Autonomy vs. beneficence. A bioethical inquiry for Covid-19 mandatory vaccination

Lately, the public discussion around mandatory vaccination has been an intensely enliven one. On the one hand, there are those who argue for the effectiveness of vaccination and demand that all procure it in order that all be immunize and that the threat of COVID-19 be minimize. On the other hand, there are those who are troubled about getting the vaccine and claim that mandatory vaccination is an infringement on their individual Autonomy. Furthermore, there are those who refuse vaccination for faith-based reasons and thus invoke religious exemption. The paper offers a moral analysis about the conflict between Mandatory Vaccination, supposed to be for the good of the community, and individual Autonomy. It clarifies why there are no moral basis for mandatory vaccination nor for religious exemption.

Choreographing conjoinment: Side Show’s fleshly fixations and disability simulation

This article aims to amplify disability theory’s impact in performance studies by generating a framework for understanding disability representation in musical theatre. Taking the original and revival Broadway productions of Side Show (1997, 2014) as a case study, I articulate how the musical simulates disability through a ‘choreography of conjoinment’ that relies on the exceptional able-bodiedness of the actors playing conjoined twins Daisy and Violet Hilton. Using disability as a category of analysis reveals how disabled bodies are made to be maximally productive iterations of themselves in musicals. To support this claim, I track the shift from the 1997 production’s co-construction of disability by the actors and audience, which replicates the social model of disability, to the 2014 revival’s grounding in a diagnostic realism typical of disability’s medical model. Side Show’s trajectory generates possibilities for considering the musical as an archive for disability representation and knowledge, bioethical inquiry, and artistic innovation.

The moral experiences of pediatric nurses in Brazil: Engagement and relationships

Background: Pediatric nursing care involves many significant ethical challenges. Although nurses are broadly recognized as professionals with relevant knowledge about children and families, little is known about how nurses experience ethical concerns in their everyday practice. Objective: The objective of this study was to better understand the moral experiences and related moral distress experiences of nurses working in pediatric settings in Brazil. Design: Interpretative phenomenological study conducted through narrative interviews. Participants and research context: Nine nurses working in three pediatric settings of a teaching hospital in a city of Southern Brazil. Ethical considerations: The study was approved by the Research Ethics Committee of the research site, and research ethics principles were respected throughout the study. Findings: This investigation illuminated a broader dimension of nurses’ moral distress, which was recognized as moral experience. In advancing our understanding of nurses’ moral experiences, engagement was identified as a central phenomenon that is present in the understandings and actions of nurses within their relationships in their daily practice and lived experiences. Three themes were described with regard to nurses’ relationships and their moral experiences: (a) relationship with the healthcare team; (b) relationship with the family; and (c) relationship with the child. Discussion: The findings of this study are congruent with emerging health literature that demonstrated the focus on moral distress as limiting for bioethical inquiry. Moreover, it is important to better understand and recognize nurses’ relational environment and engagements to advance understandings of the ethical dimensions of pediatric nursing practice. Conclusion: This study provides a better understanding on how engagement affects moral experiences, demonstrating how nurses can experience distress but also satisfaction, gratification, rewarding feelings, and a sense of responsibility for the care they provide.

The Ecosystem of Bioethics

Understanding bioethical inquiry as ecosystem aligns that thinking about health conceptually close to public health ethics. Despite having roots in decades-long, culturally-diverse, and disciplinarily-broad concerns about the relationships of human beings to environment as manifest in the work of Fritz Jahr and Van Rensselaer Potter, medical “mainstream” bioethics has maintained a relatively narrow focus on individual health. The practical instantiations of bioethics are inconsistent both with the term’s own historical international contexts and the ecosystemic nature of health, a concept of systems that includes both cultural and biological interactions. Following a growing number of international calls for such change in bioethics, this paper argues that a reinvigoration of bioethics demands transdisciplinary intersections of ecology, value, and health – as a bridge connecting across to the identified projects of public health ethics.

Guest Editorial: On Method and Resolution in Philosophical Bioethics

A large tranche of contemporary bioethical inquiry is self-consciously focused on purpose and methodology. Bioethics is a field of disparate disciplines, and it is not always clear what role the philosopher plays in the wider scheme. Even when philosophical reflections can, in principle, find application in the real world (and often, in bioethics, there is too heady a degree of abstraction for this), there can be difficulty in finding sound resolution between the competing perspectives. Where fundamentals differ, we face apparent deadlock, with theorists seemingly able only to talk across each other. Perspectives on this vary. For example, some will argue that the philosopher’s role is purely reflective and need have no practical resonance whatsoever. Others may say that philosophers are not equipped to engage with empirical questions or, when they do, they do so on flawed understandings of “the real world”; bad science or science fiction replaces brute fact and emotional, social, and empirical reality. Some may seek to strike a balance by trying to engage the questions within a political framing, allowing both for normative and real-world concerns.