Bioethics Update最新文献

The different ethical perspectives on the issue of distribution of scarce resources are discussed in this article. While the problem of distribution of resources does not exist in an ideal situation with sufficient availability of resources for everyone, in fact, in the context of a pandemic the distribution of scarce resources is revealed in a dramatic and urgent way. As regards this issue, there is agreement on the fact that distribution should be “fair”, according to the shared meaning of justice as “not to harm others” and to “give each his own”. However, within the pluralist discussion, there are different ways of conceiving justice on a theoretical level and applying it at a concrete level. This article examines classical bioethical theories that are reappearing in the discussion today – with different levels of intensity, or in different formulations – and this, in the light of the most important international and national ethical guidelines and recommendations on the distribution of resources during the COVID-19 pandemic.

The pandemic caused by the new virus COVID-19 has shaken humanity due to its serious repercussions in many fields, not only in health, but also at an economic, political, and social level. From the ethical perspective, crises always lead to reflection, and in this case, the re-encounter with an aspect of the human condition, vulnerability, has been evident. Today's extreme hedonistic and autonomous society has tried to forget about this aspect, which makes it uncomfortable, but which cannot be ignored with this terrible crisis. Vulnerability also has an important ethical aspect, and therefore its recognition and the will to minimise its effects is necessary. The present reflection is based on the thoughts of Martha Nussbaum, who provides a joint vision on the consideration of vulnerability and justice; a very necessary approach in today's society.

Direct interaction between pharmaceutical representatives and consumers is an issue that is still under-researched. In fact, the underlying ethical issues are completely absent from the radar of regulators. However, this type of communication without a mediating interface (such as a TV broadcaster or an electronic platform) or an intermediary (healthcare professionals) provides a space where consumers are highly exposed to industry influences. While the putative aim of those activities is to educate patients about their health condition, the management of their symptoms and the available treatments, the industry is seeking to replace the traditional role of health professionals. A case study, involving face-to-face interactions, allows a better understanding and provides clarifications to show that it is not the industry’s role to provide health information to consumers. Mechanisms are suggested to support government agencies in ethically regulating this practice.

The prolongation of human life is one of the characteristic features of our technological era and establishes a scenario for philosophical questions, some of which begin to find answers in the field of Bioethics. One of the most important is the so-called institutionalisation in prolonged care, or confinement, and the question is whether this is a bioethically correct option. A positive assessment of old age is part of the very roots of Western culture, however in technologically advanced societies it begins to be accompanied by negative nuances. Far from giving a positive value to old age, a new unethical myth has surfaced: that of the «young», «productive» man. Society often deprives the elderly of almost all obligations, relegating them when their work is no longer desired. The bioethical approach to the geriatric patient grants the respect owed to them as human beings instead of pity, compassion or charity. Something similar can be said of hospitalisation, which has been shown to have negative effects on the functional capacity of the elderly. In particular, this practice increases one of the most negative factors in the life of the elderly, loneliness. To combat this loneliness there are some possibilities, the first of which is to put the elderly person in contact with other people. In addition, there are new tools for combatting the loneliness of the elderly: laughter therapy and social robotics. A brief description of these is presented, as a well a discussion on their adoption.

The first section of the article explores human dignity, as well as the human body as a manifestation of that dignity. Examples of how, using legislation, limits and regulations are imposed on the use of body parts. In the second section of the article, using a small survey among different professionals about this topic, an analysis and discussion is presented on the ethical implications of exposing body parts. It is concluded that body parts should only be presented, for educational purposes and social awareness campaigns.

In this article, an analysis is presented on the birth of the first human beings subjected to an embryonic genetic modification using CRISPR/Cas9 technology from a perspective that considers the conditions that has led to its emergence. As opposed to the approaches presented so far by bioethics, an alternative account is presented that does not reduce the event to an act of individual disobedience, but rather conceives it as the expected result of certain epistemic, institutional, political, and economic dimensions of technoscience. Moreover, thoughts are presented on the role assumed by bioethics with regards to CRISPR/Cas9 and the response it has provided to its application in human embryos. It is concluded by suggesting that the model of bioethics based on heteronomy and the external control of science and technology is neither significant nor effective in the indicated context, with an alternative systemic approach being provided.

It was believed for a long time that people brought to the attention of healthcare and/or legal authorities with suicidality were automatically deemed to lack medical decision-making capacity or competence. This is despite many of these patients possessing the “mental ability to make a rational decision, which includes the ability to perceive, to appreciate all relevant facts and to reach a rational judgment upon such facts”. Several ethical and psychiatric specialists and defenders of patient rights have criticized this traditional paternalistic approach for failing to respect the right of a competent, rational person to self-determination and autonomy.

As society increasingly recognizes patients’ rights to refuse treatment, their autonomy to make decisions and the right to self-determination, the bioethical, medical and legal community must strive to identify those individuals who are not just impulsively acting and/or under the influence of factors that may hinder their capacity. As moral people who respect competent individuals who make rational decisions, regardless of whether we agree with them or not, we have a duty to respect their right to self-determination and suicide.

The preservation of cells, whether living or not, along with their sociodemographic and clinical data is common. The umbilical cord blood banks are a clear example of personalised medicine. Bioethics problems in biobanks are just emerging. A systematic review of the literature was carried out, searching in more than 4 databases, using methodology of the Cochrane Collaboration, with a total of 98 papers being found. These were divided into four subjects: bioethics, informed consent, legal and regulatory aspects, and health care policies. freedom, confidentiality, respect and dignity of the person, formed a relevant cluster. In this analysis an emergent theme appeared: the ownership, which now acquires its true significance. Informed Consent involves the respect by the health professional on the freedom of the patient, whether child or adult, capable or not. In Mexico there is no law, regulation or guidelines. The regulation of cord blood banks is urgently required in Mexico.

Current neuroscience and neurotechnology have led to an increased insight in putative mechanisms involved in emotions, behaviours, thoughts, and in moral decision-making. Concerns arise on the possible misuse and/or overuse of these tools, as well as brain manipulation. Neuroethics is the discipline dedicated to study these issues. Neuroethics in Mexico is in a nascent stage, and this prompts caveats due to issues that have not been reported in the international literature, such as medical factors (e.g. pre-Hispanic medicine), legal factors (e.g. ambiguity in neuroscientific and neurotechnological frameworks), and socio-cultural factors (e.g. ethnography and the mix of western and pre-Hispanic philosophies). Hence reflection is needed in order to (a) focus on the best interests of the patients within a Mexican culture context, and (b) foster a global neuroethics, taking into account neurocognitive cultural diversity within a framework of ethnographic respect.