FACILITATE DELIBERATION. TOWARDS A PROFESSIONALIZATION OF THE BIOETHICAL EXPERT IN THE PUBLIC ARENA.

In an increasingly specialized world, where the production of knowledge and its acquisition have become a collective enterprise, nobody can master all the fields alone. This has led to the proliferation of a myriad of experts, each of whom is specialized in a precise domain or subdomain. Given this picture, it is not surprising that people with training in bioethics are often referred to as \u2018bioethics experts\u2019 and/or \u2018bioethical experts\u2019. However, far from being confined to a specific social dimension, in today\u2019s society bioethicists are a commonplace presence in an ever-increasing range of domains. In recognition of this phenomenon, the aim of this thesis is to explore the so-called issue of bioethical expertise. This means first and foremost exploring two main questions: whether an expertise in the field of bioethics might actually exist and what are, if any, the skills that the bioethical expert is endowed with, in order to understand whether this figure is on a par with professionals of other disciplines. After presenting a general review of the current literature on this issue and briefly indicating the different research paths this research topic might lead to, the focus will be narrowed to dwell on the main research questions this work aims to address: is there a legitimate role for the bioethical expert within the public arena, and, if so, what is this role? Far from being a straightforward question, this issue is further complicated by a vast literature decrying the threat posed by bioethicists with respect to the broader context in which they operate: liberal democracies. In taking these considerations seriously, this dissertation aims to \u2018solve the paradox\u2019 connected with the figure of bioethical expert and to propose a normative model of bioethical expert which aims to be compatible with the tenets of liberal democracies and, in particular, their public decision-making processes. This figure will be defined here as the facilitator of deliberation, thus recognizing the debt it has towards the political theories of deliberative democracy. This work is structured as follows: first of all the theoretical current debate concerning the topic of bioethical expertise is presented. Secondly, by narrowing the focus of investigation I concentrate on the domain in which the bioethical expert proposed here has to operate: public bioethics. The normative proposal of bioethical expert as facilitator of deliberation is then presented, remodelling the former in relation to the already existing figures occupying the public arena. Finally, the results of a preliminary experiment, designed to empirically explore this new figure, are presented and discussed. \u200

From virtual to real healing: a critical overview of the therapeutic use of virtual reality to cope with mourning

In recent years, virtual reality (VR) has been effectively employed in several settings, ranging from health care needs to leisure and gaming activities. A new application of virtual stimuli appeared in social media: in the documentary ‘I met you’ from the South-Korean Munhwa Broadcasting, a mother made the experience of interacting with the avatar of the seven-year-old daughter, who died four years before. We think that this new application of virtual stimuli should open a debate on its possible implications: it represents contents related to grief, a dramatic and yet natural experience, that can have deep psychological impacts on fragile subjects put in virtual environments. In the present work, possible side-effects, as well as hypothetical therapeutical application of VR for the treatment of mourning, are discussed

Second international diagnostic accuracy study for the serological detection of west nile virus infection.

Background: In recent decades, sporadic cases and outbreaks in humans of West Nile virus (WNV) infection have increased. Serological diagnosis of WNV infection can be performed by enzyme-linked immunosorbent assay (ELISA), immunoflu- orescence assay (IFA) neutralization test (NT) and by hemagglutination-inhibition assay. The aim of this study is to collect updated information regarding the performance accuracy of WNV serological diagnostics. Methodology/Principal findings: In 2011, the European Network for the Diagnostics of Imported Viral Diseases- Collaborative Laboratory Response Network (ENIVD-CLRN) organized the second external quality assurance (EQA) study for the serological diagnosis of WNV infection. A serum panel of 13 samples (included sera reactive against WNV, plus specificity and negative controls) was sent to 48 laboratories involved in WNV diagnostics. Forty-seven of 48 laboratories from 30 countries participated in the study. Eight laboratories achieved 100% of concurrent and correct results. The main obstacle in other laboratories to achieving similar performances was the cross-reactivity of antibodies amongst heterologous flaviviruses. No differences were observed in performances of in-house and commercial test used by the laboratories. IFA was significantly more specific compared to ELISA in detecting IgG antibodies. The overall analytical sensitivity and specificity of diagnostic tests for IgM detection were 50% and 95%, respectively. In comparison, the overall sensitivity and specificity of diagnostic tests for IgG detection were 86% and 69%, respectively. Conclusions/Significance: This EQA study demonstrates that there is still need to improve serological tests for WNV diagnosis. The low sensitivity of IgM detection suggests that there is a risk of overlooking WNV acute infections, whereas the low specificity for IgG detection demonstrates a high level of cross-reactivity with heterologous flaviviruse

Genome sequencing and molecular characterisation of Staphylococcus aureus ST772-MRSA-V, “Bengal Bay Clone”

Background: The PVL-positive ST772-MRSA-V is an emerging community-associated (CA-) MRSA clone that has been named Bengal Bay Clone since most patients have epidemiological connections to the Indian subcontinent. It is found increasingly common in other areas of the world. Methods: One isolate of ST772-MRSA-V was sequenced using the Illumina Genome Analyzer System. After initial assembling the multiple sequence contigs were analysed using different in-house annotation scripts. Results were compared to microarray hybridisation results of clinical isolates of ST772-MRSA-V, of related strains and to another ST772-MRSA-V genome sequence. Results: According to MLST e-burst analysis, ST772-MRSA-V belongs to Clonal Complex (CC)1, differing from ST1 only in one MLST allele (pta-22). However, there are several additional differences including agr alleles (group II rather than III), capsule type (5 rather than 8), the presence of the egc enterotoxin gene cluster and of the enterotoxin homologue ORF CM14 as well as the absence of the enterotoxin H gene seh. Enterotoxin genes sec and sel are present. ST772-MRSA-V harbours the genes encoding enterotoxin A (sea) and PVL (lukS/F-PV). Both are located on the same prophage. Conclusions: ST772-MRSA-V may have emerged from the same lineage as globally spread CC1 and CC5 strains. It has acquired a variety of virulence factors, and for a CA-MRSA strain it has an unusually high number of genes associated with antibiotic resistance

Hans Jonas e il principio responsabilita'

L'articolo si propone di analizzare le tappe filosofiche del pensiero di Hans Jonas, con particolare attenzione alla proposta etica contenuta in "Il principio responsabilita'"

Un’introduzione storico-metodologica

I risultati della ricerca biomedica stanno cambiando radicalmente il volto diagnostico e terapeutico della medicina, ma stanno anche aprendo nuove questioni etiche sulle quali il cittadino deve essere informato per poter partecipare in modo consapevole alle decisioni che lo riguardano. L'utilizzo di staminali embrionali umane, la sperimentazione su animali, le prospettive della biologia sintetica, l'istituzione di biobanche, gli studi clinici su soggetti umani, le nuove frontiere della ricerca e i rischi di una nuova eugenetica, la sperimentazione di terapie cellulari, ma anche gli aspetti pi\uf9 critici delle campagne di prevenzione e del prolungamento della durata della vita umana sono tutti temi che aprono la porta a interrogativi etici nuovi o che gettano una luce diversa su problemi che da sempre si pongono alla riflessione moral

Questioni etiche dei test genetici : tra privacy e diritto di non sapere

I risultati della ricerca biomedica stanno cambiando radicalmente il volto diagnostico e terapeutico della medicina, ma stanno anche aprendo nuove questioni etiche sulle quali il cittadino deve essere informato per poter partecipare in modo consapevole alle decisioni che lo riguardano. L'utilizzo di staminali embrionali umane, la sperimentazione su animali, le prospettive della biologia sintetica, l'istituzione di biobanche, gli studi clinici su soggetti umani, le nuove frontiere della ricerca e i rischi di una nuova eugenetica, la sperimentazione di terapie cellulari, ma anche gli aspetti pi\uf9 critici delle campagne di prevenzione e del prolungamento della durata della vita umana sono tutti temi che aprono la porta a interrogativi etici nuovi o che gettano una luce diversa su problemi che da sempre si pongono alla riflessione morale

Consulenza etica e decision-making clinico. Per comprendere e agire in epoca di medicina personalizzata

La pratica clinica è intessuta di situazioni controverse, dove non è facile stabilire ciò che potrebbe essere fatto a livello clinico, perché non è chiaro ciò che dovrebbe essere fatto in termini di scelte morali. Partendo da questo concetto, il volume illustra al lettore in 11 capitoli gli strumenti principali e i possibili campi applicativi della consulenza etica in medicina. Tra gli argomenti affrontati: le metodologie pensate per i pazienti e per i medici e le loro radici storico-filosofiche; la componente neurocognitiva della comunicazione medico-paziente; ruolo e peso delle emozioni nell’ambito della consulenza etica; comprensione e comunicazione delle informazioni probabilistiche nell’ambito della medicina personalizzata; questioni etiche legate all’utilizzo di test genetici