The introduction of new medical technologies into a developing country is usually greeted with enthusiasm as the possible benefits become an object of great anticipation and provide new hope for therapy or relief. The prompt utilization of new discoveries and inventions by a medical practitioner serves as a positive indicator of high standing in the professional community. But the transfer of medical technology also involves a transfer of concomitant values. There is a danger that, in the process of adopting a (...) particular technology, the user takes for granted the general utility and desirability of the implements and procedures under consideration without recognizing the socio‐cultural peculiarities of the adopting country. A sensitivity to the social conditions and cultural traditions is important so that the emergence of new values can be examined critically and the transfer of necessary technology can be effected smoothly. In the Philippines, efforts to boost patronage of transplant technology appear to have overlooked this need for socio‐cultural sensitivity. Legislative fiat cannot be used to override deep‐seated values. There is a need to be more sensitive to the possible confrontation of values that the transfer of technology brings in order to avoid the erosion of indigenous socio‐cultural values and minimize the intrusiveness of beneficial medical technology. (shrink)

A debt of good will is incurred when a person becomes the beneficiary of significant assistance or favor given by another. Usually, the beneficiary is in acute need of the assistance given or favor granted. This provides an opportunity for the giving of help to serve as a vehicle for the expression of sympathy or concern. The debt could then be appreciated as one of good will because, by catering to another person's pressing need, the benefactor is able to express (...) positive dispositions towards the beneficiary. It is not merely the receipt of the assistance or favor that puts the recipient in a position of indebtedness. The indebtedness is created by the benefactor's kagandahang loob. An act can be considered to convey kagandahang loob only if it is done out of kusang loob ; and can only be considered to have been done out of kusang loob if the agent is not acting under external compulsion, is motivated by positive feelings towards the beneficiary, and is not motivated by the anticipation of reward. These conditions entail debt-of-goodwill relationships where the benefactor has no right to demand reciprocity but the beneficiary has a "self-imposed" obligation to repay kagandahang loob with kagandahang loob. Debts of good will are about some forms of justice. But we should not reduce all talk about debts of good will to talk about justice. (shrink)

Este trabajo explora en algunas obras de Maurice Merleau-Ponty la posibilidad de considerar el cuerpo como una máquina nerviosa, tomando como marco su crítica a la mentalidad cientificista y positivista. Para cumplir con este propósito se estudia la relación entre el cuerpo y el mundo, dando particular atención a las reflexiones vinculadas a la ciencia y la técnica. Las obras que serán protagonistas en esta exploración son La fenomenología de la percepción (1945), El mundo de la percepción (conjunto de conferencias (...) publicado en 1948 bajo el título Causeries ) y El ojo y el espíritu (último artículo publicado en su vida, en 1961). (shrink)

Background Doctors are increasingly faced with end-of-life decisions. Little is known about how medical students approach euthanasia. The objective of this study was to evaluate, among medical students and residents, the view on euthanasia and its variants; correlate such a view with empathy and religiosity/spiritualism; and with the stages of medical training in Brazil. Methods This is an exploratory cross-sectional study using an online questionnaire to be filled out on a voluntary basis among medical students and residents, consisting of: socio-demographic (...) data, an empathy questionnaire and questions with elaborate clinical cases that typify situations of the variants of euthanasia. Results From 1550 invitations, 273 volunteer participants responded (17.6%). The percentages of strong agreement/agreement on the concepts were: passive euthanasia (72.9%); active euthanasia (22.3%), orthothanasia (90.1%), dysthanasia (18.7%), assisted suicide (33%) and sedation (82.8%). Passive euthanasia, active euthanasia, dysthanasia and assisted suicide showed greater refusal with increasing length of medical training. Religious belief and degree of empathy did not significantly influence the opinion about the concepts. Strong agreement/agreement were: passive euthanasia (72.9%); active euthanasia (22.3%), orthothanasia (90.1%), dysthanasia (18.7%), assisted suicide (33%) and sedation (82.8%). Conclusions Passive euthanasia, active euthanasia, dysthanasia and assisted suicide showed greater refusal with increasing length of medical training. The external validation of our findings relies on the distinct legal, cultural, and religious frameworks found across various countries. (shrink)

A patient’s age serves as a very useful guide to physicians in deciding what disease manifestations to anticipate, what treatment to offer for certain conditions, and how to prepare for possible emergencies. In the context of the COVID-19 pandemic, determining treatment options on the basis of a patient’s chronological age can easily give rise to unjustified discrimination. This is of particular significance in situations where the allocation of scarce critical care resources could have a direct impact on who will live (...) and who will die. This paper examines the fairness of recommendations contained in resource allocation guidelines in the Philippines that have implications for the way elderly patients could be treated or excluded from some forms of critical care treatment in the context of the ongoing Corona virus emergency. (shrink)

RésuméIntroductionLa motivation est. un thème crucial et répandu en médecine. Que. ce soit pour un scénario clinique ou chirurgical, l’acceptation de prendre une pilule ou de se rendre à une consultation est. essentielle au succès du traitement médical. La “décennie du cerveau” a fourni aux praticiens des données neuroscientifiques substantielles sur le comportement humain, a aidé à expliquer pourquoi les gens font ce qu’ils font et a créé le concept de “cerveau motivé”. Les résultats de la psychologie empirique ont stratifié (...) la motivation en étapes de changement, qui sont devenues plus complexes au fil des décennies. Cette recherche vise à améliorer la compréhension de la façon dont les gens prennent des décisions concernant leur santé et comment mieux comprendre les stratégies et les techniques pour les aider à résoudre les problèmes d’ambivalence de manière efficace et ciblée.MéthodesNous établissons un dialogue avec la phénoménologie de la volonté de Ricoeur afin de comprendre le sens de ces découvertes scientifiques. À partir de la phénoménologie husserlienne, Paul Ricoeur a développé sa pensée en s’éloignant de l’idéalisme transcendantal en émancipant les structures intentionnelles de la volonté du domaine de la perception. Résultats: En introduisant les concepts de volontaire et d’involontaire, Ricoeur s’est. écarté du dualisme cartésien, qui fait du corps un corps d’objet, cible de vicissitudes naturelles. Le nouveau dualisme entre volontaire et involontaire est. traité par référence à ce que Ricoeur a appelé le mystère central de l’existence incarnée, qui considère l’homme “double dans l’humanité, simple dans lavitalité”. Cette dualité permet de considérer le cerveau comme l’organe naturel du comportement dans le corps humain et d’utiliser la psychologie empirique comme moyen d’échapper aux subjectivations superficielles des concepts.ConclusionLa simplicité (ou unité) d’existence invite la médecine à repenser certaines de ses hypothèses philosophiques, de telle sorte que les patients puissent être considérés comme des sujets autonomes avec des projets de vie d’auteur. L’anthropologie ricourienne a un impact éthique profond sur la manière dont la médecine devrait utiliser la technologie, ce qui découle de résultats de psychologie empirique. L’utilisation de ces nouvelles connaissances doit également faire l’objet d’une inspection minutieuse, car elle modifie le rôle social de la science médicale. (shrink)

Is there an Asian Bioethics? Some people might consider it blasphemous even to ask this question. But this paper asks it not so much to seek an answer as to clarify what it could actually mean. The idea is to sort out the presuppositions and possible implications of asserting the existence of an Asian bioethics. In the end, this paper makes the following points: (1) In the attempt to assert an Asian identity, one must be careful not to commit the (...) mistake of universalizing (among Asians) a single Asian perspective; and (2) In the face of pluralism and multi‐culturalism, there is some room for a kind of universalist ethics that is founded on a collage of culturally inspired perspectives rather than on a single standard of morality. (shrink)

Practical medical decisions are closely integrated with ethical and religious beliefs in the Philippines. This is shown in a survey of Filipino physicians' attitudes towards severely compromised neonates. This is also the reason why the ethical analysis of critical care practices must be situated within the context of local culture. Kagandahang loob and kusang loob are indigenous Filipino ethical concepts that provide a framework for the analysis of several critical care practices. The practice of taking-from-the-rich-to-give-to-the-poor in public hospitals is not (...) compatible with these concepts. The legislated definition of death and other aspects of the Philippine Law on Organ Transplants also fail to be compatible with these concepts. Many ethical issues that arise in a critical care setting have their roots outside the seemingly isolated clinical setting. Critical care need not apply only to individuals in a serious clinical condition. Vulnerable populations require critical attention because potent threats to their lives exist in the water that they drink and the air that they breathe. We cannot ignore these threa ts even as we move inevitably towards a technologically dependent, highly commercialized approach to health management. (shrink)

Relatively subtle forms of exploitation of human subjects may arise from the inefficiency or incompetence of a researcher, from the existence of a power imbalance between principal and subject, or from the uneven distribution of research risks among various segments of the population. A powerful and knowledgeable person (or institution) may perpetrate the exploitation of an unempowered and ignorant individual even without intending to. There is an ethical burden on the former to protect the interests of the vulnerable. Excessive or (...) insufficient compensation may be exploitative. However, genuine economic imperatives motivating needy volunteers have to be considered. These forms of exploitation should be appreciated in the context of social and cultural factors suggesting that the relationship between researcher and subject cannot properly be appraised as a contractual undertaking. While compliance with pertinent codes and regulations minimises the exploitative potential, they cannot be enforced in a way that does not recognise a society's peculiar characteristics. The experience with some Filipino cultural traits illustrates this point. (shrink)

Using a fair allocation approach, this paper identifies and examines important concerns arising from the Philippines’ COVID‐19 response while focusing on difficulties encountered by various sectors in gaining fair access to needed societal resources. The effectiveness of different response measures is anchored on addressing inequities that have permeated Philippine society for a long time. Since most measures that are in place as part of the COVID‐19 response are meant to be temporary, these are unable to resolve the inequities that have (...) led to the magnitude of morbidity and mortality associated with the pandemic. These cannot improve the country’s readiness to deal with pandemics and other emergencies in the future.Transition to a new normal recognizes the possibility that other infectious diseases could come and endanger our health security. Our pandemic experiences are proving that having an egalitarian society will serve the interests not only of disadvantaged sectors but also of everybody else, including the privileged. Response measures should thus take the opportunity to promote equity by giving importance to the concerns of the underprivileged and vulnerable while giving preference to initiatives that can be sustained beyond the period of the current pandemic. (shrink)

This essay reexamines the four-principle approach to biomedical ethics in the context of ethics education in general and in relation to possible ethics discourse within a community of inquiry in particular. A community of inquiry is the setting for learning and education in philosophy for children. This community enables children to acquire critical thinking and other skills as part of democratic education. The use of the four principles approach tends to contribute to a practice that limits critical thinking skills because (...) of the constraints on the conceptual tools that tend to be used. It has also had the effect of promoting conceptual ambiguity by encouraging the use of limited conceptual molds, thus giving rise to the possibility of multiple interpretations among diverse users, especially in the field of global bioethics. While recognizing the continuing appeal of the approach as a conceptual tool for ethical decision-making the essay brings out the limitations that need to be overcome in order to promote the clarity that the four principles approach is meant to possess. (shrink)

The offer of the fast food company gives rise to suspicion. This seems to be based on unfounded stereotypes, however. This paper argues that we need to preserve choices in taking particular courses of action. There is nothing inherently wrong in fast food consumption so long as consumers are made aware of the importance of weight management and proper nutrition.

This article discusses the establishment of a governance framework for biomedical research in Singapore. It focuses on the work of the Bioethics Advisory Committee , which has been instrumental in institutionalizing a governance framework, through the provision of recommendations to the government, and through the coordination of efforts among government agencies. However, developing capabilities in biomedical sciences presents challenges that are qualitatively different from those of past technologies. The state has a greater role to play in balancing conflicting and potentially (...) irreconcilable economic, social, and political goals. This article analyzes the various ways by which the BAC has facilitated this. (shrink)

Fast food companies like Siam Burger that participate in health awareness campaigns create a conflict of interest between the social responsibility of promoting health and the business interest of increasing sales through marketing strategies like advertising. Alternative options of raising health awareness without mitigating the involvement of fast food companies either by denying advertisements or having a third party foundation should be explored.

The Philippine government officially responded to the Declaration of Istanbul on Organ Trafficking and the related WHO Guidelines on organ transplantation by prohibiting all transplants to foreigners using Filipino organs. However, local tourists have escaped the regulatory radar, leaving a very wide gap in efforts against human trafficking and transplant tourism. Authorities need to deal with the situation seriously, at a minimum, by issuing clear procedures for verifying declarations of kinship or emotional bonds between donors and recipients. Foreigners who come (...) to the country for transplants with same-nationality donors constitute a problem that is replicated in many transplant centers around the world. Also, emotionally related living donors continue to pose challenges for ethics committees, especially because of the realities associated with the existence of extended families. Those who find themselves facing these issues need to be armed with clear protocols for going through the process of verifying documents and individual declarations assiduously. There is also a need for international referral mechanisms at least to ensure that governments are aware when their citizens travel for transplant so they can take steps they consider suitable to address the vulnerabilities of exploited persons. (shrink)

Developing World Bioethics, Volume 22, Issue 3, Page 162-169, September 2022.

A chamada Síntese Evolutiva (SE), formulada entre os anos 1920 e 1940, constitui o quadro interpretativo dominante na biologia evolutiva atual. A proposta mais bem articulada, teórica e institucionalmente, de uma mudança nesse quadro, denomina-se Síntese Evolutiva Estendida (SEE). Nosso principal objetivo será apresentar e desenvolver as seguintes objeções à SEE: (I) apesar de se declarar como uma “extensão” da SE, a SEE reinterpreta processos evolutivos, reformula sua rede conceitual e modifica pressupostos centrais da SE. Portanto, a diferença entre SEE (...) e SE não deveria ser descrita como uma relação conjunto-subconjunto (isto é, como uma “extensão”); (II) apesar de se declarar como uma “síntese”, a SEE leva, pelo menos em curto prazo, a um pluralismo de abordagens na biologia evolutiva. Portanto, a SEE não deveria ser descrita como uma síntese, mas como um quadro interpretativo amplo e plural que abarca diferentes abordagens. Essas objeções não são direcionadas às mudanças propostas, mas à interpretação dessas mudanças como uma “síntese estendida” do quadro evolutivo anterior. Com base nessas objeções, formularemos três hipóteses para explicar o uso do termo “síntese estendida” entre os seus proponentes. (shrink)

La evidencia comparativa reciente sugiere que algunas especies no humanas sienten empatía hacia otros congéneres, la cual es una capacidad necesaria para la presencia y evolución de la moralidad. Por otro lado, la Hipótesis del Cerebro Social plantea relaciones entre la evolución de la neocorteza cerebral en primates y el tamaño de sus grupos sociales. Este artículo vincula estas ideas al señalar que: (i) la empatía y la moralidad son subproductos de la expansión de la neocorteza cerebral, y (ii) la (...) función de tales capacidades es facilitar la cooperación entre individuos, aumentando su cohesión social. Recent comparative evidence suggests that some nonhuman species feel empathy towards fellow group members and empathy is a necessary capacity for the presence and evolution of morality. On the other hand, the Social Brain Hypothesis suggests relationships between the evolution of brain's neocortex in primates and the size of their social groups. This paper links these ideas by suggesting that (i) empathy and morality are by-products of the expansión of brain's neocortex, and that (ii) the function of such capacities is to facilitate cooperation between individuals, increasing their social cohesion. (shrink)

8 March, now known as International Women’s Day, is a day for feminist claims where demonstrations are organized in over 150 countries, with the participation of millions of women all around the world. These demonstrations can be viewed as collective rituals and thus focus attention on the processes that facilitate different psychosocial effects. This work aims to explore the mechanisms involved in participation in the demonstrations of 8 March 2020, collective and ritualized feminist actions, and their correlates associated with personal (...) well-being and collective well-being, collective efficacy and collective growth, and behavioral intention to support the fight for women’s rights. To this end, a cross-cultural study was conducted with the participation of 2,854 people from countries in Latin America and Europe, with a retrospective correlational cross-sectional design and a convenience sample. Participants were divided between demonstration participants and non-demonstrators or followers who monitored participants through the media and social networks. Compared with non-demonstrators and with males, female and non-binary gender respondents had greater scores in mechanisms and criterion variables. Further random-effects model meta-analyses revealed that the perceived emotional synchrony was consistently associated with more proximal mechanisms, as well as with criterion variables. Finally, sequential moderation analyses showed that proposed mechanisms successfully mediated the effects of participation on every criterion variable. These results indicate that participation in 8M marches and demonstrations can be analyzed through the literature on collective rituals. As such, collective participation implies positive outcomes both individually and collectively, which are further reinforced through key psychological mechanisms, in line with a Durkheimian approach to collective rituals. (shrink)

El artículo pretende discutir, a la luz del debate contemporáneo entremoralidad y eticidad, los modelos de comportamiento moral en el Perú. Lacrítica a la moralidad (moral moderna) se desarrolla contrastando los ideales y la práctica de los liberales independentistas del S. XIX. A pesar deexistir una mezcla de contenidos morales, las alternativas que se buscanposteriormente implican un retorno a la moral aristotélica y cristiana ( eticidad). Esto es lo que se observa en filósofos como Alejandro Deustua, en políticos como Víctor (...) Andrés Belaunde y José Carlos Mariátegui, y particularmente en la narrativa de José María Arguedas. (shrink)

This article examined the personal profiles of the Heads of Government of countries in South/North America and how they communicated with their audiences on institutional measures to contain COVID-19. Analyses were carried out on data collected from Twitter from November-2019 to November-2020. This study includes: i)quantitative analysis, measuring categories and emphases in the communication of tweets, retweets, likes, and comments on matters relevant to the pandemic; ii)qualitative analysis that allowed evaluating speeches to identify political interference and the effectiveness of communication (...) at critical moments of the pandemic. It was possible to infer that each president has his singularities and understanding about Social Media’s use as a more direct communication tool with his audience. It was also found that successful communication is not directly proportional to the volume of messages on Twitter, but to socio-political aspects and institutional leadership that can make a difference in Social Media in combating COVID-19. (shrink)