Pub Date : 2024-08-01Epub Date: 2024-06-18DOI: 10.1007/s11017-024-09674-2
Susan B Levin
Transhumanists and their fellow travelers urge humanity to prioritize the development of biotechnologies that would eliminate aging, delivering 'an endless summer of literally perpetual youth.' Aspiring not to age instantiates what philosopher Martha Nussbaum calls the yearning for 'external transcendence,' or the fundamental surpassing of human bounds due to confidence that life without them would be better. Based on Immanuel Kant's account of the parameters of human understanding, I argue that engineering agelessness could not be a rational priority for humanity on the level of public policy. This stance is complemented by an argument focused on individual decision-making in liberal-democratic milieus, where no governing conception of the good is presumed and the first-personal level matters greatly. Here, drawing on philosopher and cognitive scientist Laurie Ann Paul's concept of 'transformative experience,' I maintain that individuals could not 'rationally,' meaning, here, 'prudentially,' say 'yes' to agelessness. Absorbing the irrationality of human zeal to eliminate aging, based on assurance that an ageless existence would be better, should spur a redoubled dedication to human flourishing.
{"title":"The irrationality of human confidence that an ageless existence would be better.","authors":"Susan B Levin","doi":"10.1007/s11017-024-09674-2","DOIUrl":"10.1007/s11017-024-09674-2","url":null,"abstract":"<p><p>Transhumanists and their fellow travelers urge humanity to prioritize the development of biotechnologies that would eliminate aging, delivering 'an endless summer of literally perpetual youth.' Aspiring not to age instantiates what philosopher Martha Nussbaum calls the yearning for 'external transcendence,' or the fundamental surpassing of human bounds due to confidence that life without them would be better. Based on Immanuel Kant's account of the parameters of human understanding, I argue that engineering agelessness could not be a rational priority for humanity on the level of public policy. This stance is complemented by an argument focused on individual decision-making in liberal-democratic milieus, where no governing conception of the good is presumed and the first-personal level matters greatly. Here, drawing on philosopher and cognitive scientist Laurie Ann Paul's concept of 'transformative experience,' I maintain that individuals could not 'rationally,' meaning, here, 'prudentially,' say 'yes' to agelessness. Absorbing the irrationality of human zeal to eliminate aging, based on assurance that an ageless existence would be better, should spur a redoubled dedication to human flourishing.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"277-301"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-05-25DOI: 10.1007/s11017-024-09671-5
Mbih Jerome Tosam
The COVID-19 pandemic has provoked new interest in the notion of vulnerability and in identifying alternative approaches for responding to vulnerable patients and populations during health emergencies. In this paper, I argue that the autonomy-based approach (the most dominant approach in bioethics) to responding to vulnerability during health emergencies is deficient because it focuses only on the interests, values, and decisions of the individual patient. It overly emphasizes respect for autonomy and not respect for the patient as it does not consider the patient as a social and relational agent. Indeed, relational approaches to autonomy like the feminist and indigenous sub-Saharan African ethical approaches are promising alternatives. In this essay, I use the indigenous African relational approach to autonomy as an example of an alternative method which can be used to respond to vulnerability during a global health emergency like COVID-19.
{"title":"Autonomy-based bioethics and vulnerability during the COVID-19 pandemic: towards an African relational approach.","authors":"Mbih Jerome Tosam","doi":"10.1007/s11017-024-09671-5","DOIUrl":"10.1007/s11017-024-09671-5","url":null,"abstract":"<p><p>The COVID-19 pandemic has provoked new interest in the notion of vulnerability and in identifying alternative approaches for responding to vulnerable patients and populations during health emergencies. In this paper, I argue that the autonomy-based approach (the most dominant approach in bioethics) to responding to vulnerability during health emergencies is deficient because it focuses only on the interests, values, and decisions of the individual patient. It overly emphasizes respect for autonomy and not respect for the patient as it does not consider the patient as a social and relational agent. Indeed, relational approaches to autonomy like the feminist and indigenous sub-Saharan African ethical approaches are promising alternatives. In this essay, I use the indigenous African relational approach to autonomy as an example of an alternative method which can be used to respond to vulnerability during a global health emergency like COVID-19.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"183-197"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094833","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}
Pub Date : 2024-06-01Epub Date: 2024-05-16DOI: 10.1007/s11017-024-09666-2
Talitha Cooreman-Guittin
The Covid-19 pandemic and the repeated lockdowns have caused substantial spiritual and existential suffering, not the least for persons with dementia who may have had more difficulties than others in grasping the reality of what was going on. Therefore, it is important to address spirituality within this sector of the population when considering global health and ethics and technology in a pandemic outbreak. This contribution starts firstly with a definition of spirituality and spiritual care. Secondly, based on the works of Elizabeth MacKinlay and Laura Dewitte, the article demonstrates how spirituality can be nurtured in the dementia ward through "spiritual reminiscence." Finally, I briefly reflect on how spiritual care in the dementia ward was affected by the Covid-19 pandemic.
{"title":"Spiritual care in the dementia ward during a pandemic.","authors":"Talitha Cooreman-Guittin","doi":"10.1007/s11017-024-09666-2","DOIUrl":"10.1007/s11017-024-09666-2","url":null,"abstract":"<p><p>The Covid-19 pandemic and the repeated lockdowns have caused substantial spiritual and existential suffering, not the least for persons with dementia who may have had more difficulties than others in grasping the reality of what was going on. Therefore, it is important to address spirituality within this sector of the population when considering global health and ethics and technology in a pandemic outbreak. This contribution starts firstly with a definition of spirituality and spiritual care. Secondly, based on the works of Elizabeth MacKinlay and Laura Dewitte, the article demonstrates how spirituality can be nurtured in the dementia ward through \"spiritual reminiscence.\" Finally, I briefly reflect on how spiritual care in the dementia ward was affected by the Covid-19 pandemic.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"221-229"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-05-30DOI: 10.1007/s11017-024-09673-3
Renzo Pegoraro
The Catholic Church's reflection on and assessment of the Covid-19 pandemic has developed in several areas. Inspired by the tradition of its social teaching, specifically by the values of the dignity of the human person, justice, solidarity, and the common good, a strong sense of responsibility-on the part of all to prevent the spread of the pandemic and care for the affected sick-was called for. This resulted in a series of interventions and documents on the various medical and spiritual issues involved, particularly concerning the vaccines again Covid-19. In this short article, I draw out these insights from the official and universal reference point of the Catholic Church (i.e., Vatican sources in their various expressions and expertise). Interventions from other religions have also played a significant role during the Covid-19 pandemic as exemplified by the close relationship between certain religious actors and the World Health Organization. However, these alternative viewpoints, while important in and of themselves, do not find a suitable place within this work, which focuses on the Catholic Church's perspective.
{"title":"Catholic religious agency during the Covid-19 emergency: the issue of vaccines.","authors":"Renzo Pegoraro","doi":"10.1007/s11017-024-09673-3","DOIUrl":"10.1007/s11017-024-09673-3","url":null,"abstract":"<p><p>The Catholic Church's reflection on and assessment of the Covid-19 pandemic has developed in several areas. Inspired by the tradition of its social teaching, specifically by the values of the dignity of the human person, justice, solidarity, and the common good, a strong sense of responsibility-on the part of all to prevent the spread of the pandemic and care for the affected sick-was called for. This resulted in a series of interventions and documents on the various medical and spiritual issues involved, particularly concerning the vaccines again Covid-19. In this short article, I draw out these insights from the official and universal reference point of the Catholic Church (i.e., Vatican sources in their various expressions and expertise). Interventions from other religions have also played a significant role during the Covid-19 pandemic as exemplified by the close relationship between certain religious actors and the World Health Organization. However, these alternative viewpoints, while important in and of themselves, do not find a suitable place within this work, which focuses on the Catholic Church's perspective.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"231-239"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176945","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}
Pub Date : 2024-06-01Epub Date: 2024-05-25DOI: 10.1007/s11017-024-09670-6
Eduardo Missoni
The Covid-19 pandemic has dramatically shown the level of interconnectedness of the human population, the direct relation between human health and the ecosystem, as well as the enormous ethical challenges required for a global response. Relatedly, society has been directly confronted by issues of 'Global health,' both in terms of awareness of health conditions and health systems resiliency all around the world, as well as in terms of governance of the worldwide response and its implications at national and local levels. While Global health is often used as a cosmetic label for neocolonial approaches, it is really an interdisciplinary approach consisting of the interaction between globalization and the determinants of health. Thus, it involves the ecosystem and its transformation and implies a systemic 'One Health' decolonized approach in the definition of its strategies. The Covid-19 pandemic has highlighted the inequities and the limits of the current hegemonic Global health system governance; calling for ethics to provide a renewed, comprehensive, inclusive, and decolonized conceptualization of Global health.
{"title":"Global health, planetary health, One Health: conceptual and ethical challenges and concerns.","authors":"Eduardo Missoni","doi":"10.1007/s11017-024-09670-6","DOIUrl":"10.1007/s11017-024-09670-6","url":null,"abstract":"<p><p>The Covid-19 pandemic has dramatically shown the level of interconnectedness of the human population, the direct relation between human health and the ecosystem, as well as the enormous ethical challenges required for a global response. Relatedly, society has been directly confronted by issues of 'Global health,' both in terms of awareness of health conditions and health systems resiliency all around the world, as well as in terms of governance of the worldwide response and its implications at national and local levels. While Global health is often used as a cosmetic label for neocolonial approaches, it is really an interdisciplinary approach consisting of the interaction between globalization and the determinants of health. Thus, it involves the ecosystem and its transformation and implies a systemic 'One Health' decolonized approach in the definition of its strategies. The Covid-19 pandemic has highlighted the inequities and the limits of the current hegemonic Global health system governance; calling for ethics to provide a renewed, comprehensive, inclusive, and decolonized conceptualization of Global health.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"241-250"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-05-25DOI: 10.1007/s11017-024-09669-z
Alain Loute
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.
{"title":"Tacit social experimentation with digital technologies during the Covid-19 crisis.","authors":"Alain Loute","doi":"10.1007/s11017-024-09669-z","DOIUrl":"10.1007/s11017-024-09669-z","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"199-209"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094841","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}
Pub Date : 2024-06-01Epub Date: 2024-05-28DOI: 10.1007/s11017-024-09672-4
Lucia Galvagni, Joseph A Raho
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.
{"title":"Ethical prioritization of critical care resources during COVID-19: perspectives from Italy and the United States.","authors":"Lucia Galvagni, Joseph A Raho","doi":"10.1007/s11017-024-09672-4","DOIUrl":"10.1007/s11017-024-09672-4","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"167-181"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162663","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}
Pub Date : 2024-06-01Epub Date: 2024-05-25DOI: 10.1007/s11017-024-09668-0
Lucia Galvagni, Michele Nicoletti
{"title":"Facing a pandemic outbreak: issues of global health, ethics, and technology.","authors":"Lucia Galvagni, Michele Nicoletti","doi":"10.1007/s11017-024-09668-0","DOIUrl":"10.1007/s11017-024-09668-0","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"159-165"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094830","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}
Pub Date : 2024-05-18DOI: 10.1007/s11017-024-09667-1
Monica Consolandi
{"title":"Toward a digitalized medicine: the Covid-19 pandemic as a disclosure of the importance of digital communication in the clinical world.","authors":"Monica Consolandi","doi":"10.1007/s11017-024-09667-1","DOIUrl":"https://doi.org/10.1007/s11017-024-09667-1","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140962079","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}
Pub Date : 2024-05-18DOI: 10.1007/s11017-024-09667-1
Monica Consolandi
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.
本文重点论述医疗团队与患者及其家属之间以技术工具为媒介的数字沟通的重要性。在第四次工业(数字)革命之后,医学正在发生变化:从 CAT 扫描到 X 光、紫外线辐射、电子记录、治疗跟踪应用程序、远程医疗,以及在医生决策过程中使用人工智能。COVID-19 大流行凸显了这一医疗变革的成果和问题。事实证明,平板电脑、智能手机和视频通话应用程序等数字工具至关重要。因此,我分析了三个案例,揭示了新通信技术的帮助和局限性:对医生和非住院病人、对家属和病人,以及对医护人员和病人家属。由于医疗关系不仅是临床关系,也是人与人之间的关系,因此我们必须关注医疗关系中的沟通层面,以便至少在一定程度上保持人性化。
{"title":"Toward a digitalized medicine: the Covid-19 pandemic as a disclosure of the importance of digital communication in the clinical world.","authors":"Monica Consolandi","doi":"10.1007/s11017-024-09667-1","DOIUrl":"https://doi.org/10.1007/s11017-024-09667-1","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961313","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}