Journal articles on the topic 'Brain death Moral and ethical aspects'
To see the other types of publications on this topic, follow the link: Brain death Moral and ethical aspects.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Brain death Moral and ethical aspects.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
de Tantillo, Lila, Juan M. González, and Johis Ortega. "Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications." Policy, Politics, & Nursing Practice 20, no. 3 (August 2019): 163–73. http://dx.doi.org/10.1177/1527154419864717.
Full textAbstract:
Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule—as may be already occurring—or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.
2
McMahan, Jeff. "An Alternative to Brain Death." Journal of Law, Medicine & Ethics 34, no. 1 (2006): 44–48. http://dx.doi.org/10.1111/j.1748-720x.2006.00007.x.
Full textAbstract:
Most contributors to the debate about brain death, including Dr. James Bernat, share certain assumptions. They believe that the concept of death is univocal, that death is a biological phenomenon, that it is necessarily irreversible, that it is paradigmatically something that happens to organisms, that we are human organisms, and therefore that our deaths will be deaths of organisms. These claims are supposed to have moral significance. It is, for example, only when a person dies that it is permissible to extract her organs for transplantation.It is also commonly held that our univocal notion of death is the permanent cessation of integrated functioning in an organism and that the criterion for determining when this has occurred in animals with brains is the death of the brain as a whole – that is, brain death. The reason most commonly given for this is that the brain is the irreplaceable master control of the organism's integration.
3
Lucia, Irccs S. "Ethical Aspects of Brain Research." European Journal of Health Law 1, no. 4 (1994): 427–29. http://dx.doi.org/10.1163/157180994x00105.
Full textAbstract:
AbstractTheme I: Health and Human Rights. Health and human rights in relation to children and other vulnerable groups - for example, ethnic minorities and migrants; the role of health professionals in promoting respect for human rights; discrimination on the basis of health status. Theme II: The Death Debates. Cross-cultural and comparative religion perspectives on dying; euthanasia; nurse-assisted and physician-assisted suicide; the futility debate; advance directives; transplantation ; procuring organs from heart-beating donors or anencephalic infants. Theme III: Genetics and Reproductive Technology. The nature of human identity; genome mapping; genetic manipulation and counselling ; embryo research; preimplantation and prenatal diagnosis; the legal status of embryos, fetuses, infants, and families created by assisted reproduction; fetal tissue transplants; eugenics; population ethics. Theme IV: Health, Ecology, Persons and Planet. The connections between human health and ecological health, including how concepts developed in medicine, ethics, and law might be applicable in the promotion of ecological health, and vice versa. These include resource allocation; justice (including intergenerational justice) in health care; open and closed legal systems; and concepts of trust, covenant, and quality of life.
4
Oselka, Gabriel, and Reinaldo Ayer de Oliveira. "Ethical aspects of brain death and end-of-life." Dementia & Neuropsychologia 1, no. 3 (September 2007): 226–29. http://dx.doi.org/10.1590/s1980-57642008dn10300002.
Full textAbstract:
Abstract Ethical issues surrounding brain death and end-of-life have not been afforded in Brazil the same attention as in many developed countries. There appears to be reluctance on the part of Brazilian doctors to limit or suspend procedures or treatment which prolongs life of patients in terminal phases of severe incurable illness, or to suspend the artificial means of supporting vegetative functions in cases of brain death outside the context of organ and tissue donation for transplant. Fears grounded in possible administrative (Regional Medical Councils) or legal repercussions, as well as ambiguous interpretations of religious precepts, partially explain this reluctance which often results in unnecessary prolonging of patient suffering. A recent resolution by the Federal Medical Council on end-of-life may offer doctors some guidance and confidence in dealing with highly complex ethical situations.
5
Koplin, Julian J., and Julian Savulescu. "Moral Limits of Brain Organoid Research." Journal of Law, Medicine & Ethics 47, no. 4 (2019): 760–67. http://dx.doi.org/10.1177/1073110519897789.
Full textAbstract:
Brain organoid research raises ethical challenges not seen in other forms of stem cell research. Given that brain organoids partially recapitulate the development of the human brain, it is plausible that brain organoids could one day attain consciousness and perhaps even higher cognitive abilities. Brain organoid research therefore raises difficult questions about these organoids' moral status – questions that currently fall outside the scope of existing regulations and guidelines. This paper shows how these gaps can be addressed. We outline a moral framework for brain organoid research that can address the relevant ethical concerns without unduly impeding this important area of research.
6
Lewis, Ariane. "Contentious Ethical and Legal Aspects of Determination of Brain Death." Seminars in Neurology 38, no. 05 (October 2018): 576–82. http://dx.doi.org/10.1055/s-0038-1668075.
Full textAbstract:
AbstractAlthough the concept of death by neurologic criteria is accepted throughout much of the world and death can legally be determined by neurologic criteria throughout the United States, the process is fraught with contentious ethical and legal controversies. I explore historic and contemporary ethical and legal disputes about determination of death by neurologic criteria including the need for consent from patients' surrogates prior to determination of death, the role of religion in determination of death, management of objections to determination of death by neurologic criteria, the approach to patients who are dead by neurologic criteria but are pregnant, and gamete retrieval after determination of death.
7
Palmer, C. Eddie, and Dorinda N. Noble. "Premature Death: Dilemmas of Infant Mortality." Social Casework 67, no. 6 (June 1986): 332–39. http://dx.doi.org/10.1177/104438948606700602.
Full textAbstract:
Infant death has extreme emotional and symbolic effects on parents and health care professionals who face the moral and ethical aspects of life and death decisions, complicated by government ideology. Social workers can help with understanding the resulting dilemmas and suggest possible interventions.
8
Woods, Martin. "Balancing Rights and Duties in ‘Life and Death’ Decision Making Involving Children: a role for nurses?" Nursing Ethics 8, no. 5 (September 2001): 397–408. http://dx.doi.org/10.1177/096973300100800504.
Full textAbstract:
In recent years, increasing pressures have been brought to bear upon nurses and others more closely to inform, involve and support the rights of parents or guardians when crucial ‘life and death’ ethical decisions are made on behalf of their seriously ill child. Such decisions can be very painful for all involved, and may easily become deadlocked when there is an apparent clash of moral ideals or values between the medical team and the parents or guardians. This article examines a growing number of such cases in New Zealand and analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. The article concludes with a recommendation that nurses should be recognized as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations.
9
Horstman, Klasien, and Engeline van Rens-Leenaarts. "Beyond the Boundary Between Science and Values: re-evaluating the moral dimension of the nurse’s role in cot death prevention." Nursing Ethics 9, no. 2 (March 2002): 137–54. http://dx.doi.org/10.1191/0969733002ne494oa.
Full textAbstract:
This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bedclothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context.
10
Elmore, James, David Kenneth Wright, and Maude Paradis. "Nurses’ moral experiences of assisted death: A meta-synthesis of qualitative research." Nursing Ethics 25, no. 8 (December 28, 2016): 955–72. http://dx.doi.org/10.1177/0969733016679468.
Full textAbstract:
Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded.
11
Anderson, Curt. "Rethinking Brain Death: A Physiological, Philosophical and Ethical Approach." International Journal of Methodology, no. 1 (March 8, 2022): 11–17. http://dx.doi.org/10.21467/ijm.1.1.4546.
Full textAbstract:
The term ‘brain death’ is a rather untenable description to be defended ethically. This needs to be sorted out to ‘cortical brain death’, ‘whole brain death’ and WBD should include the brainstem. Organ transplants confound the difference between WBD and ‘biological death’, that is, the complete cessation of body function. It is clearly an ethical issue of taking a life, however, I argue for the greater good, IF it is clearly documented that irreversibility presents itself through multiple criteria (apnea, brainstem function, lack of long onset EEG, etc.). If meeting these criteria, we can have medical, physiological and moral standards and it is ethical to declare brain death, thus allowing organ transplants, and by definition, create biological death by doing so. This is a very consequentialist approach, but it does appease the dualistic ethics by separating the brain, or, more to the point, the concept of the ‘conscience’, and the possibility of defining ‘personhood’ or lack thereof. I believe the 1968 Harvard ‘declaration of death’ doesn’t fit the above criteria and the AMA declaration (formally adopted in 2003) states that: “a determination of death must be made in accordance with accepted medical standards”, however, those medical standards were not described. This paper addresses those standards.
12
Ivanyushkin, Aleksandr Ya, O. V. Popova, and I. E. Smirnov. "LEGAL AND SOCIOCULTURAL PROBLEMS OF LEGITIMIZING A NEW CRITERION OF DEATH («BRAIN DEATH») IN DOMESTIC PEDIATRICS." Russian Pediatric Journal 20, no. 5 (April 30, 2019): 294–300. http://dx.doi.org/10.18821/1560-9561-2017-20-5-294-300.
Full textAbstract:
The stages of the legitimization of the new criterion of death («brain death») in domestic medicine are presented. The semantic value of legitimizing the criterion for death is considered as recognition and confirmation of the legitimacy of the new criterion of death «brain death», based on values accepted in society. The problem of a new definition of brain death in a child patient is analyzed. The problems of philosophical and sociocultural perception of the diagnosis of brain death, organ donation, national features of the formation of the criteria for brain death, ethico-legal mechanisms for the regulation of the diagnosis of brain death are considered. Some moral and ethical problems of the development of transplantology in modern pediatrics are highlighted.
13
Mohammed, Shan, and Elizabeth Peter. "Rituals, Death and the Moral Practice of Medical Futility." Nursing Ethics 16, no. 3 (May 2009): 292–302. http://dx.doi.org/10.1177/0969733009102691.
Full textAbstract:
Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker's `expressivecollaborative' model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria.
14
Kaye, Michael P. "Pediatric brain death and organ/tissue retrieval. Medical, ethical, and legal aspects." Annals of Thoracic Surgery 49, no. 5 (May 1990): 774. http://dx.doi.org/10.1016/0003-4975(90)90020-7.
Full text
15
Kalajtzidis, Ján. "The challenge of death and ethics of social consequences: Death of moral agency." Ethics & Bioethics 8, no. 3-4 (December 1, 2018): 209–18. http://dx.doi.org/10.2478/ebce-2018-0015.
Full textAbstract:
Abstract The present paper focuses on the issue of death from the perspective of ethics of social consequences. To begin with, the paper summarizes Peter Singer’s position on the issue of brain death and on organ procurement related to the definition of death. For better understanding of the issue, an example from real life is used. There are at least three prominent sets of views on what it takes to be called dead. All those views are shortly presented and analysed. Later, the theory of ethics of social consequences is briefly presented. The paper looks for the position of this ethical theory in connection to the issue of death. The issue of organ procurement, which is closely connected to the problem of defining death, is used as a means for a better understanding of the issue. The issue of death is studied through the categories of moral subject and moral object. Using the standpoint of ethics of social consequences enables us to distinguish between the death of a moral agent and the death of the organism. That helps to soften many issues associated with the topic.
16
Sgarlata, Sara, Alicja Dłużewicz, and Karolina Napiwodzka. "Ars Moriendi. Ethical Challenges of the Ultimate Realities of Life." ETHICS IN PROGRESS 13, no. 2 (December 23, 2022): 4–10. http://dx.doi.org/10.14746/eip.2022.2.1.
Full textAbstract:
The aim of this issue of Ethics in Progress is to provide a provisional, open-ended view on the ultimate realities of life and the ethical challenges they pose in medical, sociological, and existential contexts. The issue explores axiologies and meta-ethical narratives related to the art of dying, or in other words the moral domain encompassing the quest for a good life and a good death. Two problematic aspects emerge from the latest body of research: (1) the difficulty involved in tackling ethical challenges in medical and sociological contexts; and (2) the marginal role of the patient’s agency and narrative-ownership of end-of-life decision-making. A direction is pointed out that suggests that interventions across interdisciplinary groups involved in medical aid to dying should focus on promoting ethical behaviour on the side of healthcare personnel. Finally, attention to language, discourse, communication, and the narratives of death and dying call this edition of Ethics in Progress to examine the ontological and epistemological categories that underlie the study of lifeworlds and ‘discourse communities’, which are those associated with moral agents interlacing historical motives, language, communication, normative beliefs, social norms and roles, power relations, hard clinical evidence, and contested values in the context of medical practices and, broadly speaking, practices surrounding death.
17
Bingham, Sarah-Louise. "Refusal of treatment and decision-making capacity." Nursing Ethics 19, no. 1 (January 2012): 167–72. http://dx.doi.org/10.1177/0969733011431925.
Full textAbstract:
This article explores refusal of medical treatment by adult patients from ethical and legal perspectives. Initially, consequentialist and deontological ethical theory are outlined. The concepts of autonomy, paternalism and competence are described and an overview of Beauchamp and Childress’s principle-based approach to moral reasoning is given. Relevant common law is discussed and the provisions of the Mental Capacity Act 2005 in assessing competence is evaluated. In order to demonstrate the consideration of moral issues in clinical practice, ethical theory is applied to two well-known incidents: the case of Re MB, where doubt over decision-making capacity led to a paternalistic act to override a patient’s choice; and the death of Emma Gough, a situation where respect for autonomy prevailed when healthcare staff acted lawfully in following a patient’s refusal of life-saving treatment. Finally, guidance from regulatory bodies on the roles and responsibilities of health professionals in relation to this topic are considered.
18
Rasoal, Dara, Annica Kihlgren, Inger James, and Mia Svantesson. "What healthcare teams find ethically difficult." Nursing Ethics 23, no. 8 (August 3, 2016): 825–37. http://dx.doi.org/10.1177/0969733015583928.
Full textAbstract:
Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.
19
Persson, Kirsten, Felicitas Selter, Gerald Neitzke, and Peter Kunzmann. "Philosophy of a “Good Death” in Small Animals and Consequences for Euthanasia in Animal Law and Veterinary Practice." Animals 10, no. 1 (January 13, 2020): 124. http://dx.doi.org/10.3390/ani10010124.
Full textAbstract:
Moral stress is a major concern in veterinary practice. Often, it is associated with the challenges in end-of-life situations. Euthanasia, however, is also meant to bring relief to animal patients and their owners. The reasons for the moral strain euthanizing animals causes to professional veterinarians need to be further clarified. This article investigates “euthanasia” from a philosophical, legal, and practical perspective. After introducing relevant aspects of euthanasia in small animal practice, the term is analyzed from an ethical point of view. That includes both a broad and a narrow definition of “euthanasia” and underlying assumptions regarding different accounts of animal death and well-being. Then, legal and soft regulations are discussed with regard to the theoretical aspects and practical challenges, also including questions of personal morality. It is argued that the importance of ethical definitions and assumptions concerning euthanasia and their intertwinement with both law and practical challenges should not be neglected. The conclusion is that veterinarians should clarify the reasons for their potential discomfort and that they should be supported by improved decision-making tools, by implementation of theoretical and practical ethics in veterinary education, and by updated animal welfare legislation.
20
Olsman, Erik, Bert Veneberg, Claudia van Alfen, and Dorothea Touwen. "The value of metaphorical reasoning in bioethics: An empirical-ethical study." Nursing Ethics 26, no. 1 (April 25, 2017): 50–60. http://dx.doi.org/10.1177/0969733017703695.
Full textAbstract:
Background: Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. Objective: To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. Method: Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed. The researchers wrote memos and discussed about their analyses until they reached consensus. Ethical considerations: Participants gave oral and written consent and their confidentiality and anonymity were respected. Findings: A central set of metaphors referred to the semantic field of the hands and arms and consisted of two central metaphors that existed in a dialectical relationship: grasping versus letting go. Participants used these metaphors to describe their child’s experiences, who had to “let go” of abilities, while “clinging” to structures and the relationship with their parent(s). They also used it to describe their own experiences: participants tried to “grab” the good moments with their child and had to “let go” of their child when (s)he approached death. Participants, in addition, “held” onto caring for their child while being confronted with the necessity to “let go” of this care, leaving it to professional caregivers. Discussion: The ethical analysis of the findings shows that thinking in terms of the dialectical relationship between “grasping” and “letting go” helps professional caregivers to critically think about images of good care for children with CLN3. It also helps them to bear witness to the vulnerable, dependent, and embodied nature of the moral self of children with CLN3 and their parents. Conclusion: Metaphorical reasoning may support the inclusion of marginalized perspectives in moral reasoning. Future studies should further explore the contribution of metaphorical reasoning to moral reasoning in other cases.
21
Pacholczyk, Tadeusz, and Stephen Hannan. "Challenges to the Determination of Death by Neurological Criteria." National Catholic Bioethics Quarterly 19, no. 4 (2019): 583–99. http://dx.doi.org/10.5840/ncbq201919450.
Full textAbstract:
Ethical concerns regarding the conceptual framework for the determination of death by neurological criteria, including several clinical and diagnostic practices, are addressed. The significance of a diagnosis of brain death, diagnostic criteria, and certain technical aspects of the brain-death exam are presented. Standard and ancillary tests that typically help achieve prudential certitude that an individual has died are indicated. Ethical concerns surrounding interinstitutional variability of testing protocols are evaluated and considered, as are potential apnea-testing confounders such as hypotension, hypoxemia, hypercarbia, and penumbra effects during ancillary testing. Potential adjustments to apnea-testing protocols involving capnography, thoracic impedance monitors, or spirometers to assess respiratory efforts are discussed. Situations in which individuals determined to be brain dead “wake up,” or fail to manifest the imminent cessation of somatic functioning typically seen when supported only by a ventilator, are also briefly reviewed.
22
Victorino, João Paulo, Karina Dal Sasso Mendes, Úrsula Marcondes Westin, Jennifer Tatisa Jubileu Magro, Carlos Alexandre Curylofo Corsi, and Carla Aparecida Arena Ventura. "Perspectives toward brain death diagnosis and management of the potential organ donor." Nursing Ethics 26, no. 6 (August 22, 2018): 1886–96. http://dx.doi.org/10.1177/0969733018791335.
Full textAbstract:
Background: Organ donation and transplantation represent one of the most important scientific advances over the last decades. Due to the complexity of these procedures and related ethical–legal aspects, however, there are a lot of doubts and uncertainty about the brain death diagnosis and the maintenance of potential organ donor. Aim: To identify and discuss the different meanings and experiences of registered nurses and physicians from an adult intensive care unit in relation to the diagnosis of brain death and the maintenance of potential organ donors for transplantation purposes. Study Design: Participants were registered nurses and physicians from an adult intensive care unit at a University Hospital from Brazil. Data were collected through semi-structured interviews and analyzed using content analysis. Ethical considerations: This study was approved by the University of São Paulo at Ribeirão Preto College of Nursing Research Ethics Committee. Results: Two main categories emerged from the analysis: (1) brain death diagnosis and its implications and (2) maintenance of the potential organ donor and its repercussion in the donation–transplantation process. Six subcategories were also identified: (1.1) understanding the brain death diagnosis as a tool to aid decision-making; (1.2) diagnosis as guarantee of rights; (1.3) difficulties encountered to establish the diagnosis; (1.4) clinical criteria adopted in Brazil and related ethical–legal aspects; (2.1) specificities of care to the brain dead person and outcomes; and (2.2) nurse’s duties toward the brain dead person. Conclusion: Although the brain death diagnosis is scientifically and legally defined in Brazil and the maintenance of the potential organ donor for transplantation purposes has been addressed during the last years, there are still some doubts about the subject, as its understanding varies according to the personal beliefs, culture, and educational background of individuals, including those who work in this scenario.
23
Skrypnyk, Nadiia, Valentina Sinelnikova, Sviatoslav Ovcharenko, Tetyana Shnurenko, Andriy Ivanish, and Pelaheia Pavliuchenko. "Public Morality as a Mental, Social and Determinative Phenomenon: Neuroethical Aspects." BRAIN. Broad Research in Artificial Intelligence and Neuroscience 13, no. 3 (September 30, 2022): 195–210. http://dx.doi.org/10.18662/brain/13.3/362.
Full textAbstract:
Under the conditions of a rich transformation of the Ukrainian society the national morality’s problem acquires contradictions in today's information society, therefore interaction researches of its aspects in social regulation have always been and are important. Modern neuroethics is formed as an academic disciplinary, asserting to be a variety of overlay ethical issues, apologetic and morality by the natural models established on new neurobiology’s notes and cognizable sciences.
The aim of the article is to explore the essence of folk morality as a mental, social and determinative phenomenon, its neuroethical aspects particularly.
In previous eras, education aimed to instill personal virtues and shape character, so ideas about moral life are in all cultures over time.
In centuries-old religious teaching, the commandments have been used as the basis for moral behavior. They were given by God Moses himself on Mount Sinai after a forty-day conversation (Yakuhno I., 2019).
In modern philosophy, where the ideals of democracy, for example, embrace the fundamental concepts of freedom, equality, respect and dignity for all, people have the right to determine for themselves what moral life is. Such a conversation covers different points of view among observers and scholars who think deeply about these issues. Therefore, folk morality has become the subject of our study, because it is not just a basic model to follow, but fundamental.
24
Bernat, James L. "Ethical and Legal Aspects of the Emergency Management of Brain Death and Organ Retrieval." Emergency Medicine Clinics of North America 5, no. 4 (November 1987): 661–76. http://dx.doi.org/10.1016/s0733-8627(20)30122-x.
Full text
25
McDonnell, Melissa, and Robert T. M. Phillips. "Physicians Should Treat Mentally Ill Death Row Inmates, Even if Treatment is Refused." Journal of Law, Medicine & Ethics 38, no. 4 (2010): 774–88. http://dx.doi.org/10.1111/j.1748-720x.2010.00531.x.
Full textAbstract:
The history of physician involvement in capital proceedings is longstanding and ripe with controversy and conflicts of ethical concerns. Previously one of us (Phillips) has written that the controversy is more appropriately characterized as a conflict of moral position rather than one of ethical dilemma.In hindsight, we believe that analysis, while true, does not capture the depth or complexity of the issue.Forensic psychiatric evaluations, including competency to be executed evaluations, are done with a clear understanding that no physician-patient relationship exists. Treatment, however, is not so neatly re-categorized in large measure because it involves the physician’s active provision of the healing arts.
26
Logsirup, Rosemarie. "Ansätze einer Orientierungsethik." Zeitschrift für Evangelische Ethik 33, no. 1 (February 1, 1989): 193–203. http://dx.doi.org/10.14315/zee-1989-0129.
Full textAbstract:
Abstract (verlaßt von Viggo Mortensen) Although the different ethical phenomena stick together it is vital to evaluate them separately. The paper deals with the following phenomena and aspects of moral philosophy:(1) The zone of sacrosantity and its place in the emotionallife of huma beings.(2) The difference between morality and moralisin.(3) As the sovereign life-manifestiones are spontanous can we contribute to their development?(4) What are the ideal conditions for the development of specific character traits?(5) The ethical contrast between good and evil and the contrast between life and death. How are they related to each other in the Christian Gospel?
27
Cay, Debbie. "Contemporary issues in law and ethics: Exploring the family veto for organ donation." Journal of Perioperative Practice 29, no. 11 (January 14, 2019): 361–67. http://dx.doi.org/10.1177/1750458918818998.
Full textAbstract:
This article explores current issues surrounding the impact of family veto for organ donation in the UK. A critical, reflective analysis of the theoretical, legal and ethical aspects aims to evaluate how the deceased’s explicit wish to donate may be revoked. Under current UK legislation and upon death, money and property are protected; however, the body is not. When investigating personal wishes, interests and decisions must be weighed against the moral legitimacy of the family veto.
28
Michaut, Carine, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, and Xavier Ducrocq. "An assessment of advance relatives approach for brain death organ donation." Nursing Ethics 26, no. 2 (June 23, 2017): 553–63. http://dx.doi.org/10.1177/0969733017708331.
Full textAbstract:
Background: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. Research design: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called ‘Prélor’. Participants: The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. Main findings: A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Conclusion: Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses’ attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.
29
Daoust, Ariane, and Eric Racine. "Depictions of ‘brain death’ in the media: medical and ethical implications." Journal of Medical Ethics 40, no. 4 (April 12, 2013): 253–59. http://dx.doi.org/10.1136/medethics-2012-101260.
Full text
30
Bremer, Anders, and Lars Sandman. "Futile cardiopulmonary resuscitation for the benefit of others: An ethical analysis." Nursing Ethics 18, no. 4 (July 2011): 495–504. http://dx.doi.org/10.1177/0969733011404339.
Full textAbstract:
It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field.
31
Cohen, Jeremy. "Frozen Bodies and Future Imaginaries: Assisted Dying, Cryonics, and a Good Death." Religions 11, no. 11 (November 5, 2020): 584. http://dx.doi.org/10.3390/rel11110584.
Full textAbstract:
In October of 2018, Norman Hardy became the first individual to be cryopreserved after successful recourse to California’s then recently passed End of Life Options Act. This was a right not afforded to Thomas Donaldson, who in 1993 was legally denied the ability to end his own life before a tumor irreversibly destroyed his brain tissue. The cases of Norman Hardy and Thomas Donaldson reflect ethical and moral issues common to the practice of assisted dying, but unique to cryonics. In this essay, I explore the intersections between ideologies of immortality and assisted dying among two social movements with seemingly opposing epistemologies: cryonicists and medical aid in dying (MAiD) advocates. How is MAiD understood among cryonicists, and how has it been deployed by cryonicists in the United States? What are the historical and cultural circumstances that have made access to euthanasia a moral necessity for proponents of cryonics and MAiD? In this comparative essay, I examine the similarities between the biotechnological and future imaginaries of cryonics and MAiD. I aim to show that proponents of both practices are in search of a good death, and how both conceptualize dying as an ethical good. Cryonics members and terminal patients constitute unique biosocial worlds, which can intersect in unconventional ways. As temporalizing practices, both cryonics and MAiD reflect a will to master the time and manner of death.
32
Cronqvist, Agneta, Töres Theorell, Tom Burns, and Kim Lützén. "Caring About - Caring For: moral obligations and work responsibilities in intensive care nursing." Nursing Ethics 11, no. 1 (January 2004): 63–76. http://dx.doi.org/10.1191/0969733004ne667oa.
Full textAbstract:
The aim of this study was to analyse experiences of moral concerns in intensive care nursing. The theoretical perspective of the study is based on relational ethics, also referred to as ethics of care. The participants were 36 intensive care nurses from 10 general, neonatal and thoracic intensive care units. The structural characteristics of the units were similar: a high working pace, advanced technology, budget restrictions, recent reorganization, and shortage of experienced nurses. The data consisted of the participants’ examples of ethical situations they had experienced in their intensive care unit. A qualitative content analysis identified five themes: believing in a good death; knowing the course of events; feelings of distress; reasoning about physicians’ ‘doings’ and tensions in expressing moral awareness. A main theme was formulated as caring about - caring for: moral obligations and work responsibilities. Moral obligations and work responsibilities are assumed to be complementary dimensions in nursing, yet they were found not to be in balance for intensive care nurses. In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing.
33
Spike, Jeffrey, and Jane Greenlaw. "Ethics Consultation: Persistent Brain Death and Religion: Must a Person Believe in Death to Die?" Journal of Law, Medicine & Ethics 23, no. 3 (1995): 291–94. http://dx.doi.org/10.1111/j.1748-720x.1995.tb01366.x.
Full textAbstract:
We first heard about this case from nurses in one of our intensive care units (ICUs) while we were conducting an inservice. When the session was over, we discussed it between ourselves, and decided that it must have been misrepresented. The case had been presented as one of a teenager who was brain dead, had been so for six months, yet had been brought into the ICU for treatment. We have run into this before, we thought: medical professionals confusing brain death with persistent vegetative state (PVS). But, of course, we reasoned, no one can be brain dead for six months. To us, as it would to many, the case sounded like a clinical and ethical impossibility. A week later, we were called by an attending physician from another ICU, at the urging of that unit's nursing staff. They had a patient who was brain dead, whose presence was causing distress among the staff. Ronald Chamberlain, a fifteen-year-old boy, had been a patient at a nearby longterm rehabilitation facility that is equipped to care for ventilator-dependent patients.
34
Dudzińska, Joanna, and Beata Dobrowolska. "The brain death definition and human organs transplantation in the light of the Catholic Church teaching." Pielegniarstwo XXI wieku / Nursing in the 21st Century 15, no. 1 (March 1, 2016): 55–59. http://dx.doi.org/10.1515/pielxxiw-2016-0009.
Full textAbstract:
AbstractAim. The aim of this paper is to present the teaching of the Catholic Church regarding the brain death and the human organ transplantation.Material and methodology. The analysis of the official documents of the Holy See as well as the teaching and speeches of popes was made.Results and Conclusions. The Catholic Church supports transplants from deceased persons and considers donating their organs after death for transplantation as the gift of the greatest love. However, it is not unconditional acceptance. The most important conditions are: the patient’s informed consent for organ donation and a precise statement of the death of the donor. The currently used definition of brain death has been declared by the Church not only as sufficient but also as definitive criterion of the death of a man. In Christian ethics, this criterion allows an ethical judgment, which is called as moral certainty and provides the basis for an ethically proper action. It is also stressed that the donation of organs for transplantation must be altruistic. It is unacceptable to expect and to receive any payment for such an act.
35
Berkowitz, Ivor, and Jeremy R. Garrett. "Legal and Ethical Considerations for Requiring Consent for Apnea Testing in Brain Death Determination." American Journal of Bioethics 20, no. 6 (May 22, 2020): 4–16. http://dx.doi.org/10.1080/15265161.2020.1754501.
Full text
36
Gamoneda Lanza, Amelia. "La chute dans la conscience. Animalité, philosophie et cognition dans l’oeuvre de Camus." Çédille, no. 18 (2020): 415–43. http://dx.doi.org/10.25145/j.cedille.2020.18.17.
Full textAbstract:
Camus’s work contains «blind and instinctive» aspects that the author himself pointed out as insufficiently considered by the critics. The questioning of conscience from a cognitive and moral point of view runs through his entire production, often trying to situate itself in the uncertain division that separates and brings together the animal and man. This epistemic critical axis –which straddles philosophy and the cognitive sciences– will serve in this article to analyze the articulation between L'Étranger and La Chute that makes Clamence into Meursault’s reverse. The nostalgia for an innocent paradise, the ethical and moral problem of violence and the consideration of death receive in Camus’ thought a cognitive treatment that links the phenomenological phylosophie of his time with the current biology of consciousness or evolutionary anthropology.
37
Peter, Elizabeth, Shan Mohammed, and Anne Simmonds. "Sustaining hope as a moral competency in the context of aggressive care." Nursing Ethics 22, no. 7 (October 14, 2014): 743–53. http://dx.doi.org/10.1177/0969733014549884.
Full textAbstract:
Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture how competencies may reflect an adaptation to a less than ideal work environment. Research design: A critical qualitative approach was used. Participants: Fifteen graduate nursing students from various practice areas participated. Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings.
38
Cociu, Svetlana. "Ethical Approach to Road Traffic Injuries Prevention." Studia Universitatis Babeş-Bolyai Bioethica 66, Special Issue (September 9, 2021): 46. http://dx.doi.org/10.24193/subbbioethica.2021.spiss.23.
Full textAbstract:
"Road traffic injuries are widespread public health problem, particularly in low- and middle-income countries, being the leading cause of death for children and young adults aged 5–29 years. Road injury ranks 8th after the main causes of death, and unless there will not be a complex approach to prevention those will rank 5th by 2030. The Republic of Moldova is characterized by a high mortality due to road crashes, children and adults over 50 years are more prone to injury or a road crashes and the age group 15-39 years there is a higher risk of death as driver or passenger in a transport unit. Road traffic injuries can be prevented, and many government interventions, policies and programs have been proposed in order to prevent road injuries, but their prevention was less approached by applying and respecting ethical aspects among all the participants in traffic. Each one involved in the road traffic can contribute in improving the road safety by his/her responsibility, which refers to consciousness, morality, ethics and ethical behavior, culture. Drivers and pedestrian have the moral duty while driving to use seat belt, comply with road traffic rules and safety requirements and have duty not to harm- to avoid putting themselves and others in danger. We need much more understandings of the behavior risk factors, increasing psychological capacity and benefits, investing in educational campaigns, effective communication, social support, and encouragement, increase awareness of responsibility in traffic and increasing respect for all participants in traffic, without causing any harm. Acknowledgement: Rosamond Rhodes, Ph.D., Professor of Medical Education, Director of Bioethics Education, Icahn School of Medicine at Mount Sinai, New York, USA. "
39
Thomasma, David C. "Ethical Issues and Transplantation Technology." Cambridge Quarterly of Healthcare Ethics 1, no. 4 (1992): 333–43. http://dx.doi.org/10.1017/s0963180100006514.
Full textAbstract:
Not that long ago, any thought of transferring body parts, or fluids like blood, among individuals was expressed in terms of a nightmare. Consider the problem of involuntary blood transfusions to Count Dracula! Or recall the infamous brain transplant to the brutish body under Dr. Frankenstein's ministrations. The very thought of bodily transference stimulated writers to create monsters. The stuff of evil seemed to surround any attempt. Hubris was considered the evil that exceeded the normal limits of scientific research and development. Transplantation seemed to make humans into gods who defied death but who, like Icarus and his wax wings, flew too close to the sun.
40
Rubin, Miri. "Choosing Death? Experiences of Martyrdom in Late Medieval Europe." Studies in Church History 30 (1993): 153–83. http://dx.doi.org/10.1017/s0424208400011682.
Full textAbstract:
Probably one of the most emotive words in our ethical and religious languages, ‘martyrdom’ poses the historian with a complex array of powerful images and awesome actions. Its very naturalness, as a grounding moment through which religions and radical movements are substantiated and made public, raises serious problems of perspective, empathy, judgement: studying martyrdom brings us in touch with some of the most admirable and some of the most repugnant and saddening aspects in human behaviour. Religions, parties, and nations claim martyrs as unambiguous signs of virtue, truth, and moral justification, and thus render martyrdom seemingly obvious. Painful, yes, but admirable; chilling, but satisfying, since in it men and women turn into gods, become myth-makers, and lend legitimation to whoever may claim them. So martyrdom—its discussion, definition, the claim to its virtue and beauty—is always open to appropriation, to competition, to contestation.
41
Nguyen, Doyen. "Does the Uniform Determination of Death Act Need to Be Revised?" Linacre Quarterly 87, no. 3 (June 2, 2020): 317–33. http://dx.doi.org/10.1177/0024363920926018.
Full textAbstract:
Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues’ revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust. Summary: This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.
42
Ko, Hsun-Kuei, Chi-Chun Chin, Min-Tao Hsu, and Shu-Li Lee. "Phenomenon of moral distress through the aspect of interpretive interactionism." Nursing Ethics 26, no. 5 (April 15, 2018): 1484–93. http://dx.doi.org/10.1177/0969733018766579.
Full textAbstract:
Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses.
43
AKIN, Selami Mahmut, and Nihal SÜTÜTEMİZ. "NÖROPAZARLAMA ve UYGULAYICILARIN PERSPEKTİFİYLE ETİK YÖNÜ." Business & Management Studies: An International Journal 2, no. 1 (November 20, 2014): 67. http://dx.doi.org/10.15295/bmij.v2i1.48.
Full textAbstract:
Neuromarketing which emerged in recent years assumes that brain contains information that hidden personal preferences and has a relationship between brain activity and verbal preferences. Based on that relationship, neuromarketing utilize the various techniques used in medicine to figure out consumers and create consumer marketing strategies. The techniques utilized in neuromarketing causes moral concerns about gain commercial purposes of the data obtained from consumers. In this context, the purpose of this study is examine neuromarketing and discuss it’s ethical aspects through practitioner’s perpective. For this purpose, the field of research constitute marketing research companies that apply neuromarketing techniques which located in Istanbul. Of the aforementioned companies, since Thinkneuro and Affectspots agreed to participate in this research, were determined as the sample of the study. The data obtained by interview with the managers of the two companies and descriptive analysis result has been observed that different approaches. As a result of research, the statements of companies has overlapped with literature. The assessments of companies’ about ethical aspects of neuromarketing discussed according to teleological and deontological approach of ethics.
44
Neuhaus, Carolyn P. "Ethical issues when modelling brain disorders innon-human primates." Journal of Medical Ethics 44, no. 5 (August 11, 2017): 323–27. http://dx.doi.org/10.1136/medethics-2016-104088.
Full textAbstract:
Non-human animal models of human diseases advance our knowledge of the genetic underpinnings of disease and lead to the development of novel therapies for humans. While mice are the most common model organisms, their usefulness is limited. Larger animals may provide more accurate and valuable disease models, but it has, until recently, been challenging to create large animal disease models. Genome editors, such as Clustered Randomised Interspersed Palindromic Repeat (CRISPR), meet some of these challenges and bring routine genome engineering of larger animals and non-human primates (NHPs) well within reach. There is growing interest in creating NHP models of brain disorders such as autism, depression and Alzheimer’s, which are very difficult to model or study in other organisms, including humans. New treatments are desperately needed for this set of disorders. This paper is novel in asking: Insofar as NHPs are being considered for use as model organisms for brain disorders, can this be done ethically? The paper concludes that it cannot. Notwithstanding ongoing debate about NHPs’ moral status, (1) animal welfare concerns, (2) the availability of alternative methods of studying brain disorders and (3) unmet expectations of benefit justify a stop on the creation of NHP model organisms to study brain disorders. The lure of using new genetic technologies combined with the promise of novel therapeutics presents a formidable challenge to those who call for slow, careful, and only necessary research involving NHPs. But researchers should not create macaques with social deficits or capuchin monkeys with memory deficits just because they can.
45
van Meeteren, Antoinette Schouten, Simone Lenting, Mirjam Sulkers, and Marianne van de Wetering. "OTHR-21. Ethical reflections via the dilemma method in a pediatric neuro-oncology department." Neuro-Oncology 24, Supplement_1 (June 1, 2022): i151. http://dx.doi.org/10.1093/neuonc/noac079.560.
Full textAbstract:
Abstract BACKGROUND: Professional care for children with a brain tumor can bring considerable ethical questions in clinical practice. These questions can be burdensome and cause distress among professionals, parents and patients. Awareness and skills to bring these aspects into a respectful discussion among colleagues can be meaningful and alleviate the distress. Our objective is to give overview of the ethical case deliberations which took place during a monthly multidisciplinary meeting on the pediatric neuro-oncology department. METHOD: To describe the type of ethical case deliberations as spontaneously proposed and selected by the team members for discussion. To identify main values in the care process for professionals via the dilemma method in monthly meetings led by a trained facilitator. RESULTS: The monthly meetings were visited regularly by 9-14 diverse professionals (median 10) of the team: nurses, oncologists, social worker, psychologist, educational specialist. The selected moral questions concerned children with a brain tumor between 4-13 year old (median 9) with following ten subjects: 3 not sharing the infaust prognosis with a child, 2 avoiding medical care in follow up /treatment, 2 cultural different approach for food and drink intake, 2 crossing professional boundaries and 1 time worries about emotional safety of a child. The main values that were recognized to play crucial role in the care process were honesty, respect, autonomy, quality of life, health, tolerance, courage and safety. The participants felt supported in their professional skills by sharing reflections on personal moral considerations and by openly discussing different views and experiences of other participants. CONCLUSION: The monthly ethical case discussions disclose high lights in the burden of professional care in pediatric neuro-oncology. These meetings about moral questions are supportive in the competence of the professionals to recognize and communicate about these important dilemmas.
46
Lyon, Will. "Ambiguity, death determination, and the dead donor rule." Clinical Ethics 13, no. 4 (July 26, 2018): 165–71. http://dx.doi.org/10.1177/1477750918790021.
Full textAbstract:
The dead donor rule states that organ donors must be declared dead before any vital organs are removed. Recently, scholars and physicians have argued for the abandonment of the dead donor rule, based on the rule’s supposed connection with the concept of brain death, which they view as a conceptually unreliable definition of death. In this essay, I distinguish between methods of death determination and the question of whether or not the dead donor rule should be a guiding principle of organ transplant ethics. In principle, the dead donor rule does not rely on any one definition of death, but only prohibits the taking of vital organs before a patient is declared dead. In light of this distinction, I argue that even if the dead donor rule is tied to brain death in practice, conceptual disagreement about brain death does not provide grounds for rejection of this rule. I then present evidence in support of the consistency and reliability of the diagnosis of brain death. I show that, when performed carefully and under specific clinical circumstances, the diagnosis of brain death is considered by most neurologists to be reliable. Finally, I argue that, without the dead donor rule, organ transplantation programs would become susceptible to violations of the ethical principle of respect for persons.
47
VAN NORMAN, GAIL A. "A Matter of Life and Death: What Every Anesthesiologist Should Know About the Medical, Legal, and Ethical Aspects of Declaring Brain Death." Survey of Anesthesiology 44, no. 3 (June 2000): 187–89. http://dx.doi.org/10.1097/00132586-200006000-00062.
Full text
48
Cervantes, José-Antonio, Luis-Felipe Rodríguez, Sonia López, Félix Ramos, and Francisco Robles. "Cognitive Process of Moral Decision-Making for Autonomous Agents." International Journal of Software Science and Computational Intelligence 5, no. 4 (October 2013): 61–76. http://dx.doi.org/10.4018/ijssci.2013100105.
Full textAbstract:
There are a great variety of theoretical models of cognition whose main purpose is to explain the inner workings of the human brain. Researchers from areas such as neuroscience, psychology, and physiology have proposed these models. Nevertheless, most of these models are based on empirical studies and on experiments with humans, primates, and rodents. In fields such as cognitive informatics and artificial intelligence, these cognitive models may be translated into computational implementations and incorporated into the architectures of intelligent autonomous agents (AAs). Thus, the main assumption in this work is that knowledge in those fields can be used as a design approach contributing to the development of intelligent systems capable of displaying very believable and human-like behaviors. Decision-Making (DM) is one of the most investigated and computationally implemented functions. The literature reports several computational models that enable AAs to make decisions that help achieve their personal goals and needs. However, most models disregard crucial aspects of human decision-making such as other agents' needs, ethical values, and social norms. In this paper, the authors present a set of criteria and mechanisms proposed to develop a biologically inspired computational model of Moral Decision-Making (MDM). To achieve a process of moral decision-making believable, the authors propose a cognitive function to determine the importance of each criterion based on the mood and emotional state of AAs, the main objective the model is to enable AAs to make decisions based on ethical and moral judgment.
49
R.B. "AMA Issues Statement on Anencephalics as Living Organ Donors." Journal of Law, Medicine & Ethics 23, no. 3 (1995): 296–97. http://dx.doi.org/10.1017/s1073110500004423.
Full textAbstract:
On May 24, 1995, the American Medical Association (AMA) Council on Ethical and Judicial Affairs issued a rather controversial opinion that it is ethically permissible to use anencephalic infants as living organ donors. Approximately 1,000 to 2,000 infants are born each year in the United States with anencephaly, a congenital birth defect whereby the infant has no forebrain and cerebrum. Without higher brain functions, the infants can never experience consciousness, thoughts, emotions, or pain. Fewer than half survive more than a day, and more than 90 percent die within one week. However, by the time brain death occurs in anencephalic infants, their organs are no longer suitable for donor purposes because they have deteriorated beyond use.In 1988, the AMA Council declared that it is ethical to use the infants as organ donors only after they have died. Now the Council has revised that opinion, and it proposes to allow removal of organs before death, as long as the parents consent and two doctors concur in the diagnosis of anencephaly.
50
Greenberger, Chaya. "Enteral nutrition in end of life care." Nursing Ethics 22, no. 4 (August 4, 2014): 440–51. http://dx.doi.org/10.1177/0969733014538891.
Full textAbstract:
Providing versus foregoing enteral nutrition is a central issue in end-of-life care, affecting patients, families, nurses, and other health professionals. The aim of this article is to examine Jewish ethical perspectives on nourishing the dying and to analyze their implications for nursing practice, education, and research. Jewish ethics is based on religious law, called Halacha. Many Halachic scholars perceive withholding nourishment in end of life, even enterally, as hastening death. This reflects the divide they perceive between allowing a fatal disease to naturally run its course until an individual’s vitality (life force or viability) is lost versus withholding nourishment for the vitality that still remains. The latter they maintain introduces a new cause of death. Nevertheless, coercing an individual to accept enteral nourishment is generally considered undignified and counterproductive. A minority of Halachic scholars classify withholding enteral nutrition as refraining from prolonging life, permitted under certain circumstances, especially in situations where nutritional problems flow directly from a fatal pathology. In the very final stages of dying, moreover, there is a general consensus that enteral nourishment may be withheld, providing that this reflects the dying individuals’ wishes. In the event of enteral nourishment becoming a source of overwhelming discomfort, two Halachic ethical mandates would come into conflict: sustaining life by providing nourishment and alleviating suffering. As in all moral conflicts, these would have to be resolved in practice. This article presents the issue of enteral nourishment as it unfolds in Halacha in comparison to secular and other religious perspectives. It is meant to serve as a foundation for nurses to reflect on their own practice and to explore the implications for nursing practice, education, and research. In a world that remains broadly religious, it is important to sensitize health practitioners to the similarities and differences among religions and between secular and religious approaches to ethical issues.