Center for Healthcare Ethics

Uncovering the philosophical underpinnings of eugenic ideology is as equally paramount in discovering truths regarding past medical atrocities as it is about understanding modern bioethical issues that are relevant in today’s swiftly advancing healthcare environment. Inherent relationships exist between the metaphysical and epistemological presuppositions of both the biomedical model and the ideology and ethics of eugenics. Among these metaphysical and epistemological presuppositions, the most profound include: mechanistic monism, materialism, naturalism, reductionism, and social Darwinism— all of which, when adopted consistently as a worldview framework in medical practice, often lead to a measuring of individual human worth according to physical ability and utility rather than the concept of intrinsic value. In this paper, I outline the ramifications of the biomedical model of medicine by exposing its philosophical foundations which subsequently lead to dehumanization and ultimately, an ever-growing disregard for dignity, autonomy, and the sanctity of human life. Finally, I aim to show how these ethical ramifications of the biomedical model often form the philosophical basis for justifying the adoption of eugenic ideologies in medicine, both historically and in the modern era.

As scientists work diligently to create vaccines aimed at slowing and preventing the spread of SARS-CoV-2, bioethicists and philosophers are beginning to analyze these potential eradication approaches in order to evaluate their ethicality and provide guidance on potential COVID-19 vaccine programs and policies. While Operation Warp Speed (OWS) and other local and global initiatives have allowed empirical research into the efficacy of several COVID-19 vaccine candidates to flood medical research databases at unprecedented and encouraging rates, heightened investigation and consideration into the safety and ethicality standards of these candidates are imperative, now more than ever, in order to protect the well being of eventual vaccine recipients. In this paper, I seek to identify and understand the moral epistemology of vaccine ethics in the U.S. and abroad. Comparing these opposing ethical theories, I reflect upon the history of the polio eradication effort, primarily the historical use of the live-attenuated oral polio vaccine (OPV) in the U.S., and I discuss the moral harms that have resulted when a utilitarian ethic is applied to national and global vaccination efforts. In closing, I propose an alternative deontological-virtue based approach to vaccine ethics aimed at guiding scientists and public health policymakers in their efforts toward identifying and implementing a theoretical model of disease eradication which seeks to eliminate the potential for repeating past ethical mistakes while facilitating COVID-19 and other novel disease vaccination programs of the future. Throughout the paper, I will offer philosophical ruminations on these issues in both historical and modern contexts to illuminate the foundational theoretical frameworks which underpin these ideas.

From the beginning of the scientific revolution to the modern era, deterministic philosophies have grown in popularity as a result of a fundamental paradigmatic shift toward naturalistic explanatory theories arising out of the physical and biological sciences. Identifying, comparing, and contrasting the various degrees and forms of determinism (eg. hard determinism, compatibilism, etc.) serves as a daunting yet extraordinarily vital task required to understand the logical coherence of such philosophical theories and their subsequent worldview counterparts. Not only is unpacking the foundational groundwork and worldview structure of determinism necessary in assessing its logical coherence, it is also necessary in assessing the justification for belief in determinism, and subsequently, the justification for belief in alternative theories regarding the nature of the human will. Overall, the intent of this paper is to identify and analyze the epistemological and ontological assumptions and commitments of determinismistic thought in order to evaluate it's metaethical ramifications on moral accountability and responsibility in relation to several universally held natural assumptions we have regarding ethical actions and social expectations. While I conclude with the notion that neither determinism, free will, or any compatibilist view can be formally proven or disproven, I argue that the adoption of a deterministic worldview is self-incoherent and inconsistent with universally accepted social norms, irreconcilable with the idea of mutual ethical expectation, and incompatible with the concepts of moral responsibility and accountability.

The ethics of scarce life-sustaining and life-saving resource allocation is a complex topic with significant ethical ramifications that require comprehensive theoretical and practical analysis. The COVID-19 pandemic, especially for countries such as the United States who are less experienced with rationing healthcare resources, has forced healthcare systems to create and implement crisis standards of care guidelines to help clinicians make difficult ethical decisions in the face of limited time and scarce resources. This paper aims to deconstruct the philosophical concepts and moral theory behind several states’ crisis standards of care models in the U.S. to show how certain practices of resource rationing negatively impact and infringes upon the rights and wellbeing of individuals with underlying disabilities and/or comorbidities. An ethical evaluation and critique of Pennsylvania’s 2020 Interim Crisis Standards of Care (CSC) for Pandemic Guidelines’ as well as other states’ CSC frameworks will be made. To conclude, the foundations of an alternative equity-based approach to crisis standards of care that avoids adopting the dehumanizing ethic and discriminatory protocols present in states’ current crisis standards of care model will be proposed.

This paper aims to illuminate the weaknesses and harmful implications the biomedical model of medicine has on the field and practice of bioethics by providing a brief historical review, in-depth philosophical analysis, and ethical critique of the biomedical model and its contribution to the quality-of-care crisis in healthcare today. Following the analytical and critical evaluation of the biomedical model and the harmful aspects of its impact on bioethical theory and methodology, a proposal for a re-integration of philosophy into bioethics is offered. This new philosophical approach, building off a synthesis of old ideas and contemporary literature from the fields of philosophy and bioethics, is intended to aid in the effort to solve the quality-of-care crisis modern healthcare systems face across the globe by encouraging a return to a more humanistic, ethically conscious medical worldview lens. Though the proposal only provides a preliminary foundation for this alternative philosophical approach, the hope is that such an outline may serve as the groundwork for creating a more authentic, patient-centered, empathetic ethic of care.

A consensus exists among contemporary philosophers of biology about the history of their field. According to the received view, mainstream philosophy of science in the 1930s, 40s, and 50s focused on physics and general epistemology, neglecting analyses of the ‘special sciences’, including biology. The subdiscipline of philosophy of biology emerged (and could only have emerged) after the decline of logical positivism in the 1960s and 70s. In this article, I present bibliometric data from four major philosophy of science journals (Erkenntnis, Philosophy of Science, Synthese, and the British Journal for the Philosophy of Science), covering 1930–59, which challenge this view.

It is a fact that medical technology is improving a lot regarding the quality of life of the contemporary man. The improvement generates further enthusiasm in research and creativity in general. But it is equally a fact that medical technology raises worrisome concerns in respect of human dignity, the seeming deification of machines, conventional moral values, etc. One of these concerns is the focus of this article, namely, the ethical appropriateness of creating leukocyte Antigen that matches donor child for the treating of Fanconi anemia.

The traditional Igbo moral education is a system of education that occurs in the context of the family and community, and taught to the child, at a very early age, through taboos, myths, riddles, jokes, proverbs, and through stories that often feature animals and birds. The traditional Igbo moral education emphasizes character formation, communal values -solidarity, relationships, and relational autonomy. Since the advent of the Western system of education, there has been a rush to adopt the Western method of moral education, thus, abandoning the traditional Igbo method. This repudiation along with other factors has resulted in the growing apathy to moral education and moral laxity in Igbo-land and in Nigeria in general. There is a need to recover and incorporate some sound aspects of our traditional moral values and moral education methods into the modern system of education in Igbo-land. This integration will aid in immensely ameliorating the current situation of moral decadence, and enrich the current quality of moral education.

This article adopts the traditional Catholic principle of double effect to justify condom use between spouses when one partner is infected with HIV. Recently Pope Benedict opposed this stance during his visit to Africa. But a traditional interpretation of Church teaching can permit such use. The HIV/AIDS pandemic is devastating many countries globally, especially in African. Millions of infected people are dying, thereby contributing to other multiple problems: families and communities being decimated, national development being compromised, the gap between rich and poor people becoming worse, and marginalizing already stigmatized groups. Catholic moral doctrine has a crucial role to play in containing this dreadful pandemic.

The Republic of Sierra Leone, the smallest of the West African countries being ravaged by the Ebola virus, possesses an extreme weak healthcare system. Therefore, the Ebola virus epidemic is a daunting challenge for the nation. However, the local HCPs fearlessly took up the challenge and displayed great professionalism. Sadly some HCPs are among the casualties to the epidemic. Yet the healthcare professionals remain in the fight. In this paper, I argue that the manner in which the HCPs are fighting the Ebola epidemic in Sierra Leone depicts professionalism at its best. Because of such professionalism, the principle of justice in healthcare professionalism, Cosmopolitan principle, and the preference utilitarianism theory we are morally more obligated to support them in their fight against the Ebola epidemic and in the larger task of building a strong healthcare system in Sierra Leone. Our support for them is a campaign for medical professionalism and all the advantages it brings to healthcare practice.

One of Pope Francis’ sayings that have resonated with many people is his response to the journalists on his flight back to Rome from Brazil on Monday July 29 2013. The Pope was asked about gay priests, homosexuals, and lesbians. His reply was “If someone is gay and he searches for the Lord and has good will, who am I to judge?” The pope has been advocating that the Catholic Church and her leaders adopt a less judgmental attitude in ministry, and particularly in moral teaching and practices. The Pope’s call is not only evident in but is intensified in his recent Apostolic Exhortation Amoris Laetitia (The Joy of Love). I argue in this paper that the pope’s response is not only an amplification of the primacy of conscience doctrine but more importantly a clarion call to return to the doctrine of the primacy of conscience. It further denotes the need and the importance of culture in the formation of conscience.