Can There Be Post-Persons and What Can We Learn From Considering Their Possibility?

Many prominent bioethicists have recently raised the question of the possibility of moral status enhancement. In this paper I discuss the arguments advanced by Nicholas Agar for the possible existence of the postpersons. I argue that in spite of the many limitations and shortcomings of Agar’s account, there are no conclusive reasons to rule out the possibility of moral status enhancement. However, if post-persons are as they are described by Agar, the fact of their possibility is less interesting and ethically relevant than it might seem. Most importantly, the account of post-persons given by Agar is rather an outcome of some implausible assumptions. I propose that Agar conflates the ethical with the scientific and dismisses the importance of phenomenology in framing our ethical outlook. Also, he seems to follow the assumption made by many utilitarian ethicists that such features as sentience and cognitive capacities have some universal relevance. This accounts for the delusion that we can view our moral attitudes from the point of view of the Universe

Minds, brains, and hearts : an empirical study on pluralism concerning death determination

Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of MedicineSeveral authors in bioethics literature have expressed the view that a whole brain conception of death is philosophically indefensible. If they are right, what are the alternatives? Some authors have suggested that we should go back to the old cardiopulmonary criterion of death and abandon the so-called Dead Donor Rule. Others argue for a pluralist solution. For example, Robert Veatch has defended a view that competent persons should be free to decide which criterion of death should be used to determine their death. However, there is very little data on people's preferences about death determination criteria. We conducted online vignette-based survey with Latvian participants (N = 1416). The data suggest that the pluralist solution fits best with the way our study participants think about death determination-widely differing preferences concerning death determination criteria were observed. Namely, most participants choose one of the three criteria discussed in the literature: whole brain, higher brain, and cardiopulmonary. Interestingly, our data also indicate that study participants tend to prefer less restrictive criteria for determination of their own deaths than for determination of deaths of their closest relatives. Finally, the preferences observed in our sample are largely in accord with the Dead Donor Rule for organ procurement for transplantation.publishersversionPeer reviewe

In defense of a pluralistic policy on the determination of death

Publisher Copyright: © 2018 E-flow Walter de Gruyter. All rights reserved.In his paper “The challenge of brain death for the sanctity of life ethic”, Peter Singer advocates two options for dealing with death criteria in a way that is compatible with efficient organ transplantation policy. He suggests that we should either (a) redefine death as cortical death or (b) go back to the old cardiopulmonary criterion and scrap the Dead Donor Rule. We welcome Singer’s line of argument but raise some concerns about the practicability of the two alternatives advocated by him. We propose adding a third alternative that also – as the two previous alternatives – preserves and extends the possibility of organ transplantation without using anyone without their consent. Namely, we would like to draw readers’ attention to a proposal by Robert Veatch, formulated 42 years ago in his 1976 book “Death, dying, and the biological revolution” and developed further in his later publications. Veatch argues for a conscience clause for the definition of death that would permit people to pick from a reasonable range of definitional options. This autonomy-based option, we believe, is more likely to be practicable than the two options advocated by Singer. Furthermore, we present data from a study with Lithuanian participants that suggest that there is quite pronounced variation of preferences concerning death determination.publishersversionPeer reviewe

Ethical and social issues in prediction of risk of severe mental illness:a scoping review and thematic analysis

Background Over the last decade, there has been considerable development in precision psychiatry, especially in the development of novel prediction tools that can be used for early prediction of the risk of developing a severe mental disorder such as schizophrenia, depression, bipolar disorder. Although the clinical efficiency of those tools is still unclear it is crucial to consider the future ethical and social consequences of their clinical use before they are used in clinical practice. The literature on this issue is rapidly growing and represents input from scholars from different fields-psychiatrists, bioethicists etc. However, to our knowledge, nobody has produced a review addressing these issues. Therefore, the present study aims to bridge the gap.Methods We conducted a scoping review, allowing integration of both empirical and non-empirical studies. The research question addressed is: what are the ethical and social issues raised by the potential use of predictive tools for the risk of developing of severe mental disorder identified in the existing empirical and theoretical literature? After developing the search terms, we conducted a search in three electronic databases: Scopus, Web of Science and PubMed. For the included articles bibliometric analysis and inductive thematic coding was performed. To ensure the transparency and rigour of this scoping review we followed he Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A qualitative inductive thematic analysis of the included articles was performed using Atlas.ti.Results After screening, evaluation for eligibility and citation tracing 129 publications were included in the scoping review. The articles represent a wide range of fields of research-clinical psychology, general medicine, neuroscience, genetics, clinical genetics, psychiatry and mental health, philosophy, ethics, etc. The majority of the articles (83) are theoretical studies, 35 papers report results of empirical research and 11 are review papers. Qualitative thematic analysis of the included articles revealed four main themes: 1) Potential benefits and harms; 2) Rights and responsibilities; 3) Counselling, education and communication; 4) Ethical issues in different applications.Conclusions The articles included in the review cover a wide variety of concerns that might be raised when implementing predictive tools for the risk of developing of severe mental disorder. However, some important gaps in the literature are indicated. First, there are issues that should deserve more attention than they have received thus far (clinical utility, extensive or mandatory use). In several cases there is no empirical knowledge that determines whether particular concerns are justified (stigmatisation, use of machine learning algorithms)

The Sex Doula Programme

The Welfare-Funded Sex Doula Programme is a proposed sexual needs service that advances the sexual citizenship of disabled people by providing specially trained ‘sex doulas’ to meet the various, often complex, sexual needs of disabled people. Conceived as providing disabled individuals with practical sexual support services, the role of the sex doula includes advocacy, counselling, therapy, and practical relief from sexual tension. The programme constitutes a robust, comprehensive, and theoretically cohesive welfare service that seeks to provision access to sexual citizenship for disabled people. Grounded in Aristotelian concepts of flourishing, the programme identifies sexual citizenship as a fundamental basic need and seeks to ensure that disabled people have the opportunity to achieve the same level of sexuality as able-bodied people. Work advancing the programme includes both philosophical and theoretical arguments showing how the programme is justified under several moral frameworks, and claims made therein have resulted in velitation in the literature regarding the potential of such a programme to violate individuals’ negative rights

Truth-telling and the Asymmetry of the Attitude to Truth-telling to Dying Patients in Latvia

This article deals with concerns related to truth-telling in interaction between the doctor and the dying patient, exploring such issues as conflicting duties of veracity and non-maleficence, truthfulness and deception, and reasons behind physicians' decisions either to withhold or to disclose information about patients' diagnoses and prognoses. It focuses on various attitudes to truth-telling to dying patients, such as symmetry and asymmetry, both of which can be positive and negative. The empirical part of the article reports on the methods and results of the qualitative study carried out in Latvia during the summer of 2012. This study was based on the assessment of three case scenarios from the quantitative instrument designed by Dalla-Vorgia et al. in 1992. By means of semi-structured and focus-group interviews, evidence was gathered about physicians' and medical students' attitudes towards truth-telling, which allows the drawing of conclusions about the presence of asymmetry and symmetry in both cases. Additionally, an insight about the standards used for making decisions in case scenarios was gained and the origins of these standards were explored, revealing the aftermath of a gradual evolution from the ethics of the Soviet era to modern standards of medical ethics

Morphological Variants of Ameloblastoma and Their Mimickers

Ameloblastoma is the second most common intraosseous benign odontogenic tumor.  This tumor exhibits a locally aggressive behavior.  A number of morphological variants of ameloblastoma have been documented in the literature and at times, may pose a diagnostic challenge to the pathologist. The purpose of this paper is to discuss the spectrum of histopathological variants of ameloblastoma. Recognition of the subtypes of ameloblastoma is important, as it has been documented that some subtypes may exhibit a more aggressive biological behavior than the so-called “conventional” ameloblastoma. 

Coordination and expertise foster legal textualism

Funding Information: ACKNOWLEDGMENTS. This research was supported by the Spanish Ministry of Science and Innovation (PID2020-119791RA-I00; RTI2018-098882-B-I00), the Polish National Science Centre (2020/36/C/HS5/00111; 2017/25/N/HS5/00944), the Swiss National Science Foundation (PZ00P1_179912), and the European Research Council (805498). Publisher Copyright: Copyright © 2022 the Author(s).A cross-cultural survey experiment revealed a dominant tendency to rely on a rule’s letter over its spirit when deciding which behaviors violate the rule. This tendency varied markedly across (k = 15) countries, owing to variation in the impact of moral appraisals on judgments of rule violation. Compared with laypeople, legal experts were more inclined to disregard their moral evaluations of the acts altogether and consequently exhibited stronger textualist tendencies. Finally, we evaluated a plausible mechanism for the emergence of textualism: in a two-player coordination game, incentives to coordinate in the absence of communication reinforced participants’ adherence to rules’ literal meaning. Together, these studies (total n = 5,794) help clarify the origins and allure of textualism, especially in the law. Within heterogeneous communities in which members diverge in their moral appraisals involving a rule’s purpose, the rule’s literal meaning provides a clear focal point—an identifiable point of agreement enabling coordinated interpretation among citizens, lawmakers, and judges.Peer reviewe

Natural Competence Is a Major Mechanism for Horizontal DNA Transfer in the Oral Pathogen Porphyromonas gingivalis

Porphyromonas gingivalis is a Gram-negative anaerobe that resides exclusively in the human oral cavity. Long-term colonization by P. gingivalis requires the bacteria to evade host immune responses while adapting to the changing host physiology and alterations in the composition of the oral microflora. The genetic diversity of P. gingivalis appears to reflect the variability of its habitat; however, little is known about the molecular mechanisms generating this diversity. Previously, our research group established that chromosomal DNA transfer occurs between P. gingivalis strains. In this study, we examine the role of putative DNA transfer genes in conjugation and transformation and demonstrate that natural competence mediated by comF is the dominant form of chromosomal DNA transfer, with transfer by a conjugation-like mechanism playing a minor role. Our results reveal that natural competence mechanisms are present in multiple strains of P. gingivalis, and DNA uptake is not sensitive to DNA source or modification status. Furthermore, extracellular DNA was observed for the first time in P. gingivalis biofilms and is predicted to be the major DNA source for horizontal transfer and allelic exchange between strains. We propose that exchange of DNA in plaque biofilms by a transformation-like process is of major ecological importance in the survival and persistence of P. gingivalis in the challenging oral environment