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PubMed2006

Cosmetic psychopharmacology and the President's Council on Bioethics.

Advances in neuroscience and biotechnology have heightened the urgency of the debate over "cosmetic psychopharmacology," the use of drugs to enhance mood and temperament in the absence of illness. Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003), the report of the President's Council on Bioethics, has criticized the use of cosmetic psychopharmacology. The Council claimed that cosmetic psychopharmacology will necessarily lead to "severing the link between feelings of happiness and our actions and experiences in the world," but it provided no satisfactory arguments to support this claim and ignored the possibility that cosmetic psychopharmacology might actually enhance the link between happiness and experience. The Council's arguments against cosmetic psychopharmacology depend heavily on the mistaken belief that Prozac and similar antidepressants are mood brighteners in healthy subjects. The empirical evidence, however, clearly indicates that these drugs are not forms of cosmetic psychopharmacology, thus negating much of the Council's arguments. The use of pharmaceutical agents to enhance mood or personality in normal individuals should not be rejected a priori. Instead, the effects of each agent on the individual and on society must be weighed using sound ethical reasoning and the best evidence available.

Advisory Committees↗
PubMed2003

Nuffield Council on Bioethics consultation.

The possibility of using genetic analysis to predict response to medicines has led some to make the optimistic claim that personalized medicine--"the right medicine, for the right patient, at the right dose"--will only be a matter of time. Indeed, pharmacogenetic tests could be one of the earliest practical applications that information from the Human Genome Project will have on our lives. Many patients experience side effects from medicines, and the use of pharmacogenetics in the drug discovery process has the potential to improve efficacy and safety of some treatments. However, both the research and the clinical applications raise ethical, legal, social and regulatory issues that need to be addressed before targeted prescription becomes reality. The Nuffield Council on Bioethics has established a Working Party to consider these issues and has recently issued a consultation document on the subject.

Bioethics↗
PubMed1999

Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics.

Both the increasing incorporation of medical technology and new social demands (including those for health care) beginning in the 1960s have brought about significant changes in medical practice. This situation has in turn sparked a growth in the philosophical debate over problems pertaining to ethical practice. These issues no longer find answers in the Hippocratic ethical model. The authors believe that the crisis in Hippocratic ethics could be described as a period of paradigm shift in which a new set of values appears to be emerging. Beginning with the bioethics movement, the authors expound on the different ethical theories applied to medical practice and conclude that principlism is the most appropriate approach for solving the new moral dilemma imposed on clinical practice.

Abortion, Legal↗
PubMed2005

Confucian bioethics and cross-cultural considerations in health care decision-making.

This article discusses the similarities and differences between Beauchamp and Childress's principlism and Confucian bioethics in terms of autonomy, beneficence, nonmaleficence, and justice. The author presents sensitive approaches for culturally diverse groups in health care areas and cautions against dichotomy in cross-cultural studies, which ignores the dynamic nature and intravariations of cultures. As a way of health care providers to become engaged in cultural diversity in nursing practice and research, the author suggests that they do not only have a general knowledge about the theoretical differences among groups through "normative analysis" but also learn to appreciate each individual's particular beliefs and values through narratives of morality. Health care providers as well as legal professionals need to cultivate "cultural humility," which is the willingness to explore the similarities and differences between their own and each client's priorities and values and to develop courses of action with patients.

Asia↗
PubMedDate not supplied

Heroes in bioethics.

Throughout his remarkable and too-brief career, Benjamin Freedman was concerned with the ethical standards of ethicists themselves. He worried that ethicists had been bought out, as he knew of none whose opposition to an employer had ever led to being fired. If we look today for what he sought--a bioethical hero--Benjy is himself still the preeminent example.

Bioethics↗
PubMed2000

Global bioethics: a suggested distinction between ethics and morality.

At the beginning of the new century Humankind is facing a new Era. It has to face the effects of a dramatic and accelerated population growth. Human population size increased from one billion in 1835, to six billion by the end of this century. This unprecedented increase in number, affecting specific geographical areas, has augmented the deterioration of the natural environment caused by the misuse of natural resources and the depletion of fertile soils due to climatic changes and pollution. The quality of life is now diminished by the "greenhouse effect" which is the direct result of industrialisation. Ecological integrity is a concept that has to be advanced in order to facilitate the protection of biological and ecological resources against the threat of human survival. Global Bioethics as a discipline of interaction of health professionals with the present endangered environment, the limited global resources and the new biotechnologies is needed in any Biomedical School.

Bioethics↗
PubMedDate not supplied

Can theology have a role in "public" bioethical discourse?

Lisa Sowle Cahill takes up the methodological issue of how substantive religious perspectives can be communicated in a pluralistic society. Cahill sees public discourse about bioethics as embodying a commitment to dialogue among traditions, religious and nonreligious, that have common concerns.

Abortion, Induced↗
PubMed2001

[On bioethics].

The so-called "bioethics", fashionable today, is mostly sophistry to obscure the fact that human embryos are human beings. This holds already for the human zygote, as it embodies a complete and individualized human "entelechy": a human being in its early stage of life. Therefore experimenting on human embryos resembles closely the dealings of the infamous dr Mengele. Possibly the new biology will force upon mankind deep religious and political divisions never known before.

Bioethical Issues↗
PubMed2002

The core concepts of the 'four principles' of bioethics as found in Islamic tradition.

Ethics can be described as a sub-branch of applied philosophy that seeks 'what is the right and the wrong, the good and the bad set of behaviours in a given circumstance'. Bioethics, however, is a quasi-social science that offers solutions to the moral conflicts arising in medical and biological science practice. There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers, Beauchamp and Childress, formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' which have almost always existed and govern the ethical behaviour of human societies, were presented by the authors as universal and applicable to any culture and society. These 'Four Principles' have been one of the most widely discussed issues in Biomedical Ethics with arguments for and against them. The authors' claim has been tested by research conducted in different cultures and societies. In this study we aim to explore the roots of the 'Four Principles' in Islamic tradition and culture, and show that this particular set of principles are not something new but only one of the latest formulations of age-old common sense principles. It is therefore concluded that these principles are already being applied in Islamic traditional and cultural societies.

Beneficence↗
PubMed2001

Pragmatism, bioethics and the grand American social experiment.

There is tension in bioethics between two strains of pragmatism. The most prominent strain, following John Dewey, proposes a content-rich ethos of controlled, collective moral inquiry. A second strain, descending from Charles Peirce and Josiah Royce, favors an open-ended approach where diverging moral communities evolve without extensive inter-communal oversight. This essay defends the second strain. The Deweyan approach, I argue, exhibits a problematic quasi-foundationalist character insofar as it canonizes a dubious constellation of "liberal" political values and seeks to establish these values by interposing a consensus of moral experts where genuine inter-communal dialogue, and compromise, would be more fruitful. I hold that the alternative approach of Peirce and Royce is preferable, and truer to the fundamental commitments of classical American pragmatism. Recognizing the epistemic fallibility of various content-rich moral-political formulations, Peirce and Royce hope to cultivate and sustain moral inquiry by allowing each moral community (1) to generate and test its own moral system (as long as it does so peaceably) and (2) to freely make or refuse to make collaborative arrangements with other moral communities. This approach is illustrated in a brief discussion of the Oregon Medical Experiment.

Bioethics↗
PubMedDate not supplied

Heroic measures. Just bioethics in an unjust world.

In its excitement over the quandries posed by biotechnology, bioethics is in danger of neglecting basic health care needs. What is needed is an understanding of ethics that emphasizes responsibility to others rather than rights.

Altruism↗
PubMed2000

The runaway corruption-cynicism syndrome in Asian cultures: its redemption and the future of bioethics.

Corruption has been cynically dismissed as a global phenomenon by some Asian leaders. This attitude becomes a plausible cloak for mala fide deeds. Worse, it becomes a veritable shield for the corrupt. But modern information and investigative systems can penetrate the meticulously built smoke screens and illuminate the murky shadows. Bailouts due to political-economic patronage are, however, routine and considered unworthy of protracted media pursuance, resulting in further cycles of brazen corruption. Public indifference towards the latter is a product of institutional, moral and cultural failures, resulting in corresponding cycles of cynicism. The overall consequence is near total despondence of any meaningful redemption, or overall improvement. In Asia, demographic pressures and/or socio-economic frailities, as also politico-religious bigotry add to the general public disillusion and indifference, and breeds an unending treadmill of further corruption and disgruntled cynicism without much hope for amelioration. The solution, and salvation, lies only in individual and collective (social) espousal of the ethical in every walk, and work, of life. Social, spiritual and cultural pressures enabling political activism in ostracizing both criminal intent and action in public life, maintenance of decorum and propriety in private life by public figures can rekindle hope and confidence, and banish sullen cynicism from the heart and mind of the lay public. In most of Asia this has become an imperative needing urgent attention and implementation, but hardly any silver clouds are yet discernible on any Asian horizon. A sea change in moral perspectives of whole communities only can redeem the situation, and pave the way to a renaissance of the Bioethical culture which, the author asserts, has been an underlying universal ingredient of the Asian psyche through the ages.

Asia↗
PubMed2004

Is bioethical training useful in preparing doctors to take decisions in the emergency room?

We study the decisions taken in five real cases by 178 doctors working in hospital emergency services and compare their decisions with those proposed a reference group composed of professionals with a master's degree in bioethics. The findings of our study point to an increased ability to take difficult decisions in critical situations involving the use of life-support measures in the emergency room. The group of professionals chosen as "gold standard", despite lacking the training and clinical preparation of emergency doctors, made decisions that were technically very close to the most suitable. In this respect, an adequate ethical training facilitated the taking of decisions that required the involvement of personally held values, underlining the need for such training in the case of professionals who will work in hospital emergency services.

Adult↗
PubMed2004

[Bioethics: problems and prospects within a research institute].

Bioethics aims to identify an ethical framework by means of a multidisciplinary debate open to the scientific community, in order to allow support to scientists involved in biomedical research. The Istituto Superiore di Sanità (Italian National Institute of Health) has recognized the need for an ethical review board to cope with the problems of different researches carried on within the Institute. An Ethics Committee, better defined as an Independent Review Board, has therefore been appointed by the Minister of Health in order to evaluate different research proposals ranging from clinical trials to non clinical biomedical research. The experience of the first Committee is described.

Academies and Institutes↗
PubMedDate not supplied

Religion and bioethics.

This paper discusses the role of religious arguments in public bioethical debate. It is argued that attempts to rule out religious arguments as valid contributions to the pubic debate fails for a number of reasons. There is no non-arbitrary way of dividing religious arguments from non-religious arguments, and all arguments refer ultimately to a background comprehensive worldview that is never fully consistent or coherent and which is furthermore always contested. There are thus no good arguments for treating religious arguments differently than any other type of argument.

Bioethics↗
PubMed2005

The failure of formal rights and equality in the clinic: a critique of bioethics.

For communities which espouse egalitarian principles, the hierarchical nature of care-giving relationships poses an extraordinary challenge. Patients' accounts of their illnesses and of their medical care capture the latent tension which exists between notional, political equality and the need for dependency on care from others. I believe that the power imbalance in doctor-patient relationships has broad implications for liberal democracies. Professional and care-giving relationships almost always consist of an imbalance of knowledge and expertise which no template of egalitarian moralism can suppress. When we seek help or guidance from authority figures, we are at a disadvantage politically even though we may be equal citizens theoretically and legally. Hierarchic relationships persist within democracies. Moreover, they tend to exist within a realm of privacy which is only partially visible from the social realm. In the end, traditional notions of liberal autonomy and egalitarianism do not properly describe or monitor these interactions. Liberal rhetoric (i.e., terms such as equality, rights, consent, etc.) pervades much of bioethical literature and interventions but, this very language tends to mask the persistence of structural hierarchies in the clinic. The doctor-patient relationship forces democratic communities to confront the problem of continuing hierarchic power relations and challenges liberalism to revise its understanding of individual autonomies.

Bioethics↗
PubMed1990

Bioethics: its philosophical basis and application.

Contemporary medicine involves a lot more than technologies that now permit effective medical intervention where none was possible before. Among other things, changes in technology have been accompanied by changes in social and cultural attitudes that are having major effects on health care and medical practice. This article provides a brief overview of many of the more important changes and their relationship to developments in the field of medical bioethics.

Beneficence↗
PubMed1988

Establishing a Nursing Bioethics Committee.

Nursing must keep pace with the technological revolution and radical new treatment modalities of patient care, many of which cause ethical dilemmas. To address the unique ethical concerns of staff nurses and managers, the authors discuss the development, implementation, and evaluation of a Nursing Bioethics Committee. The findings of a questionnaire measuring staff nurses' perceptions of the degree of difficulty and frequency of ethical problems in clinical practice are described. The benefits of the committee are presented from the perspective of staff nurses and nurse executives.

Attitude of Health Personnel↗