept of bioethics synthesized work of both Jahr and Potter, advocating "the need to expand our ethical obligations and embrace the most developed groups of animals, not only physically but also psychologically." Third, we will reflect on the lasting legacy of "bioethics" on biomedical and environmental bioethics today. Thematic elements such as interconnectedness of planetary health and human health, dedication to living in harmony with nature, and emphasis on systems and symbiosis remain unchanged from the legacy of Tochio onward. CONCLUSION: Our conclusion will underscore the necessity of understanding the connections between planetary, environmental, and human health.

COMMENT: Bioethics in Unani medicine: Relevant quotes from Kamilussanah, a 10th century manuscript.

The World Health Organization (WHO) in its Alma Ata Declaration, 1978, focuses on the development, promotion and recognition of the traditional medical systems. India has taken steps in this direction by recognising Unani medicine with other traditional medical systems practised in India. Presently, Government is promoting integration of the recognised traditional medical systems with conventional medicine at the national level, as an interdisciplinary approach to providing better patient-centred care. Bioethics is a field of enquiry that examines ethical issues and dilemmas emerging from medical care and research involving humans. Although the term 'bioethics' was first mentioned in 1927 and later established as a distinct discipline in 1970s, the ethical principles in various contexts had been described centuries ago in the classical texts pertaining to traditional medical systems. Since ethics as a code of conduct was followed by ancient Unani physicians to safeguard the interests of humanity when providing healthcare, it was felt that a review of classical Unani manuscripts should be attempted to give an insight into codes of conduct described by various Unani physicians. In this paper, a 10th century book, "Kamilussanah" authored by Ali ibn Abbas al-Majoosi, also known as Majoosi (930-994 CE), is reviewed through the prism of ethics.

Hacia una sociedad más justa y equitativa a través de la enfermería renacentista de San Juan de Dios / Rumo a uma sociedade mais justa e mais justa através da Enfermagem do Renascimento de São João de Deus / Towards a fairer and more equitable society through the Renaissance Nursing of Saint John of God

Background: Was there bioethics before Potter? Certainly yes, and a clear example is the Nursingof San Juan de Dios, father of modern Nursing of the s. XVI. After performing various trades, it will bein Granada where he will reform the socio-health care by observing the great inequalities between peopledue to a social and individual conscience numbed by the sense of honor; developing a high sense ofotherness, being his being, the other, framed within a community. And since the poor were his focus ofaction, the sick were his priority, since they were the most disadvantaged dying on the streets of Granada.Aim: Therefore, in this study we propose to describe the principle of Justice and Equality in San Juan deDios through his care, influenced by his Master San Juan de Ávila. Methodology: For this we resort tothe historiographic-hermeneutic method, being the documentary sources the texts of the same closest totheir time. Results-Conclusion: In them we have been able to observe how their spirituality led them totake care of all kinds of people, being the poor, sick, women and children, the center of their actions.However, he took care of the entire population, awakening solidarity among the entire population,making them co-responsible for all their hospital reform through material and human resources. (AU)

Introducción: ¿Existía bioética antes de Potter? Ciertamente sí, y un claro ejemplo es laEnfermería de San Juan de Dios, padre de la Enfermería moderna del s. XVI. Tras desempeñar diversosoficios, será en Granada donde reformará la atención socio-sanitaria al observar las grandesdesigualdades entre personas por una conciencia social e individual adormecida por el sentido del honor;desarrollando un alto sentido de la alteridad, siendo su ser, el otro, enmarcado dentro de una comunidad.Y siendo los pobres su foco de actuación, los enfermos fueron su prioridad, pues eran los másdesfavorecidos muriendo por las calles de Granada. Objetivo: En este estudio nos proponemos describirel principio de Justicia e Igualdad en San Juan de Dios a través de sus cuidados, influido por su MaestroSan Juan de Ávila. Metodología: Para ello recurrimos al método historiográfico-hermenéutico, siendo lasfuentes documentales los textos de los mismos más cercanos a su tiempo. Resultados-Conclusión: Enellos hemos podido observar cómo su espiritualidad les llevó a atender a todo género de personas, siendolos pobres, enfermos, mujeres y niños, el centro de su actuación. Sin embargo, cuidó a toda la poblacióndespertando la solidaridad en toda persona haciéndoles co-responsables de toda su reforma hospitalariamediante recursos materiales y humanos. (AU)

Introdução: Havia bioética antes de Potter? Certamente sim, e um exemplo claro é a Enfermagemde San Juan de Dios, pai da Enfermagem moderna do s. XVI. Depois de realizar vários ofícios, será emGranada onde irá reformar o sistema sócio-sanitário observando as grandes desigualdades entre aspessoas devido a uma consciência social e individual entorpecida pelo sentido da honra; desenvolver umalto senso de alteridade, sendo seu ser, o outro, enquadrado em uma comunidade. E como os pobres eramo seu foco de ação, os doentes eram a sua prioridade, pois eram os mais desfavorecidos morrendo nasruas de Granada. Objetivo: Portanto, neste estudo, propomos descrever o princípio da Justiça e daIgualdade em San Juan de Dios com seus cuidados, influenciados por seu Mestre San Juan de Ávila.Metodologia: Para isso, recorremos ao método historiográfico-hermenêutico, sendo as fontesdocumentais os textos mais próximos do seu tempo. Resultados-Conclusão: Neles, conseguimos observarcomo sua espiritualidade os levou a cuidar de todos os tipos de pessoas, sendo pobres, doentes, mulherese crianças, o centro de suas ações. No entanto, ele cuidou de toda a população, despertando asolidariedade entre toda a população, tornando-os co-responsáveis por toda a reforma hospitalar atravésde recursos materiais e humanos. (AU)

Bioética e seus paradigmas teóricos / Bioethics and its theoretical paradigms / La bioética y sus paradigmas teóricos

Resumo O artigo busca contribuir para a compreensão da história e dos modelos teóricos da bioética por meio de abordagem interdisciplinar que engloba diversas áreas do conhecimento, em especial história e filosofia. Num primeiro momento, o trabalho procura caracterizar o panorama histórico de surgimento da bioética, as questões terminológicas surgidas nesse período e o enquadramento da bioética como disciplina ou campo de discursividade. Posteriormente, o texto apresenta os principais paradigmas teóricos da bioética e os analisa criticamente.

Abstract This article seeks to contribute to the understanding of the history and theoretical models of bioethics by an interdisciplinary approach that encompasses different areas of knowledge, especially history and philosophy. First, the study characterizes the historical background on the emergence of bioethics, the terminological issues that arose in this period, and the framing of bioethics as a discipline or field of discourse. Subsequently, the text presents the main theoretical paradigms of bioethics and critically analyzes them.

Resumen El artículo busca contribuir a la comprensión de la historia y los modelos teóricos de la bioética a través de un enfoque interdisciplinario que abarca varias áreas del conocimiento, especialmente la historia y la filosofía. En un primer momento, el trabajo busca caracterizar el panorama histórico del surgimiento de la Bioética, las cuestiones terminológicas surgidas en ese período y el encuadre de la bioética como disciplina o campo de discursividad. Posteriormente, el texto presenta los principales paradigmas teóricos de la Bioética y los analiza críticamente.

Chapitre 1. Bioéthique et Droits de l'homme : historique comparé entre l'Europe et l'Amérique latine aux XVIIIe et XIXe siècles.

In this work, the aggressions of the “First Peoples” An analysis of the place of “Mother Nature” in human thought suggests the importance of respecting it. This respect is an important foundation for respect for human rights, as is the awareness of, constantly, fighting poverty and considering all human beings as totally equal.

Ética, prudencia y educación médica. De la moral tradicional a la necesidad actual / Ethics, prudence and medical education. From classical moral to current needs

RESUMEN Dentro de las líneas comunes entre la educación médica y la educación en ética se destaca la utilización de la prudencia como virtud. Tanto en la formación clínica como en la moral impera un eje rector: ante todo no hacer daño y procurar el bien en las acciones. Dichas similitudes han sido la constante desde la época clásica griega. Pensadores como Hipócrates y Aristóteles tenían algo en común: ambos eran médicos apasionados y promotores de la vida buena. En el presente artículo se realiza un análisis del juramento hipocrático y se correlaciona con el ideario bioético actual. Asimismo, se pretendió demostrar cómo desde tiempos remotos hasta hoy, con los nuevos retos de los tiempos modernos, la prudencia y la virtud moral se entrelazan de inicio a fin en la formación de los profesionales de la salud (AU).

ABSTRACT Among the common links between medical and ethical education, prudence, as a virtue, is highly important. Both, in clinical training and in moral education there is a main principle: not to damage and seeking good in actions. These similarities have being a constant since the ancient Greece; philosophers like Hippocrates and Aristotle had something in common: both were passionate doctors, and both were sponsors of the good living. In the current article we analyze the Hippocrates oak, stating its relationship with the modern bioethics thoughts. Likewise, we intended to show how, since the ancient times up today, with the new challenges of the modern times, prudence and moral virtue intertwine from the beginning to the end in health professionals training (AU).

Genome Editing among Bioethics and Regulatory Practices.

In the last decade, genome editing technologies became very effective and several clinical trials have been started in order to use them for treating some genetic diseases. Interestingly, despite more than 50 years of discussion about the frontiers of genetics in human health and evolution, the debate about the bioethics and the regulatory practices of genome editing is still far from satisfactory answers. This delay results from an excessive emphasis on the effectiveness of the genome editing technologies that is relevant for the regulatory practices, but not at a bioethical level. Indeed, other factors (such as accessibility and acceptability) could make these techniques not accepted at the bioethical level, even in the presence of their 100% effectiveness.

The Making of a Clinical Ethicist: A Personal Tribute to Al Jonsen.

In this account, the author shares her long-standing personal and professional relationship with her mentor, Albert R. Jonsen, PhD, a prominent figure in the history of bioethics.

CE: Brain Death: History, Updates, and Implications for Nurses.

In 1968, the criteria for brain death were established by the Harvard Ad Hoc Committee. Despite what may appear to be unambiguous definitions, clinicians, ethicists, and the public have grappled with the concept of brain death since its inception. In light of recent public discourse on the topic, Harvard Medical School convened a conference to examine research and ethical inquiry conducted over the past 50 years related to death as defined by neurologic criteria. Drawing on the report produced by this conference, this article provides an overview of the development of brain death criteria, describes recent controversies and updates, and discusses implications of these criteria for nurses.

Ernest Everett Just (1883-1941): Hero in Cell Biology and Evolutionary Bioethics.

Ernest Everett Just is celebrated for his contributions to cell biology. Among other firsts, he was first to describe the "wave of negativity" spreading around an egg cell from the entrance point of the fertilizing spermatozoon. His accomplishments in biology are celebrated in Black Apollo of Science (1983) by Kenneth Manning, and by a 1996 Black Heritage postage stamp. What is not yet widely appreciated, however, is that Just connected evolutionary biology to ethical behavior (1933, 1939, 1940). He was probably the first cell biologist to argue that human ethical behavior evolved from our very most primitive cellular origins. Today, Just's contributions to evolutionary bioethics, including "the law of environmental dependence," can be better appreciated because his unpublished booklength manuscript, "The Origin of Man's Ethical Behavior" has been preserved at Howard University's Moorland-Spingarn Research Center.

The Belmont Report and Innovative Practice.

One of the Belmont Report's most important contributions was the clear and serviceable distinction it drew between standard medical practice and biomedical research. A less well-known achievement of the Report was its conceptualization of innovative practice, a type of medical practice that is often mistaken for research because it is new, untested, or experimental. Although the discussion of innovative practice in Belmont is brief and somewhat cryptic, this does not reflect the significant progress its authors made in understanding innovative practice and the distinctive ethical issues it raises. This article explores the history and broader context of Belmont's conception of innovative practice, its strengths and weaknesses, and its contemporary relevance for scholars working in bioethics and health policy. While this conception of innovative practice deserves our attention, it is inherently limited in some important ways.

Desafios atuais da bioética brasileira / Current challenges of the Brazilian bioethics / Desafíos actuales de la bioética brasileña

Resumo Este estudo tem como objetivo analisar os desafios atuais da bioética no Brasil. Trata-se de pesquisa exploratória, analítica, de abordagem qualitativa e perspectiva histórico-social. Utilizou-se a técnica de entrevista semiestruturada, e a seleção dos participantes (14 pesquisadores brasileiros) se deu por conveniência e amostragem por bola de neve. Dos resultados surgiram quatro eixos: características da bioética brasileira; desafio de ultrapassar fronteiras; dificuldade de aproximação à política da bioética; e introdução desse campo do conhecimento no âmbito acadêmico. Concluiu-se que, como processo em permanente devir, a bioética transpôs diversas barreiras desde que chegou ao país e, à medida que avança e se constitui como campo de conhecimento e ação política, novos desafios se apresentam. Aprovação CEP-UFSC CAAE 04382612.0.0000.0121

Abstract This study aims to analyze the current challenges of bioethics in the Brazilian perspective. This is an analytical-exploratory study with a qualitative approach and a social-historical perspective. The semi-structured interview technique was applied. The selection of participants (14 Brazilian bioethics researchers) was performed by convenience and snowball sampling was used. Four axes emerged from the results: Characteristics of the Brazilian Bioethics; the Challenge of overcoming borders; the Challenge of bringing politics to bioethics; and Academic challenges for Brazilian Bioethics. It is concluded that, as a process in permanent transformation, Brazilian Bioethics has overcome several obstacles from the beginning of the discussions and, as it progresses, it grows as a field of knowledge and political action. Aprovação CEP-UFSC CAAE 04382612.0.0000.0121

Resumen Este estudio tiene como objetivo analizar los desafíos actuales de la Bioética en Brasil. Se trata de una investigación exploratoria, analítica, de abordaje cualitativo y con perspectiva histórico-social. Se utilizó la técnica de entrevista semiestructurada. La selección de los participantes (14 investigadores brasileños) se realizó por conveniencia y el muestreo por bola de nieve. De los resultados emergieron cuatro ejes: características de la bioética brasileña; desafío de atravesar las fronteras; dificultad de aproximación a la política de la bioética; e introducción de este campo de conocimiento en el ámbito académico. Se concluye que, en tanto proceso en constante devenir, la bioética transpuso diversas barreras desde que llegó al país y, a medida que avanza y se constituye como campo de conocimiento y de acción política, se presentan nuevos desafíos. Aprovação CEP-UFSC CAAE 04382612.0.0000.0121

Análise das publicações sobre os comitês de ética em pesquisa em Scientific Electronic Library Online (Scielo) / Analysis of publications on research ethics committees in Scientific Electronic Library Online (SciELO) / Análisis de las publicaciones sobre los comités de ética en investigación en Scientific Electronic Library Online (SciELO)

Resumo: Considerando a importância do trabalho desenvolvido pelos Comitês de Ética em Pesquisa (CEPs) e sua implicação com a própria história da formação da bioética, o objetivo deste artigo é analisar as fontes de informação sobre os Comitês de Ética em Pesquisa envolvendo seres humanos presentes na Scientific Eletronic Library Online (SciELO), a fim de mapear os principais aspectos do campo nesta área. Trata-se de pesquisa exploratória descritiva com técnica de análise de revisão sistemática para coleta de dados. Foram recuperados 137 resumos, dos quais foram analisados 41. Pela análise dos dados, verifica-se que há uma intensificação nas publicações sobre este tema a partir de 2010, não apresentando uma clara concentração num periódico específico. A maior parte dos estudos é de cunho teórico e varia entre análises exploratórias de orientação descritiva sobre o papel dos CEPs e críticas sobre a forma em que estes elaboram seus pareceres. Observa-se uma intensificação do debate em relação à análise das pesquisas sociais. Nesse sentido, quatro questões nos parecem marcantes: (a) a ingerência promovida pelos CEPs em relação ao método das pesquisas; (b) a questão da análise ética das pesquisas oriundas das ciências humanas não pode ser vista como uma relação de inclusão ou exclusão; (c) a burocratização dos CEPs; e (d) a questão em relação à necessidade de acreditação dos CEPs.

Abstract: Considering the importance of the work developed by the Research Ethics Committees (REC) and their involvement with the history of bioethics training itself, the objective of this article is to analyze the sources of information on the Research Ethics Committees that involve human beings present in the Scientific Electronic Library Online (SciELO), in order to map the main aspects of the field in this area. This is a descriptive exploratory investigation with systematic review analysis technique for data collection. 137 abstracts were retrieved, of which 41 were analyzed. By analyzing the data, it is verified that there is an increase in the publications on this subject as of 2010, not presenting a clear concentration in a specific newspaper. A large part of the studies is theoretical and varies between exploratory analysis of descriptive guidance on the role of the RES and criticisms on how they prepare their opinions. There is an intensification of the debate regarding the analysis of social research. In this sense, four points seem important to us: (a) the interference promoted by the CIS in relation to the research method; (b) the ethical analysis of the investigations of the human sciences cannot be seen as a relation of inclusion or exclusion; (c) the bureaucratization (burocratização) of the RES; and (d) the need for accreditation of the RES.

Resumen: Considerando la importancia del trabajo desarrollado por los Comités de Ética en Investigación (CEI) y su implicación con la propia historia de la formación de la bioética, el objetivo de este artículo es analizar las fuentes de información sobre los Comités de Ética en Investigación que involucran seres humanos presentes en el Scientific Eletronic Library Online (SciELO), con el fin de mapear los principales aspectos del campo en esta área. Se trata de una investigación exploratoria descriptiva con técnica de análisis de revisión sistemática para la recolección de datos. Fueron recuperados 137 resúmenes, de los cuales se analizaron 41. Por el análisis de los datos, se verifica que hay una intensificación en las publicaciones sobre este tema a partir de 2010, no presentando una clara concentración en un periódico específico. Gran parte de los estudios es de carácter teórico y varía entre análisis exploratorios de orientación descriptiva sobre el papel de los CEI y críticas sobre la forma como estos elaboran sus pareceres. Se observa una intensificación del debate en relación al análisis de las investigaciones sociales. En este sentido, cuatro puntos nos parecen importantes: (a) la injerencia promovida por los CEI con relación al método de las investigaciones; (b) el análisis ético de las investigaciones oriundas de las ciencias humanas no puede ser visto como una relación de inclusión o exclusión; (c) la burocratização de los CEI; y (d) la necesidad de acreditación de los CEI.

Professionalism: An Archaeology.

For more than two decades, classes on "professionalism" have been the dominant platform for the non-technical socialization of medical students. It thus subsumes elements of previous foundation courses in bioethics and "medicine and society" in defining the appropriate relation between practitioners, patients, and society-at-large. Despite its importance, there is, however, no clear definition of what "professionalism" entails or the manner in which it serves various purported goals. This essay reviews, first, the historical role of the vocational practitioner in society, and second, the introduction of "professionalism" as a newly constituted, core value in teaching. The structure of the paper is as an archaeology, a Foucauldian term for an investigation of seemingly separate but related antecedent contexts and ideas whose result is a perspective or point of view. The goal thus is an attempt to precisely locate "professionalism" within the greater history of medicine and its contemporary role in medical socialization.

Mapping Bioethics in Latin America: History, Theoretical Models, and Scientific Output.

OBJECTIVE: To present a narrative review of the history of bioethics in Latin America and of scientific output in this interdisciplinary field. METHODS: This was a mixed-methods study. RESULTS: A total of 1458 records were retrieved, of which 1167 met the inclusion criteria. According to the Web of Science classification, the predominant topics of study were medical ethics (n= 488), social sciences and medicine (n= 354), and environmental and public health topics (n= 279). Four themes of bioethics output in the Latin American literature have emerged: (a) issues involving the beginning and end of life, (b) ethics in human research, (c) patient-provider relationships, and (d) ethics training for health professionals. CONCLUSION: Although bioethics is a growing interdisciplinary field in Latin America, its academic impact is still very low, and programmes are highly concentrated in large urban centres in a few countries. Challenges includes the regional and international impact of local scientific output.