"Brain reading": achievements, perspectives and ethical problems

The new trend in brain research designated as brain reading is considered. This research deals with decoding the informational content of the brain processing via its physiological parameters. Such studies are based on rather complicated methods of mathematical analysis. Single records rather than averaged data are used to reveal their content. Three main streams of studies are distinguished, i.e. the object classification, the emotion recognition and brainotyping. Particularly, the studies directed to recognizing the type of thinking via EEG spectra, carried out in the author's laboratory, are reviewed. The possible outcome of the brain reading technique is considered. Finally it is argued that in the future, the broad application of this technique needs to be controlled with some ethical rules.     

Medicare prospective payment--the ethical implications of converging clinical and financial decisions in long-term care

The principles of bioethics indicate that Prospective Payment has a moral dimension. Because Prospective Payment unifies clinical and financial decisions, it poses problems for long-term care facilities, especially those motivated by a humanitarian mission rather than financial considerations. This article outlines how Prospective Payment conflicts with the ethical principles of respect for persons, autonomy, justice, promise keeping, and fidelity.     

Collection of voucher specimens for bat research: conservation,ethical implications,reduction, and alternatives

Voucher specimens have played a fundamental role in biology, but ethical and conservation concerns have been raised over unnecessary collection of organisms. From 1996 to 2017, 222 studies mentioned the collection of 7482 bats of 376 species, mostly from South America and Asia (India, China, and South‐East Asia). Researchers mostly aimed to compile checklists or establish geographic ranges. Strong ethical reasons exist to avoid unnecessary collection, and suitable alternatives should be sought; for example, collecting voucher specimens for retrospective taxonomic confirmation can be replaced with molecular methods. We provide information on alternative methods and when to use them to avoid harming fragile populations of bats.     

Edinburgh primary care depression study: treatment outcome,patient satisfaction,and cost after 16 weeks.

OBJECTIVE--To compare the clinical efficacy, patient satisfaction, and cost of three specialist treatments for depressive illness with routine care by general practitioners in primary care. DESIGN--Prospective, randomised allocation to amitriptyline prescribed by a psychiatrist, cognitive behaviour therapy from a clinical psychologist, counselling and case work by a social worker, or routine care by a general practitioner. SUBJECTS AND SETTING--121 patients aged between 18 and 65 years suffering depressive illness (without psychotic features) meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition for major depressive episode in 14 primary care practices in southern Edinburgh. MAIN OUTCOME MEASURES--Standard observer rating of depression at outset and after four and 16 weeks. Numbers of patients recovered at four and 16 weeks. Total length and cost of therapist contact. Structured evaluation of treatment by patients at 16 weeks. RESULTS--Marked improvement in depressive symptoms occurred in all treatment groups over 16 weeks. Any clinical advantages of specialist treatments over routine general practitioner care were small, but specialist treatment involved at least four times as much therapist contact and cost at least twice as much as routine general practitioner care. Psychological treatments, especially social work counselling, were most positively evaluated by patients. CONCLUSIONS--The additional costs associated with specialist treatments of new episodes of mild to moderate depressive illness presenting in primary care were not commensurate with their clinical superiority over routine general practitioner care. A proper cost-benefit analysis requires information about the ability of specialist treatment to prevent future episodes of depression.     

What 'most people' do: Exploring the ethical implications of genetic counselling

Genetic counselling, and the ethical principles of non-directiveness and client autonomy that counsellors aspire to, are a cornerstone in the defence of genetic practice against accusations of eugenics. This paper examines the practical application of these principles using a conversation analytic approach, arguing that there is a need to pay greater attention to local interactional contexts in analysing counsellors' attainment or otherwise of ethical ideals.     

Emerging genomic technologies and the concept of personalized medicine: An overview of ethical,legal and social implications

With the completion of the Human Genome Project in May 2006, genetic testing for every American is rapidly becoming a reality. As the advanced technology fuels the path towards personalized medicine, genetic nondiscrimination legislation follows closely behind. It seems that the 2007 Genetic Information Nondiscrimination Act (GINA) will finally pass through both chambers of Congress and will be signed by the President, but questions remain. On May 1, 2008, the House passed GINA by a vote of 414 to 1. Why is this the year that genetic nondiscrimination legislation could finally become the reality? Is this the beginning of a new relationship between science and policy, where policy is finally catching up? We examine the answers to these questions through a look at the history of genetic nondiscrimination legislation and where it stands today, including arguments for and against the bill. We conclude by discussing how we can achieve a future of safe personalized medicine for the populous, which would require continuous productive interactions between policymakers and scientists.     

Gibbard's evolutionary theory of rationality and its ethical implications

Gibbard's theory of rationality is evolutionary in terms of its result as well as its underpinning argument. The result is that judgments about what is rational are analyzed as being similar to judgments of morality — in view of what Darwin suggests concerning the latter. According to the Darwinian theory, moral judgments are based on sentiments which evolve to promote the survival and welfare of human societies. On Gibbard's theory, rationality judgments should be similarly regarded as expressing emotional attachments to behavioral norms which originate and function to coordinate social interaction. Consequently, Gibbard's theory of rationality might be used to illuminate Darwin's theory of morality, and vice versa. Additionally, as argued in the present essay, both can be further elaborated, and defended, by developing related themes in philosophical ethics: viz., connected with Hume and 20th-century emotivists. The main problem is that this general Darwinian approach faces widespread opposition nowadays, not only in ethics but in philosophy of science. The purpose of this essay is to analyze Gibbard's theory, critically and constructively, with emphasis on the pertinent commonalities in Darwin, Hume and the emotivists, while also critically addressing their common enemies. The pervasive methodological orientation is to relate this analysis to (philosophy of) science in general, and biological science in particular.     

The social, moral, ethical, legal and political implications of today's biological technologies: an Indian point of view

The last 50 years have seen an increasing emphasis on ethical, moral, social, legal, political and economic implications of science for reasons that are discussed in this article. Biotechnology has been no exception to this trend. Areas of biotechnology where the above implications have been important, are briefly described. Ethical and related issues in today's biology-based technologies are discussed with special reference to India. Examples of technological exploitation within a country, or of one country by another, using modern biology-based technologies are given. The possible implications of one new and emerging biology-based technology are discussed. It is concluded that a well-informed and knowledgeable society is the only assured insurance against possible misuse of biology-based technologies of today and tomorrow, including their use for the exploitation of people. The recent decision of the Prime Minister of India to set up a National Knowledge Commission is mentioned in this context.     

Stem cell tourism and future stem cell tourists: policy and ethical implications

Stem cell tourism is a small but growing part of the thriving global medical tourism marketplace. Much stem cell research remains at the experimental stage, with clinical trials still uncommon. However, there are over 700 clinics estimated to be operating in mostly developing countries--from Costa Rica and Argentina to China, India and Russia--that have lured many patients, mostly from industrialized countries, driven by desperation and hope, which in turn continue to fuel the growth of such tourism. While much research has focused on such dimensions as the promotions that allow such businesses to make their services known, media coverage, some patient research, and regulatory conditions for developing country clinics, little attention has been paid to the non-affected members of the general population, the future potential users of such services. This empirical study based on five focus group discussions with a diverse group of healthy adults in a Canadian city, explored participant views of patients who use stem cell tourism services, the likelihood they would avail themselves of such services if they were to suffer similar illnesses, and the conditions under which they might do so, and the impact that admonitions and advice from international expert bodies might have on their decisions. Our findings suggest that these healthy adults are sympathetic to the drivers of hope and desperation, and, despite cautions about research limitations, may seek such treatments themselves under similar conditions. These findings are discussed in the context of the policy and ethical issues raised by this form of medical tourism.     

The ethical and social implications of exploring African American genealogies

In June 2002, the University of Minnesota hosted a conference to explore the implications of using genetic technologies and genealogical methods to reconstruct African identity. This paper includes transcribed remarks from that conference by Annette Dula, Marian Gray Secundy and Charmaine Royal.     

When families cannot "let go": ethical decision-making at the bedside.

Shared decision-making at the bedside is now a regular feature of medical practice. When disagreements arise between a patient and family members caregivers sometimes find themselves caught in a complex tangle of human relationships that strains monochrome ethical thinking. The patient''s expressed wishes are often compromised for the sake of the family''s needs. Conversely, a unilateral appeal for patient autonomy may prove insensitive to the hurt and the needs of the family. We describe a relatively unsuccessful attempt by a patient''s caregivers to buy time to maximize the interests of the patient and her family and discuss the way in which the family dynamics militated against the rather obvious solution of promoting the patient''s right to refuse treatment. The purpose of this article is not to evoke sympathy for health care professionals in dealing with such conflicts but rather to heighten awareness of the issues at stake and to stimulate thinking about ways and means to bring about a more favourable outcome than the one described here.