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articles in english
1. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Johanna Ahola-Launonen Conceptions of Personal Responsibility in Present and Future Bioethics
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There is much discussion about individual responsibility in bioethics, especially in the context of health care distribution. Despite some different views, the majority of literature seems to admit that there are limits to individual responsibility, because of environmental factors, including ecological, physical, social and societal issues and epigenetics that affect a person’s health and well-being and her ability to control her life and make genuine choices. However, when the discussion comes to health care in the future and new genetic technologies, environmental issues seem to be forgotten. The issues concerning health and well-being are reduced to genetics and choices about genetics, as if the present environmental effects through epigenetics and societal issues would be diminished. It appears that a person’s ability to control her life would somehow be remarkably increased. This notion is a fallacy, because - despite new genetic technologies - the environment will continue to affect a person’s life both at a molecular and societal level. The environmental issues should be acknowledged also in scenarios of the future, for -otherwise- the discussion about individual responsibility will lead to a questionable direction and the most efficient means for improving health and well-being will be undermined.
2. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
V. Arshinov, E. Chapny, V. Chekletsov Intersubjectivity and Complexity in Human Enhancement Problem
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The paper deals with implementation of complexity paradigm in human enhancement issues. The transdisciplinary view on mind and body extension is proposed, where classical intersubjectivity problem has to be re-read in the context of mutual understanding of natural intelligence and AI. For self/self, self/other and self/environment communication we consider specific fractal interfaces. For this interfaces the complexity-observer is a reflective observer of self-organized “partial observers ensemble”, which includes himself as an order parameter. Such observer cognition is embodied and situated. Further, convergence of human enhancement and ambient technologies (internet of things, augmented reality and other hybrid environment and pancommunication trends) makes possible to create certain layer of reality (of city landscape for example), representing a certain mode of our corporeality as emerging process.
3. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Aikaterini A. Aspradaki On Democratic Deliberation in Bioethics
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The idea of deliberative democracy has attained increasing attention by philosophers, political and legal theorists over the last two decades. Proponents have supported different arguments for deliberation within the democratic theory and an argument from autonomy has been developed. Taking into consideration the interest in both democratic deliberation and autonomy in bioethics, I discuss two examples in reference to the relevant documents: The first deals with democratic deliberation and autonomy on the basis of Rawlsian procedural justice in ethical frameworks, regarding public health policy issues, such as in the cases of infectious diseases, obesity, alcohol and smoking, and the fluoridation of water (Nuffield Council on Bioethics: Public health: ethical issues report). The second deals with democratic deliberation and respect for persons as basic ethical principles suggesting guidelines for emerging technologies in health, such as in the case of the whole genome sequencing (Presidential Commission for the study of bioethical issues: Privacy and progress in whole genome sequencing report). Finally, I introduce into the dialogue in bioethics the challenge of a deliberative model flown from a normatively founded principle of respect for autonomy persons.
4. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Myrto Dragona-Monachou In Search of a Minimal Consensus on Euthanasia
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Euthanasia is perennially the most intricate ethical problem and nowadays, due to the biotechnological revolution, the most debatable bioethical dilemma. It is difficult, if not impossible, to attain even an overlapping consensus on this issue; therefore, euthanasia is hardly discussed directly in Universal and International Declarations. Most forms of euthanasia are defended by secular pro-choice liberal bioethicists according to the bioethical principles of autonomy, dignity, beneficence and respect for human vulnerability, whereas pro-life conservatives and religiously minded supporters of the sanctity of life take a stand against it. In this paper, after a short historical account, I shall argue that there can be a minimal consensus between both sides at least as far as the artificial prolongation of life of patients with incurable diseases is concerned. Since it is the process of dying rather than life itself prolonged by mechanical devices, artificial preservation of the ‘life’ of terminally ill patients amounts to medical futility. Therefore, some theologians and most secular bioethicists agree that delivering incurable patients from aggressive therapy and mechanical support and offering palliative care is an altruistic, merciful and socially fair recourse and lets nature lead its course.
5. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Michael Etim Human Dignity and Assisted Human Reproduction: Bioethical Challenges within the Nigerian Context
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Reproduction is a fact of life and assisted human reproduction signifies all those techniques which involve the manipulation of germ cells as a substitute for natural procedures with the finality of achieving reproduction. Most of the techniques – ‘intra-corporeal’, ‘extra-corporeal’ and ‘micro-assisted-techniques’ – developed in assisted human reproduction have emerged as part of the response to the challenges of human infertility. Infertility is a major reproductive health problem in Nigeria, the bulk of the burden of the negative impact of infertility is borne by women. Most techniques of assisted reproduction are available in Nigeria. It is important to have an open bioethical reflection in the country with regard to these techniques and their use. There is virtually no regulation with regard to assisted reproductive technologies in the country; the recommended prospect is that the question of the current ‘legal vacuum’ needs serious attention. It is important for us as a society to examine the question of human dignity and assisted human reproduction. The expression ‘human dignity’ remains complex; however, its complexity as an over-arching principle also gives it the profundity which is important in dealing with ethical issues, especially those that touch upon human life, human responsibility and human reproduction.
6. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Shin Fujieda Between the Secular and the Religious: Japanese Buddhism in the Public Discourse on the Issues of Organ Transplant
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In Japan the Western philosophy (ethics-based) bioethics was introduced in the 1980s, and from that time the term ‘bioethics’ has been regarded as almost equivalent to ‘secular bioethics’. It is true that it must be secular in such a sense that it would be able to be the basis of public policy-making. But, before making the consensus, bioethical discourses should follow a pluralistic process of public debate, where secular arguments, as well as faith-based opinions, are equally supposed to be allowed. This presentation will examine the role of Buddhism in contemporary Japan with reference to the public statements Buddhist denominations make on organ transplantation issue.
7. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Ana Ylenia Guerra Vaquero The Importance of Patient’s Autonomy: The Advance Directives
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Advance directives for health care have become widely accepted as a necessary tool to guarantee the civilized management of one’s life during increasingly protracted periods of aging and frail health. The advance directives allow a person with capacity to state their wishes, values, and treatment preferences in advance, prospectively, so that their authentic voice will be heard when their capacity has lapsed. As an ethical matter, a patient’s right to accept or decline particular treatments at the end of life is based on the principle of autonomy. In some cases, however, the principle of beneficence might outweigh the patient’s interest in autonomy, especially if the proposed treatment would reduce the pain or increase functioning without adverse consequences or if the patient were unable to make a rational decision about accepting or declining treatment. Substitute decision makers rely on directions or instructions left by the patient when they had capacity to express and communicate their treatment preferences and goals of care. We find a strong justification for advance care planning. However, there are several critics to advance directives that we will discuss.
8. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Yuehong Han, Yunbao Yang Is ‘Dignity’ a Useless Concept in Bioethics?
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In bioethics is ‘dignity’ useful or useless? This is a debate focus in bioethics at present. This paper responds to the ‘useless theory’ and proves that: Firstly, ‘dignity’ cannot be equal to ‘respect’ and has more connotation called ‘surplus’ beyond the ‘respect’. Secondly, in bioethics ‘dignity’ is not only useful but also great useful, and has bioethical fundamental value. Especially “the dignity of human life” is the bioethical core and key value. To protect the dignity of human life is the purpose of bioethics. Thirdly, ‘dignity’ in practical application generally needs to be transited or transformed from the normal values to the basic ethical principles, then to the ‘four principles’, then to the rights.
9. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Nancy Jecker Justice between Age Goups
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A society is said to age when its number of older members increases in relation to its number of younger members. The societies in most of the world’s industrialized nations have been aging since at least 1800. In 1800 the demographic makeup of developed countries was similar to that of many Third World countries in the early 1990s with roughly half the population under the age of 16 and very few people living beyond age of 60. Since that time, increases in life expectancy, combined with declines in fertility rates, have dramatically increased the proportion of older persons in developed nations. The rapid increase in the number of older persons relative to younger ones carries important societal implications. In the domain of healthcare, societal aging will increase costs and exert greater pressure to ration services. It will, thus, bring to the fore questions, regarding a just distribution of healthcare between young and old age groups. This paper considers some of the most influential arguments to date for age-based rationing of health care. I show that these arguments fall short, and that the theoretical assumptions underlying them do not withstand careful scrutiny.
10. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Dominique Martin Self-sufficiency in Human Biological Materials: Time for an Aristotelian Perspective on Donation Policies
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National self-sufficiency in human biological materials such as blood and organs is now commonly invoked as a goal for healthcare policy makers. Despite its history as a strategic response to the ethical hazards of global trade in human blood, the ethical dimensions of the concept have been inadequately explored. This paper introduces self-sufficiency as an ethical paradigm for policy-making and explores some of the parallels found in Aristotle’s account of autarkeia in the polis. It highlights the ethico-political challenges of pursuing self-sufficiency in culturally diverse societies and suggests that the motivation of donation through solidarity rather than the use of financial incentives is consistent with contemporary and ancient versions of the self-sufficiency model.