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1. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Johanna Ahola-Launonen

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There is much discussion about individual responsibility in bioethics, especially in the context of health care distribution. Despite some different views, the majority of literature seems to admit that there are limits to individual responsibility, because of environmental factors, including ecological, physical, social and societal issues and epigenetics that affect a person’s health and well-being and her ability to control her life and make genuine choices. However, when the discussion comes to health care in the future and new genetic technologies, environmental issues seem to be forgotten. The issues concerning health and well-being are reduced to genetics and choices about genetics, as if the present environmental effects through epigenetics and societal issues would be diminished. It appears that a person’s ability to control her life would somehow be remarkably increased. This notion is a fallacy, because - despite new genetic technologies - the environment will continue to affect a person’s life both at a molecular and societal level. The environmental issues should be acknowledged also in scenarios of the future, for -otherwise- the discussion about individual responsibility will lead to a questionable direction and the most efficient means for improving health and well-being will be undermined.
2. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
V. Arshinov, E. Chapny, V. Chekletsov

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The paper deals with implementation of complexity paradigm in human enhancement issues. The transdisciplinary view on mind and body extension is proposed, where classical intersubjectivity problem has to be re-read in the context of mutual understanding of natural intelligence and AI. For self/self, self/other and self/environment communication we consider specific fractal interfaces. For this interfaces the complexity-observer is a reflective observer of self-organized “partial observers ensemble”, which includes himself as an order parameter. Such observer cognition is embodied and situated. Further, convergence of human enhancement and ambient technologies (internet of things, augmented reality and other hybrid environment and pancommunication trends) makes possible to create certain layer of reality (of city landscape for example), representing a certain mode of our corporeality as emerging process.
3. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Aikaterini A. Aspradaki

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The idea of deliberative democracy has attained increasing attention by philosophers, political and legal theorists over the last two decades. Proponents have supported different arguments for deliberation within the democratic theory and an argument from autonomy has been developed. Taking into consideration the interest in both democratic deliberation and autonomy in bioethics, I discuss two examples in reference to the relevant documents: The first deals with democratic deliberation and autonomy on the basis of Rawlsian procedural justice in ethical frameworks, regarding public health policy issues, such as in the cases of infectious diseases, obesity, alcohol and smoking, and the fluoridation of water (Nuffield Council on Bioethics: Public health: ethical issues report). The second deals with democratic deliberation and respect for persons as basic ethical principles suggesting guidelines for emerging technologies in health, such as in the case of the whole genome sequencing (Presidential Commission for the study of bioethical issues: Privacy and progress in whole genome sequencing report). Finally, I introduce into the dialogue in bioethics the challenge of a deliberative model flown from a normatively founded principle of respect for autonomy persons.
4. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Myrto Dragona-Monachou

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Euthanasia is perennially the most intricate ethical problem and nowadays, due to the biotechnological revolution, the most debatable bioethical dilemma. It is difficult, if not impossible, to attain even an overlapping consensus on this issue; therefore, euthanasia is hardly discussed directly in Universal and International Declarations. Most forms of euthanasia are defended by secular pro-choice liberal bioethicists according to the bioethical principles of autonomy, dignity, beneficence and respect for human vulnerability, whereas pro-life conservatives and religiously minded supporters of the sanctity of life take a stand against it. In this paper, after a short historical account, I shall argue that there can be a minimal consensus between both sides at least as far as the artificial prolongation of life of patients with incurable diseases is concerned. Since it is the process of dying rather than life itself prolonged by mechanical devices, artificial preservation of the ‘life’ of terminally ill patients amounts to medical futility. Therefore, some theologians and most secular bioethicists agree that delivering incurable patients from aggressive therapy and mechanical support and offering palliative care is an altruistic, merciful and socially fair recourse and lets nature lead its course.
5. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Michael Etim

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Reproduction is a fact of life and assisted human reproduction signifies all those techniques which involve the manipulation of germ cells as a substitute for natural procedures with the finality of achieving reproduction. Most of the techniques – ‘intra-corporeal’, ‘extra-corporeal’ and ‘micro-assisted-techniques’ – developed in assisted human reproduction have emerged as part of the response to the challenges of human infertility. Infertility is a major reproductive health problem in Nigeria, the bulk of the burden of the negative impact of infertility is borne by women. Most techniques of assisted reproduction are available in Nigeria. It is important to have an open bioethical reflection in the country with regard to these techniques and their use. There is virtually no regulation with regard to assisted reproductive technologies in the country; the recommended prospect is that the question of the current ‘legal vacuum’ needs serious attention. It is important for us as a society to examine the question of human dignity and assisted human reproduction. The expression ‘human dignity’ remains complex; however, its complexity as an over-arching principle also gives it the profundity which is important in dealing with ethical issues, especially those that touch upon human life, human responsibility and human reproduction.
6. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Shin Fujieda

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In Japan the Western philosophy (ethics-based) bioethics was introduced in the 1980s, and from that time the term ‘bioethics’ has been regarded as almost equivalent to ‘secular bioethics’. It is true that it must be secular in such a sense that it would be able to be the basis of public policy-making. But, before making the consensus, bioethical discourses should follow a pluralistic process of public debate, where secular arguments, as well as faith-based opinions, are equally supposed to be allowed. This presentation will examine the role of Buddhism in contemporary Japan with reference to the public statements Buddhist denominations make on organ transplantation issue.
7. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Ana Ylenia Guerra Vaquero

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Advance directives for health care have become widely accepted as a necessary tool to guarantee the civilized management of one’s life during increasingly protracted periods of aging and frail health. The advance directives allow a person with capacity to state their wishes, values, and treatment preferences in advance, prospectively, so that their authentic voice will be heard when their capacity has lapsed. As an ethical matter, a patient’s right to accept or decline particular treatments at the end of life is based on the principle of autonomy. In some cases, however, the principle of beneficence might outweigh the patient’s interest in autonomy, especially if the proposed treatment would reduce the pain or increase functioning without adverse consequences or if the patient were unable to make a rational decision about accepting or declining treatment. Substitute decision makers rely on directions or instructions left by the patient when they had capacity to express and communicate their treatment preferences and goals of care. We find a strong justification for advance care planning. However, there are several critics to advance directives that we will discuss.
8. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Yuehong Han, Yunbao Yang

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In bioethics is ‘dignity’ useful or useless? This is a debate focus in bioethics at present. This paper responds to the ‘useless theory’ and proves that: Firstly, ‘dignity’ cannot be equal to ‘respect’ and has more connotation called ‘surplus’ beyond the ‘respect’. Secondly, in bioethics ‘dignity’ is not only useful but also great useful, and has bioethical fundamental value. Especially “the dignity of human life” is the bioethical core and key value. To protect the dignity of human life is the purpose of bioethics. Thirdly, ‘dignity’ in practical application generally needs to be transited or transformed from the normal values to the basic ethical principles, then to the ‘four principles’, then to the rights.
9. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Nancy Jecker

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A society is said to age when its number of older members increases in relation to its number of younger members. The societies in most of the world’s industrialized nations have been aging since at least 1800. In 1800 the demographic makeup of developed countries was similar to that of many Third World countries in the early 1990s with roughly half the population under the age of 16 and very few people living beyond age of 60. Since that time, increases in life expectancy, combined with declines in fertility rates, have dramatically increased the proportion of older persons in developed nations. The rapid increase in the number of older persons relative to younger ones carries important societal implications. In the domain of healthcare, societal aging will increase costs and exert greater pressure to ration services. It will, thus, bring to the fore questions, regarding a just distribution of healthcare between young and old age groups. This paper considers some of the most influential arguments to date for age-based rationing of health care. I show that these arguments fall short, and that the theoretical assumptions underlying them do not withstand careful scrutiny.
10. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Dominique Martin

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National self-sufficiency in human biological materials such as blood and organs is now commonly invoked as a goal for healthcare policy makers. Despite its history as a strategic response to the ethical hazards of global trade in human blood, the ethical dimensions of the concept have been inadequately explored. This paper introduces self-sufficiency as an ethical paradigm for policy-making and explores some of the parallels found in Aristotle’s account of autarkeia in the polis. It highlights the ethico-political challenges of pursuing self-sufficiency in culturally diverse societies and suggests that the motivation of donation through solidarity rather than the use of financial incentives is consistent with contemporary and ancient versions of the self-sufficiency model.
11. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Sebastian Muders

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Despite some initial and in part ongoing skepticism, human dignity has reached a strong standing in several applied debates in biomedical ethics. The debate on assisted suicide features prominently among them, since human dignity is put to work there to enhance important arguments on either side: It is used to give claims to autonomy the appropriate normative weight; and also to free up the theistic flavor in arguments about the sanctity of human life. The aim of this paper is to show the importance of including the normative background assumptions of the concept of dignity when assessing the plausibility of these arguments. I will first analyze two examples from a group of ethical positions I call ‘natural good theories’. I argue that they have an important pragmatic advantage, when their notion of dignity is applied to debates, where it is used with apparently divergent meanings. In a second step, I present two further examples to demonstrate how discussions of dignity enhanced arguments in the debate on assisted suicide regularly fail to give sufficient attention to the background assumptions of the specific normative theories where the notion stems from, and how this prevents significant advancement with respect to these arguments.
12. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Rekha Navneet

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Genetic engineering, the latest offshoot of biotech, furnishes medical sciences with an ability to design and invent living organisms (e.g. Chimera, a hybrid between sheep and human) as well as to observe and analyze their function However, this genetic engineering leading to process of cloning, stem-cell research and reproduction innovations, which are being heralded as new age wonders in bio-medical technology need to be contemplated with an ethical-philosophic vision to ponder over the pertinent query, Whether we are crossing thresholds into improved existence of a long and very healthy living or are we metaphorically opening Pandora’s box? In my paper, I have tried to raise a few concerns that need to be deliberated upon by lawyers, policy makers, scientist, researchers, common public and academics before new life forms and world view become an actual socio-cultural reality. The queries about values and virtues in the context of the quality and dignity of life and human relationship in relation to the continued research and advancement in bio- medical technology i.e., in genetic cloning form the integral part of this paper.
13. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Takako Okinaga

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People in the past, handled most areas of life and death using religion. Because of progressed ‘advanced biosciences’, it is necessary for us to rethink the meaning of life and death. Advanced medical technologies have enabled people to live by receiving another person’s organs, to have babies using another person’s eggs or sperm or by borrowing another woman’s uterus. However, these medical technologies have raised ethical questions, such as ‘should we manipulate life?’ In this paper, I discuss the matter of ‘education for life and death’ and the value of life, which is questioned by the study of Bioethics. It centers on ethical dilemmas in the clinical field that involves ‘life’, which are discussed in conventional bioethics education. On July 13, 2009, the organ transplant bill stating, ‘brain death means the person’s death’ was passed by both houses of the Diet. Considering the present situation, I discuss the following two cases: a. the ethical issue related to transplants of organs from a brain-dead person; and b. of surrogate pregnancies, based on the report of ‘Prohibition of surrogate birth” compiled in 2003 by the Ministry of Health, Labor and Welfare. Regarding issues related to ‘the right of self-determination of life’ in the clinical field of life and death, I would like to consider the “education for life and death.”
14. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Evangelos Protopapadakis

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Ever since the debate concerning euthanasia was ignited, the distinction between active and passive euthanasia – or, letting die and killing – has been marked as one of its key issues. In this paper I will argue that a) the borderline between act and omission is an altogether blurry one, and it gets even vaguer when it comes to euthanasia, b) there is no morally significant difference between active and passive euthanasia, and c) if there is any, it seems to favor active instead of passive euthanasia. Therefore, while the distinction between active and passive euthanasia might be meaningful in terms of description, if it is considered to be endowed with moral weight and used on purpose of justifying one type of euthanasia instead of the other, it becomes morally problematic and misleading.
15. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Maya Rakhimova

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The scientific and technocratic world of today normally takes more than gives back: on the one hand, we’ve got some determinable standards of culture as terms of living in modern culture matrix (modern ‘musts’ and ‘shoulds’ of an average society member, such as the categories of success, career and welfare (material wealth), some huge opportunities in science); on the other hand, we’ve lost our spiritual identity as the way one conceives his/her place and role in the life space given. How could we know what would really be better for us today, what sort of happiness should we get in order to feel ourselves full and calm? It’s complicated to know and feel the direction for the development of our inner world. At the same time this development, having no relation to the technocratic progress, is the only means to reach a harmonic state of mind and soul and is the key to happiness in everyday life of a man. The article is devoted to an issue of a bioethical challenge of modern sci-tech epoch, evidencing disparity of active rise of scientific discoveries in separate sciences (e.g., in molecular biology) and of philosophical learning and apprehension of the results of such rise. Under analysis stands a philosophy’s peril about possible modification of a human conscience caused, in particular, by a bioethical revolution and gene engineering. It is suggested that the phenomenon of pluripotency of cell material discovered by scientists may consequently cause pluripotency of a human mind, which in its turn shall make real a threat of waste by a human being of a need and desire to stay a human being, shall cause degrading of a human need of spiritual growth.
16. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Bernard Reber

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If some of European Parliamentary Offices of technological and scientific assessment have been inspired by the former Congressional Office of technological assessment of the US (OTA), they have made new revolutionary experiments with the introduction of the participation of ordinary citizens (lay people). TA has, thus, become Participatory Technological Assessment (PTA). In most cases these citizen have a large initiative according to 50 different devices. The wealth of these TA and PTA are uncommon innovations in the field of institutional design. The list of problems selected here tries to explicit some theoretical deadlocks linked with PTA on the way to Participatory Bioethical Assessment. If they are not been thought and envisaged by the organizers these problems embedded in the making of PTA process are key questions and conditions for the quality of the results. Bioethics is understood here in its complete and original sense, as Potter (1998) coined the term: “The time has come to recognize that we can no longer examine medical options without considering ecological science and the larger problems of society on a global scale” (p.2). This bioethical turn constitutes a major change in PTA as well. In a way it is a return of the good life, but thought largely and not only on an individual basis. The problem goes beyond the questions of pluralism of expertise and interdisciplinarity. We have to combine ‘horizontal’ interdisciplinarity with ‘vertical’ normativity. Some of the technical and scientific problems discussed, may sometimes be stabilized. In such cases we are in a prevention context, where we have only to deal with the moral controversies. We have there to open a new space of research, exposing the methods of bioethics, while considering the assessment of ordinary citizens and their beliefs. Very often we are in a context of precaution, and we find the controversies on both sides, on scientific and ethical grounds. In this respect, we have to consider a co-dependence between ethical and scientific inquiries. We will consider in this paper some theoretical problems on the way towards Participative Bioethical Assessment: the choice of normative political theory to constrain the debate; the definition of an argument (composition and type) in deliberative democracy facing moral pluralism; articulation between ethical and political deliberation; articulation between descriptive sciences and normative ones.
17. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Stefan Antonio Sandu

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Ethics of care is a theoretical model centered on the interdependence of the actors involved in the care. The ethics of care takes into account the fact that some communities or individuals are more vulnerable than others, thus requiring further attention. As a moral theory ethics of care emphasizes on the interdependence and relationship elements that are established in the human existence. In its normative model, the ethics of care aim to maintain inter-relations and their transformation into a network of social relations involving them both: care-givers and care-receivers. Among the most important promoters of ethics of care, we mention Milton Mayeroff, who formulated the term of ‘ethics of care’, and Carol Gilligan and Nel Noddings, who founded ethics of care as a distinctive moral theory that presents the ‘voice of care’, seen as an alternative to liberal theories of human rights. Carol Gilligan formulated the principles of ethics of care, which are opposed to the theory of moral development proposed by Kohlberg. Kohlberg’s model, as Gilligan says, is a ‘male’ perspective on moral reasoning perspective, which contrasts the care perspective that comes from hearing other significant voices in moral development: women, children etc.
18. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Natalia N. Sedova, Boris A. Navrotskiy

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One can distinguish three levels in the integrative unity of knowledge and norms (assessments), which is termed as ‘bioethics’. The first level is theoretical. It is connected with the facts and truths. The second level deals with establishing of certain standards and rules of conduct, with the monitoring of their implementation and the assessment of the results of implementation (violation) of norms. The third level is associated with individual behavior, formed on the basis of relevant knowledge (or the lack of it as is evident from the table), and the rules governing its application. The theoretical bioethics can act and act as an applied philosophy. At the same time, all three levels of bioethics exist in unity; the relationship between them has a vector character. Theoretical bioethics development lags behind that of practical and applied, which may lead to defragmentation of the discipline in general and loss of its scientific and social status. It is possible to overcome this trend purposefully, treating axiological problems of bioethics as primary to the deontological ones.
19. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
William Soderberg

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The utilitarian argument of John Harris and the libertarian position of Ronald Green concerning genetic modifications of children omit a parental perspective. John Rawls proposes that the negotiators of obligations to future generations be viewed as heads of families. Drawing upon John Rawls, Erik Malmqvist, and Michael Sandel, I defend four claims: first, in seeking to balance social stability, autonomy, and general welfare the negotiators of obligations to future generations would assign priority to social stability; secondly, the negotiators would preserve a distinction between therapeutic and non-therapeutic human genetic modifications; thirdly, they would rule out non-therapeutic genetic modifications of children; finally, the negotiators would endorse a right not to be discriminated against on the basis of genotype.
20. Proceedings of the XXIII World Congress of Philosophy: Volume > 3
Lawrence Ogbo Ugwuanyi

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Severally, issues in bioethics generate tensions on the ground that, while life is generally accepted to be valuable, the basis for this value is not often universally acceptable to all people. As result of this, theories of life and the basis, on which life should be found as valuable, often hinge differently on religion, morality, culture, customs etc., and are reliable only to the extent that they do not disagree or contradict one’s own standpoint as anchored on any of these. In this wise then, religion, culture or customs strongly provide the grounds on which literatures on bioethics flourish. In this paper I intend to locate a fresh basis on which alternative theories of bioethics from the African worldview could be explored; one which will improve the literature on bioethics as well as diversify the ethical basis for life and, thereby, mediate in the tensions that define bioethical principles. I shall do this through an analysis of the important essay of the South African (based) philosopher Thaddeus Metz (2009) “African and Western theories in a bioethical context”. Through a critical study of this essay and by providing the insight it offers on bioethics, I shall demonstrate how this theory provides positions that strongly suggest alternative but valuable basis for bioethical principles, anchored on African worldview and its theoretical and practical potentials in promoting the growth of literature on bioethics.