Theoretical medicine and bioethics最新文献

In the management of the Covid 19 crisis, digital technologies were used in a major way. This article defends the hypothesis that these technologies took the form of a "tacit social experimentation". This article justifies this concept in three levels. The first part uses this concept to qualify the form of biopolitics that was implemented to manage the crisis. Digital technologies were used to discipline the population and, literally speaking, as instruments of knowledge of the population. Uncertainty forced experts to make preliminary observations and act to produce knowledge. Second, this article shows that the use of digital technologies during the crisis was experimental in a second sense. By promoting telemedicine within a more flexible legal framework, the authorities authorised an experimental use of telemedicine without knowledge or control of its side effects. Finally, the article defends the use of the concept of "tacit social experimentation" for ethical and political purposes. For indeed, understanding the experiments carried out during the crisis begs the question of the involvement of the participants and their democratic steering.

This article examines some of the ethical challenges of prioritizing intensive care resources during the Covid-19 pandemic by comparing the Italian and United States contexts. After presenting an overview to the clinical, ethical, and public debates in Italy, the article will discuss the development of triage allocation protocols in United States hospitals. Resource allocation criteria underwent increased scrutiny and critique in both countries, which resulted in modified professional and expert guidance regarding healthcare ethics during times of emergency and resource scarcity.

This paper focuses on the importance of digital communication between medical teams and patients and their families when mediated by technological tools. Medicine is changing following the fourth industrial (the digital) revolution: from CAT scans, to X-rays, to UV radiation, to electronic records, to treatment tracking apps, to telemedicine, and the use of AI in doctors' decision-making processes. The COVID-19 pandemic highlighted both the fruitful and problematic sides of this medical evolution. Digital tools such as tablets, smartphones, and video calling apps proved to be essential. Accordingly, I analyze three cases that reveal the helpfulness and the limitations of new communication technologies: on physicians and non-hospitalized patients, on families and patients, and on healthcare professionals and patients' families. Since the medical relationship is not only clinical but also relational and human, one must pay attention to the communicative dimensions of it to remain at least partly human-e.

Kairos has been a key concept in medicine for millennia and is frequently understood as "the right time" in relation to treatment. In this study we scrutinize kairos in the context of diagnostics. This has become highly topical as technological developments have caused diagnostics to be performed ever earlier in the disease development. Detecting risk factors, precursors, and predictors of disease (in biomarkers, pre-disease, and pre-pre-disease) has resulted in too early diagnoses, i.e., overdiagnoses. Nonetheless, despite vast advances in science and technology, diagnoses also come too late. Accordingly, timing diagnostics right is crucial. In this article we start with giving a brief overview of the etymology and general use of the concepts of kairos and diagnosis. Then we delimit kairos in diagnostics by analysing "too early" and "too late" diagnosis and by scrutinizing various phases of diagnostics. This leads us to define kairos of diagnostics as the time when there is potential for sufficient information for making a diagnosis that is most helpful for the person. It allows us to conclude that kairos is as important in diagnostics as in therapeutics.

Although Western biomedical ethics emphasizes respect for autonomy, the medical decision-making of Muslim patients interacting with Western healthcare systems is more likely to be motivated by relational ethical and religious commitments that reflect the ideals of equity, reciprocity, and justice. Based on an in-depth cross-cultural comparison of Islamic and Western systems of biomedical ethics and an assessment of conceptual alignments and differences, we argue that, when working with Muslim patients, an ethics of respect extends to facilitating decision-making grounded in the patient's justice-related customs, beliefs, and obligations. We offer an overview of the philosophical contestations of autonomy-enhancing practices from the Islamic tradition of biomedical ethics, and examples that demonstrate a recommended shift of emphasis from an autonomy-centered to a justice-focused approach to culturally competent agency-promotion.

My fundamental thesis is that Rachels dismisses the traditional Western account of the morality of killing without offering a viable replacement. In this regard, I will argue that the substitute account he offers is deficient in at least eight regards: (1) he fails to justify the foundational principle of utilitarianism, (2) he exposes preference utilitarianism to the same criticisms he lodges against classical utilitarianism, (3) he neglects to explain how precisely one performs the maximization procedure which preference utilitarianism requires, (4) his account of the sanctity of life is subject to the very criticism he levels against the traditional position, (5) he cannot justify the exceptions he makes to his interpretation of the sanctity of life, (6) his account could easily be used to justify murder, (7) his embrace of autonomy as an ethical principle undermines his preference utilitarianism, and (8) he cannot maintain the moral identification of acts of killing and letting die.

In 2017, Michael Nair-Collins formulated his Transitivity Argument which claimed that brain-dead patients are alive according to a concept that defines death in terms of the loss of moral status. This article challenges Nair-Collins' view in three steps. First, I elaborate on the concept of moral status, claiming that to understand this notion appropriately, one must grasp the distinction between direct and indirect duties. Second, I argue that his understanding of moral status implicit in the Transitivity Argument is faulty since it is not based on a distinction between direct and indirect duties. Third, I show how this flaw in Nair-Collins' argument is grounded in the more general problems between preference utilitarianism and desire fulfillment theory. Finally, I present the constructivist theory of moral status and the associated moral concept of death and explain how this concept challenges the Transitivity Argument. According to my view, brain death constitutes a valid criterion of death since brain death is incompatible with the preserved capacity to have affective attitudes and to value anything.