Bioethics最新文献

A prominent critique of cognitive or athletic enhancement claims that certain performance-improving drugs or technologies may 'cheapen' resulting achievements. Considerably less attention has been paid to the impact of enhancement on the value of moral achievements. Would the use of moral enhancement (bio)technologies, rather than (solely) 'traditional' means of moral development like schooling and socialization, cheapen the 'achievement' of morally improving oneself? We argue that, to the extent that the 'cheapened achievement' objection succeeds in the domains of cognitive or athletic enhancement, it could plausibly also succeed in the domain of moral enhancement-but only regarding certain forms. Specifically, although the value of moral self-improvement may be diminished by some of the more speculative and impractical forms of moral enhancement proposed in the literature, this worry has less force when applied to more plausibly viable forms of moral enhancement: forms in which drugs or technologies play an adjunctive or facilitative, rather than a determinative, role in moral improvement. We illustrate this idea with three examples from recent literature: the possible use of psychedelic drugs in certain moral-learning contexts, 'Socratic Al' (a proposed Al-driven moral enhancer) and empathy enhancement through virtual reality (VR). We argue that if one assumes that these technologies work roughly as advertised, the 'cheapened achievement' objection loses much of its bite. The takeaway lesson is that moral enhancement in its most promising and practical forms ultimately evades a leading critique of cognitive and athletic enhancement. We end by reflecting on the potential upshot of our analysis for enhancement debates more widely.

The ethical permissibility of the "slow code" sparks vigorous debate. However, definitions of the "slow code" that exist in the literature often leave room for interpretation. Thus, those assessing the ethical permissibility of the slow code may not be operating with shared definitions, and definitions may not align with clinicians' understanding and use of the term in clinical practice. To add clarity and nuance to discussions of the "slow code," this manuscript highlights the salient medical and moral components that distinguish resuscitative practices, resulting in a taxonomy that includes nine distinct entries: the Fake Code, Casual Code, Time-Limited Code, Family Code, Contained Code, a la Carte Code, Preventive Code, Passive Code, and Accepted Code. We argue that cogent analyses of the ethical implications of the "slow code" must begin with clear, shared understandings of the practices under debate.

It is often said that it is important for patients to possess hope that their treatment will be successful. We agree, but a widely appealed to type of hope-hope based on conviction (religious or otherwise), renders this assertion problematic. If conviction-based hope influences patient decisions to undergo medical procedures, then questions are raised about the scope of patient autonomy. Libertarians permit patients to make decisions to undergo medical procedures on the basis of any considerations, including conviction-based hopes, on grounds of respect for freedom of choice. Rational interventionists want to restrict choices made on the basis of conviction-based hope on the grounds that choices based on hope incorporate irrationality of a sort incompatible with autonomous decision-making. In this article, we navigate a middle path between these extremes, arguing that patient decision-making based on conviction-based hope ought to be acceptable and permitted in health care when it conforms to norms of practical rationality. These norms allow patients some room to make decisions to consent to undergo medical procedures informed by conviction-based hope.

For years, the sexual and reproductive health of women with intellectual and developmental disability or disabilities has been insufficiently addressed by institutions and family members due to a lack of information, training, and, sometimes, religious issues. In this context, contraceptive digital pills can enhance the sexual and reproductive control of this population group. Digital pills could help to improve adherence to treatments aimed to prevent unwanted pregnancies, as well as allowing women and their caregivers to exert better drug intake control. However, there are some ethical risks to consider that may outweigh these benefits. This study sets out to explore the ethical considerations that should be taken into account in the case of a potential roll-out of contraceptive digital pills as a way of improving the sexual and reproductive health of these women.

The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the function of UTx (and what constitutes its 'success'), as well as the recipient eligibility for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this-the treatment of uterine infertility-explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which both cis- and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non-procreative motivations for uterus acquisition ought to be taken seriously as a matter of non-discrimination and consistency.

This paper explores the notion of loneliness as lack of solidarity in relations to Palestinians living in the Occupied Palestinian Territory, Israel, and the diaspora. Loneliness as lack of solidarity is defined as lacking someone to identify with and/or lacking someone who is willing to assist while carrying a burden. We describe the mechanism of lack of identification using the concept of epistemic injustice. The paper suggests that art may serve as a way to mitigate this kind of loneliness, and focus on the Freedom Theater, which was operating in Jenin Refugee Camp until recently.

The subject of this paper is a critique of the pronatalist metaphysics that underlies bioethics and shapes the thinking and discourse on reproductive rights. The point of reference is the philosophy of antinatalism presented by Marcus T. L. Teo. Seemingly arguing in favor of antinatalism, Teo mixes antinatalist concepts with pronatalist intuitions. The consequence of combining the impossible is the restoration of negative eugenics on the one hand, and a series of contradictions on the other. The article shows that philosophical antinatalism is a universal position that indicates that procreation always, everywhere and for everyone is wrong. The paper simultaneously exposes and criticizes the metaphysics of pronatalism underlying bioethical discourse. Weakening pronatalism in bioethics and turning more attention to antinatalism could bring good results for women, the environment, and bioethics itself in terms of its thematic preferences.

From an ethical point of view, there is an important distinction between two types of prenatal screening. The first of these targets maternal or foetal conditions (e.g., infectious diseases, blood group sensitization) where early detection allows for interventions that improve the chances of a healthy pregnancy outcome. The second screens for foetal conditions such as Down syndrome, where a timely diagnosis in most cases only allows for a choice between preparation for a child with special needs or termination of the pregnancy. Whereas the former makes an easy fit with the prevention aim of most other population screening programmes, the latter does not. In order to steer clear from a possible eugenic reading of its aim, a wide international consensus has emerged for the view that prenatal screening of this type should have the atypical aim of helping women (couples) to make autonomous reproductive choices, rather than reducing the birth prevalence of the relevant disorders. However, keeping these types of prenatal screening apart may become increasingly difficult given the development of tests, such as the Non-Invasive Prenatal Test, which cannot only be used for both types of screening but may also lead to interconnected findings on both sides of the divide. This makes it an urgent question: What the aim or aims of this new hybrid screening should be? As neither 'prevention' nor 'autonomy' will do, we argue for a normative framework that gives both aims their due, while recognizing the tensions between them.

Can it be ethical to conduct xenotransplant research on a human brain-dead decedent (HB-DD) whose organs could otherwise be given to persons in need? The ethical consensus is that it is better to save existing persons via organ donation than to devote a HB-DD to research that will not directly benefit anyone. I argue otherwise. Given how rapidly xenotransplant research is progressing, and its clinical promise in the next couple of years or decades, I argue that it can be ethical to conduct xenotransplant research on a HB-DD whose organs could otherwise be given to individuals in need.