Browsing by Subject "bioethics"

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  • Ahola-Launonen, Johanna (Helsingfors universitet, 2012)
    This thesis is an analysis of the relationship between the concepts of chance, choice and responsibility in Michael Sandel’s 'The Case against Perfection' (2007). Sandel predicts that if genetic enhancements were introduced in the society, the social meaning of these concepts would change significantly and social solidarity would vanish. He argues that that if people were able to control their genome and the element of chance in the genetic lottery would be replaced with choice, individuals could be held responsible for their deficiencies. Thus, the societal motivation to share our wealth with the disadvantaged would be eroded. However, the philosophical premises in Sandel’s argument remain obscure. Therefore, a new means for the philosophical assessment of Sandel’s argument is introduced in my thesis. The method for the analysis is to examine the premises in Sandel’s argument by comparing it to responsibility-sensitive egalitarian theories and their critique. The central literature used in the analysis is Sandel’s 'Liberalism and the Limits of Justice' (1982) and 'Democracy’s Discontent: America in Search of a Public Philosophy' (1996). The examination of responsibility-sensitive egalitarianism is based on Ronald Dworkin’s article 'What is Equality? Part 2: Equality of Resources' (1981) and contrasted to John Rawls’ 'A Theory of Justice' (1971), and the critique of responsibility-sensitive egalitarianism is derived from Samuel Scheffler’s article 'What is Egalitarianism?' (2003). I suggest that Sandel’s argument is based on the principle of responsibility of the responsibility-sensitive egalitarian theories: unequal outcomes are just if they arise from factors for which individuals can properly be held responsible and are otherwise unjust. As Sandel’s argument entails this principle, the critique of the principle of responsibility can be applied to it. I conclude that due to extensive critique posed to the principle of responsibility, Sandel’s prediction about the changing notions of responsibility and solidarity is not as straightforward as he suggests. Furthermore, I propose that the principle of responsibility is not compatible with the general foundations of Sandel’s philosophy, which are the aspiration for cultivating a strong sense of community and social solidarity. The principle of responsibility does not foster social solidarity and, therefore, is not suitable for Sandel’s vision of a good society. This vision would be better achieved with a principle that guarantees a certain asset of basic needs to each person, regardless of the responsibility and control that people have in particular situations. It remains an open question why Sandel adopts in his argument the principle of responsibility that is contradictory to his general philosophy.
  • Buscariolli, André (Helsingfors universitet, 2017)
    Advance healthcare directives (AD) are written documents in which patients can express their preferences regarding the provision of specific medical treatments, providing future instructions in case they become unable to communicate and make the decisions for themselves. Whereas these documents are praised for promoting patient’s autonomy, recent research has shown that patients often fail to predict what kind of treatment they would like to receive. This leads to an apparent contradiction: on which grounds can patient’s autonomy be regarded as the positive feature of AD if patients themselves are not likely to anticipate future preferences? This thesis draws on different agency theories to further elaborate on this contradiction while exploring taken for granted assumptions about patient’s autonomy. Relying on the premises of symbolic interactionism and social constructionism, it argues that goals are construed during emerging social interactions, subjected thus to constant reevaluation and reinterpretation. Methodologically, I used Goffmanian frame analysis to analyze semi-structured interviews of six Finnish physicians, elaborating on how they frame end-of-life treatment discussions, how they constructed the agency of different actors, how they approach patient’s autonomy, and what are the implications for the use of advance directives. From the data five frames were identified: medical knowledge frame, patient’s autonomy frame, negotiation frame, ethical frame, and legal frame. During the interviews physicians used these frames to discuss and negotiate the nature and meanings of advance directives, as well the agency and interests of different actors involved in end-of-life decision-making. Two meanings of patient’s autonomy have emerged from analysis: as the patients’ souvereign right to express his/her will of end-of-life treatment; and as the patients’ capacity to choose between different treatments . Whereas physicians often praise the first meaning, the second becomes problematic to the extent that patients’ capacity for decision-making can be compromised. Thus, physicians reframe the notion of patient’s autonomy in relational terms constructing themselves as agents for the patients’ interests. In conclusion, I propose that instead of trying to improve advance directives reliability; their situational component should be incorporated into the very principle that establishes their use, accounting for a holistic process in end-of-life care decision-making.
  • Häyry, Matti (Yliopistopaino, 2001)
    Doctors, nurses and scientists have often been accused of ‘playing God’ in life-and-death decisions, reproductive medicine and genetics. The tenor of this book is that the same accusation can be extended to ethicists and public decision-makers who refuse to examine the is­ sues analytically before they pass their judgements. In many cases, they are the jealous gods who obstruct the voyage of honest philoso­phers and bioethicists who desperately try to find their home island of intellectual zeal and emotional security in the stormy sea of high feeling and firmly held prejudice.
  • Takala, Tuija; Hayry, Matti (2019)
    This paper explores how Finnish research ethics deals with matters of justice on the levels of practical regulation, political morality, and theoretical studies. The bioethical sets of principles introduced by Tom Beauchamp and James Childress in the United States and Jacob Dahl Rendtorff and Peter Kemp in Europe provide the conceptual background, together with a recently introduced conceptual map of theories of justice and their dimensions. The most striking finding is that the internationally recognized requirement of informed consent for research on humans can be ideologically tricky in a Scandinavian welfare state setting.
  • Rasanen, Joona; Louhiala, Pekka (2021)
    It is a common practice for authors of an academic work to thank the anonymous reviewers at the journal that is publishing it. Allegedly, scholars thank the reviewers because their comments improved the paper and thanking them is a proper way to show gratitude to them. Yet often, a paper that is eventually accepted by one journal is first rejected by other journals, and even though those journals' reviewers also supply comments that improve the quality of the work, those reviewers are not customarily thanked. We contacted prominent scholars in bioethics and philosophy of medicine and asked whether thanking such reviewers would be a welcome trend. Having received responses from 107 scholars, we discuss the suggested proposal in light of both philosophical argument and the results of this survey. We argue that when an author's work is published, the author should thank the reviewers whose comments improved the paper regardless of whether those reviewers' journals rejected or accepted the work. That is because scholars should show gratitude to those who deserve it, and those whose comments improved the paper deserve gratitude. We also consider objections against this practice raised by scholars and show why they are not entirely persuasive.