Life-extension: a biomedical goal? Scientific prospects, ethical concerns

The potential for development of biomedical technologies capable of extending the human lifespan raises at least two kinds of question that it is important both to distinguish and to connect with one another: scientific, factual questions regarding the feasibility of life extension interventions; and questions concerning the ethical issues related to the extension of life- and healthspans. This paper provides an account of some life extension interventions considered to be amongst the most promising, and presents the ethical questions raised by the prospect of their pursuit. It is suggested that problems concerning the effects of these technologies on health care resources and on intergenerational relationships will be the most difficult to tackle

What "best practice" could be in Palliative Care: an analysis of statements on practice and ethics expressed by the main Health Organizations

<p>Abstract</p> <p>Background</p> <p>In palliative care it would be necessary to refer to a model. Nevertheless it seems that there are no official statements which state and describe that model. We carried out an analysis of the statements on practice and ethics of palliative care expressed by the main health organizations to show which dimensions of end-of-life care are taken into consideration.</p> <p>Methods</p> <p>The official documents by the most representative health organisations committed to the definition of policies and guidelines for palliative and end-of-life care had been considered. The documents were analysed through a framework of the components of end-of-life care derived from literature, which was composed of 4 main "areas" and of 12 "sub-areas".</p> <p>Results</p> <p>Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States). Up to 56 documents were selected and analysed. Most of them (38) are position statements. Relevant quotations from the documents were presented by "areas" and "sub-areas". In general, the "sub-areas" of symptoms control as well as those referring to relational and social issues are more widely covered by the documents than the "sub-areas" related to "preparation" and to "existential condition". Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance.</p> <p>Conclusions</p> <p>An integrated model of the best palliative care practice is generally lacking in the documents. It might be argued that the lack of a fixed and coherent model is due to the relevance of unavoidable context issues in palliative care, such as specific cultural settings, patient-centred variables, and family specificity. The implication is that palliative care staff have continuously to adapt their model of caring to the specific needs and values of each patient, more than applying a fixed, although maybe comprehensive, care model.</p

Libertà e medicina. Il principio di autonomia nell'etica biomedica

In recent decades, respect for patient autonomy has progressively established itself as a reference principle in biomedical ethics. At the same time, there has been a proliferation of different interpretations and definitions of this concept, which have led to ideological clashes even violent, as in recent cases of euthanasia, the focus of media attention. In the face of such a rich and diversified debate, this study proposes a reconstruction of the genesis of the notion of autonomy in biomedical ethics and a significant reinterpretation of this concept through the critical analysis of different philosophical models. The volume concludes with an examination of decisions regarding people with reduced or evanescent autonomy, with the aim of showing how the dilemma of such decisions can be deciphered starting from a conception of autonomy as a "relationship of authority"