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.

Methodology of the Relationship between Bioethics, Philosophy, and Law

One can distinguish three levels in the integrative unity of knowledge and norms （assessments）, which is termed bioethics. The first level is theoretical. It is connected with the facts and truths. The second level deals with establishing of certain standards and rules of conduct, with the monitoring of their implementation and the assessment of the results of implementation/violation of norms. The third level is associated with individual behavior, formed on the basis of relevant knowledge （or lack of it, as is evident from the table）, and the rules governing its application. Theoretical Bioethics is an integral part of Philosophy---the practical Bioethics is directly related to Law and applied Bioethics deals with the personal standards of specific behavior in concrete situations. Social need for regulatory control of any activity with living entities has led to rapid development of practical Bioethics, while its philosophical content developed more slowly. This creates a conflict of norms and values, hampering the adoption of individual decisions now in the field of applied Bioethics. Deontologization of Bioethics can lead to the fact that it will lose its philosophical content and become a specific area of Law. This, in turn, leads to the dehumanization of Bioethics. It is therefore necessary to conduct a methodological analysis of the relationship of Philosophy, Bioethics and Law, the results of which will focus the researchers on the synchronization of the axiological, praxeological and ethical components of scientific research in order to preserve the intellectual integrity of Bioethics.

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.

Xenotransplantation--reflections on the bioethics

Background:Similar to most countries in the world,China has a severe shortage of human organs,and this is one of the main issues restricting the application of organ transplantation technology.In 2019 alone,only 19,454(23.90%)of the 81,410 people waiting were able to receive organ transplants.There is an increasing focus from both the medical profession and society on how to fill the gap between supply and demand.Methods:Xenotransplantation using animal organs is being considered as one option to make up for the shortage of human organs for transplantation.For some years now,the international medical community has been examining the possibility of using animal organs for human transplant.However,the research has faced two important types of challenges:scientific and ethical issues.Results:In January 2021,the first clinical trial of transgenic pig heart transplantation into a human recipient was completed by the Medical Center of the University of Maryland in the United States.This has stimulated enthusiasm and interest in xenotransplantation.Conclusions:The trend towards xenotransplantation has highlighted global problems such as the severe shortage of organ transplant donors and the high cost of organ transplantation.China needs to consider how to cope with the scientific,public health,and social ethics challenges of xenotransplantation clinical trials.

Modern Bioethics and Human Rights

Ⅰ Since the late 1940s, the ethical studies aimed at safeguarding human dignity to life and health security in the fields of medical and life sciences have witnessed rapid development. The main domains in this regard include the studies of medical ethics, which involve ethical issues concerning the purposes, missions, subjects, technical means, doctor-patient relations in clinical treatments and making of public health policies centering around medical activities; and the studies of bioethics, which touch upon a variety of ethical issues cropping up along with the progress and intervention of bio technologies with regard to human life and its cycles, from human reproduction, medical care, human experiments till the end of the life. In addition, there are also studies of eco-

Human Dignity and Human Rights： A Universal Language for Bioethics

One of the aims of the Universal Declaration on B ioethics and Human Rights （UNESCO） is to ＂promote respect for human dignity and protect human rights＂,l Here are two overarching principles at work, ensuring that the biomedical sciences fulfill their task within an ethical framework. The principle of respect for human dignity is a universal moral concept, meant to be applied in human encounters. Protecting human rights underscores the legal principle of not only affirming the fundamental equality of all human beings, but equally safeguarding it. These two principles are universally defined, but are ordinarily specified by the particular value system of individual cultures in which they are employed. It is within such particular cultural application that their relevance stands out. The thrust of this paper is that, since principles are general action guides, they actually constitute a universal language for the analysis and evaluation of all human conduct. However, there is also recognition of the fact that moral contexts vary from culture to culture, and that while the scope of the two principles above is not restricted by any particular culture, it is indeed those cultural specifics of each moral context that constitute the framework within which the principles become operational. As general action guides, I will argue that these principles lack moral relevance outside of those particular cultural settings wherein they are contextualized. Without such relevance, these principles become meaningless mantras. I will further show that such principles do not merely uphold values informed by particular cultures, but they are an embodiment of values inherent to human nature in general. Consequently, these principles do not just serve as instruments for addressing issues peculiar to ＂Western bioethics＂ or any other particular cultural setting in an exclusive sense, but are also used for moderating bioethics discourse that transcend particular cultural boundaries. I will further explain that such universal discourse is potentially instructive with regards to how cultural universals are viewed in relation to the cultural particulars, and that this discourse essentially becomes a lingua franca for cross-cultural dialogue in bioethics.

Cross-Cultural Bioethics at an International University in Japan

Ritsumeikan Asia Pacific University （APU） in Beppu city, Japan has a large body of students from well over 90 countries, especially from the Asia Pacific region, including Japanese, Korean, Chinese, Thai, Vietnamese, and Indonesian students. To improve analytical thinking skills among college students, a course on ＂bioethics＂ was introduced and offered in two consecutive semesters to undergraduate students for which 245 students registered at each semester. The course was taught in the form of 14 lecture and discussion sessions, each for 95 minutes based on the content of A Cross-Cultural Introduction to Bioethics （2006） edited by Darryl Macer, and reviewed a wide variety of ethical and bioethical issues. In the next semester, the students received a similar teaching content that was rearranged to reflect the 15 universal principles of bioethics and human rights covered in the Bioethics Core Curriculum （2008）. Case studies were also added to each unit of the Core Curriculum with the support of the UNESCO＇s Asia Pacific Regional Office, Bangkok （Case Studies for Bioethics 2010）. To evaluate the results of teaching and to compare the achieved objectives between the two groups of students, a short questionnaire was given to all students who finished the course and took up the final written examination. In the whole, 454 students （225 in group I and 229 in group 2） completed the course and took the final examination and 427 （218 in group 1 and 209 in group 2） responded to the questionnaire which inquired into their interest in the discussion of bioethical issues： why they believed they were important, and what they had learned through them. The results of the questionnaire have been examined and compared to evaluate the success of ＂bioethics＂ in stimulating the interest and thinking ability of the students and enriching their experience of a cross-cultural discussion over bioethical issues using universal principles as general guidance. The result of this examination was so impressive that from 2011 bioethics has been formalized into the reformed curriculum of our international school.

Global Bioethical Prevention of the Collision of Biological and Cultural Evolution on Miserable Human Survival

With the cultural myth that science can only determine the way the world ＂is＂ （facts）, while humanities, social sciences, lawyers, philosophers, and theologians must determine the way the world ＂ought to be＂ （values）, those in position of global-, national-, and local-political power make major decisions of the use （or non-use） of scientific knowledge and technology. As a result, the human being has created a non-scientifically based cultural environment that is affecting his ability to survive. In effect, cultural evolution is occurring more rapidly than biological evolution that can adapt to the changes brought about in the physical and psycho-social environments. In a pluralistic cultural world, where each society has generated a different view of human nature and different ethical values, the use, misuse, or non-use of scientific and technological advances are derived from these unscientific views of human nature. Since all life depends on limiting interacting environmental and ecological factors, it is imperative that scientific information be used to govern how to minimize irreversible effects on life-sustaining ecological factors, but also scientific information bearing on understanding human nature ought to be integrated into a ＂global bioethics＂. While ethical values cannot be directly derived from scientific factors, it is also true that human values or our ＂ought＂ cannot be maintained in ignorance or defiance of the facts or the ＂is＂.

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.

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.

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

With the development of precision medicines based on small molecules,antibodies,RNAs and gene therapy,technological innovation is providing some exciting possibilities to treat the most severe genetic diseases.However,these treatments do not always lead to a cure for the disease,and there are several factors that may hinder their overall success.Patients living during a period of great medical change and innovation may benefit from these technological advances but may also just face failures,both in terms of frustrated hopes as well as suffering.In this article,we are telling the stories of three children with rare and severe disorders,who live in an age of significant medical changes,bearing the burden of difficult scientific and ethical choices.The first two cases that are suffering respectively from severe immunodeficiency and beta thalassemia have already been described in scientific journals,as well as in popular magazines.Although similar when considering the medical challenges,the two cases had opposite outcomes,which resulted in distinct ethical implications.The third case is a baby with spinal muscular atrophy,living at a time of continued innovation in the treatment of the disease.With these cases,we discuss the challenges of providing correct information and proper counseling to families and patients that are making the bumpy journey on the road of medical innovation.

儒家生命伦理融入老年护理学课程思政的实践效果

目的:探讨儒家生命伦理融入老年护理学课程思政的实践效果。方法:采取整群抽样法,以2018级312名(对照组)和2019级266名(试验组)本科护生为研究对象,对照组采用常规教学模式,试验组开展融入儒家生命伦理的老年护理学课程思政教学,课程结束后调查试验组护生对课程思政的内容和效果的感受,分析两组护生关怀能力、服务老年人意愿和考试成绩。结果:试验组266名护生中96.2%认为我国传统文化对医学生有可借鉴的智慧和思想,83.1%认为教学设计参与性和启发性较好,92.5%对课程评价总体满意。与老人共同生活的时间、家庭关系、对老龄化问题的关注程度会影响护生服务老年人意愿(P<0.05)。试验组护生关怀能力、服务老年人意愿、考试成绩均高于对照组(P<0.05)。结论:将儒家生命伦理融入老年护理学课程思政的教学设计有助于提升护生关怀能力和服务老年人意愿,促进其道德品质提升,更好地满足社会对老年护理人才的需求。

尊严能为生命伦理学奠基吗?——兼评程新宇《人的尊严与生命伦理》

针对尊严能否作为生命伦理学的基础的问题,有些学者基于尊严的相对性、可压倒性与可还原性,声称尊严是一个无用的概念,因此不能为生命伦理学奠基。实际上,概念的相对性并不能成为可将其视为无用的根据。尊严绝非无用的概念,恰恰相反,尊严成为生命伦理学基础具有不可逃避性。当然,承认了尊严的有用性也并不等于主张尊严是不可压倒、不可替代、至高无上的。换言之,尊严作为生命伦理学的基础具有非唯一性,它与其他价值一起在生命伦理学的相关讨论中发挥重要作用。

Challenges and Suggestions of Ethical Review on Clinical Research Involving Brain-Computer Interfaces

Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.

人脑替代模型研究的伦理和治理建议

[背景]人脑组织无疑是分析人脑发育和疾病机制的最佳资源,但人脑的研究长期面临样本获取困难及人类胚胎研究受限于“14天原则”的困境.近年来神经科学家们开发了新型人脑模型,为预防、治疗导致人类痛苦的神经系统疾病和精神疾病带来了希望.该领域迅猛发展的同时,也面临着自身固有的道德两难,即在摆脱“不像人脑”困难的同时,因逐渐“太像人脑”而陷入更危险的伦理困境,这也是影响神经科学发展的关键伦理难题之一.[进展]本文首先介绍了脑科学进展和5种人脑替代模型,即基因编辑非人动物、人-非人动物神经嵌合体、人脑类器官、鲜活离体脑组织和类脑人工智能.然后从生命伦理视角出发,系统论述了其所引发的道德地位、死亡判定、知情同意、隐私保护,以及人-非人动物神经嵌合体的福利和利益5个方面的伦理学问题.最后提出6条涉及人脑模型研究的伦理指导原则作为治理框架.[展望]坚持伦理先行风险前瞻,可扭转伦理作为科技活动之外的“旁观者”角色和侧重“事后”反思批判的范式,对推动我国伦理治理体系从被动应对型向主动预防型转变有重要意义,也为参与全球新兴科技伦理治理提供中国方案.

当代医疗的儒家伦理负载——回应评论者

为《当代医疗与儒家思想》一书作出的11篇精彩评论予以回应,这些评论均认识到以问题为导向的当代医学伦理学研究的重要性,以及它们同儒家伦理传统的思想和价值的密切相关性,同时指出当代儒家医学伦理学与现代西方伦理观点和价值难以若合符节。分析如何发展儒家美德理论来适当地解决这些问题,回答这些评论对于拙作提出的一些明确的批评意见,深入探讨如何继承儒家家风,在医疗保健领域延续和再兴儒家家庭主义伦理传统。最后,对于“儒家公共理性”与“儒家生命伦理观”的关系问题,作出初步反思,提出区域全球伦理学取代全球伦理学的构想。

当代儒家生命伦理学的建构和道德如何现实化

以传统文化系统地回应当前生命科技高速发展而涌现的生命伦理问题是相较于流行的原则主义更具实践性的策略,而其落实(即具体的生命伦理学的建构)则需要具体的建构框架,它至少应该包括在宇宙论、态度和方法、分析视角和规范特征等方面的创建性的原则。范瑞平在其新书《当代医疗与儒家思想》的第三部分利用儒家思想资源回应了生命科技带来的挑战,提供了具有建设性的建构框架,它包括了四个方面:其一,在“气一元论”的宇宙论基础上,以儒家身心合一的视角探讨生命伦理问题;其二,儒家重构主义的态度和方法;其三,儒家家庭本位的伦理立场;其四,提出儒家生命伦理学的原则和规则的特征是构成性的、客观的和具有权威性的。在商榷部分,提出片面的“生存性恐惧”是道德现实化的障碍,而当代社会的基本特征是对声势浩大的片面的生存性恐惧的制造。进而,如果无法解决“道德力量的来源”和“如何克服道德现实化的障碍”这两个问题,就无法缓解当代社会恶的泛滥,也无法真正应对生命科技的伦理挑战。

厄休拉·勒奎恩的道家生命伦理书写

美国当代著名科幻作家厄休拉·勒奎恩深受道家思想影响,其创作主旨是对生命本质的探讨。本文以《地海传奇》系列作品为研究对象,分析勒奎恩作品的道家生命伦理书写。研究认为,《地海传奇》关于地海诞生、生命成长和英雄回归的叙事,呈现了对道家生命本源论、生命存在观和生命境界观的借鉴和化用。