History of Bioethics

In recent years there has been an increase in the number of requests for“mercy killings” by patients and their relatives. Under certain conditions,the patient may prefer death to a life devoid of quality. In contrast to thosewho uphold this “quality of life” approach, those who hold the “sanctity oflife” approach claim that life has intrinsic value and must be preservedregardless of its quality. This essay describes these two approaches,examines their flaws, and offers a “golden path” between the two extremepositions.We discuss the halachic and the secular views, arguing for a balancebetween the sanctity of life and the quality of life. We argue that, indeed,such a balance exists in practice, and that life is important, but it is not sacred. Life can be evaluated, but quality of life is not the solecriterion.

The chapter argues that Malthus’s ethics was a rather traditional kind of Christian morality, far from the ‘new morality’ announced by Bentham.
He argued for consistent application of traditional virtues as the keystone of a new moral and political construction that was called forth to limit and control most evils arising from the principle of population; what is new in Malthus’s approach to ethical issues is instead something almost opposite to Bentham’s spirit. Its mark is modesty, an awareness that there are indeed virtues and moral precepts but there are also greater and lesser evils, and the moral and political science is indeed a moral science not only in the sense that is science of man but also in the sense that it is a applied moral theology, and yet, in so far as it applied, it cannot turn out to be abstract moralizing, the highest the value preached the better. On the contrary Malthus insists that there are indeed consequences of lines of action and policies, and there greater and lesser evils, and policies should be designed for a world made of human beings as they are, not as they ought to be.

The book reflects on some of the troubling questions in medical ethics:  Medicine, Technology, Law and Decisions at the Beginning of Life; Planned Orphanage; Wrongful Life; Ethical Education and Research in Medical Schools and Hospitals; Organ Transplantation; Allocation of Resources, Health Care Systems and Health Rights; Decisions at the End of Life: Mercy Killings and the Right to Die in Dignity; Clinical Ethical Issues. The book is comprised of essays that were written by members of the Medical Ethics Think-tank that worked under the auspices of The Van Leer Jerusalem Institute during 1995-1998. The contributors come from different disciplines: physicians, philosophers, ethicists, legal theorists, social workers and religious authorities. The scholars represent all six Israeli universities and some of them are also affiliated to the principal medical centers in the country. These are top scientists, renowned for their quality research and scholarship, who have been working together for three years. The group has produced in its brain storming sessions high quality papers that will enrich the thinking and knowledge on various issues in the field of medical ethics, especially on decision making at the beginning of life and at the end of life. The book offers significant contribution to the analysis of practical questions from theoretical and analytical perspectives, combining theory and fieldwork conducted in hospitals.

We want this book to evoke a debate on major issues in medical ethics in Israel and to serve all those who are interested in the issue.












דילמות באתיקה רפואית
רפאל כהן-אלמגור (עורך)


תוכן עניינים

רפאל כהן-אלמגור
הקדמה

שער ראשון
על זכויות בריאות וחינוך לאתיקה רפואית

כרמל שלו
זכויות בריאות

שמעון גליק ועדנה בנשלום
ההתמודדויות האתיות של סטודנטים לרפואה

גרשון ב. גרונפלד
ועדות אתיקה במוסדות רפואיים


שער שני
תחילת החיים: על הזכות להורות, יתמות מתוכננת, והזכות לא להיוולד בפגם

רות הלפרין-קדרי
"להשאיר חיים אחריך": יילוד העובר מגוף הנפטרת - האמנם בכל מקרה?
ורדית רביצקי
הזכות להורות בעידן ההפריה הטכנולוגית
מרדכי הלפרין
הגדרת הורות וזכות איתור השורשים הביולוגים

רוזלי בר
סוגיות אתיות ביצירת ילדים באמצעות אם פונדקאית

רות לנדאו
יתמות מתוכננת

אסא כשר
"יתמות מתוכננת": התמונה המאוזנת

עמוס שפירא
הזכות לא להיוולד בפגם: פלוגתות של לוגיקה, ערכים ומדיניות משפטית

דוד הד
האם קיימת זכות לא להיוולד בפגם? תגובה פילוסופית לעמוס שפירא

שער שלישי
השתלות איברים וסוף החיים בראי ערכים הלכתיים וליברליים

משה זמר
תרומת איברים וההלכה

אברהם שטיינברג
החולה הסופני - מבט השוואתי בין "ערכים דמוקרטיים והלכתיים"

רפאל כהן-אלמגור
על אוטונומיה, המתות חסד והזכות למות בכבוד


שער רביעי
מדיניות טיפולית

איתי בנטוב וצ'רלס ספרונג
בעיות אתיות בברירת חולים לטיפול נמרץ

אבי עורי
היבטים אתיים ברפואה שיקומית

ברוך מודן ושלומית פרי
גורמי סיכון וגורמי פיצוי: מדיניות הממשלה מול מוקרני הגזזת

Prima di porsi delle domande “bioetiche”, occorre porsi delle domande sulla Bioetica e sul suo statuto epistemologico; ma anche sul suo legame con le altre discipline, la sua appartenenza a un ambito piuttosto che ad un altro e sulla sua modalità di rispondere alle questioni pratiche che continuamente la riguardano. Solo così potremo giungere a uno dei principali obiettivi di questo testo: la riscoperta della Bioetica a partire dai suoi fondamenti. Si è fatta tanta Bioetica in questi anni, eppure paradossalmente gli studiosi ancora non trovano un accordo sulla sua identità. Si è data, anche comprensibilmente, priorità alla risoluzione di casi o alla discussione di leggi o alla ricerca di principi e teorie da applicare nella questione concreta, si è data precedenza più alla ricerca di un pluralistico consenso che a una presa di coscienza morale solida e fondata, con il rischio di una scivolata empirista e una difficoltà evidente di definirla e fondarla.
Prima di arrivare a dimostrare questo dato e abbozzare un tentativo di definizione, occorre fare un passo indietro e comprendere da dove sorge questa disciplina, come ha svolto la sua funzione in questi anni e come emerge solitamente nel dibattito.

A doctor is no longer at his intellectual peak just because he knows the best new methods … he must also have a talent for conversation that must adapt to every individual. (F. Nietzsche, Omenesc prea omenesc, 1878) ABSTRACT. Ethical Issues on Doctor-Patient Relationship. From the medical ethics of 1950s to the latest developments after 2000, medical decision, under the exclusive competence of physicians, gradually came to involve patients, or at least, they are becoming more involved in their therapeutic solutions. This transformation is, in fact, the passage from the paternalistic model, focused on therapeutic benefit to the autonomy model, centered on the respect for the individual and their freedom of decision. Doctors of our time are seen as professionals or technicians working for " consumers of treatments " and patients gradually become ordinary " customers " who claim " services ". They have the task to inform patients about all potential risks and then they will decide freely. This is supposed to be the way of the respect for the individual and his autonomy. In this paper we will describe the development stages of the doctor-patient relationship, we analyze the models by which is classifying this relationship and we see the complexity of dynamics of this relationship and its specificity, showing also the limits of proposed models for the Romanian context. REZUMAT. De la etica medicală a anilor 1950 la ultimele evoluții de după anii 2000, decizia medicală, aflată în competența exclusivă a medicilor, a ajuns să treacă treptat în sarcina pacienților, sau cel puțin aceștia să fie din ce în ce mai implicați în soluțiile terapeutice ce urmează a li se aplica. Această transformare este, în fapt, pasajul de la un model de tip paternalist, centrat pe beneficiul terapeutic, la un model autonom, centrat pe respectul persoanei și a libertății sale de decizie. Medicii timpurilor noastre sunt văzuți ca fiind profesioniști sau tehnicieni, care lucrează pentru " consumatorii de tratamente " , iar pacienții devin, treptat, simpli " clienți " care solicită " servicii ". Aceștia au sarcina de a-i informa cu privire la toate riscurile potențiale, apoi îi lasă să decidă liber. Aceasta se presupune a fi calea

Just over 20% of white women in America will never bear children, the highest percentage in modern history.  Only half of this group-10% of women without children- are considered infertile.  Many women in the fertile but childless group are voluntarily so:  the self-proclaimed childfree.

Yet despite the growing acceptability in remaining a childfree adult, doctors are resistant to sterilizing women without children. Access to sterilization is usually repeatedly denied, often with tactics of humiliation, hoop jumping, or second-guessing the legitimacy of the patient’s desire for sterilization, despite the legal status of voluntary sterilization for any competent person over the age of 21- regardless of parity.     

This paper will examine the many reasons why a woman who does not have children would want to continue in her childfree lifestyle, evaluate the accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization- both from the woman’s and the physicians’ perspective, and assess the legal status of voluntary sterilization for nonparous women. The paper will conclude that sterilization for childfree women is an ethical, legal option and that willing doctors should follow recommended guidelines for counseling women who desire sterilization, and urge hesitant doctors to reconsider their oppositions to voluntary sterilization for childfree women and provide the contraception of preference to women.

There are few issues more emotional and divisive than what has become known as “the right to die.” One camp advocates the “death with dignity” approach, according to which the patient is an autonomous being who can form his or her own judgment on the timing and process of dying. The other camp advocates the sanctity of life approach, in which life is intrinsically valuable and should be sustained as long as possible. Is
there a right answer?
    In The Right to Die With Dignity, Raphael Cohen-Almagor takes a balanced approach in analyzing this emotionally charged debate, viewing the dispute uniquely from public policy and international perspectives. This book offers an interdisciplinary, compelling study in medicine, law, religion and ethics. It is, arguably, the most comprehensive book yet to be written on the fascinating question of whether physician-assisted suicide should be allowed. Cohen-Almagor delineates the distinctions between active and passive euthanasia and discusses some of the legal measures that have been invoked in the United States and abroad. He outlines the reasons non-blood relatives should be given a role in deciding a patients’ last wishes. He examines euthanasia policies in the Netherlands and the 1994 Oregon Death with Dignity Act, suggesting improvements to each. Finally, he makes a circumscribed plea for voluntary physician-assisted suicide.

The foundations of modern Catholic bioethics were
laid with the teachings of Christ and his message of
love of God and neighbor, especially in the example
He set as the Divine Physician and through the parable of the Good Samaritan. The Church thus cared for the sick and built hospitals for two thousand years before adopting a definite bioethical focus. Edmund Pellegrino places the origins of a definite bioethical focus in “the confessional manuals of the Middle Ages, and the treatises of the moral theologians of the sixteenth century to the present day.” In recent times, secular bioethics split from theology and metaphysics in favor of the rationalism and humanism which developed out of Enlightenment thought, whereas Catholic bioethics continued its own development, keeping both its theological and its metaphysical roots.

This article will examine the claims offered by both sides of the debate as to whether Brain Death definition was linked to Organ Transplantion needs by looking at historical studies on the relationship between them, either establishing such a link or rejecting it. In the last section, the role of Henry Beecher as the Committee chairman will be highlighted to put this debate in a proper perspective. Beecher is widely known for his role as a whistleblower of unethical experimentations on human subjects in the 1960s. His concerns for ethical behavior for scientists and physicians had an important impact on the Harvard committee, a role which has often been ignored.

"Representations", N. 129, Winter 2015.

The essay analyzes the project of maintaining the body of V. I. Lenin in the Mausoleum in Moscow for the past ninety years, focusing on the unique biological science that developed around this project, and the unexpected political role this body has performed.

The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most likely imprudent. But on the other hand, the more “sensible” proposals – sensible in the sense of being both practically achievable and more plausibly ethically justifiable – can be rather hard to distinguish from both “traditional” forms of moral enhancement, such as non-drug-mediated social or moral education, and non-moral forms of bioenhancement, such as “smart drug” style cognitive enhancement. In this essay, I argue that bioethicists have paid insufficient attention to an alternative form of moral bioenhancement—or at least a likely candidate—that falls somewhere between these two extremes, namely the (appropriately qualified) use of certain psychedelic drugs.

Since the times of the Enlightenment, traditional control of religion in vital spheres of the social order began to crumble under the secular challenge of politics, culture, science, economy, judiciary, philosophy, and education.  Ethics and theology were probably the last strongholds until they eventually succumbed as well under the influence of the now secularized academia.  This happened at a time when society was restless with exciting medical discoveries which brought with them the age-old questions of just distribution, legitimate use of technology and justified manipulation of nature.  The debate on contraception was among the test cases of novel technology with ethical substance, and dissent against church teaching caused an exodus of scholar to join the burgeoning field of bioethics.  Even though theologians made important seminal contributions in the early days of bioethics, it was philosophy that bioethics eventually fell back on because of the troubles facing theology.  Principlism soon became the dominant philosophical model to be applied in policymaking and at the bedside.  However, the consensus achieved by this ethic looked contrived and open to manipulation of the potent.  As discontents brewed, a plethora of competing models surged on the horizon, many of them sought to relocate ethics in the context of the situation or the character of the moral agent.  Unwittingly, this puts secular bioethics on the path toward ethical relativism, liberalism and nihilism.  Bioethics has become a secular creature which not only rejects religion but now questions the very possibility of reason itself.  Different speculations sought to provide the causes of the secularization of bioethics.  At root is an uncertainty about the place of religion in democracy, and of situating religious ethics in public ethics.  Secular bioethics’ inadequacy also calls for a reexamination of the possible contribution of religion and theology in terms of distinctively religious content, communities and methodologies.  Hence, a ray of hope appears on the horizon for religion to reinsert itself into the bioethical debate, which has become impoverished from its absence.

The paper analyses the role of Albert Schweitzer in the antinuclear movement during the 1950s and 1960s. Having come face to face with the unthinkable threat of nuclear destruction, Schweitzer joins with renowned scientists to raise public awareness about the necessity of banning nuclear testing. Schweitzer applies the view summed up in the concept of reverence for life to a question of global importance, insisting on the personal responsibility of each individual for the present and future generations. His contribution to the antinuclear
movement also sheds light on the decisive role of the movement in the formation of the field of bioethics. In conclusion, the authoress points to the need for redefining the origins of bioethics.

After a long journey in research reaching at this point, we consider it appropriate to underline the topicality of philosophical thinking of Hippocrates. The general spirit of learning, knowledge, philosophy and humanity enters several times in second place, neglecting the bioethics anthropology and political philosophy of the Ancient medical philosophers whose practice method and way of life should again puzzle us positively in the 21st century.
Several opinions on the great medical philosopher of Kos Island even today are highly timely, as both the scientific education, and the fight of Hippocrates against priestly Medicine against preconceptions or superstition of the time is important.
Today unfortunately the Hippocratic Oath is no longer pronounced in several medical schools of the modern world and perhaps this is a sample of variance of historical knowledge and reality. Bioethics and the ethics report on activity of the philosopher practitioner retains all its validity for Hippocrates, mainly in scientific rigor and moral rigor, which equates them to a genuine social and political philosophies and true medical anthropology, of the "Father of Medicinal" science.
We felt his presence as a Greek and philosopher, educator and anthropologist, even though we read about him intensely. We tried and listened to his silence, more than we heard his words through his writing lessons. Medical ethics deontology in the modern world of science doesn't belong only to physicians but also to lawyers, to sociologists, to philosophers, to theologians, and in every human being simplistic or scientist. With a nice initiative in Greece the birthplace of Hippocrates founded the Greek company Ethics and became accepted with a purpose to outline the safeguards that ensure the dignity of human existence and merit-based coexistence. From the perspective of Orthodox Christian morality addressing these issues is done on the basis of anthropological teaching of the fathers of the Christian Church. So with this survey it is attempted to define the scientific field of bioethics and the historic retrospect of Hippocratic point of view and of John Chrysostom. Thus it is attempted the pinpointing and promotion of the principles underlying the science of bioethics and the determination of the basic principles of Orthodox Christian morality through which made the deal with the issues arising from the application of genetic engineering in humans.
Today it is needed not only good scientific and technical training but also critical thinking psychic sensitivity, excellent information on ethical issues. The life of man constitutes God's gift, it is not private property that degrades to an object of derogatory decisions but in divine gift that the Creator God gave out oflove to man. As we know the value of human life is prevalent in all religions and all people and Nations of the world, its removal brings shock to humanity. Having all this in mind the medical philosopher and educator must respect the value of human life of every human being regardless of their psychosomatic problem. 
The terrible signs of the upcoming catalysis of godless physician Antichrist, from the almighty word of Healer Christ will be the darkening of the Sun and the stars.
The great luminers who were created by the therapist physician Creator God himself will shake and will be destroyed in the appearance of the Almighty Creator, who is praised by the universes and who will come to launch 'new heavens' spiritual, yielding the justice for centuries with the resurrection of all the righteous and the unrighteous, for the first to eternal life, for the second to eternal hell. According to Hippocrates, all diseases come from the Soul. Everything gets sick when the Soul is sick. Finally, the Greek physician and philosopher Hippocrates from the island of Kos, teaches us that what matters is the healing of the human soul, because from there come the diseases in man. John Chrysostom completes this teaching by emphasizing that the healing of the human soul is done only by the Creator God who also acts as a healing physician of souls and bodies.

The non-therapeutic alteration of children’s genitals is typically discussed in two separate ethical discourses: one for girls, in which such alteration is conventionally referred to as “female genital mutilation” (or FGM), and one for boys, in which it is conventionally referred to as “male circumcision.” The former is typically regarded as objectionable or even barbaric; the latter, benign or beneficial. In this paper, however, I call into ques- tion the moral and empirical basis for such a distinction, and I argue that it is untenable. As an alternative, I propose an ethical framework for evaluating such alterations that is based upon considerations of bodily autonomy and informed consent, rather than sex or gender.

In 2012, the American Academy of Pediatrics (AAP) updated its policy on infant male circumcision, arguing that the benefits of the procedure outweigh the risks. In response, medical authorities from Europe and Canada argued that the AAP report exhibited cultural bias in favor of circumcision. In this commentary, originally published at the University of Oxford’s Practical Ethics website, I argue that the AAP is on less secure footing than it seems to think. Taking into consideration both scientific and ethical perspectives, I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy.

In this chapter, an infringement of bodily integrity (BI) is defined as any penetration into a bodily orifice, breaking of the skin, or alteration of a person’s physical form. A violation of a person’s right to BI is any infringement of their BI that wrongs them. An autonomous person is wronged by an infringement of their BI if they did not consent to it. If a person is incapable of consenting because they are temporarily non-autonomous – as in the case of an intoxicated adult or a pre-autonomous child – the infringement should be delayed until the individual becomes autonomous and can make their own decision. It is only when the infringement cannot be delayed without putting the person into a situation they would be even less likely to consent to (if they were autonomous) that the infringement does not wrong them. Given the seriousness of violating anyone's right to BI, and especially that of the most vulnerable persons, the appropriate likelihood-of-consent for proceeding with a BI infringement on a child is argued to be at or near the ‘medically necessary’ threshold.

This article critically examines speculative bioethics—bioethical discourse focused on possible future technologies. It traces the origin and development of this phenomenon against the backdrop of larger changes in bioethics discourse. Drawing on work in science and technology studies, it critiques the tendency of ‘regulatory’ bioethics to reify and legitimate technological futures rather than interrogating them. It argues that speculative inquiry needs to shift into a ‘prophetic’ mode to explore technological imaginaries as aspects of the present, and to question the values and assumptions implicit in their construction.

In the seventh Book of The Politics, Aristotle claims that the practice of abortion must be forbidden when the embryo acquires sensation and life because, in this case,  it constitutes an impious act. My aim in the present article is to examine this very negative stance of the Stagirite against abortion. Based primarily on his biological works, I will firstly attempt to reconstruct the status the philosopher attributed to the life of the human embryo and, secondly, examine the reason that authorized him to include abortion among other impious acts. Moreover, given that during Classical period abortion is not included among the written or unwritten interdictions, my ultimate purpose is to highlight that the integration of abortion among impious act marks an attempt by Aristotle to redefine the social status of abortion based on his biological theory.

Studies of epidemics and related fears and neuroticisms are especially relevant nowadays. Our research topic is an interesting aspect of early Soviet healthcare which has not been extensively studied: Sanitary propaganda on the subject of Sexually Transmitted Disease (STD) which was widespread in the 1920s after the First World War, the Revolution and the Civil War. The study also focuses on people’s reaction to this kind of propaganda: as an involuntary consequence, people were afraid of venereal diseases much more than they should have been. This paper offers a first approach to the systematization and analysis of some useful and almost unknown primary sources on the history of medicine, sanitary propaganda and its impact on the population of the USSR in the 1920s.

«Aspectos éticos de la nanotecnología en la atención a la salud es un recorrido desde el surgimiento y características de las nanotecnologías a su aplicación en el campo de la salud y medicina, pasando por las implicaciones éticas, y lo que se considera la ética de las nanotecnologías. El texto está abrumadoramente referenciado, lo cual facilita al lector interesado perseguir caminos de pensamiento o temáticas paralelas. Álvarez Díaz enfoca las disyuntivas éticas de la nanomedicina desde la filosofía deliberativa del médico y filósofo Diego Gracia Guillén, donde el juicio prudente y la deliberación constituyen la guía; e intuye las dificultades de una democracia deliberativa en la sociedad actual, pero al mismo tiempo su alternativa.»
Del Prólogo, por Guillermo Foladori

La primera versión de este trabajo consiguió el accésit al “Premio del Colegio Oficial de Médicos de Valladolid” 2012, otorgado por la Real Academia de Medicina y Cirugía de Valladolid, España, de la cual el autor es Académico Correspondiente. El haber sometido el texto a la revisión de un Comité Editorial y a la dictaminación por pares académicos ha tenido aportes importantes. Con todo ello ha ganado no solamente el texto final, sino también el lector.
El autor

Lo sviluppo della medicina ha permesso di debellare malattie prima considerate incurabili, contribuendo ad aumentare notevolmente la longevità umana. Tuttavia, questa storia luminosa non è priva di lati oscuri. Casi di vivisezione umana e abusi nella ricerca clinica hanno accompagnato passo passo la scoperta di straordinarie tecniche chirurgiche e farmaci efficaci. Dalle dissezioni di Erofilo, ai test con veleni e antidoti nelle corti rinascimentali, passando per gli esperimenti di Josef Mengele, fino al famigerato studio sulla sifilide di Tuskegee, abbondano i casi di soggetti deboli usati, loro malgrado, nella ricerca clinica. Carcerati, anziani, bambini ritardati, disabili, malati, orfani, membri di minoranze etniche e poveri sono stati non di rado trasformati in cavie da laboratorio. Gli sviluppi dell'etica medica e della bioetica si comprendono anche alla luce di queste poco edificanti vicende. È importante mantenere viva la memoria storica degli abusi, se non vogliamo che si ripetano in futuro.

Clyde Snow’s osteobiographic approach, with its focus on the individual and acknowledgment of speculation’s part in analyses, provides a starting point (a counterpoint, more appropriately) for developing a subdisciplinary bioethos. The concept refers to consolidation of a habit that gives rise to moral, normative practices related to exhumation, documentation, analysis, and posthumous treatment of dead bodies. To this end, conversations in bioethics—about consent, anonymity, vulnerable populations, legislation of policy, and so forth—are germane but require expansion to be useful for the particulars of studying dead bodies. I cite the contemporary case of HeLa/Henrietta Lacks as instructive for building models of greater applicability to the remains of ancient (or historic) decedents. As an example of the latter, I discuss Kennewick Man/Ancient One. More than a cautionary or idiosyncratic tale, events surrounding the Kennewick case involved normative, disciplinary practices in need of deliberation. I focus on naming, facial reconstruction, and genetic testing. These techniques are useful for personalizing individuals, thereby making academic analyses more interesting to nonspecialists. Yet they also raise epistemological and ethical concerns related to stakeholders’ ontological security (or its disruption) and dissemination of narratives in mediascapes, among other issues. By way of conclusion, I suggest that osteobiographers begin research by posing certain key queries about the historic antecedents for their work, the current political context in which it takes place, and its possible repercussions.



Para desarrollar un “bioethos” subdisciplinario, comienzo con el enfoque osteobiográfico de Clyde Snow, con su foco en el individuo y su reconocimiento de la especulación en la investigación. El concepto “bioethos” se refiere a la consolidación de un hábito que da lugar a prácticas morales y normativas relacionadas con la exhumación, documentación, análisis y tratamiento póstumo de cuerpos muertos. Para tal fin, las conversaciones en bioética (sobre el consentimiento, el anonimato, las poblaciones vulnerables, la legislación de políticas, etcétera) son pertinentes, pero requieren expansión para aquellos que estudian cuerpos muertos. Discuto el caso contemporáneo de HeLa / Henrietta Lacks. Esto caso ayuda a construir modelos que son aplicables a los restos antiguos (o históricos). Como ejemplo del último, discuto Hombre de Kennewick / El Antiguo. Más que un cuento de precaución o ejemplo idiosincrásico, los eventos que rodean el caso de Kennewick involucraron prácticas normativas y disciplinarias que requieren deliberación. Me concentro en nombrar, la reconstrucción facial y la prueba genética. Estas técnicas son útiles para personalizar individuos, lo que hace que el análisis académico sea más interesante para los no especialistas. Sin embargo, plantean inquietudes éticas y epistemológicas relacionadas con la seguridad ontológica (o su interrupción) y la difusión de narrativas en “mediascapes,” entre otras cuestiones. Para concluir, yo sugiero que los osteobiógrafos comiencen sus estudios haciendo preguntas clave sobre los antecedentes históricos de su trabajo, su contexto político y sus posibles repercusiones.

Ethical debate surrounding human enhancement, especially by biotechnological means, has burgeoned
since the turn of the century. Issues discussed include whether specific types of enhancement are permissible
or even obligatory, whether they are likely to produce a net good for individuals and for society, and
whether there is something intrinsically wrong in playing God with human nature.We characterize the
main camps on the issue, identifying three main positions: permissive, restrictive and conservative positions.
We present the major sub-debates and lines of argument from each camp. The review also gives
a flavor of the general approach of key writers in the literature such as Julian Savulescu, Nick Bostrom,
Michael Sandel, and Leon Kass.

Despite its many strengths, Engelhardt's After God displays two surprising features: an affinity for voluntaristic ethics and a tendency to oppose Eastern Orthodoxy (as a purely revealed religion) to philosophy. Neither of these is in keeping with the mainstream of Eastern Orthodox tradition. Here, I offer a modest corrective. I begin with the figure of Socrates as presented in the Apology and Phaedo, highlighting the role that faith plays for Socrates and the reasons why he was widely admired by the early Church. I then describe more broadly the attitude of the Greek Church Fathers to philosophy, showing that, although they were cautious of its potential errors, they nonetheless embraced the ideal of philosophy as a way of life dedicated to the pursuit of wisdom. For many, in fact, Christianity is itself simply the true philosophy, an attitude that led many of the most eminent patristic and Byzantine theologians to draw extensively on philosophical sources. Finally, I discuss the Euthyphro dilemma, contrasting the voluntaristic approach favored by Engelhardt with the Platonic approach adopted by the mainstream of Orthodox tradition.

En este trabajo se hacen algunas consideraciones históricas acerca de la evolución de la embriología a principios del siglo XX y el inmenso avance que permitió el desarrollo de técnicas complejas de reproducción asistida. Posteriormente se examinan los adelantos que han tenido las variantes y posibilidades de las citadas técnicas. Finalmente, se proponen cuatro periodos históricos en relación con el progreso de las técnicas complejas de reproducción asistida. Palabras clave: historia, bioética, técnicas complejas de reproducción asistida (TRA).

One of the founders of the discipline of bioethics, Texan philosopher H. Tristram Engelhardt, Jr. entirely revised many of his positions in the wake of his conversion to Orthodox Christianity in the early 1990s.  This made me very curious to find out how his treatment of the key notions of nature and person might have changed in light of patristic theology, providing the impetus for the investigation this article will relate into the evolution of Engelhardt thought. For it makes it possible to compare within a single author’s corpus both the secular humanist principles and the Christian dogmatic tenets that the notions of nature and person bring into play within bioethics discourse. Not that patristic positions simply took the place of humanist standards for Engelhardt, as one might infer from the fact that he published in 2000 The Foundations of Christian Bioethics as though in echo to his famous 1986 treatise on The Foundations of Bioethics. It is more that he defined their respective areas of validity in the context of a society that is both post-Christian and post-modern, where no grand narrative can any more give substantial content to a common morality applicable to bioethical dilemmas. This is why I have focused on comparing the two editions of The Foundations of Bioethics: that of 1986 –prior to Engelhardt’s conversion, and that of 1996 –which followed it, requiring supplementation by The Foundations of Christian Bioethics, so as to provide traditional Christians with the substantial moral standards they cannot find in the thin modus vivendi of peaceable coexistence between “moral strangers” within the same political society that is, for lack of legitimate alternatives, the sole object of general secular morality as H. Tristram Engelhardt, Jr. understands it.

The article opens with the hypothesis that the default position that should guide healthcare providers when treating patients at the end of life is that patients opt for life. In the absence of an explicit request to die, we may assume that patients wish to continue living. Thus the role of the medical profession is to provide patients with the best possible conditions for continued living.
The article makes a case for physician-assisted suicide legislation. It examines the ‘quality of life’ argument, and the issue of the patient’s autonomy and competence. It is argued that (1) quality of life is a subjective concept. Only the patient can conclude for herself that her quality of life is so low to warrant ending it, and that (2) only competent patients may request ending their lives. Patients’ lives should not be actively terminated by the medical team without the explicit consent of patients.
The article then probes the role of physicians at the end of life, arguing that medicine should strive to cater to the wishes of all patients, not only the majority of them. Physicians should not turn their backs to justified requests by their patients. Physicians are best equipped to come to the help of patients at all stages of their illness, including their end-of-life. At the same time, in ending life, the final control mechanism should be with the patient. Thus physician-assisted suicide is preferred to euthanasia in order to lower the possibility of abuse and of ending the lives of patients without their consent and against their wishes. As matters of life and death are grave, they should be taken with utmost seriousness, requiring the instalment of ample checks against abuse and facilitating mechanisms designed to serve the patient’s best interests. The article concludes with nineteen careful and detailed guidelines for physician-assisted suicide. These are necessary measures designed to ensure that the best interests of the patients are served as they wished.

this is a timely book in the age of vertiginous technological advances in the field of medicine. the author Dr. Herbert Ho Ping Kong makes his observations from the perspective of a clinician who has been practicing internal medicine for fifty years spanning three continents.

This is the first of six chapters exploring the applicability of the innovative ownership principle ‘common heritage of mankind (CHM)’ as found in international law to the human genome and provides some starting points for the construction of a governance regime for the human genome based on the common heritage of humanity. It addresses the following questions: Is the human genome a common heritage of humanity? How is it linked to human rights? What is the basis of the common heritage principle? What is the relationship between the common heritage principle and patenting?

Chapter One approaches the issue of governance from a historical perspective and takes a look at the earliest efforts at establishing legal rules on bioethical issues. The issue of consent was at the heart of the Nuremberg Code, which was a code formulated by judges from various Western countries sitting in judgment during the trial of medical doctors who carried out cruel experiments on prisoners and other people during the Nazi regime. This was the first attempt to establish legal rules in bioethics issues. The second phase of international bioethics rules has begun with more advances in science and technology and a spate of national legislation and rules by self governing professional bodies to protect subjects of experimentation and treatment. The new wave of rule making also has as its aim the protection of human rights, including economic and social rights. It is hoped that bioethical rules would strengthen their implementation. The major concerns that have been flagged up by the international community are about the ‘post human’ (following from Francis Fukuyama’s usage of the term) future of humanity, where humans would have dramatically advanced capabilities, and concerns about equitable distribution of benefits. The new field of international bioethical law should concern itself with the two big questions: What should the ‘post human’ future of man look like? and how can we ensure that the benefits of human genome research are distributed to the whole of humanity? This following chapters are mainly concerned with the second question.

Em 1941, na cidade de Riga, na época ocupada pelos nazis, uma jovem rapariga foi surpreendida por um militar alemão a cobrir com terra um corpo morto, totalmente exposto. Apesar de não ter intenções políticas, a jovem não deixou de ser interrogada pelo sentido do seu acto. Simplesmente respondeu: «Era o meu irmão. Para mim, isso basta». Do mesmo modo, Charlotte Delbo celebra, num dos seus poemas, a acção das mulheres da aldeia de Kalavrita. Quando, em 1943, os alemães ocuparam esta pequena aldeia do Peloponeso, mataram todos os homens e proibiram explicitamente as mulheres de se aproximarem dos assassinados. Mesmo colocando as suas vidas em risco, nada impediu estas mulheres de fugirem da escola onde tinham sido presas, de chorarem a morte cruel e gratuita dos seus maridos e de os enterrarem.

The methodology of this research is based on a critical review of the literature supplemented by communications with leading scholars and practitioners. First, concerns are raised about euthanizing people who say that they are ‘tired of life’. Some suggestions designed to improve the situation are offered. The Belgian legislators and medical establishment are invited to reflect and ponder so as to prevent potential abuse.

This opinion paper is aimed to suggest an improved set of guidelines for physician-assisted suicide. Thus it is very practical, based on 25 years of research in eight countries and it does not expand on the underpinning theoretical basis for the guidelines. I have been an advocate of physician-assisted suicide and explained the reasoning elsewhere, primarily in The Right to Die with Dignity  and Euthanasia in the Netherlands.  I support the idea that patients should be able to decide the time of their death with the help and support of the medical profession. People have human dignity. At the end of their lives, the medical profession should respect their wishes and help them to the best of their abilities. By ‘dignity’ it is meant worthiness, merit. The Oxford English Dictionary defines it as “the state or quality of being worthy of honour or respect”.  Kant explained that human beings are end in themselves and that for something to be an end in itself, “it doesn’t have mere relative value (a price) but has intrinsic value (i.e. dignity)”.  He further elucidated that autonomy is the basis for the dignity of human nature and of every rational nature.  Kant calls dignity an unconditional and incomparable worth that admits of no equivalent.  All rational creatures have it, by virtue of their reason, and dignity constrains the ways in which we can legitimately interact. In a similar fashion, Dworkin asserted that individuals have a right to dignity because they are human.  I argue that dignity is both objective and subjective concept. It is socially constructed and made up of values and feelings that one feels about oneself, about one’s self-worth and respect.  It is further argued that legislation of physician-assisted suicide is a matter of moral necessity and political expediency.

La bioetica è senza dubbio una disciplina “giovane”, eppure è già possibile – ed anzi opportuno – ricostruirne non solo la storia, ma altresì quella che potremmo a buon diritto definire la “preistoria”, ovvero i contribuiti anteriori agli anni ’70. In quest’ottica gli interventi svolti da papa Pacelli durante gli anni del suo pontificato (1939-1958) risultano particolarmente significativi ed una loro ricostruzione analitica consente di mettere a fuoco alcuni problemi classici del dibattito bioetico: dalle questioni generali dell’antropologia medica alle problematiche legate alla vita nascente (procreazione, contraccezione, metodi di regolazione delle nascite, aborto, sterilizzazione, fecondazione e inseminazione artificiali), dalle questioni bioetiche “durante la vita” (parto naturale e indolore, ricerca medica e sperimentazione sull’uomo, psichiatria e psicologia, genetica ed eugenetica, amputazioni e trapianti,
chirurgia estetica, analgesia) alle problematiche legate al fine vita (rianimazione ed eutanasia).

Bioethics is undoubtedly a "young" discipline, and still it is already possible - and indeed opportune - to reconstruct not only history, but also what we could rightly define the "prehistory", that is to say contributions made before the 1970s. In this point of view, the speeches made by Papa Pacelli during the years of his pontificate (1939-1958) are particularly significant and an analytical reconstruction of them lets you focus some classic issues of bioethical debate: from the general issues of medical anthropology to issues related to nascent life (procreation, contraception, birth control methods, abortion, sterilization, fertilization and insemination artificial), from bioethical issues "during the life" (natural and painless birth, medical research and human experimentation, psychiatry and psychology, genetics and eugenics, amputations and transplants, aesthetic surgery, analgesia) to life-related issues (resuscitation and euthanasia).

The relation between bioethics and the sacrament of the sick appears, at the first glance, somewhat disjointed. Contemporary bioethical literature would rarely admit any dealings with faith practices and beliefs into its discussion. Recuperating some of these visions and applying them to current issues of bioethics would prove to be a very interesting adventure, especially in today’s context of high technology and increasingly dehumanized medicine. In its relation to the sacrament of the sick, a first aspect that could be touched upon is the relationship between faith and healing. But I am more interested in dedicating a greater space to the current debate of euthanasia and the “good death” seen under the light of this sacrament. A third point would relate to the pastoral application of the Christian interpretation of a “good death.”

The article presents the concept of Bio-Ethik by the German theolo‑
gian Fritz Jahr (1895–1953) and discusses the reasons of the interest
to his legacy in Central Europe. The popularity of Fritz Jahr’s works
fits into the specific context of a complex development of bioethics in
Central Europe at the turn of the twenty-first century. The appeal to
Fritz Jahr’s ideas in the field of bioethics allows us to assess the con‑
tribution of Christian thinkers to the articulation of bioethical issues
and to raise the question of why in modern bioethics, which is trying
to draw upon universal, non-religious values, there was a demand for
theological works of a Protestant pastor. The article describes the at‑
titude to bioethics in Germany at the turn of the 1980s–90s, the ide‑
ological conflict of the “anti-bioethics” movement and the context of
the new reception of Fritz Jahr’s works

The aim of this paper is to show the inherent contradiction in the Belgian euthanasia practice. While stressing patient's autonomy, medical professionals exhibit paternalism in deciding the patient's fate. First, background information is provided. Then the 2014 Belgian Society of Intensive Care Medicine Council Statement Paper will be considered. Concerns are voiced about euthanizing people who fail to find meaning in their lives, including those who underwent unsuccessful sex-change operation and blind people, euthanizing patients who did not give their consent, and euthanizing people with dementia. Finally, some suggestions designed to improve the situation are offered.

El presente artículo trata de cómo autoridades estadounidenses y mexicanas, a través de lo que llamaron programa profiláctico, experimentaron la penicilina G-procaína con monoestearato de aluminio a 2% en microcristales, en prostitutas en la ciudad de Tijuana Baja California entre 1949 y 1952. Este hecho se encuentra enmarcado en las investigaciones de United States Public Health Service referentes a las enfermedades de transmisión sexual.

From Dawn till Dusk embraces the conceptual challenges often associated with Bioethics by taking the reader on a journey that embodies the circle of life and what it means to be human. The beginning and the end of life have always been an impossible riddle to humans. Bioethics does not aspire to unveil utter truths regarding the purpose of our existence; on the contrary, its task is to settle controversial issues that arise within this finite, very fragile and vulnerable life, yet a life we still have to live. This book discusses thorny ethical issues that transcend time and are related to the dawn and the dusk of life: abortion and infanticide, genetic engineering, human reproductive cloning, the fear of death, rational suicide, and the right to die. The book's highest aspiration, though, is to both provide the reader with an opportunity to see the world from different perspectives and to showcase the irresistible charms of bioethical debates.

Este livro, coletânea, que se apresenta à comunidade científica com o
título: Fronteiras da bioética: os reflexos éticos e socioambientais, possui vínculo direto com o projeto de pesquisa “Direito socioambiental e o constitucionalismo democrático latino-americano”, que está sendo
desenvolvido com o Grupo de Pesquisa Metamorfose Jurídica, vinculado ao Mestrado e Doutorado em Direito, Centro de Ciências Jurídicas da Universidade de Caxias do Sul (UCS). E, também está vinculado às pesquisas do NID: Observatório de Cultura de Paz, Direitos Humanos e Meio Ambiente, vinculado às linhas de pesquisa Ética e Direitos Humanos e Cidadania; Meio Ambiente e Sustentabilidade.
O escopo da presente obra é apresentar ao debate da comunidade
científica estudos, ensaios teóricos, debates conceituais sobre temas de
Bioética e suas implicações morais e socioambientais despertadas pelas pesquisas científicas, tanto no campo da Biologia quanto da Medicina e do Direito.

Telling a story is ascertaining a beginning, but the historical origin of bioethics is still a matter of discussion. First, we should be aware that the reconstruction of the history of bioethics depends on the  the nature, function and role you want to assign to this field of study. Therefore, I will try to outline the main stories of bioethics, starting from the various identified "historical origins".