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The ethics of health-promoting nudges. 促进健康的伦理推动。
IF 0.5 Q4 ETHICS Pub Date : 2021-09-01 DOI: 10.30444/CB.104
Polychronis Voultsos

The paper aims to provide an overview of current knowledge related to the ethicality of health-promoting nudges and a further elaboration, particularly in terms of linking the interpretation of the findings of the study and the conclusions adopted. A comprehensive narrative review of literature on the topic of interest was undertaken, aiming to contribute to the current debate on the topic of interest. It is practically hard to determine whether or not the nudgee's agency will be eroded by the particular nudge because the line of distinction between emotions or automatic ways of human reasoning and cognitive ways of human reasoning remains blurry, and the various types of nudges fall on a combination of two continuums: the one ranging from transparent to non-transparent and the other ranging from reflective to automatic. Therefore, the majority of nudges are most likely to work as reason-bypassing nonargumentative influences, thus eroding the nudgee's agency. It is time to accept a deviation from the strict commitment to the principle of (individualistic) autonomy in degrees proportional to the incontestably anticipated patient's benefit. In case that patient's best interest is less than clear or the nudging promotes another individual's best interest (not the decider's one), or even the common good, the ethicality of nudging is not always beyond reasonable doubt. In such cases the deviation should be as minimal as possible (i.e. limited to nudges that are transparent or almost transparent and work reflectively or almost reflectively). Nudging may be used against the COVID-19 pandemic.

本文旨在概述与促进健康的轻推的伦理性有关的现有知识,并进一步阐述,特别是在将研究结果的解释与所采用的结论联系起来方面。对有关主题的文献进行了全面的叙述审查,目的是对当前有关主题的辩论作出贡献。实际上很难确定轻推者的代理是否会被特定的轻推所侵蚀,因为情感或人类推理的自动方式与人类推理的认知方式之间的界限仍然模糊,各种类型的轻推落在两个连续体的组合上:一个从透明到不透明,另一个从反射到自动。因此,大多数助推最有可能成为绕开理性的非争论性影响,从而侵蚀了助推者的能动性。现在是时候接受对(个人主义)自治原则的严格承诺的偏离,其程度与无可争议的预期患者的利益成正比。如果病人的最佳利益不太明确,或者轻推促进了另一个人的最佳利益(而不是决策者的利益),甚至是共同利益,轻推的道德并不总是排除合理怀疑。在这种情况下,偏差应尽可能小(即,限制在透明或几乎透明的推力,并反射或几乎反射地工作)。轻推可用于应对COVID-19大流行。
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引用次数: 0
[Care and support: children of a lesser god?] 关心和支持:小神的孩子?]
IF 0.5 Q4 ETHICS Pub Date : 2021-09-01 DOI: 10.30444/CB.105
Francisco Barón, Álvaro Sanz

Our health system runs the risk of ruling out or neglecting a significant proportion of patients who require less technological but closer and humane care, those who require more support and attention. In this scenario, it is easy that both the assistance and close care and the patients who need this care and who would not benefit from aggressive or interventionist treatments may be considered as secondary: as children of a lesser god. It would be necessary to change the paradigm to understand that the quality of care is not limited to technology. And it would also be necessary to promote the dignity of care so that it is not seen as secondary and passive. On the contrary, care should be understood not only as active but also as intense without losing its close and human profile. Promoting the dignity of care also means promoting the dignity of all patients who may have been marginalized or excluded from this health system that is marked by technology and complexity and whose goal is efficiency.

我们的卫生系统面临着排除或忽视相当一部分患者的风险,这些患者需要较少的技术但更密切和人道的护理,他们需要更多的支持和关注。在这种情况下,帮助和密切护理以及需要这种护理的患者,以及那些不会从积极或干预治疗中受益的患者,很容易被认为是次要的:作为一个次等上帝的孩子。有必要改变这种模式,以了解护理的质量并不局限于技术。同时也有必要提高护理的尊严,使其不被视为次要的和被动的。相反,关心不仅应该被理解为积极的,而且应该被理解为强烈的,而不会失去其亲密和人性化的形象。促进护理的尊严还意味着促进所有可能被边缘化或被排除在这个以技术和复杂性为特征、以效率为目标的卫生系统之外的患者的尊严。
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引用次数: 0
[AEBI regarding the entry into force of the Organic Law for the Regulation of Euthanasia in Spain.] [关于《西班牙安乐死管理组织法》生效的AEBI。]
IF 0.5 Q4 ETHICS Pub Date : 2021-09-01 DOI: 10.30444/CB.109
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引用次数: 2
[Use of ataluren in Spain: administrative incoherences and ethical implications]. [在西班牙使用ataluren:行政上的不连贯和伦理影响]。
IF 0.5 Q4 ETHICS Pub Date : 2021-09-01 DOI: 10.30444/CB.108
Pilar Pacheco López, María Antonia Meroño Saura, Ana Aranda García

Duchenne muscular dystrophy is a rare genetic disease with only ataluren like pharmaceutical treatment available. This drug received a conditional authorization by the European Medicines Agency (EMA) in 2014, meaning that it was commercially available while waiting for more solid results that demonstrate the efficacy and safety. Currently, the authorization still maintains the ″conditional″ modality, and the actual health benefits of the drug still remain unclear. In Spain, ataluren is not financed by the National Health System. The decision of non-financing has generated a heated debate, especially because in those patients who se treatment were started prior to the non-financing decision the drug has continued being funded. This controversial situation encompasses complex aspects of pharmaceutical and health management related to scientific evidence, the motivations of regulatory agencies and the pharmaceutical industry in the processes of drug investigation and authorization. Furthermore, as the center of the debate, some pillars of bioethics such as justice and equity, as well as certain legal principles, such as the protection of minors, are involved.

杜氏肌营养不良症是一种罕见的遗传性疾病,只有非营养品类药物治疗可用。2014年,该药物获得了欧洲药品管理局(EMA)的有条件批准,这意味着它可以在等待更可靠的疗效和安全性结果的同时上市。目前,该授权仍保持″有条件″模式,药物的实际健康益处仍不清楚。在西班牙,ataluren不是由国家卫生系统资助的。不资助的决定引起了激烈的争论,特别是因为那些在不资助决定之前就开始治疗的患者,药物继续得到资助。这种有争议的情况包括与科学证据、监管机构和制药行业在药物调查和授权过程中的动机有关的制药和健康管理的复杂方面。此外,作为争论的中心,涉及到生命伦理学的一些支柱,如正义和公平,以及某些法律原则,如保护未成年人。
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引用次数: 0
[Surrogacy, uterus transplantation and artificial uterus: approaches from the biolaw]. 【代孕、子宫移植、人工子宫:从生物学角度探讨】。
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.99
María Valle Robles

More than forty years after the first baby's birth through in vitro fertilization, innovations in the field of human reproduction have experienced a significant growth increase. Those first techniques have led evolved to others that push the biological limits of reproduction. Recent developments in genomic editing -particularly, CRISPR/Cas9 technology- had leaded an intense ethical, social and legal discussion about the boundaries limits of the new models of human reproduction, and their consequences in recent years. The number of conflicting legal interests suggests that the application of these techniques must combine the respect for the law, the defense of the human rights of all the agents involved in the process, and the freedom of scientific research. The present paper tries to deal with the diverse ethical implications and legal limits of three of those techniques, recently developed or to be developed in the near future: surrogacy, uterus transplantation and artificial uterus.

在第一个婴儿通过体外受精出生后的四十多年里,人类生殖领域的创新经历了显著的增长。这些最初的技术已经进化到其他技术,这些技术突破了生殖的生物学极限。近年来,基因组编辑的最新发展——特别是CRISPR/Cas9技术——引发了一场激烈的伦理、社会和法律讨论,讨论的主题是人类生殖新模式的界限、限制及其后果。相互冲突的法律利益的数量表明,这些技术的应用必须结合对法律的尊重、对参与这一过程的所有人员的人权的保护以及科学研究的自由。本文试图处理最近开发或将在不久的将来开发的其中三种技术的各种伦理影响和法律限制:代孕,子宫移植和人工子宫。
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引用次数: 0
[Transhumanism and desire: phenomenological approach]. [超人类主义与欲望:现象学方法]。
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.95
David García Díaz

In this article we approach to understand the presuppositions of the transhumanist current to recognize some of the fundamental and universal notes of human nature that are manifested through its proposals. From the approaches of transhumanism, the human being can be recognized as a yearning being, a being who naturally desires. Moreover, it is recognized that this desire motivates the action of man and that the person is always on the way to perfection, motivated to overcome without limits what reality offers him to fulfill his desire for fulfillment. In addition, the main proposals for human improvement sustained from transhumanism are analyzed to understand which are the desires of the heart of man that are manifested through them. The recognition of these desires can be taken as a good starting point for the dialogue between transhumanism and other currents that recognize desire as a fundamental part of a human nature. We also judge whether transhumanism can be understood as an adequate response to satisfy the deepest desires of the human heart for happiness and fulfillment, concluding that transhumanist theses are insufficient when it comes to calming the fundamental concerns of human heart.

在本文中,我们试图理解超人类主义思潮的前提,以认识到通过其建议表现出来的人性的一些基本和普遍的音符。从超人类主义的观点来看,人可以被认为是一种渴望的存在,一种自然渴望的存在。此外,人们认识到,这种愿望激励着人的行动,人总是在通往完美的道路上,被激励着去无限制地克服现实给他提供的一切,以实现他对实现的愿望。此外,本文还分析了超人类主义对人类进步的主要建议,以了解哪些是人类内心的欲望通过它们得到体现。对这些欲望的认识可以被视为超人类主义与其他承认欲望是人性基本组成部分的流派之间对话的一个良好起点。我们还判断超人类主义是否可以被理解为满足人类内心对幸福和满足的最深切渴望的一种充分的回应,结论是超人类主义的论点在平息人类内心的根本关切方面是不够的。
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引用次数: 0
[Human nature in the Aristotelian-Thomist tradition: a brief exposition]. [亚里士多德-托马斯主义传统中的人性:简要阐述]。
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.101
Ángel Sánchez-Palencia Martí

The present work analyzes the classical notion of human nature. He studies this concept in Aristotle, in whom the Greek intellectual understanding of the notion of nature culminates as the later Thomistic reception of it. The main objective of this work is to provide a brief and concise introduction to the philosophy of man, which underlies in many of the authors who not only consider transhumanist thought reductive, with respect to their conception of what man is, but also they try to provide ethical solutions to take on the great opportunities that technoscience presents to today's man.

本文分析了经典的人性观念。他在亚里士多德那里研究了这个概念,在亚里士多德那里,希腊知识分子对自然概念的理解在后来的托马斯式接受中达到了顶峰。本书的主要目的是简要介绍人的哲学,这是许多作者的基础,他们不仅认为超人类主义思想是简化的,就他们对人的概念而言,而且他们还试图提供伦理解决方案,以接受技术科学给今天的人带来的巨大机会。
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引用次数: 0
[Transhumanism and law: from human nature to self-determination as the foundation of human rights]. [超人类主义与法律:从人性到作为人权基础的自决]。
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.100
María Lacalle Noriega

This article analyzes the general evolution of human rights due to the influence of transhumanist ideas, which were already present in 1948. Specifically, we will consider their denial of human nature, and self-determination as the new cornerstone of the legal order. We will see how nature is no longer considered the foundation of law, and instead how the focus is now on self-determination and the possibilities of technology. Although the 1948 Declaration of Rights has not changed, the anthropological conception has been modified, and new rights have been introduced, thanks to the interpretation made by the courts. The proposal is to recover the notion of human nature and natural law, which offers a universal terrain for dialogue and inspiring keys to find the true rights of the person and the good of society.

本文分析了在1948年就已经存在的超人类主义思想的影响下,人权的总体演变。具体地说,我们将把它们对人性的否定和作为法律秩序新基石的自决考虑在内。我们将看到自然如何不再被视为法律的基础,相反,现在的焦点如何放在自决和技术的可能性上。虽然1948年的《人权宣言》没有改变,但由于法院的解释,人类学的概念已经改变,新的权利已经引入。该提案旨在恢复人性和自然法的概念,这为对话提供了一个普遍的领域,并为找到个人的真正权利和社会的利益提供了启发。
{"title":"[Transhumanism and law: from human nature to self-determination as the foundation of human rights].","authors":"María Lacalle Noriega","doi":"10.30444/CB.100","DOIUrl":"https://doi.org/10.30444/CB.100","url":null,"abstract":"<p><p>This article analyzes the general evolution of human rights due to the influence of transhumanist ideas, which were already present in 1948. Specifically, we will consider their denial of human nature, and self-determination as the new cornerstone of the legal order. We will see how nature is no longer considered the foundation of law, and instead how the focus is now on self-determination and the possibilities of technology. Although the 1948 Declaration of Rights has not changed, the anthropological conception has been modified, and new rights have been introduced, thanks to the interpretation made by the courts. The proposal is to recover the notion of human nature and natural law, which offers a universal terrain for dialogue and inspiring keys to find the true rights of the person and the good of society.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"32 105","pages":"225-235"},"PeriodicalIF":0.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Organic Law 3/2021 on regulation of Euthanasia: A dehumanizing law?] 关于安乐死监管的第3/2021号组织法:一项不人道的法律?]
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.102
Roberto Germán Zurriaráin

The Spanish Congress of Deputies has approved the law regulating euthanasia. Precisely, the article deals 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 and from which the other three are derived. For this reason, by defending the dignity that the human being possesses, simply, by the fact of being it, it is against said Law. Human dignity is not destroyed by terminal illness, or by dependency, suffering, weakness or frailty. Each human life has value in itself, which must be safeguarded and which makes it non-negotiable in all situations and conditions. That the non-negotiable value of life sustains any democratic system. However, the supposed right to euthanasia is typical of an individualistic 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 lives of others. Faced with offering euthanasia, as the only solution to the suffering of people in the last stage of their life, quality palliative care should be proposed. These are the only ethical option, consistent with respect for human dignity. Respecting, valuing, caring for, and attending to vulnerable and fragile human life means progress in humanity.

西班牙议会通过了一项规范安乐死的法律。确切地说,这篇文章讨论的是其辩护者所作的陈述。这些都围绕着以下概念:尊严、权利、自由,最后是痛苦。人的尊严是最卓越的个人和社会原则,其他三项原则都是由它衍生出来的。由于这个原因,它捍卫人类所拥有的尊严,仅仅因为它是人类的事实,它就违反了上述法律。人的尊严不会被绝症、依赖、痛苦、软弱或脆弱所摧毁。每个人的生命本身都有价值,必须加以保护,在任何情况和条件下都不容谈判。生命的不可协商的价值维系着任何民主制度。然而,所谓的安乐死权是典型的个人主义和简化主义对人类及其生命的看法;还有一种自由,既不受选择和行动的好坏影响,也不受对他人生命的责任影响。面对安乐死,作为人们生命最后阶段痛苦的唯一解决方案,应该提出高质量的姑息治疗。这是符合尊重人类尊严的唯一道德选择。尊重、重视、关心和照顾脆弱和脆弱的人的生命意味着人类的进步。
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引用次数: 0
[Transhumanism, human enhancement and bioethical challenges of emerging technologies for the 21st century]. [21世纪新兴技术的超人类主义、人类增强和生物伦理挑战]。
IF 0.5 Q4 ETHICS Pub Date : 2021-05-01 DOI: 10.30444/CB.92
Elena Postigo Solano

In this article we start by submitting a definition of transhumanism and then turn to the main bioethical problems that arise from it, with particular attention to the so-called human enhancement perspective. Secondly, and without being exhaustive, we shall seek to identify some of the main challenges posed by emerging sciences in the 21st century, specially with an eye to convergent technologies or NBICs (nanotechnology, biotechnology, informatics and cognitive sciences). And finally, we end up by enumerating some of the bioethical questions every researcher should take into account before considering applying any new technology on humans in the coming decades.

在本文中,我们首先提出超人类主义的定义,然后转向由此产生的主要生物伦理问题,特别关注所谓的人类增强观点。其次,在不详尽的情况下,我们将设法确定21世纪新兴科学带来的一些主要挑战,特别是着眼于融合技术或nbic(纳米技术、生物技术、信息学和认知科学)。最后,我们列举了一些生物伦理问题,每个研究人员在未来几十年考虑将任何新技术应用于人类之前都应该考虑到这些问题。
{"title":"[Transhumanism, human enhancement and bioethical challenges of emerging technologies for the 21st century].","authors":"Elena Postigo Solano","doi":"10.30444/CB.92","DOIUrl":"https://doi.org/10.30444/CB.92","url":null,"abstract":"<p><p>In this article we start by submitting a definition of transhumanism and then turn to the main bioethical problems that arise from it, with particular attention to the so-called human enhancement perspective. Secondly, and without being exhaustive, we shall seek to identify some of the main challenges posed by emerging sciences in the 21st century, specially with an eye to convergent technologies or NBICs (nanotechnology, biotechnology, informatics and cognitive sciences). And finally, we end up by enumerating some of the bioethical questions every researcher should take into account before considering applying any new technology on humans in the coming decades.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"32 105","pages":"133-139"},"PeriodicalIF":0.5,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39433091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Cuadernos de Bioetica
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