In this article, we explore questions about the culture of trustworthy artificial intelligence (AI) through the lens of ecosystems. We draw on the European Commission’s Guidelines for Trustworthy AI and its philosophical underpinnings. Based on the latter, the trustworthiness of an AI ecosystem can be conceived of as being grounded by both the so-called rational-choice and motivation-attributing accounts—i.e., trusting is rational because solution providers deliver expected services reliably, while trust also involves resigning control by attributing one’s motivation, and hence, goals, (...) onto another entity. Our research question is: What aspects contribute to a responsible AI ecosystem that can promote justifiable trustworthiness in a healthcare environment? We argue that especially within devising governance and support aspects of a medical AI ecosystem, considering the so-called motivation-attributing account of trust provides fruitful pointers. There can and should be specific ways and governance structures supporting and nurturing trustworthiness beyond mere reliability. After compiling a list of preliminary requirements for this, we describe the emergence of one particular medical AI ecosystem and assess its compliance with and future ways of improving its functioning as a responsible AI ecosystem that promotes trustworthiness. (shrink)

English summary: Enhancement is the term used to describe biomedical interventions, increasingly in demand, aimed at improving physical characteristics such as endurance or attractiveness as well as cognitive abilities or the state of mind. Is it however ethically acceptable or justifiable to interfere in this optimizing manner with the bodily integrity of an individual? This question leads the author to focus on a basic philosophical aspect: the identity of an existing (or future) human being who would like to undergo such (...) an intervention (or whose genome has been altered before birth). What is the normative significance of enhancement for existence throughout time, for the socially constituted personality as well as the self-conception of human beings? The author deals with these questions pertaining to personal autonomy and the good life. German description: aEnhancement bezeichnet biomedizinische Eingriffe, die auf die Verbesserung korperlicher Eigenschaften wie Ausdauer oder Attraktivitat, die Erweiterung kognitiver Fahigkeiten oder die Steigerung der Gemutsverfassung abzielen und von vielen Menschen in immer starkerem Ausmass nachgefragt werden. Doch ist es uberhaupt ethisch zulassig oder vertretbar, dass auf diesem Wege aoptimierend in die leibliche Integritat eines Individuums eingegriffen wird? Ein grundlegender philosophischer Aspekt gelangt hierbei in den Blickpunkt: die Identitat einer existierenden (bzw. zukunftigen) Person, die sich einer solchen Intervention unterziehen mochte (bzw. deren Genom vorgeburtlich verandert wird). Welche normative Bedeutung hat Enhancement fur die Fortexistenz uber die Zeit, die sozial konstituierte Personlichkeit sowie das Selbstverstandnis des Menschen? Fragen nach der Autonomie der Person und dem guten Leben sind damit angesprochen. (shrink)

This book examines the relationship between law and scientific advancement, with a particular focus on the theory of evolution and medical innovation. Historically, the law has struggled to keep pace with modern medical advances. The authors demonstrate that the laws that govern human behaviour must evolve in response to such advances."--Provided by publisher.

Written by a sociologist and a biologist and science historian, this text considers the social aspects of organ transplantation and chronic hemodialysis. Their research, begun in 1968, focused on the experience of research physicians engaged in this work, the "gift- exchange" social dimensions of these practices, and the impact of these technologies on society as a whole. This reprint of the 1978 edition includes a new introduction by the authors. c. Book News Inc.

What are the final limits of medicine? What should we not try to cure medically, even if we had the necessary financial resources and technology? This book philosophically addresses these questions by examining two mirror-image debates in tandem. Members of certain groups, who are deemed by traditional standards to have a medical condition, such as deafness, obesity, or anorexia, argue that they have created their own cultures and ways of life. Curing their conditions would be a form of genocide. (...) Members of other groups are seeking to provide medical treatment to what would conventionally be deemed 'cultural conditions'. Mild neurotics who take anti-depressants to elevate their mood, runners who use steroids, or men and women seeking cosmetic surgery are asking for medical treatment for problems that might be solved culturally, by changing norms, pressures, or expectations in the broader culture. Each of these two debates endeavors to locate medicine's final frontier and to articulate what it is that we should not treat medically even if we could. This volume analyzes what these two contemporary debates have to say to each other and thus offers a new way of determining medicine's final limits. (shrink)

Examines the ethical dilemmas created by contemporary biomedical advances, describing the techniques, applications, and ethical, legal, moral, and social ramifications of such developments as artificial insemination, cloning, prenatal screening, redesigne.

The Medical Innovation Bill continues its journey through Parliament. On 23 January 2015, it was debated for the final time in the House of Lords and with one final amendment, the House moved to support the Bill, which then moved to the House of Commons on 26 January. It will be debated again on 27 February 2015. The Bill’s purpose is to encourage responsible innovation in medical treatment. Although this goal is laudable, it is argued that the Bill (...) is unnecessary and has the potential to undermine the very cause it aims to advance. More useful for encouraging responsible innovation is the continued education of health-care professionals on how the law already supports practitioners who look to improve care through responsible innovation. (shrink)

A globe-spanning investigation into the Transhumanist movement, considering the tech billionaires, scientific luminaries, and DIY body-hackers attempting to prolong, improve, and ultimately transcend the limits of human life.

AbstractWhile the literature on oncofertility decision-making was central to the bioethics debate on social egg freezing when the practice emerged in the late 2000s, there has been little discussion juxtaposing the two forms of egg freezing since. This article offers a new perspective on this debate by comparing empirical qualitative data of two previously conducted studies on medical and social egg freezing. We re-analysed the interview data of the two studies and did a thematic analysis combined with (...) interdisciplinary collaborative auditing for empirical ethics projects. Despite their different contexts, major similarities in women’s decision-making and reasoning were found. We developed two main common themes. Firstly, women felt a clear need to plan for future options. Secondly, they manipulated decision-times by postponing definitive decisions and making micro-decisions. The comparison highlights that the passage of time and the preservation of future choice seems to permeate all aspects of the patient experiences in both studies. As a result of considering real-world lived experiences, we suggest that there are many overlaps in women’s reasoning about egg freezing regardless of why they are making a decision to freeze. These overlaps are morally relevant and thus need to be further integrated into the existing arguments that have been canvassed in the flourishing egg freezing and fertility preservation debates across the field, and in policy and practice globally. (shrink)

This book from the Center for Bioethics and Human Dignity provides a faith-based evaluation of recent technologies and trends in bioethics--including the current debate surrounding stem cell research. Fifteen noted scholars and medical practitioners discuss some of today's new and controversial work in biomedicine--xenotransplantation, artificial intelligence, cybernetics, and more--and evaluate from a Christian perspective both the science and the ethical questions it raises. Designed to orient general readers to the current state of biomedical research, Cutting-Edge Bioethics is must reading (...) for anyone wishing to confront and wrestle with the challenging moral issues posed by this ever-advancing field. (shrink)

The aim of this paper is to provide a conceptual framework that will help in understanding and evaluating, along social and ethical lines, the issue of killing day-old male chicks and two alternative directions of responsible innovations to solve this issue. The following research questions are addressed: Why is the killing of day-old chicks morally problematic? Are the proposed alternatives morally sound? To what extent do the alternatives lead to responsible innovation? The conceptual framework demonstrates clearly that there (...) is a moral “lock-in”, and why the killing of day-old chicks is indeed an issue. Furthermore, it is shown that both alternative directions address some important objections with regard to the killing of day-old chicks, but that they also raise new dilemmas. It also becomes clear that the framework enables and secures anticipation, reflection, deliberation with and responsiveness to stakeholders, the four dimensions of responsible innovation, in a structured way. (shrink)

Neurodevices that collect neural (or brain activity) data have been characterised as having the ability to register the inner workings of human mentality. There are concerns that the proliferation of such devices in the consumer-directed realm may result in the mass processing and commercialisation of neural data (as has been the case with social media data) and even threaten the mental privacy of individuals. To prevent this, some argue that all raw neural data should be conceptualised and regulated as (...) “medical data” even if it is collected from consumer-directed devices in obviously non-clinical settings. In this paper, we argue that without a clearer formulation of what does and does not count as medical data, this approach might also uncritically enlarge the scope for medical influence and an unwarranted medicalisation of everyday aspects of mental life. Indeed, if we were to accept the position that all neural data is medical data because it offers insights into personally sensitive information (such a person’s thoughts, emotions, or intentions) then this could even unnecessarily expand the boundaries of medical data to other forms of data that otherwise seem to be non-clinical. If all brain data (neural activity data) is considered to be medical data even when collected from consumer-directed devices then we might unintentionally reduce meaningful distinctions between what is and what is not rightfully in the purview of medicine. (shrink)

If biotechnology can be used to "upgrade" humans physically and mentally, should it be done? And if so, to what extent? How will biotechnology affect societal cohesion, and can the development be controlled? Or is this a Pandora's box that should remain closed? These are just a few of the many questions that arise as a result of the increasing ability of technology to change biology and, eventually, transform human living conditions. This development has created a new horizon of a (...) posthuman future that will influence contemporary life and politics in a number of ways. The book gathers researchers within the fields of biotechnology, medicine, ethics, politics, and aesthetics. Among the contributors are Francis Fukuyama, Julian Savulescu, Maxwell Mehlman, Lone Frank and Chris Hables Gray. (shrink)

The aim of this paper is to provide a conceptual framework that will help in understanding and evaluating, along social and ethical lines, the issue of killing day-old male chicks and two alternative directions of responsible innovations to solve this issue. The following research questions are addressed: Why is the killing of day-old chicks morally problematic? Are the proposed alternatives morally sound? To what extent do the alternatives lead to responsible innovation? The conceptual framework demonstrates clearly that there (...) is a moral “lock-in”, and why the killing of day-old chicks is indeed an issue. Furthermore, it is shown that both alternative directions address some important objections with regard to the killing of day-old chicks, but that they also raise new dilemmas. It also becomes clear that the framework enables and secures anticipation, reflection, deliberation with and responsiveness to stakeholders, the four dimensions of responsible innovation, in a structured way. (shrink)

En la actualidad Cuba desarrolla un Programa de Atención Integral al Paciente con Úlcera de Pie Diabético mediante el uso del Heberprot-P, esencial para disminuir la amputación y la discapacidad. El trabajo tiene el objetivo de realizar un diagnóstico sobre la aplicación del Heberprot-P en el Servicio de Angiología del Hospital Provincial Universitario Manuel Ascunce Domenech de Camagüey. Se realizaron encuestas a pacientes para identificar necesidades sentidas relacionadas con el tratamiento y para las actitudes manifiestas, y se hicieron entrevistas al (...) personal médico y de enfermería. El diagnóstico permitió corroborar la necesaria investigación con enfoque social del servicio de salud escogido a nivel territorial. Destaca elevar el trabajo de captación de pacientes desde el nivel primario de salud para garantizar un mayor alcance del programa, así como la trascendencia del apoyo familiar y la relación profesional de la salud- paciente a fin de lograr la calidad requerida. At present Cuba is developing a program concerning the care of patient with ulcer of the diabetes foot by means of Heberprot-P essential to reduce the amputation and disability. The aim of this paper is to carry out a diagnosis about social aspects of the application of the Heberprot-P in the Angiology service at Manuel Ascunce Domenech Hospital in Camaguey. Some surveys were carry out to identify certain needs related with the treatment and the attitude shown and on the other hand some interview were made to the medical and nursing staff. The diagnosis allowed to verify the need of the research with social approach. The paper highlight how to incorporate patients from the primary health level, in order this program has a higher scope and the importance of the family support and the professional relationship to accomplish the quality required. (shrink)

The aim of this paper is to understand how evolving ideas about heredity and genetics influenced new medical interests and practices and, eventually, the formation of ‘medical genetics’ as a medical specialism in Britain. I begin the paper by highlighting the social and institutional changes through which these ideas passed. I argue that, with time, there was a decisive convergence in thought that combined ideas about the familial aspects of heredity and the health needs of populations (...) with an omnibus ‘genetic’ approach to health and illness that focused on the structures and activities of chromosomes and genes in individuals. I show how this convergence in thought was spurred on, first, by innovations in genetic science and technology in the years after 1960, and, second, by negotiated protocols and standards of medical practice worked out by bodies such as the relevant royal colleges, the linked associations and societies for medical professionals, affected training and research authorities, and the state. The notion of ‘medical genetics’ in Britain consequently gained a semblance of unanimity over its basic reference points and arrived at a meaning directly tributary to current acceptance of the term in the context of a medical specialism. (shrink)

A bottom-up approach grounded in micro-level understanding of the thinking, feeling, behavioral, and social aspects of living with low income and associated low literacy can lead to greater understanding and improvement of interactions in the health arena. This paper draws on what we have learned about marketplace interactions in subsistence economies to inform innovations in medical education, design and delivery of healthcare for lowincome patients, outreach education, and future micro-level research at the human-healthcare interface.

Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between “medical” and “social” egg freezing —contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the “regulatory boundary-work” around the “medical”–”social” distinction in different egg freezing regulations. Based on systematic documents’ analysis we present a cross-national comparison of the way the “medical”–”social” (...) differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: the definition of MEF and its distinctiveness—highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it ; and hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between “medical” and “social” are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects. (shrink)

In her foreword to Science Next, Elizabeth Edwards wrote of science as a tool for social progress: "Innovation is not simply the abstract victory of knowledge [or] the research that gave me years to live; the next science can advance human flourishing and serve the common good. That's the kind of world I want to leave for my children, and for yours." With these words, she joined a tradition that goes back to America's founders, who saw America itself as (...) a "great experiment." Yet while no one can deny that science undergirds the American Dream, it has long been fertile terrain for the "culture wars." Along with arguing the pros and cons of abortion and healthcare, policymakers must now grapple with advancements that raise questions about what it means to be human: we've decoded the genome, but should we modify it to enhance certain "desirable" traits? If we can, should we prolong life at any cost? Will we soon be counting robots, cyborgs, and chimeras among our friends and family?The first book to unpack our love/hate relationship with science from our country's origins to today, The Body Politic is essential reading for science buffs and concerned citizens alike.Jonathan D. Moreno is editor of the Center for American Progress' online magazine Science Progress and professor of bioethics at the University of Pennsylvania. Author and editor of many seminal books and articles on science and science policy, he divides his time between Philadelphia, PA, and Washington, DC. (shrink)

Symptom Checker Applications (SCA) are mobile applications often designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology. The aim of this scoping review is to identify the ELSA of SCA in the scientific literature. A scoping review was conducted to identify the (...) ELSA of SCA. Ten databases (e.g., Web of Science and PubMed) were used. Studies on SCA that address ELSA, written in English or German, were included in the review. The ELSA of SCA were extracted and synthesized using qualitative content analysis. A total of 25,061 references were identified, of which 39 were included in the analysis. The identified aspects were allotted to three main categories: (1) Technology; (2) Individual Level; and (3) Healthcare system. The results show that there are controversial debates in the literature on the ethical and social challenges of SCA usage. Furthermore, the debates are characterised by a lack of a specific legal perspective and empirical data. The review provides an overview on the spectrum of ELSA regarding SCA. It offers guidance to stakeholders in the healthcare system, for example, patients, healthcare professionals, and insurance providers and could be used in future empirical research to investigate the perspectives of those affected, such as users. (shrink)

Misunderstanding Science? offers a challenging new perspective on the public understanding of science. In so doing, it also challenges existing ideas of the nature of science and its relationships with society. Its analysis and case presentation are highly relevant to current concerns over the uptake, authority, and effectiveness of science as expressed, for example, in areas such as education, medical/health practice, risk and the environment, technological innovation. Based on several in-depth case-studies, and informed theoretically by the sociology of scientific (...) knowledge, the book shows how the public understanding of science questions raises issues of the epistemic commitments and institutional structures which constitute modern science. It suggests that many of the inadequacies in the social integration and uptake of science might be overcome if modern scientific institutions were more reflexive and open about the implicit normative commitments embedded in scientific cultures. (shrink)

Lower limb major amputations are both life-saving procedures and life-changing events. Individual responses to limb loss are varied and complex, some individuals experience functional, psychological and social dysfunction, many others adjust and function well. Some patients refuse amputation for religious and/or cultural reasons. One of the greatest difficulties for a person undergoing amputation surgery is overcoming the psychological stigma that society associates with the loss of a limb. Persons who have undergone amputations are often viewed as incomplete individuals. The (...) medical and physical consequences of amputation serve as the centerpiece in acute care and are commonly at the forefront of prosthetic rehabilitation. Prosthetic prescription aims to compensate for functional and/or cosmetic losses where possible. The aims of rehabilitation following amputation are to restore acceptable levels of functioning that allow individuals to achieve their goals, to facilitate personal health, and to improve participation in society and quality of life either with or without prosthesis. Our article aims at underscoring some medical, social and religious aspects that can contribute to the wellbeing of patients who suffer a life changing event such as lower limb amputation. (shrink)

The interdisciplinary field of neurorobotics looks to neuroscience to overcome the limitations of modern robotics technology, to robotics to advance our understanding of the neural system’s inner workings, and to information technology to develop tools that support those complementary endeavours. The development of these technologies is still at an early stage, which makes them an ideal candidate for proactive and anticipatory ethical reflection. This article explains the current state of neurorobotics development within the Human Brain Project, originating from a close (...) collaboration between the scientific and technical experts who drive neurorobotics innovation, and the humanities and social sciences scholars who provide contextualising and reflective capabilities. This article discusses some of the ethical issues which can reasonably be expected. On this basis, the article explores possible gaps identified within this collaborative, ethical reflection that calls for attention to ensure that the development of neurorobotics is ethically sound and socially acceptable and desirable. (shrink)

Nanotechnology is an important platform technology which will add new features like improved biocompatibility, smaller size, and more sophisticated electronics to neuro-implants improving their therapeutic potential. Especially in view of possible advantages for patients, research and development of nanotechnologically improved neuro implants is a moral obligation. However, the development of brain implants by itself touches many ethical, social and legal issues, which also apply in a specific way to devices enabled or improved by nanotechnology. For researchers developing nanotechnology such (...) issues are rather distant from their daily work in the lab, but as soon as they use their materials or devices in medical applications such as therapy of brain diseases they have to be aware of and deal with them. This paper is intended to raise sensitivity for the ethical, legal and social aspects (ELSA) involved in applying nanotechnology in brain implants or other devices by highlighting the short term problems of testing and clinical trials within the existing regulatory frameworks (A), the short and medium-term questions of risks in the application of the devices (B) and the long-term perspectives related to problems of enhancement (C). To identify and address such issues properly nanotechnologists should involve ethical, legal and social experts and regulatory bodies in their research as early as possible. This will help to remove pressure from regulatory bodies, to settle public concern and to prevent non-acceptable developments for the benefit of the patients. (shrink)

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the United Kingdom (UK) from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from the ethical and legal stream of the study, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and (...) information governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were coded using qualitative thematic analysis. Participants told us that a significant aspect of Big Data research in public health is varying drivers of mistrust—of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish greater confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach to research in this area can help assure (1) that meaningful community and participant engagement is taking place and that extant challenges are addressed, and (2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied, including those who are often marginalised in research. (shrink)

The essays in this book clarify the technical, legal, ethical, and social aspects of the interaction between eHealth technologies and surveillance practices. The book starts out by presenting a theoretical framework on eHealth and surveillance, followed by an introduction to the various ideas on eHealth and surveillance explored in the subsequent chapters. Issues addressed in the chapters include privacy and data protection, social acceptance of eHealth, cost-effective and innovative healthcare, as well as the privacy aspects of employee wellness (...) programs using eHealth, the use of mobile health app data by insurance companies, advertising industry and law enforcement, and the ethics of Big Data use in healthcare. A closing chapter draws on the previous content to explore the notion that people are 'under observation', bringing together two hitherto unrelated streams of scholarship interested in observation: eHealth and surveillance studies. In short, the book represents a first essential step towards cross-fertilization and offers new insights into the legal, ethical and social significance of being 'under observation'. (shrink)

The utilisation of human organoids has the potential to expedite the cycle of biological innovation significantly, yet it also raises a series of ethical and societal concerns. This study aims to evaluate the perceptions and attitudes of researchers regarding the ethical and social challenges associated with the research and application of human organoids. A 20-item questionnaire was developed to assess various aspects: four items evaluated the overall understanding of organoids, 13 items addressed ontological, ownership, informed consent and additional ethical (...) issues, while the remaining four items focused on ethical governance and regulatory concerns. This questionnaire was distributed to attendees of the 3rd China Symposium on 3D Cell Culture and Organoids in May 2023. Basic descriptive statistical analyses and chi-square tests were conducted. The work has been reported in line with the ARRIVE guidelines 2.0. A substantial majority (over 70%) of participants expressed concerns that the research and application of human organoids might raise ethical issues, such as moral status, informed consent and commercialisation. In contrast, a minor segment (4.5%, n = 8) reported feelings of disgust or nausea towards human-animal neural chimeras, with a significant gender difference (p = 0.004). Regarding informed consent for human organoid samples, over 90% of researchers rejected blanket consent for all purposes, and more than half preferred a model of continuous consent, which entails resoliciting consent for new uses. Further, over 40% of participants believed that the commercialisation of human organoids is dependent on their specific type. Our findings show that some researchers held that as long as human embryonic stem cells are not utilised in human organoid research and application, there are no ethical relevant issues. Most researchers also showed indifference towards the concern of moral status and humanisation of animals. The majority believe that the “consent for governance” model is preferable than broad consent or specific consent. We believe to realise the promise of human organoids for medicine, navigating complex ethics tensions and proactively engaging diverse stakeholders are required. Only with prudent, thoughtful and effective guidance, mutual understanding and trust between scientists and public can be fostered; the promising field of organoids can progress rapidly and responsibly. (shrink)

The ArgumentEugenics is the paradigmatic case of the conflict between biology and medicine over social influence. Commenting on as essay by Debora Kamrat–Lang(1995), the paper reconstructs the historical roots of eugenics as a form of preventive medicine. A comparision between the development of some crucial aspects of eugenics between Germany and the United States reveals that the prevalence of the value placed on the individual over hereditary health of a population ultimately determined the outcome of the conflict but collective (...) concepts may be revived by new biological knowledge. (shrink)

In the United States, single individuals and LGBTQ couples who wish to conceive biological children are considered to be “socially infertile” due to their relationship status. Due to the high cost of infertility treatments and inadequate insurance coverage, the socially infertile has minimal access to assisted reproductive technology. Under the current medical definitions of infertility, even in states with infertility insurance mandates, only heterosexual couples with physiological infertility are covered for ART. It is well documented that infertility interferes with (...) many aspects of the human experience and reduces the quality of life for involuntarily childless individuals regardless of whether the infertility is physiologically or socially based. Physiological infertility was initially considered to be a private issue before being recognized as a medical diagnosis and has since legitimized heterosexual couples’ access to ARTs. The medical diagnosis of infertility not only affirms that their intention to conceive biological children is justifiable but also confirms that it is a condition that can and should be treated with current medical interventions. Expanding the current definition of infertility to include social infertility will elevate it to a treatable medical condition, justifying the use of ART for such individuals and potentially alleviating the negative impacts of infertility. Thus, states with infertility insurance mandates should provide the same infertility coverage to socially infertile individuals as physiologically infertile heterosexual couples. (shrink)

Technological innovations and social developments have led to dramatic changes in the practice of medicine and in the way that scientists conduct medical research. Change has brought beneficial consequences, yet these gains have come at a cost, for many modern medical practices raise troubling ethical questions: Should life be sustained mechanically when the brain's functions have ceased? Should potential parents be permitted to manipulate the genetic characteristics of their embryos? Should society ration medical care to (...) control costs? Should fetal stem cells be experimented upon in an effort to eventually palliate or cure debilitating diseases? Bioethicists analyze and assess moral dilemmas raised by medical research and innovative treatments; they also counsel healthcare practitioners, patients, and their families. In this anthology, fifteen philosophers, social scientists, and academic lawyers assess various aspects of this field. (shrink)

Martin Sand and Luca Chiapperino find in the concept of serendipity a versatile umbrella term to reassess their previous work on moral luckLuck (also, Epistemic Luck, Moral Luck) and collectiveCollectiveresponsibilityResponsibility. Moral luck supposedly occurs when someone receives praise or blame for things beyond control. Given the ubiquity of luckLuck (also, Epistemic Luck, Moral Luck), this seems to be a seriously disquieting aspect of ordinary morality. The rewards and recognition for serendipitous discoveries fall into exactly this category. That is: more than (...) the intentions, actions, and characters of scientists matters for discoveries to obtain, just as in cases of moral luckLuck (also, Epistemic Luck, Moral Luck) something beyond morality affectsAffect our moral judgments. Even if a theoretical way of resolving the conceptual ambiguities that underlie this debate were found, there remain practical questions of how to perform stratification in science and innovationInnovation in ways that both hinge on, and yet refrain from, considerations of desert and achievement. With the example of Edward Jenner’sJenner, EdwardluckLuck (also, Epistemic Luck, Moral Luck)- and serendipity-infused discoveryDiscovery (also, Scientific Discovery) of vaccination, the authors attempt to better understand the intricate valueValue trade-offs that underlie stratification policies in science, which have to be constantly re-negotiated to maintain their legitimacy. Thereby, Sand and Ciapperino aim to take a bold step towards understanding the ethicsEthics of serendipity. (shrink)

Although ethics is increasingly integrated in the curriculum of U.S. medical schools, it remains not well integrated with system issues, and social and structural contexts of illness. Moreover, ethical analysis is not often taught as a clinical skill. To address these issues, an outcomes driven course in Social Sciences, Humanities, Ethics and Professionalism (SHEP) was created. Within the course, a web-based concept mapping device, SHEP Case Analysis Tool (SCAT), was created which schematizes the structure and flow of (...) clinical cases from diagnosis to treatment options, to shared decision making to outcome, and includes key stakeholders, influences, and structural features of the health system. In the course, each student analyzes a case in which they were directly involved using SCAT and presents their analysis to faculty and peers. This exercise 1) reinforces knowledge-based portions of the course pedagogy, 2) supports meta-cognition and critical thinking through concept mapping, 3) applies multidimensional analysis to identify ethical, social, and system issues that impact patient-care. 4) develops problem solving skills, 5) counters the hidden curriculum/support professional identity formation, and 6) develops skills in reflective discourse. This paper outlines the development and use of this concept mapping case analysis tool in an undergraduate medical education curriculum. (shrink)

Technological innovations and social developments have led to dramatic changes in the practice of medicine and in the way that scientists conduct medical research. Change has brought beneficial consequences, yet these gains have come at a cost, for many modern medical practices raise troubling ethical questions: Should life be sustained mechanically when the brain's functions have ceased? Should potential parents be permitted to manipulate the genetic characteristics of their embryos? Should society ration medical care to (...) control costs? Should fetal stem cells be experimented upon in an effort to eventually palliate or cure debilitating diseases? Bioethicists analyze and assess moral dilemmas raised by medical research and innovative treatments; they also counsel healthcare practitioners, patients, and their families. In this anthology, fifteen philosophers, social scientists, and academic lawyers assess various aspects of this field. (shrink)

The medical cannabis industry in Colombia is recognized as an emerging industry, and the development of the regulatory framework stimulated the interest of entrepreneurs in creating companies for medicinal purposes. The objective of the work was to examine the key components of the sustainability of the therapeutic cannabis sector in Colombia. In this sense, the study with a mixed approach and analytical scope included a review of the theoretical aspects and regulatory framework. A statistical analysis was carried out to (...) determine the perception of potential clients of the medicinal cannabis industry. A downward projection was found in the number of licenses granted. In conclusion, the therapeutic cannabis sector in Colombia shows promising potential, and its long-term sustainability requires addressing the gaps identified in the implementation of policies, improving social inclusion, promoting innovation for the development of high value-added products, and ensuring environmentally sustainable practices. From a social perspective, the industry promises to generate employment and boost rural development. Environmentally, the industry could contribute to reducing deforestation associated with illicit crops. The sustainability of the sector is an achievable goal, but it will require coordinated efforts in the regulatory, economic, social and environmental spheres to materialize its potential. (shrink)

Contemporary accounts of medical ethics and professionalism emphasize the importance of social justice as an ideal for physicians. This ideal is often specified as a commitment to attaining the universal availability of some level of health care, if not of other elements of a “decent minimum” standard of living. I observe that physicians, in general, have not accepted the importance of social justice for professional ethics, and I further argue that social justice does not belong among (...) professional norms. Social justice is a norm of civic rather than professional life; professional groups may demand that their members conform to the requirements of citizenship but ought not to require civic virtues such as social justice. Nor should any such requirements foreclose reasonable disagreement as to the content of civic norms, as requiring adherence to common specifications of social justice would do. Demands for any given form of social justice among physicians are unlikely to bear fruit as medical education is powerless to produce this virtue. (shrink)

Cet ouvrage s'inscrit dans le fil du travail collectif entrepris en 1995, l'Histoire de la pensée médicale en Occident (trois volumes sous la direction de Mirko D Grmek, Seuil, 1995, 1997, 1999). Il rend compte du déploiement des recherches pluridisciplinaires et transdisciplinaires de la pensée médicale et aborde les discussions et controverses actuelles sur les politiques de santé. Du fait du développement des connaissances théoriques et des innovations techniques, la notion même de soin, sous ses aspects sociaux, économiques, mais (...) aussi épistémiques, se trouve questionnée. La pensée médicale ne saurait se limiter aux données biologiques, et ses composantes spécifiquement humaines et sociales sont explorées et interrogées ici dans une perspective historique qui tient compte des découvertes du dernier siècle. (shrink)

As the functional capabilities of high-tech medical products converge, supplying organizations seek new opportunities to differentiate their offerings. Embracing product sustainability-related differentiators provides just such an opportunity. This study examines the challenge organizations face when attempting to understand how customers perceive environmental and social dimensions of sustainability by exploring and defining both dimensions on the basis of a review of extant literature and focus group research with a leading supplier of magnetic resonance imaging (MRI) scanning equipment. The study (...) encompasses seven hospitals and one private imaging center in the Netherlands and identifies five social aspects that cover 11 indicators. The authors conduct 22 customer perception interviews with key decision-making stakeholders involved in purchasing MRI scanning equipment. Respondents find environmental and social sustainability dimensions personally relevant but professionally secondary to cost, performance, and ability to use the equipment in their organizations' physical infrastructure. Finally, incorporating a product's environmental and social credentials within the marketing of MRI scanning equipment enhances the perception of the product offering in decisionmaking stakeholders' minds and provides a means of differentiation. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social (...) interaction, communication involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

The social aspects of causality in medicine and healthcare have been emphasized in recent debates in the philosophy of science as crucial factors that need to be considered to enable, among others, appropriate interventions in public health. Therefore, it seems central to recognize the bearing of social causes (broadly understood, e.g., social inequalities and socio-economic status) in bringing about certain concrete pathologies. Being aware of the relevance of social causes in medicine and healthcare is particularly important (...) in the face of the role that artificial intelligence-based systems (such as machine learning algorithms) are increasingly playing in these high-stakes fields. In fact, these systems bear the dangerous potential of concealing relevant social causes. This is highly problematic not only because it reinforces issues of distributive injustice but also because it can pave the way for issues of epistemic injustice. The central aim of this chapter is to make a first effort to point out possible connections between the importance of recognizing social causes in medicine and healthcare and forms of epistemic injustice. (shrink)

Public goods, as well as commercial commodities, are affected by exclusive arrangements secured by intellectual property (IP) rights. These rights serve as an incentive to invest human and material capital in research and development. Particularly in the life sciences, IP rights regulate objects such as food and medicines that are key to securing human rights, especially the right to adequate food and the right to health. Consequently, IP serves private (economic) and public interests. Part of this charge claims that the (...) current IP regime is privatizing the very building blocks of research and development – that used to be part of the commons. The public domain, in contrast to the private domain, may be the locus of much more diverse forms of creativity that at the same time ensures a wider plurality of productive traditions. An IP regime must support a sense of public morality because it is dependent upon civil support. This inevitably prompts questions of what are “good” exclusive rights and what are “bad” exclusive rights, and how shall such IP rights be developed. We argue that the democratization of the current IP regimes is an important first step to respond to these issues. (shrink)

Social representations of addiction and the resulting stigmatization have been widely described and studied in the literature, but their effects are no less problematic. These representations, which also occur in care settings, generate a climate of distrust which damages the therapeutic relationship, and its ethical quality. This article, combining clinical experience and an ethical stance, offers an original, innovating approach to the existence of distrust in care relationships in the area of addiction. Pragmatic approaches deriving from the human sciences (...) and analytical philosophy provide an invitation to escape from the demanding climate of mistrust, and to take the gamble on trust so as to improve the quality of interactions between protagonists in care. In complementary fashion, a sociology of action can combat the disquiet generated by distrust through a new commitment to innovating forms of action. This “poetic” mode of action is legitimized by the reflection that backs it up, and by its presentation to peers qualified to approve it. Finally, continental moral philosophy underlines the importance of a carefully weighed commitment on the part of caregivers and addicted patients towards promises aiming to support a sincere care relationship, without damaging the therapeutic dynamic or the ethical quality by providing too many safety nets. This reflection is intended to achieve better identification of the clinical and ethical issues raised by mistrust, and inclusion of these aspects in the training of personnel and in care provision planning. (shrink)

Early practitioners of the social studies of science turned their attention away from questions of institutionalisation, which had tended to emphasize macrolevel explanations, and attended instead to microstudies of laboratory practice. The author is interested in re-investigating certain aspects of institution formation, notably the formation of scientific, medical, and engineering disciplines. He emphasises the manner in which science as cultural practice is imbricated with other forms of social, political, and even aesthetic practices. The author considers the following (...) topics: the organic physics of 1847; the innovative research program of Carl Ludwig as a model for institutionalising science-based medicine, optics, painting, and ideology in Germany, 1845-95; the Haber-Bosch synthesis of ammonia; and the introduction of nuclear magnetic resonance instrumentation into the practice of organic chemistry. (shrink)

Academia is a competitive environment. Early Career Researchers (ECRs) are limited in experience and resources and especially need achievements to secure and expand their careers. To help with these issues, this book offers a new approach for conducting research using the combination of mindsponge innovative thinking and Bayesian analytics. This is not just another analytics book. 1. A new perspective on psychological processes: Mindsponge is a novel approach for examining the human mind’s information processing mechanism. This conceptual framework is used (...) to construct models in studies. The framework is highly flexible and widely applicable for many different types of information processes. The mindsponge approach can help researchers discover interesting ideas or even formulate their very own theories when investigating psychosocial phenomena. This approach brings a fresh wind to the current landscape of social sciences and humanities (SSH). 2. Easy-to-follow analysis protocol: The Bayesian Mindsponge Framework (BMF analytics) is useful in terms of computing and visualizing power but also easy to learn and apply. Contrary to being intimidating, the Bayesian analytics section of this book is presented in a reader-friendly manner with a detailed yet clear step-by-step procedure. Examples are from published BMF articles, allowing readers to immediately practice the method and quickly create their own applications. With educational purposes in mind, the book is very suitable for ECRs who are looking to innovate their research methods. 3. Advocating for low-cost, high-quality research: Doing science can be very costly. Mindsponge innovative thinking and BMF analytics help produce impactful studies using openly available data on online repositories. This is based on the authors’ previous works and experiences. The book presents examples of employing the open R package bayesvl on secondary data from different sources. With less financial constraints, researchers can have more freedom of thought to pursue their curiosity and creativity. ECRs in low- and middle-income countries may find this aspect crucial in their careers. 4. Support and collaboration: The authors share their insights from experiences in the academic publishing system to help readers get through the processes of manuscript writing and peer-reviewing more easily. The authors are also ready to support other researchers with further inquiries and collaboration opportunities at the following website, mindsponge(dot)info. This book is for: a) ECRs whose only abundant resources are their innovation capacity and strength of will; b) Researchers in SSH who want to explore a novel approach to thinking and study conducting; c) Low- and middle-income countries’ researchers looking for a cost-effective research protocol; and, d) Innovative thinkers who want to turn their interesting thoughts into good publications. (shrink)

Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the "natural" body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the (...) body and identity, New Health Technologies explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create "new illness." Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this book is essential reading for students andacademics of medical sociology, health and allied studies, and anyone with an interest in new health technologies. (shrink)