OUTLINING ETHICAL ISSUES IN NANOTECHNOLOGIES

Nanotechnologies are an expression of the human ability to control and manipulate matter on a very small scale. Their use will enable an even and constant monitoring of human organisms, in a new and perhaps less invasive way. Debates at all levels – national, European and international – have pointed out the common difficulty of giving a complete, clear definition of nanotechnologies. This is primarily due to the variety of their components, to the fact that there is not just one technology but several.
The most significant medical applications of nanotechnologies are in the diagnostic and the therapeutic fields, eg biosensors and molecular imaging, providing diagnosis and drug delivery with no invasive methods involved.
Like any other emerging field, such technologies imply new possibilities for improving health but, on the other hand, they are still at an experimental stage and therefore should be implemented under rigorous safety testing before going on general release. For this purpose, the ethical, legal and social implications (ELSI) of nanotechnologies have been elaborated by study groups, in order to develop solutions before the results of the tests are diffused into medical practice.
The aim of this paper is to define some of the ethical issues concerning biomedical applications and to evaluate whether there is a need for new or additional guidelines and regulations.     

AUTONOMY AND ETHICAL TREATMENT IN DEPRESSION

Antidepressant medication and evidence‐based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self‐knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor‐related decisions. I further argue that such an effect comprises a compelling moral reason for doctors to see evidence‐based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression.     

PARENTAL LOVE PILLS: SOME ETHICAL CONSIDERATIONS

It may soon be possible to develop pills that allow parents to induce in themselves more loving behaviour, attitudes and emotions towards their children. In this paper, I consider whether pharmacologically induced parental love can satisfy reasonable conditions of authenticity; why anyone would be interested in taking such parental love pills at all, and whether inducing parental love pharmacologically promotes narcissism or results in self‐instrumentalization. I also examine how the availability of such pills may affect the duty to love a child.     

LEISHMANIASIS ENTOMOLOGICAL FIELD STUDIES: ETHICAL ISSUES

Occupational health remains neglected in developing countries because of competing social, economic and political challenges. Ethical issues in the workplace related to the hazards and risks of becoming infected by Leishmania (Leishmania) mexicana , through the bite of naturally infected sand flies, is another area of concern that has been neglected as well. We report here the results of reviewing two entomological field studies carried out in our research center from 2003 to 2006. Eight students from our School of Biology were invited to catch sand flies. A total of six of the eight (75%) developed a typical clinical picture of Localized Cutaneous Leishmaniasis (LCL) caused by L. (L.) mexicana . In this article we identify the ethical issues related to these kinds of studies and propose some guidelines for conducting them.     

PRINCIPLISM AND THE ETHICAL APPRAISAL OF CLINICAL TRIALS

For nearly two decades, the process of reviewing the ethical merit of research involving human subjects has been based on the application of principles initially described in the U.S. National Commission's Belmont Report, and later articulated more fully by Beauchamp and Childress in their Principles of Biomedical Ethics. Recently, the use of ethical principles for deliberating about moral problems in medicine and research, referred to in the pejorative sense as “principlism”, has come under scrutiny. In this paper we argue that these principles can provide a foundation for the source of ethical appraisal of human research, but are not themselves wholly adequate for this purpose. Therefore, we further propose that (1) principles should be understood as heuristics that can be “specified” as described by DeGrazia (1992), and (2) that the principle-based approach should be supplemented by formally incorporating “sensitivity to context” into the evaluation of clinical trials     

UNDERSTANDING DOCTORS' ETHICAL CHALLENGES AS ROLE VIRTUE CONFLICTS

This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis.     

A ROBUST,PARTICULARIST ETHICAL ASSESSMENT OF MEDICAL TOURISM

Recently, in increasing numbers, citizens of wealthy nations are heading to poorer countries for medical care. They are traveling to the global South as medical tourists because in their home nations either they cannot get timely medical care or they cannot afford needed treatments. This essay offers a robust, particularist ethical assessment of the practice of citizens of richer nations traveling to poorer countries for healthcare.