Neuroscientific deconstruction of the ideologised »hopelessness« of the vegetative state

Recent neuroscientific research challenges today's prejudice of a vegetative state as a «hopeless» state. The results from these findings not only destroy the actual existing prejudices about people in a vegetative state, but they also provide a new insight into the epistemological problematics of the accurate diagnostic process of the actual state, followed up with ethical and social implications. They also provide a better understanding of the mere nature of consciousness and awareness, implying the moral and social responsibility towards these people, and at the same time leaving no place for «hopelessness». Therefore, the primary aim of this article is to demonstrate how, with the development of these new insights into the state of disorders of consciousness, side by side, from the mere beginning has been developing prejudice of «hopelessness», as a side-effect of insufficient and inadequate knowledge related to the nature of consciousness in the vegetative state. This conformity prejudice has had direct influence on clinical decision-making regarding artificial life-sustaining measures: from hydration and nutrition withdrawal, to do not resuscitate orders, and finally to ventilator withdrawal, retaining that the person has no hope for recovery after the determination of the vegetative state diagnosis. Furthermore, this prejudice of «hopelessness» has not only deeply paved the morally doubtful way for performing passive euthanasia, but was, even more, misused and politicised as one of the main arguments and examples of the pro-euthanasia movements in the fight for euthanasia legalisation

JOSEPH FRANZ DOMIN (1754-1819) AND HIS CONTRIBUTION TO ELECTROTHERAPY

Joseph Franz Domin (1754-1819) as the croatian theologian and philosopher is primary animist (vitalist), and in practice he has worked as physicist - mechanist, although the humoral theory at that time will be a foundation of medical philosophy more than twenty centuries from Hippocrates to the half of 19th century and Virchow’s cellular theory. Besides his academic and researcher’s work he has been working on electrotherapy of numerous conditions and diseases about which he has published (cephalea, neuralgia, paresis, plegias, pterigyum oculi, rheumatisms, Gicht, epilepsia, arthralgias, febres etc). The latter is undoubtedly progressive natural scientific theory which at that time have widely spread at Habsburgs Monarchy Universities and as proof between first and second Wien’s medical school by integration of other scientific branches (physics and chemistry) in medicine. According to the various researchers Domin was an author of the first electrotherapy manual published in Zagreb, practitioner of electrotherapy in pregalvanic era in contemporary Austrian empire and for sure a scientist who have left a significant remark in contemporary applied physics in medicine, which continued in professional and scientific elaborations not until the end of the 19th century

Moral injury in healthcare professionals: A scoping review and discussion

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration

Why teach “Bioethics and Human Rights” to healthcare professions undergraduates?

This article highlights the importance of teaching “bioethics and human rights” to undergraduate students seeking health care degrees and illustrates how this topic fits well within these programs of studies. Historical, cultural, anthropological and practical reasons support teaching these topics as enrichment of medical training. The years after the Second World War showed how bioethics, human rights and medicine are closely intertwined. Moreover the relationship between human rights and bioethics has grown ever closer increasingly involving medicine and health care professionals. The authors observe that medical students have to face a cultural pluralism in bioethics and biolaw and we give students the opportunity to develop their critical thinking and logical argumentation abilities as well as their interest in academic research. Furthermore, the authors – who draw up briefly the experience of the Institute of Bioethics at the Faculty of Medicine and Surgery of the UCSC (Rome) - assert the necessity to help medical students to be respectful of patients in every clinical setting. It is therefore of utmost importance to train students to focus on the ethical dimension of care and to make good ethical decisions even in dilemmatic cases. To achieve this outcome, healthcare professionals should possess an integral vision of their work (technical and humanistic competence) and sharp skills to reflect in depth, avoiding superficiality and negligence. From this perspective, the teaching of “bioethics and human rights” could be very useful

The challenges in human life extension between enhancement and agony

© 2020 Strossmayer University of Osijek, Catholic Faculty of Theology in Djakovo. All rights reserved. The main aim of this paper is to present two different forms of human life extension. On the one hand there is dysthanasia, i.e. therapeutic persistence in the provision of life-sustaining measures to terminally ill patients, and on the other hand, transhumanism as a philosophical viewpoint which in its core strives towards unlimited extension of human life with the fundamental desire to eliminate disease, ageing and death. By putting them in correlation with the healthcare practice, the paper points to implications in clinical practice and draws attention to ethical and anthropological issues in connection with life extension

State of the art on ethical, legal, and social issues linked to audio- and videobased AAL solutions

Working Group 1. Social responsibility: Ethical, legal, social, data protection and privacy issuesAbstract Ambient assisted living (AAL) technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between high-income countries (HIC) and low and middle-income countries (LMIC). Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things (IoT) devices and ones equipped with artificial intelligence (AI) quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private (e.g., the home). The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues (ELSI). A set of ELSI guidelines is needed to integrate these factors at the research and development stage. Keywords Ethical principles, Privacy, Assistive Living Technologies, Privacy by Design, General Data Protection Regulation.publishedVersio

State of the art on ethical, legal, and social issues linked to audio- and video-based AAL solutions - Uploaded on December 29, 2021

Ambient assisted living (AAL) technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap between high-income countries (HIC) and low and middle-income countries (LMIC). Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things (IoT) devices and ones equipped with artificial intelligence (AI) quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private (e.g., the home). The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues (ELSI). A set of ELSI guidelines is needed to integrate these factors at the research and development stage

Position paper on ethical, legal and social challenges linked to audio- and video-based AAL solutions

This publication is based upon work from COST Action GoodBrother – Network on Privacy-Aware Audio- and VideoBased Applications for Active and Assisted Living, supported by COST (European Cooperation in Science and Technology).In this position paper, we have used Alan Cooper’s persona technique to illustrate the utility of audio- and video-based AAL technologies. Therefore, two primary examples of potential audio- and video-based AAL users, Anna and Irakli, serve as reference points for describing salient ethical, legal and social challenges related to use of AAL. These challenges are presented on three levels: individual, societal, and regulatory. For each challenge, a set of policy recommendations is suggested.publishedVersio