Medicine and Ethics

A new world has probably emerged through the progression of technology which has led to significant debates on social, cultural, legal, and ethical issues, especially in the biomedical field in this century. Application of physician-patient relationship, principles of pluralism, autonomy, democracy, human dignity, and human rights is being challenged within the medicine and health-care system of today. Development of technology-based remedies has fostered greater degrees of medicalization. Hence, the automatic application of such technologies risks distorting the nature of medicine. To be sure, there is a cultural shift that is affecting the society that is increasingly unable to adapt to traditional legal systems. This cultural shift, perhaps, demands new ethics. This entry aims to evaluate the gap between traditional deontological nature of medicine and the emerging new ethics and assess why bioethical reflection is needed

Measuring Care and Justice Moral Orientation: Italian validation and revision of the MMO-2 scale

This study presents the Italian adaptation of the Measure of Moral Orientation Second Revision (MMO-2). Based on Carol Gilligan’s theory of the Ethics of Care, the MMO-2 was designed to measure two complementary moral stances, namely Care and Justice. For this study, questionnaire responses from 683 university students were assessed against an Italian-adapted MMO-2 scale. Data were analysed through Exploratory Structural Equation Modelling first as separate scenarios and then as a single model. The final model comprises four intercorrelated pairs of latent variables and shows highly satisfactory goodness of fit indices with moderate construct validity and reliability. Strengths, limitations, and directions for the future developments of the MMO-2 will be discussed

La questione animale: il caso della sperimentazione tra razionale scientifico e dibattito etico-pubblico

A ogni livello della nostra cultura la \u201cquestione animale\u201d \ue8 diventata oggetto di una crescente attenzione. Di fatto, tale attenzione sta promuovendo un processo di dilatazione dei \u201cconfini morali\u201d, destinato non solo a mettere in questione un\u2019attitudine meramente strumentale nei confronti della vita animale, ma anche a incidere sulla visione della soggettivit\ue0 umana. Si deve riconoscere tuttavia che, proprio perch\ue9 va a toccare nervi particolarmente sensibili della nostra cultura, questo processo continua a essere attraversato da resistenze e forzature. Una visione condivisa di un nuovo rapporto tra vita umana e vita animale \ue8 tutta da costruire. Avendo di fronte questo scenario, il capitolo si propone di istruire i termini della \u201cquestione animale\u201d, concentrandosi su una pratica particolarmente significativa, la sperimentazione animale, attraverso una stretta interazione di competenze scientifiche, etico-filosofiche e biogiuridiche. Punto di partenza della riflessione \ue8 una sintetica ricognizione delle attitudini che la cultura occidentale ha espresso in relazione al rapporto tra vita umana e vita animale, accompagnata da un\u2019analisi critica delle posizioni pi\uf9 dibattute dell\u2019animalismo contemporaneo

End-of-life decisions in pediatric intensive care. Recommendations of the Italian Society of Neonatal and Pediatric Anesthesia and Intensive Care (SARNePI)

End-of-life decisions represent one of the most complex and challenging issues in pediatric intensive care. These recommendations aim to offer Italian pediatric intensive care unit (PICU) teams a framework for the end-of-life decision-making process. The paper proposes a process based on the principle that the use of a diagnostic or therapeutic tool must comply with a \u2018criterion of proportionality\u2019. Appropriately informed parents, as natural interpreters and advocates of the best interests of their child, can contribute in assessing the burdensomeness of the treatment and determining its proportionality. The decision to limit, withdraw or withhold life-sustaining treatments considered disproportionate represents a clinically and ethically correct choice. This decision should be made (a) collectively by PICU team and the other caregivers, (b) with the explicit involvement of parents, and (c) noting in the patient's clinical record the decisions taken and the reasons behind them. The withdrawing or withholding of life support can never entail the abandonment of the patient nor the withdrawal of any therapy aimed at treating any form of suffering. No action aimed at deliberately hastening the death of the patient is ever acceptable. These recommendations advocate a decision as far as possible shared by patient (whenever feasible), parents and caregivers. Ensuring that all involved are kept fully informed and that there is open and timely communication between them is the key to achieving this. It is the physician in charge of the patient's care and the head of the unit who bear the main responsibility for the final decision