Bioethics

Resumo: O objetivo deste artigo é relatar a experiência do Comitê de Ética em Pesquisa da Secretaria de Estado de Saúde do Distrito Federal (CEP/SES/DF) Brasil, durante o período de 10 anos a partir de sua fundação. Trata-se de uma avaliação descritiva e documental, na modalidade estudo de caso, utilizando-se a totalidade de projetos protocolados no CEP/SES/DF (Nº 052/08) nesse período. As pendências mais freqüentes dos projetos foram: termo de consentimento livre e esclarecido (30%), folha de rosto (25%), metodologia (20%), curriculum vitae (12%), planilha de orçamento (9%), outros (4%). O relato das atividades do CEP/SES/DF no período de 10 anos revelou, através de sua produtividade, a legitimidade do processo de análise ética dos protocolos visando à proteção dos participantes da pesquisa. Palavras chave: ética em pesquisa, comitês de ética, avaliação

The globalization of clinical research is a relatively recent phenomenon, in which many of these studies are taking place on a global scale, with a significant increase of clinical trials in developing countries. The largest clinical trials average annual growth from 2005–2012 occurred in Asian (30%), and Latin American/Caribbean (12%) regions; other geographic regions had growth rates less than the world average (8%). The largest average annual growth occurred in lower-middle income (33%) and low-income (21%) regions. Emerging economies from low-middle income countries (Iran, China, Egypt) had the largest country-specific growth; other countries included South Korea, Japan, India, Brazil, and Turkey. With the globalization of clinical trials, it becomes necessary to strengthen legal and ethical guidelines for guaranteeing the research participants’ integrity. Some observers noted, more than a decade ago, that studies were being run in developing countries without concerns regarding...

Background: Ensuring women's rights during childbirth care based on humanized and bioethical principles results in better quality of care and patient safety and provides positive childbirth experiences. We aim to explore the available evidence on the application of bioethical principles in the general context of childbirth care. Our scoping review will follow the Joanna Briggs Institute Reviewer's Manual. Published and unpublished bibliographic materials will be considered based on the following inclusion criteria: reports of the application of bioethical principles (concept) in assistance to the predelivery, childbirth, and postpartum periods (population) in the hospital context (context). We will search for relevant studies in PubMed and the Virtual Health Library, including MEDLINE, LILACS, BDENF, SCiELO, Web of Science, and Google Scholar. Two reviewers will perform the screening of titles and abstracts, read the full texts, and extract data from the selected articles. The data will then be organized and expressed into categories based on their content. The analyzed data will be presented through flowcharts, tables, and descriptive narratives. A paper summarizing the findings from this review will be published in a peer-reviewed journal. In addition, a synthesis of the key findings will be disseminated to health services linked to university hospitals in Brazil. They will also be shared with the academic community and policy makers involved in the Childbirth Assistance Network, which will potentially adopt our recommendations in their decision-making process regarding childbirth care practice in Brazil. The findings from this review will inform, through the translation of knowledge, childbirth support groups, feminist movements, movements in favor of humanization of childbirth, and other childbirth support networks in the country.

Background: Ensuring women's rights during childbirth care based on humanized and bioethical principles results in better quality of care and patient safety and provides positive childbirth experiences. We aim to explore the available evidence on the application of bioethical principles in the general context of childbirth care. Our scoping review will follow the Joanna Briggs Institute Reviewer's Manual. Published and unpublished bibliographic materials will be considered based on the following inclusion criteria: reports of the application of bioethical principles (concept) in assistance to the predelivery, childbirth, and postpartum periods (population) in the hospital context (context). We will search for relevant studies in PubMed and the Virtual Health Library, including MEDLINE, LILACS, BDENF, SCiELO, Web of Science, and Google Scholar. Two reviewers will perform the screening of titles and abstracts, read the full texts, and extract data from the selected articles. The data will then be organized and expressed into categories based on their content. The analyzed data will be presented through flowcharts, tables, and descriptive narratives. A paper summarizing the findings from this review will be published in a peer-reviewed journal. In addition, a synthesis of the key findings will be disseminated to health services linked to university hospitals in Brazil. They will also be shared with the academic community and policy makers involved in the Childbirth Assistance Network, which will potentially adopt our recommendations in their decision-making process regarding childbirth care practice in Brazil. The findings from this review will inform, through the translation of knowledge, childbirth support groups, feminist movements, movements in favor of humanization of childbirth, and other childbirth support networks in the country.

Resumo: O artigo explora as relações entre corporalidade e incerteza na experiência do pacientes com doenças oncológicas avançadas, atendidos em uma unidade de Cuidados Paliativos da cidade de Buenos Aires, Argentina. A partir de uma abordagem etnográfica, interessa apresentar diferentes formas de interrogar as sensações corporais associadas à doença em contextos de forte incerteza. Primeiro, analisa-se uma forma de hipervigilância do corpo, constituído como espaço onde ler o avance da enfermidade e a morte, ligada à abordagem sintomática dos Cuidados Paliativos e as imagens do caráter expansivo do câncer. Segundo, apresenta-se uma forma de interrogar o corpo em que a experiência da incerteza e projetada em narrativas da esperança. Tentativas, precárias, ameaçantes ou reparadoras, as interpretações que os pacientes fazem de seus signos corporais apresentam tênues variações do saber biomédico, onde a dimensão emocional se revela como central na experiência do padecimento.  Palavras-chave: corpo, incerteza, esperança, cuidados paliativos.

This introduction to human dignity explores the history of the notion from antiquity to the nineteenth century, and the way in which dignity is conceptualised in non-Western contexts. Building on this, it addresses a range of systematic conceptualisations, considers the theoretical and legal conditions for human dignity as a useful notion and analyses a number of philosophical and conceptual approaches to dignity. Finally, the book introduces current debates, paying particular attention to the legal implementation, human rights, justice and conflicts, medicine and bioethics, and provides an explicit systematic framework for discussing human dignity. Adopting a wide range of perspectives and taking into account numerous cultures and contexts, this handbook is a valuable resource for students, scholars and professionals working in philosophy, law, history and theology.

Hasta no hace muchos años, el concepto de la atención médica se basaba en una actitud paternalista por parte del médico. En líneas generales éste no le informaba al paciente sobre su enfermedad; simplemente se limitaba a prescribir sin mediar justificativo alguno, las medicinas o tratamientos que consideraba indicados. Lo realizaba amparado en dos principios morales: el llamado "principio de beneficencia" y el de "no maleficencia". El principio de beneficencia es "la obligación que tiene el médico de mantener su preparación científica y, desde ella, buscar lo que considere mejor y más favorable para el enfermo. Para ello, debe ponerse en el lugar del paciente y pensar qué sería lo más beneficioso en el caso de que el enfermo fuera él mismo". Y, por otro lado, el principio de no maleficencia se resume en el deber que todo médico tiene de no dañar al paciente, respetando su integridad psicofísica. Beuchamp y Childress lo distinguieron del anterior señalan...

Empathy shapes the landscape of our social lives. It motivates prosocial and caregiving behaviors, plays a role in inhibiting aggression, and facilitates cooperation between members of a similar social group. Thus, empathy is often conceived as a driving motivation of moral behavior and justice, and as such, everyone would think that it should be cultivated. However, the relationships between empathy, morality, and justice are complex. We begin by explaining what the notion of empathy encompasses and then argue how sensitivity to others' needs has evolved in the context of parental care and group living. Next, we examine the multiple physiological, hormonal, and neural systems supporting empathy and its functions. One troubling but important corollary of this neuro-evolutionary model is that empathy produces social preferences that can conflict with fairness and justice. An understanding of the factors that mold our emotional response and caring motivation for others helps provide organizational principles and ultimately guides decisionmaking in medical ethics.

Trust is frequently discussed with reference to the professional-patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the "public" and "experts." Public engagement activity in healthcare ethics may invoke "trust" in analysing a moral question or problem but less frequently conceives of trust as integral to "public engagement" itself. This paper explores the relationship between trust and the ways in which questions of healthcare ethics are identified and negotiated by both "experts" and the public. Drawing on two examples from the author's "public engagement" work-a radio programme for the British Broadcasting Corporation and work with a playwright and theatre-the paper interrogates the ways in which "public engagement" is often characterized. The author argues that the common approach to public enga...

El presente articulo de reflexion desarrolla la hipotesis siguiente: la manipulacion genetica no es un pecado etico. La humanidad no puede renunciar a los usos agricolas de las biotecnologias, ?como es posible entonces aplicar con responsabilidad el principio precautorio en el contexto de una economia global avida de ganancias y carente de escrupulos?, ?como discernir con un margen razonable de bioseguridad aquellas aplicaciones destinadas a la produccion de alimentos que no comprometan la salud humana y no agredan irreversiblemente la biodiversidad? La consideracion del impacto de los avances biotecnologicos en la salud humana como fenomeno global, pasa necesariamente por el tamiz del analisis del equilibrio medioambiental. La confluencia de estas ideas, mas alla de su derrotero etico-filosofico es esencial para la busqueda del minimo moral de la cultura de la supervivencia que enuncio Van Rensselaer Potter.

Η ραγδαία εξέλιξη των τεχνικών υποβοηθούμενης αναπαραγωγής έχει επιφέρει σημαντικές επιπτώσεις στο δίκαιο της οικογένειας, στην ερμηνεία της έννοιας της γονεϊκής ιδιότητας και στη σχέση δικαίου και βιοηθικής. Η εδραίωση πρακτικών όπως η δωρεά γαμετών, η εξωσωματική γονιμοποίηση και η κατάψυξη γενετικού υλικού (ωαρίων, σπέρματος και εμβρύων), εγείρει σειρά νομικών αντιρρήσεων που αφορούν την αναγνώριση της γονικής ιδιότητας, την προστασία του παιδιού, την ιδιωτικότητα του βίου και την ανθρώπινη αξιοπρέπεια.

In the United States, approximately one in five couples is infertile. Scientific advancements in reproductive technology, however, allow couples to combat problems with conception through various surrogacy arrangements. 2 In vitro fertilization (IVF) is one type of artificially assisted conception procedure that creates an embryo ex utero, combining the egg of the intended mother with the sperm of the intended father in a petri dish.' This surrogacy arrangement allows infertile couples the 4 chance to become parents when they otherwise are unable to conceive.

Os avanços da biotecnologia oriundos do advento da genética e genômica vêm exigindo crescente esforço reflexivo e regulatório sobre aspectos éticos, bioéticos, de biossegurança e jurídicos, uma vez que a sociedade não pode debelar de regulamentações para manter um equilíbrio entre as pesquisas científicas e a dignidade da pessoa humana. O desafio está em ampliar e democratizar o espaço de debate sobre a bioética diante dos avanços ligados à terapia gênica, que consiste na introdução de genes modificados em outro organismo através da tecnologia do DNA recombinante. Estas práticas ainda requerem esclarecimentos e regulamentações, pois pesquisas desta natureza tem seus riscos inerentes, que podem violar o mais admirável princípio da Bioética e do Biodireito: a autonomia. Portanto, torna-se imprescindível o reconhecimento deste panorama –a sua complexidade e conflitos- que tange a bioética e o direito, diante das lacunas na intepretação e operacionalização da lei para resguardar o direi...

Neste livro, o autor mergulha em uma reflexão profunda e necessária sobre a interseção entre o Direito e a Tecnologia, explorando como os sistemas tecnológicos estão transformando a prática jurídica e a própria essência do Direito. A obra analisa, sob uma perspectiva ontológica e ética, a emergência dos sistemas tecnojurídicos, que automatizam funções jurídicas e desafiam as estruturas tradicionais do Estado Democrático de Direito. Com base em uma investigação transdisciplinar que envolve Filosofia, Tecnologia e Direito, o autor examina as condições de possibilidade da associação entre essas duas entidades, identificando as propriedades e os atributos que as tornam compatíveis ou incompatíveis. A obra questiona se as atividades jurídicas realizadas por inteligência artificial podem ser consideradas como Direito no sentido tradicional, e explora os impactos sociotécnicos desses sistemas na sociedade contemporânea

This study tackles a contemporary issue belongs to what iscalled (AL- NawazilFiqh)(Jurisprudence of contemporary issues). The issue discussed in this study is the banks of milk. It is a new issue as it appeared in the seventies of the twentieth century in Europe and U.S.A. Banks of milk have spread in the same way banks of blood, corneas, sperms and prosthetic limbs did. The idea of banks of milk can be simply summarized by collecting milk from volunteer mothers (or paid mothers) who give their milk either because they have more than what their infants need or because the mother has lost a child. The milk is taken from the mother by a sterilized method and kept in sterilized bottles at banks of milk.Opinions and (Fatwas) in this connection have varied widely. Some scholars have disapproved the issue and some have approved due to their different opinions in the issue of breastfeeding. This study will focus on reviewing/and discussing both opinions and views and discuss the reason of ...

This article seeks to reflect on the perspective of bioethics of protection and explain its tools, by using a bibliographic survey based on the theorical marks of its main idealizers and the informative reading technique, which seeks to identify the thematic and the main ideas involved. To that end, we first present protection as a bioethical principle by going deeper into the origin, to the definition and the analysis of the terms “vulnerability”, “susceptibility” and “injury”. Then, we seek to present the bioethical approaches regarding the “principle of protection”. Finally, we argue that bioethics of protection works as a paradigm for the apprehension, analysis, and resolution of moral conflicts in public health, revealing itself a fundamental approach in this field, considering its challenge is facing the tension between the individual and the collective spheres.

This book, authored by Dr. Jamuel Yaw Asare, offers an in-depth philosophical exploration of existence, ethics, and the human search for meaning, weaving together classical and contemporary perspectives to address timeless questions in the context of modern challenges. Through a series of reflective essays, it examines the nature of being, drawing on ontological insights from Parmenides, Heraclitus, Heidegger, and Sartre, proposing a dynamic interplay between permanence and change, informed by quantum mechanics. Ethical inquiry integrates Kantian deontology, Mill's utilitarianism, and Aristotelian virtue ethics, advocating a contextual approach to navigate dilemmas like climate change and AI governance. The quest for purpose is explored through Frankl's logotherapy, Nietzsche's critique of nihilism, and Buber's "I-Thou" relationality, emphasizing mindfulness and dialogue as antidotes to technological alienation. A balanced scepticism, inspired by Descartes, Hume, and Peirce's pragmatism, is championed as a tool for addressing epistemic uncertainties in the digital age. Enhanced by an expanded appendix of philosophical concepts, a glossary, and a comprehensive bibliography, this work invites readers to engage critically with philosophical inquiry, fostering dialogue and reflection on the human condition.

En un article de l'any 2002, Enrique Bonete Perales reivindica la necessitat de pensar una tanatoètica -això és, una ètica de la mort-fora de la bioètica, que permeti subratllar les especificitats pròpies de la reflexió moral al voltant de la mort. 1 En aquest mateix article, l'autor fa una interessant distinció entre les dimensions que, segons ell considera, aquesta nova tanatoètica hauria d'abastar i les divideix segons se succeeixen al voltant de tres moments: el pre-mortem, el ja-morir i el post-mortem. 2 Una de les dimensions que Bonete defineix, la tècnica, la discuteix com a pertanyent al voltant del ja-morir, és a dir, als moments que precedeixen immediatament la mort d'un individu. 3 Doncs bé, tot i que d'aquest article ja en fa 17 anys, parlar de la tècnica en relació amb la immediatesa de la mort continua sent

The article deals with a contemporary debate on Hippocratic ethics. Both the opponents and proponents of Hippocratic medical ethics seem to ignore the complexity of the said ethical system. The ethics of the Corpus Hippocraticum can be properly understood only in relation to physiological, psychological, and other factors. Therefore, the ongoing debate only partially represents ethical issues, and a number of arguments in it cannot be considered as valid. Moreover, the complexity of Hippocratic ethics reveals that quite a few of its principles are still valid today and deserve to be further analyzed. In addition, some of its principles have been incontestably incorporated into contemporary medical ethics.

The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power-the legitimation of physicians' power-a core concept of clinical ethics. In the absence of legitimation, the physician's power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians' power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility.

The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power-the legitimation of physicians' power-a core concept of clinical ethics. In the absence of legitimation, the physician's power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians' power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility.

Los aloinjertos compuestos vascularizados (ACV) son una alternativa para la reconstrucción de lesiones que afectan la integridad corporal (amputaciones, malformaciones, etc.). Los ACV tienen tejidos de las tres capas germinales (nervios, músculo, vasos sanguíneos, hueso, articulaciones, entre otros), son susceptibles al daño por isquemia, necesitan inmunosupresión para evitar su rechazo y deben ser reparados vasos sanguíneos como parte del procedimiento del trasplante. Alrededor del mundo se han hecho más de 100 aloinjertos compuestos vascularizados (cara, extremidad superior, pierna, útero, pared abdominal, laringe y otros). En México, desde 2005 se estableció el Subcomité de Trasplante de Tejidos Compuestos (SCO-TTCO) en el Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán» (INCMNSZ), desde entonces una de las principales tareas fue la sensibilización para dar a conocer el programa y encontrar donadores de extremidad superior (ES). Esta sensibilización la llevamos de manera directa a través de los integrantes del equipo, dirigida a gente joven y personal de salud; a través de redes sociales, pláticas con pacientes, participación en la formación de coordinadores hospitalarios de donación de órganos

Los aloinjertos compuestos vascularizados (ACV) son una alternativa para la reconstruccion de lesiones que afectan la integridad corporal (amputaciones, malformaciones, etc.). Los ACV tienen tejidos de las tres capas germinales (nervios, musculo, vasos sanguineos, hueso, articulaciones, entre otros), son susceptibles al dano por isquemia, necesitan inmunosupresion para evitar su rechazo y deben ser reparados vasos sanguineos como parte del procedimiento del trasplante. Alrededor del mundo se han hecho mas de 100 aloinjertos compuestos vascularizados (cara, extremidad superior, pierna, utero, pared abdominal, laringe y otros).1-4 En Mexico, desde 2005 se establecio el Subcomite de Trasplante de Tejidos Compuestos (SCOTTCO) en el Instituto Nacional de Ciencias Medicas y Nutricion «Salvador Zubiran» (INCMNSZ), desde entonces una de las principales tareas fue la sensibilizacion para dar a conocer el programa y encontrar donadores de extremidad superior (ES). Esta sensibilizacion la llev...

Romania is among the top of European countries with the highest prevalence of self-medication. A better understanding of the present management of medical non-compliance could have a contribution in understanding and improving, from the ethical perspective, of the medical staff’s behaviour for the purpose to reduce this phenomenon.

Giriş: Kişisel sağlık verilerinin hem sağlık hizmetlerinin sürekliliği ve verimliliği hem de kişilerin hak ve özgürlüğü kapsamında özenle korunması gerekmektedir. Sağlık kurumlarında değişik meslek gruplarındaki tüm görevlilerin kişisel sağlık verilerinin kayıt ve korunmasına yönelik sorumlulukları vardır.

This article is a complement to “A Template for Non-Religious-Based Discussions Against Euthanasia” by Melissa Harintho, Nathaniel Bloodworth, and E. Wesley Ely which appeared in the February 2015 Linacre Quarterly. Herein we build upon Daniel Sulmasy's opening and closing arguments from the 2014 Intelligence Squared debate on legalizing assisted suicide, supplemented by other non-faith-based arguments and thoughts, providing four nontheistic arguments against physician-assisted suicide and euthanasia: (1) “it offends me”; (2) slippery slope; (3) “pain can be alleviated”; (4) physician integrity and patient trust. Lay Summary: Presented here are four non-religious, reasonable arguments against physician-assisted suicide and euthanasia: (1) “it offends me,” suicide devalues human life; (2) slippery slope, the limits on euthanasia gradually erode; (3) “pain can be alleviated,” palliative care and modern therapeutics more and more adequately manage pain; (4) physician integrity and...

Mrs. Mary Carpenter has experienced post-menopausal vaginal bleeding. Her gynecologist, Dr. John, diagnosed endometrial cancer and recommended a hysterectomy. She and her husband, Joe, go to visit Dr. John at his office at Good Samaritan Catholic Hospital to discuss their options. Dr. John explains the indications for the procedure, the nature of the procedure, the risks and benefits, and the alternatives, including second opinions and not having the procedure. In order to ensure that Mary and Joe have understood everything, Dr. John asks them to repeat back what they have heard. After they take a moment to discuss it among themselves, Mary signs the informed consent form, and they make plans for the operation.

Practitioners of pain medicine and palliative care may already be quite familiar with clinical ethics, yet still uncertain about the precise nature of the field and the scope of its activities. Clinical ethics is centrally concerned with the ethics of the encounter between the healthcare professional and the patient in clinical care settings. It is thus a subset of bioethics, and distinct from research ethics and organizational ethics. The various ways of organizing teaching activities, research programs, and case consultations in clinical ethics are described and critiqued. The author describes some new and emerging ideas and practices in clinical ethics, speculates about future directions for the field, and concludes with a call for greater collaboration between practitioners of pain medicine and clinical ethicists.

Within a week of his 20 January 2025 inauguration, US President Donald J. Trump issued an order that froze all federal grants and loans, creating confusion and anxiety about the future of research and development in US biomedical science. The politicisation of science creates significant challenges not only for the researchers who depend on public funding to undertake their research, but also for the public understanding of why basic research is so important to the health and economic prosperity of the world's ageing populations. In 1944 US President Franklin D. Roosevelt wrote a letter to the director of the Office of Scientific Research and Development, Dr. Vannevar Bush, asking Bush how science and medicine could be best harnessed to win the war of science against disease. Bush's response, in his acclaimed 1945 book entitled Science, The Endless Frontier, detailed how 'scientific capital' determines the pace and shape of technological progress. The war against disease approach to public health and medicine has helped increase life expectancy, by reducing the prevalence of premature death, but it has also contributed to the increasing global healthspan-lifespan gap, which is nearly 10 years. Translational gerontology, and in particular the goal of developing geroprotective drugs that may help fortify the 'biological resilience' needed to increase healthy life expectancy, must become an integral part of a 'wisdom-inquiry' approach to public health and medicine if the aspiration of healthy longevity is to be realised this century.

For many, dementia disrupts basic ideas about what it means to be human, raising profound philosophical and theological questions on the nature of personhood. In this article I ask what dementia might reveal about personhood in a “secular age.” I suggest that the ill-fitting relationship between Western bioethics, with its emphasis on autonomy, and dementia throws into relief the boundaries of a secular self, and I tease out the ethical implications of the limits of those boundaries by highlighting a biopolitics of secularism. Lastly, I offer a theological account of dementia that situates dependence as a central feature of the human condition, and enriches a secular biomedical understanding of this neurocognitive disorder.

O presente artigo realiza um estudo da irrenunciabilidade e da
intransmissibilidade dos direitos da personalidade, características expressamente previstas pelo art. 11 do Código Civil. Após a compreender a noção e a importância da irrenunciabilidade e da intransmissibilidade dos direitos da personalidade, o trabalho analisa a relação existente entre referidas características. O texto ainda estuda a autonomia privada no âmbito dos direitos da personalidade, em particular a possibilidade de renúncia ou de transmissão do próprio direito da personalidade, bem como as situações em que a renúncia ou a transmissão dizem respeito apenas ao exercício dos direitos da personalidade. Por fim, o estudo da matéria busca instigar o leitor a procurar soluções no direito estrangeiro para problemas existentes no Brasil.
This article examines the unrenounceability and untransferability of personality rights, characteristics that are expressly established in Article 11 of the Civil Code. It is a research that uses descriptive and deductive
methodology, based mainly on bibliography, case law and legislative research. After understanding the concept and importance of the unrenounceability and untransferability of personality rights, the paper analyses the relation between these characteristics. The text also studies private autonomy in the context of personality rights, in particular the possibility of renouncing or transferring the personality right itself, as well as the situations in which the renunciation or transfer concerns only the exercise of personality rights. Finally, the study of the subject aims to encourage the reader to seek solutions in foreign law to problems that
exist in Brazil.

This paper critically examines the conceptual and ethical challenges in framing human-animal relationships through the lens of rights and justice. Arguing that both "human" and "animal" lack universal, non-reductive definitions, the paper interrogates the viability of animal rights frameworks, highlighting parallels with the limitations of human rights. It traces religious and philosophical perspectives that cast animals as a "quasi-self" in relation to humans, underscoring how anthropocentric paradigms shape both empathy and dominance. Through a biopolitical analysis inspired by Agamben's Homo Sacer and State of Exception, this study critiques contemporary approaches, including utilitarianism, capabilities theory, and speciesism, for failing to address systemic inequities underpinning human-animal dynamics. Examining practices such as domestication, companionship, and industrial exploitation, the paper situates these relationships within the broader ethics of capitalism and commodification. It concludes by reimagining the human-animal relationship as a negotiation of existence that resists universalizing categories, advocating for ethical frameworks grounded in lived experience and relationality over abstract rights discourse.

The United Kingdom was the first country to legalize the refusal to provide health care in the name of "conscientious objection", allowing doctors to refuse to provide abortions based on personal or religious beliefs. A historical review into the origins and motivation behind the "conscientious objection" clause in the 1967 Abortion Act found that Parliamentarians and the medical profession wanted to preserve doctors' authority over patients, protect objecting doctors from liability, and appease religious anti-abortion beliefs. These factors point to an unprincipled basis for the introduction of "conscientious objection" into healthcare, which ultimately came at the expense of patients' rights and health. The "conscience clause" also represented a negation of basic ethical directives in medical practice including patient autonomy and physicians' fiduciary duty to patients. The term "conscientious objection"-borrowed from the military but misapplied to healthcarehelped mask the practice as a moral "right" of doctors, even while it disregarded patients' health and dignity. Refusing to provide treatment on the basis of "conscience" is harmful and discriminatory, and should be phased out gradually using disincentives and other measures to encourage objectors to choose other fields.

The purpose of this paper is to analyse the euthanathic homicide in the ancient Rome. The author is looking for answers to the questions: How did the ancient Romans understand euthanasia? Was euthanasia in the modern sense of the word known and practiced by the Romans? What could be the methods of performing a murder on demand? What legal repercussions were associated with this? The author used primarily the historical-legal and dogmatic-legal research methods. In the ancient Rome, we encounter the term euthanasia, understood primarily as a good death or gentle dying. Currently, in the Polish law, euthanasia is a murder on demand performed under the influence of compassion (Article 150 of the Penal Code). Beside many descriptions of suicides, there is little evidence that Rome resorted to mercy killing under the influence of compassion. Nevertheless, such types of behaviour described, for example, by Valerius Maximus in relation to those tired of life from Marseilles, make us think that such today's understanding of euthanasia sporadically occurred in the era under study. With the help of others, one resorted to being impaled with a sword, opening veins or using poison. Although we do not have regulations directly relating to killing on demand under the influence of compassion, the weariness of life (taedium vitae), however, so present in the Roman legislation mitigated the legal consequences of taking one's own life.

I would like to sincerely thank all the people who accompanied me on the rewarding and challenging journey this dissertation has been. From the first ideas about the possible topic until this project's completion, I was blessed to have people in my life who supported and inspired me. I am eternally grateful to my family, friends, and colleagues, without whom this dissertation would not have been possible. First and foremost, I want to thank the most important contributors to this projectmy research participants, who allowed me to study their life and work, often hidden even from their own families and friends. I am truly thankful to Ukrainian egg donors, surrogate mothers, and fertility specialists, who shared with me their aspirations and concerns. I am very privileged to be the one they trusted with their thoughts and feelings. My utmost gratitude goes to the egg bank "Cryova" which opened its doors to me and became my home for over a year of fieldwork. I could not have imagined a more hospitable, cordial, and generous welcome in L'viv, where I was fortunate to meet so many amazing people, who will be lifelong friends. Special thanks to my advisor and mentor Sarah D. Phillips, who encouraged and challenged me, provided me with expert knowledge, guidance, and inspiration, and supported me with her endless kindness and patience. Throughout all the ups and downs of this journey, you always gave me the feeling that I will succeed. I could not wish for a better advisor! I would also like to express my deepest gratitude to the members of my Doctoral Committee, Sara L. Friedman, Andrea S. Wiley, and Lessie Jo Frazier, who have meticulously read this dissertation and given critical feedback, insights, and advice that have profoundly shaped my work. I would like to thank the members of the Department of Anthropology at Indiana University for being incredible colleagues and friends who always made me feel part of a strong community of support and solidarity. Thank you to the Russian and East European Institute and Russian Studies Workshop at Indiana University for funding my research, continuously supporting my development, and providing me with a platform to share the results of my work. Other special thanks go to the Association for Slavic, East European, and Eurasian Studies for financially supporting my fieldwork in Ukraine. iv My sincere thanks go to the incredible scholars who participated in the dissertation writing group organized by Sarah D. Phillips. Our discussions in-person and via Zoom throughout the last three years have been fundamental in determining the direction this dissertation took. Thank you for listening to my fieldwork experiences and giving me the chance to put my feelings and thoughts into words. Thank you,

A realização de pesquisas científicas em crianças é uma questão bastante controversa. Durante muitos anos o desenvolvimento de pesquisas científicas em crianças foi fortemente desaconselhado e até mesmo proibido, provavelmente em função de alguns estudos eticamente inadequados realizados com esse grupo específico. A maioria das diretrizes internacionais sobre pesquisa em seres humanos desaconselha a inclusão de crianças em estudos que possam ser realizados em adultos. A dúvida quanto a realizar ou não pesquisas em crianças pode ser melhor esclarecida através da análise do complexo cenário que abrange fatos, circunstâncias, princípios éticos, casos antecedentes, alternativas e conseqüências, permitindo o emprego do modelo bioético baseado na complexidade para a análise dessas situações. O objetivo deste artigo é discutir os diferentes aspectos envolvidos na realização ou não de pesquisas em crianças e adolescentes. A exclusão das crianças como participantes de projetos de pesquisa po...

The Council of Europe Convention on Human Rights and Biomedicine is European in conception but has a wider territorial application since non-Member States which have participated in its elaboration may sign it. This article evaluates the Convention as the first legally binding international biomedical law and ethics document to uphold human dignity as a fundamental concept and to provide a legal framework for societies with different sociocultural and philosophical backgrounds. It is argued that such a legal framework must be underpinned by a monist-naturalist conception of justice privileging human dignity as one of its guiding principles.

The development of the human papillomavirus (HPV) vaccine provides an opportunity to prevent the majority of HPV infections that cause genital warts and cervical cancer. Although the vaccine is largely recognized as a medical breakthrough, its acceptance by the public is lagging for several reasons. Contributing factors include underestimation of HPV risk, the challenge of completing a three-shot regimen, concerns about cost, and parental barriers to acceptance. There is also some public concern about vaccine safety in general, although HPV vaccines have excellent safety records. Attempts to publicize the vaccine's safety have been undermined by recent erroneous claims linking the vaccine to mental retardation by political figure Michele Bachmann. These inflammatory and irresponsible remarks mislead the public about the safety and efficacy of the vaccine. We examine the facts concerning the HPV vaccine, its utility, and appropriate responses medical professionals can make to false claims.

Hassoun does not contest P1. i Instead, she objects to P2, which is the focal i While we will not quibble at length with Hassoun's formulation of P1, it runs together two sources of obligation: (1) associative ties that bind community members to one another and (2) role-based obligations of leaders. As we write in our article, 'Our claim is that community membership and intra-communal