Search

The most visible change to medicine in 2020 has rendered human faces only halfvisible. In an effort to reduce transmission of the SARS-CoV-2 virus, healthcare professionals everywhere, and patients too, are now wearing face masks covering the nose and mouth whenever meeting in person. Masks block germs, but they can also block communication, as positive emotions are conveyed by the lower part of the face. When the mouth is covered, smiles are hidden. Expressions of intent may seem ambiguous, of concern neutral, of empathy imperceptible. Although medically necessary during an infectious pandemic, masks shroud a vital feature of our shared sense of humanity and may lessen the perception of presence at the bedside. In order that the face-to-face healing encounter is not reduced to a rendezvous of the hemianonymous, masked caregivers must be especially intentional in their eye contact, tone of voice, and chosen words. [ABSTRACT FROM AUTHOR]

Epidemics and pandemics have profoundly shaped the course of human history. Naming them has ethical consequences because of the value laden in words. Nuances of language can themselves be contagious, influencing attitudes toward people, nations, and other qualities that may be incidental to the initiation or propagation of an infectious disease. A poorly chosen name for an infectious outbreak can divide communities at a time when people should be coming together and collaborating for the sake of the common good. Striving for objectivity in language is helpful, but it is also insufficient, for it omits the ethical framework needed to respond to a pandemic and does not adequately address the meaning of suffering. [ABSTRACT FROM AUTHOR]

The neurobiological capacity for language, a cardinal aspect of being human, can be lost by disease and, in some cases, partially restored by technology. Research is advancing toward more sophisticated devices to detect and compute methods to decode brain signals corresponding to language, including brain-computer interfaces that might one day disclose unspoken words. Enabling the mute to communicate is a prima facie ethical duty in neurore habilitation. Extending the reach of brain computer interface technology beyond its therapeutic grasp to enhance normal function is both intriguing and ethically problematic. [ABSTRACT FROM AUTHOR]

Students entering the healthcare professions today stand at the threshold of what may be a historic technological discontinuity as artificial intelligence begins to enter into the clinical arena. Computational machines programmed to have the capacity for logic, reasoning, learning, problem-solving, and planning can potentially support clinical care in ways beyond what might have been imagined just a generation ago. Artificial intelligence can be a welcome tool for clinical decision support, reduction of medical errors, and optimization of care processes, as well as managing the vast genomic data sets that hold promise for the future of precision medicine, whereby medical interventions can be tailored to patients' individual genetic profiles. Already artificial intelligence applications have outperformed human diagnostic and surgical skill in select areas. Some interpret these developments as proof of concept that artificial intelligences will eventually displace physicians and nurses while others maintain that there is a human element that machines can never adequately replace. Whether machines could ever become self-aware in the way that humans experience consciousness, and whether machines could be designed to love, are questions of ongoing debate. Meanwhile, computer programs that interact with people are being designed to recognize and mimic ever more closely human emotions. Suppose, hypothetically, that at some future time artificial intelligences have taken on a more primary role as healthcare professionals. What advice might a senior artificial intelligence give to a graduating class of newly minted artificial intelligences entering into medical practice? Perhaps it would be an upgraded version of Sir William Osler's classic essay, "Æquanimitas," which exhorted graduating medical classes to cultivate mental imperturbability under stress. This he believed to be the premier quality of a good physician. [ABSTRACT FROM AUTHOR]

Through an electric coil positioned over the head, transcranial magnetic stimulation (TMS) penetrates the protective enclosure of the skull as no mechanical intrusion can to stimulate, inhibit, or modulate neuronal activity in the underlying cerebral cortex. Proposed medical and nonmedical applications of this developing technology have the potential to influence cognitive capacities relevant to personal identity and its perception, both of oneself and of others. The power to use targeted pulses of electricity to alter, intentionally or unintentionally, the subtle flow of one's private thoughts in regard to perceptions, preferences, emotions, biases, memories, or judgments challenges notions of personal authenticity and raises crucial questions about how to decide on appropriate use of a technology that may impinge on human nature. Its prospective beneficial medical indications are promising and should be pursued and investigated under rigorous scientific conditions. Its potential for medical or social harm if used carelessly, recreationally, or without restraint is cause for concern. [ABSTRACT FROM AUTHOR]

Gene editing biotechnologies have introduced an unprecedented degree of power to reconfigure genomes, not only of living creatures, but also of their descendants, potentially for the rest of history. Such technologies can be applied for good purposes, such as preventing or treating genetic disease, or they can be misused and cause harm. Because potential outcomes are often mixed, involve uncertainties, and require assessment of value, ethical reflection is needed. This essay analyzes the ethical question of whether CRISPR technology should ever be used to drive to extinction an entire species--in this case, certain strains of mosquito that transmit malaria and other diseases deadly to humans. The principle of double effect, while helpful, guides the ethical assessment incompletely. Society must also grapple with the Promethean implications of a technology that places into the hands of imperfect people nearly absolute power over inherited genetic identity. [ABSTRACT FROM AUTHOR]

As finite human beings, healthcare professionals cannot always be everywhere there is medical need. Communication technologies increasingly supply partial means to bridge this gap and extend the reach of timely medical expertise. Whereas access from a distance can provide substantial material health benefits, less easily translated through intervening technology are the often unmeasured, sometimes overlooked, morally significant, human elements that are essential to an in-person medical encounter. The technologies that connect people can facilitate healing, but they can also distract from care or reconfigure the relationship. Ethical medical practice must remain focused on the patient as a whole person who is more than a data set or collection of digital images. [ABSTRACT FROM AUTHOR]

An instrument potentially useful in assisting medicine in making difficult ethical decisions, artificial intelligence is advancing in its imitation of human thought and behavior. Machine intelligence may also come to mimic human foibles, including the psychosocial phenomenon of “groupthink,” in which excessive conformity to the group dynamic inhibits appropriate critical reassessment of a group’s policies and actions. This essay predicts a parallel phenomenon in which an artificial intelligence that is bound to the assumptions and biases inherent in the programming shared by a cyber collective suppresses data processing pathways that might otherwise redirect its executive output. Locked into allied algorithms, the artificial intelligence exhibiting “loopthink” would tend toward utilitarian assessments while omitting or excluding abstract moral principles, such as human dignity, that are vital to bioethics yet defy translation into arrangeable lines of computer code. [ABSTRACT FROM AUTHOR]

Human trafficking is a pervasive problem that exceeds the capacity of social and organizational resources to restrain and for which guidelines are inadequate to assist medical professionals in responding to the special needs of victims when they present as patients. One obstacle to appropriate disagreement with an inadequate status quo is the lure of group cohesion. "Groupthink" is a social psychological phenomenon in which presumed group consensus prevails despite potentially adverse consequences. In the context of the medical response to human trafficking, groupthink may foster complacency, rationalize acquiescence with inaction on the basis of perceived futility, create an illusion of unanimity, and accommodate negative stereotyping. Despite these inhibiting influences, even in apparently futile situations, medical professionals have unique opportunities to be a force for good. [ABSTRACT FROM AUTHOR]

As innovative technology replaces more and more of what physicians do, the question arises whether there is any limit to the potential medical capabilities of technology at the bedside. Drug-dispensing kiosks, robotic surgery, computerized sedation devices, and other novel medical technologies bring practical advantages while also raising philosophical questions about the nature of the relationship between the patient and technology that serves as a proxy for the healthcare professional. Moreover, the shift in language from "professional" to "provider" accommodates a detrimental attitude that regards technical performance and human care to be interchangeable. This paper unpacks the meaning of professionalism from the perspective articulated by the Christian Medical & Dental Associations and examines its technical, ethical, and spiritual aspects vis-à-vis surrogate technology. A close examination of the meaning of professionalism finds that there are aspects of medical practice that are irreducibly human. [ABSTRACT FROM AUTHOR]

It is the nature of ethics to hold in tension contrasting ideas. Their relationship may be complementary, in which case inclusion of differing perspectives enriches and enlarges understanding. Elsewhere ideas may conflict, resulting in a dilemma, resolution of which involves deciding in light of first principles or predicted consequences. At the heart of many ethical dilemmas is the question of how to bridge the gap between fact and value. Attempts to derive an "ought" from an "is," or a principle of value from an empirical fact, are open to accusations of committing the naturalistic fallacy. This crucial distinction resembles the seemingly unbridgeable mathematical divide in physics between theories of the subatomic and cosmic realms. Both disciplines, ethics and physics, rest on an uneasy balance of two theoretical frameworks that, although having logical integrity within their own domains, yet are mutually incompatible. This leads in ethics to the enigma of whether there is a moral aspect to reality and how it can be reliably known and objectively demonstrated. This leads in physics to the enduring puzzle of the seeming impossibility of explaining the law of gravity in terms of quantum field theory. The latest reconciliatory effort in physics seeks evidence of the graviton, a hypothetical fundamental particle which, if found, could combine the physical sciences into a single formulation to explain all natural phenomena. A corresponding project in ethics might be to locate the "ethicon," the fundamental explanatory particle, the behavior of which would provide a factual basis for weighty matters of morality, make sense of right and wrong, and answer objectively questions of origin, meaning, and purpose. Ultimately, however, the particular answer to moral questions might not, after all, be a particle. [ABSTRACT FROM AUTHOR]

Access to medical technologies is no longer limited to clinicians and researchers. Increasingly, patients are availing themselves of biosensor technologies to monitor their health. Devices designed to sense cardiovascular functions, for example, display information about changes in heart rate and blood pressure that are coordinated by the autonomic nervous system and normally occur below the level of conscious awareness. Once awareness is attained, choice becomes possible, and with increased knowledge comes increased responsibility. This responsibility is best shared by patients and their healthcare professionals. Accordingly, ethical assessment of health-monitoring technology is needed so that it may be used in ways that promote health and well-being while avoiding harm. [ABSTRACT FROM AUTHOR]

Beginning with the premise that the human mind is fundamentally a computer, and extrapolating from the history of computer technology, which has yielded ever-increasing processing speeds, some futurists forecast a time when it may become possible to upload the human brain to a computer and thereby attain enhanced powers and a sort of immortality. Such predictions add new meaning to the idiom of having one's mind in a cloud. They also raise profound ethical questions. The suggestion that brain uploading could be achieved safely suggests unbridled hubris. The belief that human identity could be faithfully replicated in a machine is possible only within a reductionistic, hence inadequate, understanding of the human person. A hypothetical post-neuron future in silicon could never be more than a collection of inauthentic human representations. [ABSTRACT FROM AUTHOR]

The central question in debates over whether to apply biotechnology to enhance human capacities beyond species norms is that of what it means to be human. A satisfactory answer requires knowledge from multiple disciplines, including not only biology and neuroscience, but also history, sociology, philosophy, and theology. Christian theology, in particular, has rich traditions of reflection on this question, the complexities of which are evident in the diverse perspectives on enhancement held by Christians today. These perspectives may be categorized and expounded according to Niebuhr's five motifs for how Christians throughout history have regarded and engaged culture. [ABSTRACT FROM AUTHOR]

Multitasking, which requires shifting mental focus among simultaneous tasks, has become increasingly prevalent in our digitally connected culture. Whereas the clinical environment necessarily entails attending to multiple demands competing for the healthcare professional's time and attention, excessive multitasking has been shown to lead to distraction, information loss, and cognitive overload with the potential for medical error. Moral reasoning, which is essential for clinical ethics, engages brain systems that may also be susceptible to impaired performance when external streams of information intrude or interrupt. Intentionally limiting multitasking habits is important for the sake of both patient safety and medical ethics. [ABSTRACT FROM AUTHOR]

Lightning and other electrical incidents are responsible for more than 300 injuries and 100 deaths per year in the United States alone. Lightning strikes can cause a wide spectrum of neurologic manifestations affecting any part of the neuraxis through direct strikes, side flashes, touch voltage, connecting leaders, or acoustic shock waves. This article describes the first case of trigeminal neuralgia induced by lightning injury to the trigeminal nerve, thereby adding a new syndrome to the list of possible lightning-mediated neurologic injuries. [ABSTRACT FROM AUTHOR]

The highly offensive epithets, "moron, imbecile, and idiot," were once accepted clinical terms denoting patients with subnormal intelligence. How their meaning has degenerated over time exposes the danger of allowing hubris a voice in place of Hippocrates at the bedside. Healthcare professionals should exercise moral probity when choosing words that describe their patients and in all circumstances avoid the "neuroslur"-- use of language that denigrates others by imputing inferior intellectual capacity. [ABSTRACT FROM AUTHOR]

The recent creation of human cerebral organoids resembling miniature brains has opened a new chapter in neuroethics. Ethical analysis of this innovative biotechnology begins with a comparative examination of the biological constitution of brain-like entities, followed by consideration of the moral status of isolated brains, the potential benefits to medical science in the prevention and treatment of neurologic disease, and potential health risks of neural transplantation. Whereas these experiments touch on philosophically fascinating questions about what it would mean to have brains without bodies, thankfully such morally disturbing prospects remain beyond the reach of neuroscience for the foreseeable future. [ABSTRACT FROM AUTHOR]

The pen, once the instrument of clinical documentation, is yielding to the more efficient technology of computer-assisted voice recognition. With this transition, in place of the quirky handwriting that has long characterized medical practice, electronic medical documents supply readable and detailed, yet imperfect, text. Technology has not fully solved the problem of medical error but has, in some ways, magnified it. The ethical dimensions of physician-to-computer communication raise questions regarding moral responsibility at the interface of mind and machine. [ABSTRACT FROM AUTHOR]

Names are important, especially when they influence how healthcare professionals regard patients. Accordingly, the word 'dummy' is best avoided when referring to human patient simulation mannequins. Although the patient is physically absent from simulation-based learning scenarios, an environment of verisimilitude reproduces aspects of the social context of the relationship between caregiver and patient. Healthcare professionals should avoid disrespectful language when referring to mannequins that are patient surrogates in order to cultivate a habit of mind that translates to consistently respectful patient care. [ABSTRACT FROM AUTHOR]

The article discusses the neuroscientific framework of reason and rhetoric in relation to healthcare ethics or bioethics which reflects the moral ambiguities involved in decision-making in biomedical science, medicine, and neuroscience. It mentions the connection between reason and rhetoric in bioethical discourse that considers moral principles, decisions, and rationales. It explains the application of the vocabulary of reason in ethical deliberations and the language of rhetoric in arguments.

The right of conscience is the right of an individual to refuse to do something requested by another on the basis of a deeply-held moral belief. Although debates over rights of conscience in medicine have focused on controversial questions at life's margins, the physician's exercise of conscience also extends to many other areas of care. Conscience is at the heart of the medical profession's commitment to honesty, compassion, and taking responsibility to prevent harm. Conscience in obedience to truth is the bedrock on which rests the moral integrity of the physician, which is essential to the patient's trust. Objections to a medical professional's right of conscience have been based on flawed reasoning. The argument that physicians should provide any medical service that is legal upon request jeopardizes the moral integrity of the physician who is required to implement interventions he believes to be harmful to patients. Whereas the patient's right to refuse a treatment is nearly inviolable, a patient's right to demand a specific treatment is subject to physician discretion. To compel the physician to act in violation of his or her conscience would be to require that professional to become complicit in an action that he or she believes to be harmful or immoral. The philosophical appeal to moral relativism is also flawed, because to insist that there is no universal standard of morality in medicine is to assert a truth claim that itself is not empirically verifiable. The absence of consensus on moral issues, on which conscientious people may disagree, does not establish that there exists no truth to be found on those issues. Differing views on ethical dilemmas are inevitable in a pluralistic society and should be welcomed as opportunities for dialogue and discovery. Moreover, to consider the patient's moral beliefs to be worthy of respect rather than arbitrary is to acknowledge the validity of moral beliefs. Neuroscience, while not possessing a complete theory of conscience, has mapped brain regions underlying moral reasoning. Conscience, which has both innate and cultivated aspects, involves empathy, social awareness, reasoning, memory, and assessment of anticipated consequences. The cognitive capacities that enable conscience are essential to human interactions and growth in wisdom. They are also imperfect. An individual professional's conscience is answerable to the professional community, to humanity, and to God. Medicine strives for a higher moral standard than can be codified in law, rationalized by philosophy, or pictured by brain scans. Abstract disciplines are detached from the patient as person, but medicine cannot be morally neutral. Medical care is actively concerned with human health and need. The practice of medicine is not merely an exchange of information or a technical procedure but is first and foremost a moral endeavor. The conditions at the bedside — the fact of illness, the act of profession, and the provision of medicine — define the healing relationship, where patient and physician partner together as moral agents for the patient's benefit. Preservation of the moral integrity of the medical profession is in everyone's interest. [ABSTRACT FROM AUTHOR]

The article focuses on the author's thoughts about the brain-based theory of neuroethics. The author asserts that the brain-based neuroethics recognizes that humanity belongs to a common moral community. He claims that it is possible to complete the theory of neuroethics by mapping out the brain's moral folds through technology.

The article highlights the ethical principles of turning a blind eye to conveniently deny the truth leading to serious errors in the medical community. It outlines the history for medical ethics to avoid turning the blind eye to human suffering in relation to the care of patients. It divulges that highest ethical standard basically adhered in the practice of medicine but trained professionals are not immune to tendency of turning the blind eye in the wrong direction.

The article focuses on the implication of ethics education for medical practitioners and physicians. It details a case against medical practitioners or camp doctors and Nazi physicians involved in assisting the mass murder of Jew prisoners, from the island of Kos in Greece, under the German Nazi regime from 1941 until 1945 at Auschwitz death camps. It discusses the role of the physicians in the mass murder and evaluates the ethics of medical practitioners.

An essay is presented which discusses the use of cognitive performance enhancement pharmaceuticals in the U.S. It explains the students' use of enhancement pharmaceuticals to increase mental focus, sustain wakefulness, and increase alertness. It also mentions that some pharmaceutical companies are planning to produce lifestyle drugs that will improve quality of life rather than relieve diseases.

An essay is presented on the effect of online networking in the social aspect of bioethics and explores the influence of human face in ethics. It discusses the broader participation of people in bioethical discourse that could raise the breadth of public understanding of medical science and help nonexperts to inquire the significances of scientific implications. The author states that online bioethics networking could possibly expand the global bioethics community, connecting cultures.