Challenges of Bioethics Education in Pediatric Basic Nursing Education: A Faculty Perspective

In the field of pediatric nursing, in the perinatal period, numerous ethical issues arise alongside the advancement of medical technology. However, sufficient education on bioethics is not provided in the pediatric nursing domain of basic nursing education. The purpose of this research is to examine the current status of bioethics education in the pediatric nursing domain of basic nursing education and explore the challenges perceived by the pediatric nursing faculty regarding bioethics education. The research method was a questionnaire survey on 100 randomly selected pediatric nursing faculty members from nursing universities across Japan. The results revealed that although bioethics issues were considered important, the emphasis remained primarily on addressing bioethics as part of nursing that respects children’s rights. Furthermore, respondents expressed difficulties regarding teaching methods and content related to bioethics.

Healthcare bioethics: a new proposal of ethics for clinical practice

The expression“patient revolution”is the social,educational,cultural,and political movement initiated at the end of the twentieth century and beginning of the twenty-first century,which sustains the protagonism of the patients in their care as the primary decision maker and holder of human rights.The patient revolution comprises varied approaches and references,such as Patient-Centered Care,Shared Decision-Making,Patient Participation,and Patients’Rights,which combine to uphold that the patient is a moral agent and anchor healthcare in the biopsychosocial model.In this sense,this movement is a new proposal of ethics for clinical practice.This theoretical research primary goal is to develop theoretical contributions that support this new Bioethics dimension,emphasizing the context in healthcare that calls for new ethics in clinical practice,characterized as a patient revolution movement.We concluded that the patient revolution had driven a new paradigm in healthcare based on Patient-Centricity,SDM,and Patients’Rights.Despite this critical change in the health sphere,the patient revolution appears to have reverberated in clinical bioethics.Thus,theoretical contributions must be developed for new ethics in the clinic,a task undertaken in this article through the proposal of Healthcare Bioethics as an adequate frame of reference to be adopted at all levels of clinical care.Thus,it is concluded that having Bioethics Healthcare as a beacon of ethics in clinical encounters can contribute to the quality of care and its ethical provision,confronting practices that violate Patients’Rights.It is imperative to change paternalistic theoretical frameworks that mitigate the Patients’Right to participate in every decision regarding their health.Only with the adoption of new approaches and an insight into the patient’s role in clinical interaction can a new culture in Patient-Centered healthcare take shape.

Exploring the Management of Stem Cell Research Based on Bioethics

Stem cell research has brought hope to mankind to overcome various diseases,but ethical issues arise in stem cell research,and people have doubts about how to develop stem cell research healthily and whether it can bring the gospel to mankind.Management of stem cell research based on bioethics is extremely necessary.From the perspective of bioethics,the number of research literature is used to analyze the development of stem cell research and the management of stem cell research in China,to provide suggestions for further strengthening the management of stem cell research.

当代中国生命伦理学研究的缺陷及其历史使命

目前,中国生命伦理学对东西方道德文化传统资源存在着双重的误读,在引进和应用西方理论资源时,没有注意到它们与西方历史文化传统和社会生活背景的复杂关系,轻率地建构评价和指导体系并以此来影响政策制定和科学实践;而中国传统伦理观念已经变成了箴言式的、支离破碎的道德训条,被随意整合进当代生命伦理学规范体系之中,没有机会与外来的生命伦理信条进行真正的对话和交流。这种隔阂的状态必然导致伦理认知和道德实践两个方面的错乱状态。

Grounded theory qualitative approach from Foucault's ethical perspective:Deconstruction of patient self-determination in the clinical setting

This paper aims to explain the construction of the autonomous subject from Foucault's ethical perspective for the qualitative analysis of interprofessional relationships,patient-professional relationships,and moral ethics critique.Foucault tried to break loose from the self,which is merely the result of a biopol-itical subjectivation and constituted an interpersonal level.From this,different elements involved in the decision-making capacity of patients in a clinical setting were analysed.Firstly,the context in which decision-making occurs has been explained,distinguishing between traditional practices involved in self-care and the more modern conceptions that make certain possible transformations.Secondly,an attempt is made to explain the formation of the medicalisation of society using the transformations of what Foucault called"techniques of the self".Finally,the ethical framework for a subject's"self-creation",insisting more on the exercises of self-subjectivation,reinforcing the ethics of the self by itself,the"care of the self",has been explained.The role of the patient is understood as an autonomous subject to the extent that the clinical institution and the professionals involved comprehend how the patient’s autonomy in the clinical environment is constituted.All these elements could generate grounded theory on the qualitative methodology of this phenomenon.The current ethical model based on universal principles is not useful to provide a capacity for patients decision-making,relegating to the background their opinions and beliefs.Consequently,a new ethical perspective emerges that aims to return the patient to the fundamental axis of attention.

Zika Virus Controversies: Epidemics as a Legacy of Mega Events?

The current knowledge of the Zika Virus epidemic clearly lacks a comprehensive understanding of its determinants and clinical outcomes. Until recently regarded as a “simple” dengue-like infection, it nowadays turned into a real challenge to Public Health around the world. The Zika Epidemic shows a quick spread, affects unprepared health systems, and presents with severe neurological complications of newborns—a concrete threat to pregnancies. This re-emerging infectious disease is a source of deep doubts and harsh debates regarding Public Health and even bioethical issues. Several doubts still remain on how to deal with the various possible transmission ways of the disease, the surge of a generation of thousands of microcephalic newborns (and questions on how to handle them within limited health systems), and severe malformations concentrated so far in Northeastern Brazil. Finally, a debate is raised about how the “Endemic State” of Brazil, deeply merged in a health care crisis for almost 40 years now, currently confronts 3 current epidemics of the arboviruses Dengue, Chikungunya and now Zika, all associated with a lack of basic sanitation. Brazil must deal with these biological threats in the context of the Rio 2016 Olympic Games, since Chikungunya has probably been brought to Brazil during the FIFA Soccer World Cup (2014) and Zika Virus spread is associated with the Soccer Confederations Cup (2013).

Should we use full analgesic dose of opioids for organ procurement in brainstem dead?

Families facing the growing demand for organ removal from their loved ones are questioning the possible suffering of the brainstem dead patient.A frequent question they ask to coordinating doctors is:Are you sure he will not feel anything?Currently due to the risk of exacerbation of spinal reflexes and abnormal movements following surgical stimuli,it is recommended to use a curarization and an analgesic agent(most often morphine).The doses of opioids are less important than during usual anaesthesia,whereas the person is considered brainstem dead and there is no longer any cerebral integration of the pain.But what assures us that absolutely no more sensibility exists at this precise moment?Should the use of full analgesic dose of opioids not be continued anyway?Could this make the levies more"ethical"?

What Is the Preferable Idea of Justice in Healthcare?

When we talk about“health”,we can understand very different meanings,if we refer to the Italian context,rather than the American one.In Italy,health is a fundamental right,and the healthcare system is a model for making this right concrete.In this paper,we will discuss how the American healthcare system is very different from a philosophical and bioethical point of view.We will try to figure out what reasons can be adduced to argue that“health”is a right and not a commodity like others on the market.This paper focuses on philosophical and bioethical issues related to health and healthcare,analyzed in both the Italian and American contexts.Emphasis will be given,using bioethical and legal arguments,to both concepts of health as a right and a good,taking into consideration the current economic and social crisis.In particular,the paper analyzes the theoretical models adopted by the two aforementioned countries and highlights fundamental differences between them.Analysis of the best and most fair allocation of resources leads to a proposal for new definitions for“resource”and preferable idea of justice for healthcare.

Innovation for rare diseases and bioethical concerns: A thin thread between medical progress and suffering

@Alberto Tommasini@Andrea Magnolato@Irene

The Dying Process across Human Life Cycle: Ethical Considerations on Terminal Care

Dying is an event that affects human development throughout the life cycle—impacting individuals, communities, and society. Providing terminal care may mitigate the suffering of patients and families. Notwithstanding, it poses challenges concerning patients’ decision-making and autonomy, in regard to communicating bad news, resuscitation orders, and voluntary termination of life. This study seeks to discuss ethical issues underlying terminal care, showing how the problem of patients’ decision-making and autonomy can be addressed at the end of life. It distinguishes the notion of worthy death, which could ground ethical decisions for health attention across different developmental stages.

Philosophy of Gerontology from the Past to the Future in Japan

Gerontology is not only an interdisciplinary and intra disciplinary study,but also an international and inter-professional study.Gerontology is a study to create awareness on the concept among people,throughout the world.The philosophy of Gerontology is a lively active philosophy to explore the nature of humanity itself and to practice learning.Moreover,Gerontology is considered as a science as well as human philosophy.This paper introduces philosophy of Gerontology in Japan from the past to the present.It explains that Zen has fundamental philosophy of Gerontology.

Purpose, Composition and Function of the Research Ethical Committee in the Sarah Rehabilitation’s Hospital

Introduction: The Research Ethical Committee (REC) is responsible for the ethical evaluation of the projects presented by the scientific community to inform and train the members and researchers. Objective: To describe the purpose, composition and function of the REC of the Association of Social Pioneers (APS) located in the Sarah Rehabilitation’s Hospital (Brasilia, Brazil). Methodology: Descriptive analysis of the REC/APS based on 2013’s collected data was done. Results: The REC/APS is an independent collegiate body, which was established in 1998 in accordance with Brazilian regulation. The main objective is promoting the application of ethical principles and human rights in research involving humans. The REC was composed by chairperson and a substitute;secretary, fourteen regular members and five substitutes. We analyzed 164 projects submitted. The minimum time to a committee member who came up with the first opinion has been estimated as 14 days and the insurance of the consolidation occurred in 30 days. We approved 64 projects, of which 25 had pendencies in the first analysis, one project failed and 99 were excluded. The main problems were related to the writing of informed consent and the multicenter projects that did not include aspects such as costs, schedule and methodological limitations. We observed that the researcher could provide assistance. We considered the important role of the REC/APS to ensure trust between researchers and participants in the research. Conclusion: Despite the purpose, composition and function of the APS research ethical committee, there were encountered many obstacles in its formation, considering monitoring the progress of the research, national normative, international researches and others. The ethical committee does a vital public service with the variety of the specialized views on the meeting. We need to strike a balance and we must weigh up risks and benefits related to knowledge, in its essence, to research’s participant and its relevant social participation.

Bioethical Questions in Brazilian Scientific Research

It is considered here that the ethical behavior of the Brazilian scientific community leaves a lot to be desired. Motives for ethical lapses can be summed up by one only: the haste to grow at any price in order to earn prestige and wealth, setting at naught those who don’t have the political support of the institution. With this intent, many researchers publish whatever they can, neglecting the fact that scientific research should serve the interests of the community—not their own.

An Instrument for Perceiving Ethical Problems in Primary Healthcare: Psychometric Parameters and Ethical Components

Ethical issues in primary (health) care (PC) are common and are confronted daily. In the scarce literature that was available, Zoboli and Silva developed an instrument (IPE-APS) for perceiving ethical conflicts. Two empirical ex post facto studies to gather psychometric evidence for the instrument were outlined. In the first study, 88 nurses and physicians from Brazil’s Family Health (Saúde da Família—SF) responded to the IPE-APS, and the results confirmed its validity and accuracy. In total, 14 items were grouped in Factor I (relationship/responsibility), which was described as having human rights and deontological nature (Cronbach’s alpha = 0.92), and 11 items were grouped in Factor II, which was described as having a labor structure nature (Cronbach’s alpha = 0.90). In the second study, 207 SF professionals in Goiania, Goiás responded to the IPE-APS. The results showed that Factor I had a high factorial congruence index (0.98), which revealed high similarity and showed that the instrument displayed practical validity to identify and assess ethical problem perception in PC.

Alienation and Existential Predicaments of Clones:Interpreting Never Let Me Go in the Context of Posthumanism

The literary background of Kazuo Ishiguro’s novel Never Let Me Go sets in a highly developed scientific and technological world where clones are created by human and“educated”in the Hailsham School for the sake of“donating”their vital organs to human three or four times before death.By depicting miserable fate of clones,the novel conveys deep concerns on the consequences of abusing technology in modern society.Ever since the burgeoning development of life science and artificial intelligence in the 1990s,the trend of posthumanism/transhumanism has emerged.Posthumanism promotes approaches to enhancing human body condition and organism,and extending human lifespan to augment human capacity and well-being by the advancement of technology.In literary field,contemplation on the relationship between human beings and technology has become a major concern of posthumanism.Putting Never Let Me Go in the context of posthumanism,this essay probes into the significant themes of the novel from three aspects:(1)clones’torments in the existential predicaments imposed by human;(2)human’s violation to the principles of bioethics causing the existential predicaments of alienated clones;(3)appealing to human to ruminate on the relationship between scientific technology and ethics.