We carried out a cross-sectional quantitative, anonymous survey to examine how nurses perceive end-of-life decisions and attribute causality to physicians’ actions in a socio-cultural context in which palliative care is unregulated and active euthanasia is illegal. The survey concerns a hypothetical elderly patient with a terminal illness and considers three scenarios: withholding mechanical ventilation (MV), withdrawing MV, and medically assisted death. One hundred seventy-three nurses from a private university hospital in Buenos Aires participated. Over 70% perceived that illness was the cause of death when MV was withheld or withdrawn at the patient’s request. In the case of physicianassisted suicide, 61% perceived that the physician was the cause of death. Among nurses who perceived illness as the cause of death when MV was withheld, 73% (χ² test, p < .001) reported the same perception when MV was withdrawn. By contrast, only 33% (χ² test, p ≤ .001) of those who perceived illness as the cause of death when MV was withdrawn reported the same perception in the scenario of physician-assisted suicide. The nurses’ responses indicate variability in the attribution of causality when life-sustaining treatment is withdrawn, rather than evidencing a uniform interpretative pattern. Within these limits, the findings raise ethically relevant questions regarding how “letting a patient die” is understood in clinical practice. Normative ethical considerations are discussed separately, building on – but not directly inferred from – the empirical results.
My aim in this paper is to outline an “ecosophy”, which is a wisdom about home, along with an embedded ethic. I also want to clarify why this perspective is crucial and how it can contribute to the ongoing debate on the current ecological crisis. Knowledge and care for our home is essential to understanding and taking care of ourselves and our environment. To address this topic, I will begin the first part “From Home” by clarifying that as human beings, we create homes in order to inhabit the world, and a key element of dwelling is the concept of care. In the second part, I will analyze the significance of “Starting at Home”, emphasizing that education and our way of being in the world originate in the childhood home. In the third section I will elaborate on the meaning of loving one’s home. Finally, in conclusion, I want to emphasize that the concept of oikophilia compels the ecological debate to consider the true essence of human existence in the world. This reflection is universally recognized as the singular and vital starting point for building a sustainable future.
This paper examines the implications of creating a technocratic elitism in society where advancements in such medical technologies as “designer babies” pose significant threats. The power to rewrite human heredity is no longer confined to speculative fiction. Germline treatments extend these abilities to future generations, posing significant ethical questions of social justice, input, and perfection, even as somatic gene modification promises medicinal hope for healing disorders inside humans. Germline editing transfers changes to offspring, whereas somatic editing works within a single body’s genome and seeks to treat conditions. Because medicinal use and augmentation frequently overlap in language but differ in moral authority, thus, this distinction is essential to bioethics. This paper offers a humanities centered critique of “designer babies,” emphasizing the ethical concerns, societal (maybe racial) implications, and justice-related challenges surrounding embryonic gene editing. It argues that unregulated germ-line interventions risk solidifying social inequalities by creating a new form of inherited privilege that undermines the principles of democratic fairness. The analysis concludes with policy recommendations grounded in solidarity and global equity.
The “Art4ART” platform integrates Artificial Intelligence into oncology care by providing artistic stimuli to patients undergoing radiation therapy. This study preliminarily assesses the perceived ethical implications of the platform, examining healthcare professionals’ perceptions, by creating a 69-item questionnaire designed to evaluate the ethical principles of Beneficence, Non-Maleficence, Autonomy, Justice, and Explicability (in accordance with international guidelines). Thirty-four healthcare professionals working in an Italian research hospital (Dept. of Radiation Oncology) evaluated the Art4ART platform. Findings suggest the platform meets ethical standards by promoting wellbeing, supporting patient autonomy, and providing equitable access to care. Yet, certain areas, like data transparency and system monitoring, require further attention. Healthcare professionals also noted the need for enhanced training and clear communication on the system’s limitations and malfunction reporting. Overall, the platform’s focus on patient- centered care and the conveyance of positive values is well-received, underscoring the importance of ethical oversight in AI applications. This analysis highlights that the platform’s value lies not only in its technological features but also in fostering human-centered, compassionate care that respects oncology patient freedom and dignity within their therapeutic journey.
The global shortage of nursing personnel, estimated at approximately 5.8 million professionals, is prompting many highincome countries to resort to international recruitment as a means of rapidly filling care gaps. While this strategy may be effective in the short term, it raises ethical, legal, and organizational issues of considerable complexity. This study examines the phenomenon of international nursing mobility, with a focus on the Italian context, analyzing attraction models, qualification recognition procedures, integration mechanisms, and ethical implications. Through a combined analysis of scientific literature and data from institutional sources, critical issues are identified, including the brain drain from low- and middle-income countries, the heterogeneity of recognition procedures, the risk of waste of skills, and vulnerabilities associated with precarious contractual conditions and discriminatory practices. Based on the findings, the paper proposes a governance approach grounded in transparency, international responsibility, and distributive justice, encompassing structured professional integration pathways, mentoring programs, and the valorization of prior competencies. It also underscores the need to limit the systematic use of emergency derogations from formal recognition procedures, ensuring safe and sustainable care standards. An ethical and inclusive governance of nursing mobility has the potential to transform professional migration into an opportunity for innovation, social cohesion, and social justice, while simultaneously safeguarding the health of populations in both source and destination countries.
The case Indi Gregory constitutes a testing ground for pediatric clinical ethics in decisions concerning end-of-life care. The child, afflicted with a severe degenerative genetic disease, became the subject of a heated conflict between the parents and the medical staff regarding the discontinuation of life-sustaining therapies. The controversy, resolved in court, highlighted the central role of the principle of best interest of the child as a guiding criterion in clinical and legal decisions, overcoming divergences between parental will and medical assessments. The British context, with similar cases such as those of Alfie Evans and Charlie Gard, has underscored the importance of a multidisciplinary approach that considers not only medical prognosis but also the quality of life to be guaranteed to the minor. The ethical analysis emphasizes the delicate balance between parental autonomy, medical paternalism, and legal protection, highlighting the risk of excessive objectification that could harm the dignity of the person. The case confirms the necessity of strengthening pediatric palliative care as a compassionate and respectful response in the terminal phase. In conclusion, the experience of Indi Gregory calls for a critical and thorough reflection on how to structure ethical, transparent, and participatory decision-making processes capable of harmonizing the various interests involved and firmly affirming the respect for the most vulnerable person: the child.
This article examines how market-driven healthcare, guided by actuarial assessments, inverts medicine’s ethos by prioritizing financial risk over patient need. Through the case of “Bill”– a healthy individual denied long-term-care coverage due to a genetic predisposition to ALS – I reveal how utilitarian efficiency fosters exclusion rather than support. Drawing on critiques by Illich, Foucault, and MacIntyre, as well as Kantian and personalist ethics, I argue that healthcare must uphold the patient’s ontological dignity rather than reducing individuals to actuarial liabilities. While acknowledging the necessity of resource allocation, I contend that true moral legitimacy demands subordinating economic considerations to solidarity and justice. Moreover, emerging technologies like AI-driven diagnostics stand at a crossroads: they can either intensify selection based on genetic risk or be harnessed for preventive, person-centered care. Ultimately, I call for a reorientation of healthcare around the irreducible dignity of each patient rather than profit-driven imperatives.
Questo contributo mira a esplorare il progetto di ectogenesi, oggetto di innumerevoli sforzi nel campo della ricerca scientifica e fonte di fascino nell’attuale panorama femminista. Appropriandosi della lettura che de Beauvoir ha offerto della maternità e della biologia femminile, diverse autrici hanno infatti intercettato nella costruzione di un utero artificiale un radicale mezzo emancipatorio, in quanto capace di liberare la donna dalle proprie facoltà riproduttive. Il contributo mira così anzitutto a esaminare la lettura patologizzante della gravidanza e del parto implicita in questa rappresentazione, per poi evidenziare come l’impresa di rifacimento tecnico della condizione umana cui la nostra epoca si è definitivamente consacrata trovi proprio nell’utero artificiale una delle sue declinazioni più radicali e inquietanti.
La recente dichiarazione Dignitas Infinita del dicastero per la Dottrina della Fede ha riaffermato la valenza del concetto di dignità umana, che tradizionalmente il magistero interpreta in chiave ontologica, ovvero come valore intrinseco della persona. Attraverso il presente contributo, in primo luogo verranno analizzate quattro correlazioni che emergono dalla dichiarazione stessa, ovvero tra il concetto di dignità e le categorie di Imago Dei, relazionalità, natura e diritti umani. In secondo luogo, considerando in via generale le gravi violazioni della dignità umana elencate nella parte quarta del documento, verrà evidenziata la centralità del nesso vulnerabilità-dignità-cura. L’indagine svolta permette di evincere da una parte come la lettura ontologica non escluda un’interpretazione dinamica e relazionale di questo principio; dall’altra, come il rispetto per la dignità umana così inteso si configuri ultimamente nei termini di un appello alla cura della vulnerabilità.
Objetivo: Evaluar el conocimiento sobre el concepto de eutanasia y la opinión sobre su legalización, que tienen los estudiantes de medicina de una universidad privada de Buenos Aires, Argentina. Método: Estudio de tipo descriptivo correlacional de diseño transversal. Se realizó un encuesta voluntaria y anónima a estudiantes de medicina. Resultados: El 65.8% de los encuestados apoya la legalización de la eutanasia. Sin embargo, el 70.9% confunde la eutanasia con la limitación del esfuerzo terapéutico. Hay una relación estadísticamente significativa de la aceptación de la eutanasia en función del año de carrera [p<. 001] disminuyendo su aceptación en los últimos años. Hay una asociación significativa [p<. 001] entre la elección de la definición correcta de eutanasia y la aceptación de su legalización. Aquellos alumnos que conocen correctamente el concepto de eutanasia tendían a estar en desacuerdo con su práctica. Entre los que apoyan su legalización el 13.6% eligieron la definición correcta. El 68.4% de los que la rechazan conocen adecuadamente qué es la eutanasia. Se encontró una asociación significativa [p<. 001] que indica que aquellos alumnos que tenían un sentido trascendente de la vida tendían a no estar de acuerdo con la legalización de la eutanasia. Conclusión: Un alto porcentaje de los alumnos de medicina confunde la eutanasia con limitación del esfuerzo terapéutico, equiparando la eutanasia a los cuidados paliativos. El avance en la formación médica y bioética aumenta significativamente el rechazo a la legalización de la eutanasia. Esto evidencia la importancia de profundizar en la formación bioética de los estudiantes.
L’articolo affronta i problemi etici della medicina estetica, partendo da una definizione della disciplina che ne delimita gli ambiti ed esplicitando il confine sfumato tra cura e potenziamento/miglioramento nel contesto della concezione della salute intesa come pieno benessere fisico, psichico e sociale. L’articolo analizza le teorie etiche in questo contesto, con particolare attenzione al principio di proporzione e sproporzione tra rischi e benefici, alla luce anche della normativa vigente (con particolare riferimento alla legge 219/2017) e il codice deontologico. Una particolare attenzione è dedicata agli interventi estetici sui minori, con riferimento al consenso dei genitori e alla partecipazione dei minori alle scelte. Vengono inoltre affrontati, in modo critico, gli aspetti della formazione e dell’informazione sociale. Un decalogo finale è elaborato al fine di offrire indicazioni per un approccio etico alla medicina estetica.
Medical progress offers opportunities to save and prolong lives, but with these come ever more excruciating decisions on when to withdraw or withhold invasive medical treatments for terminally ill young children. Parents and clinicians normally need to agree on the child’s medical plan; however, if intractable disagreements among the parties occur, the final decision is remitted to the Family Court in the UK as in most countries around the world. The aim of this paper is to analyse the factors that define medical treatments as futile and the role played by the principles (variously understood) of quality-of-life and sanctity-of-life in the decision-making process both at the juridical and medical level. The paper will analyse court decisions and the academic literature in an attempt to shed more light on these pressing and multifaceted issues. It will then be argued that the interdependence of these factors is essential for making informed and unbiased decisions about the suspension or otherwise of life-sustaining treatments in terminally ill children.
L’intelligenza artificiale è strumento al servizio dell’umano e mezzo di perseguimento del benessere integrale. Tale strumento mira al miglioramento della condizione umana e rimuove le barriere di ordine pratico che ostacolano il pieno sviluppo della felicità, intesa come ricerca del senso del vivere e di quelle buone pratiche che rendono l’uomo virtuoso. Tale concetto è rintracciabile nell’Etica Nicomachea di Aristotele sotto il lemma di Eudaimonia e rappresenta ancora oggi un orientamento fondamentale sulla questione etica. In ambito sanitario si impongono complesse e annose questioni etiche sottese all’implementazione delle tecnologie. Il rischio di impiegare sistemi di intelligenza artificiale per finalità prive di fondamento etico e la possibilità, altrettanto grave e concreta, di rinunciarvi per eludere tale rischio, solleva questioni fondamentali sull’utilizzo di questi sistemi a supporto delle cure terapeutiche e del sistema sanitario in generale. Il lemma inglese di «cure», che si riferisce a interventi tout court in ambito sanitario, e quello di «care», che si riferisce invece al benessere integrale del paziente, rappresentano due approcci necessari e non escludenti.
Come segnala Martin Heidegger, ogni vivente è mortale ma solo l’essere umano ha contezza di esserlo. Motivo per cui si deve distinguere la morte, relativa al momento puntuale del cessare di vivere o perire, dal morire, che accompagna ogni istante del vivere umano in quanto appartiene al suo specifico modo di essere e di esistere. In questa cornice s’inscrive il presente contributo, volto a recensire gli atteggiamenti e le pratiche con cui il soggetto si rapporta alla morte e al morire, per poi illustrare modelli di cura buona.
The “Goldwater Rule”, introduced in 1973 by the American Psychiatric Association (APA), prohibits psychiatrists from publicly expressing diagnostic opinions about public figures whom they have not personally examined and without their consent. Originating in the aftermath of the 1964 presidential campaign and the Fact Magazine case, this rule stands as a central point of ethical debate between freedom of expression, professional responsibility, and the protection of individual dignity. This article traces the origins and evolution of the rule, analyzing its major violations and reinterpretations—from Jerrold Post’s psychological profile of Saddam Hussein to Bandy X. Lee’s The Dangerous Case of Donald Trump—and examining their connection to the legal principle of Duty to Warn derived from the Tarasoff ruling. The discussion also includes the perspective of psychology, which proposes a more flexible approach based on observable and documentary data, and reviews contributions that downplay psychiatric diagnosis as the sole criterion of leadership fitness, drawing on psychohistorical studies and the notion of “depressive realism” in historical leaders. A section is devoted to the European context, where there is no uniform consensus on the Goldwater Rule. Finally, the article examines contemporary defenses of the rule by scholars and ethics committees, reaffirming its importance in safeguarding the credibility of psychiatry and preventing political or media misuse. The concluding reflections emphasize the rule’s inherent ambiguity and contextual nature, its limited enforceability, and the need for its revision to align with the ethical and communicative challenges of modern society.
Canada’s medical assistance in dying (MAiD) framework has transitioned from a complete prohibition to a regulatory scheme that permits access for individuals whose conditions are not imminently life-ending. This article examines whether persistent existential distress, including psychological or spiritual suffering associated with illness, may satisfy the eligibility criteria under the current legal regime. While the analysis recognises that such suffering can fall within the statutory threshold, it maintains that inclusion should remain narrow and guided by strong procedural safeguards. The central concern is how law and policy can acknowledge non-physical suffering without weakening protections for those who may still recover or require support. Through doctrinal analysis, it traces the evolution from the Supreme Court’s Carter decision to subsequent statutory amendments, with particular attention to the tension between safeguarding individual autonomy and protecting those considered vulnerable. Psychological literature is employed to delineate the clinical features of existential suffering and the complexities of assessing irremediability. Comparative insights from Belgium and the Netherlands illuminate procedural safeguards and mechanisms for error reduction. The article recommends statutory clarification, comprehensive psychosocial assessment protocols, and enhanced oversight to maintain ethical consistency and minimize foreseeable risk.
The clinical and research contexts in which health care is provided are increasingly characterized by new challenges for health professionals, who often find themselves confronted with moral questions, which are not rare phenomena and therefore deserve special attention. Due to their more holistic approach to medicine, osteopaths may face a broad range of ethical dilemmas. A framework of ethics analysis specifically tailored for osteopathic medicine is needed to provide practical guidance for students and future practitioners. Italian law has recently recognized osteopathy as a health profession requiring a three-year university degree or an equivalent qualification. Consequently, Italian academies and universities that will offer osteopathic education in the near future should align their curricula with other healthcare professional’s education programs. Despite a widespread adoption of medical ethics curricula and the publication of several helpful reviews on ethics education, in the case of osteopathic medicine many questions remain about the nature, goals, and outcomes of ethics programs. The Italian Academy of Osteopathic Medicine (AIMO), with the support of the Research Center for Clinical Ethics (CREC), has recently undertaken the task of providing adequate training in medical ethics for its students. The aim of this article is to design and describe an ethics education program perfectly fitted for osteopathic profession through the analysis of key aspects such as quality and quantity of ethics instruction, type and format of ethics courses, teaching topics, methods and learning outcomes.
