Pravne, socijalne i etičke implikacije editovanja humanog genoma primenom tehnologije CRISPR/Cas9

Discovery of CRISPR/Cas9 technology produced a revolution in human medicine, because of the availability, efficiency and low cost, which has raised a number of questions. Given that by applying CRISPR/Cas9 technology we can program our future children and extend their life expectancy, question is whether we should allow it. The point of the paper is to determine the limits of legal admissibility and ethical justification of this procedure, considering contemporary legal theoretical views, ethical values and social significance. Using normative, comparative and sociological method the authors analyze the impact of biotechnology development, in the context of genetic interventions, on redefining the regulatory framework. Critical consideration in the context of legal standardization of human genetic interventions and meeting the interests of all participants, has been identified as a core subject of research, which will be considered in accordance with a holistic approach to the realization of human rights.

Digital Contact Tracing Applications during COVID-19: A Scoping Review about Public Acceptance

Digital contact tracing applications (CTAs) have been one of the most widely discussed technical methods of controlling the COVID-19 outbreak. The effectiveness of this technology and its ethical justification depend highly on public acceptance and adoption. This study aims to describe the current knowledge about public acceptance of CTAs and identify individual perspectives, which are essential to consider concerning CTA acceptance and adoption. In this scoping review, 25 studies from four continents across the globe are compiled, and critical topics are identified and discussed. The results show that public acceptance varies across national cultures and sociodemographic strata. Lower acceptance among people who are mistrusting, socially disadvantaged, or those with low technical skills suggest a risk that CTAs may amplify existing inequities. Regarding determinants of acceptance, eight themes emerged, covering both attitudes and behavioral perspectives that can influence acceptance, including trust, privacy concerns, social responsibility, perceived health threat, experience of and access to technologies, performance expectancy and perceived benefits, and understanding. Furthermore, widespread misconceptions about the CTA function are a topic in need of immediate attention to ensure the safe use of CTAs. The intention-action gap is another topic in need of more research.

Normative Epistemology for Lethal Autonomous Weapons Systems

The rise of human-information systems, cybernetic systems, and increasingly autonomous systems requires the application of epistemic frameworks to machines and human-machine teams. This chapter discusses higher-order design principles to guide the design, evaluation, deployment, and iteration of Lethal Autonomous Weapons Systems (LAWS) based on epistemic models. Epistemology is the study of knowledge. Epistemic models consider the role of accuracy, likelihoods, beliefs, competencies, capabilities, context, and luck in the justification of actions and the attribution of knowledge. The aim is not to provide ethical justification for or against LAWS, but to illustrate how epistemological frameworks can be used in conjunction with moral apparatus to guide the design and deployment of future systems. The models discussed in this chapter aim to make Article 36 reviews of LAWS systematic, expedient, and evaluable. A Bayesian virtue epistemology is proposed to enable justified actions under uncertainty that meet the requirements of the Laws of Armed Conflict and International Humanitarian Law. Epistemic concepts can provide some of the apparatus to meet explainability and transparency requirements in the development, evaluation, deployment, and review of ethical AI.

The Empty Demand for Solidarity

In times of crisis, an increasing number of voices are being raised calling for solidarity. It can therefore be assumed that the ability to behave in solidarity is of public interest and should be cultivated. Can and must solidarity then be an educational goal and in what way could it be implemented? A first step in answering these questions is to determine the content of the concept of solidarity, which has been interpreted in many different ways. In this article, I follow Simon Derpmann’s understanding of solidarity in order to propose a pedagogical view based on it. Consequently, two educational goals can be named that are conducive to the cultivation of solidarity: First, moral identity as the assurance and commitment to one’s own moral convictions, and second, the ability to collaborate in order to pursue shared and common goals with others. Finally, there remains the question of whether solidarity has an intrinsic value for the education of subjects, or whether it is a political endeavor that has no educational ethical justification in pedagogical debates.

Righting Wrongs or Wronging Rights?

This chapter highlights one of the classical and most disputed debates in transitional literature: the ethical justification of the transitional justice measures, as opposed to its legal dimensions. By employing a conceptual analysis to spell out the 'retributive' and 'holistic' conceptions of justice, it argues that both views fail to fully tailor their normative framework to the empirical conditions in which such institutions are implemented (e.g. large-scale wrongdoings and institutional weakness). In this sense, the chapter draws out a proposal that synthesizes the motivating concerns behind both positions, and attempts to overcome the diagnosed flaws, by drawing a conceptual bridge between the two opposing views. Rather than advocating for one position or the other, it tries to articulate the crucial insights of both views in light of the victims' right to justice. It suggests that transitional justice measures should be oriented towards creating appropriate conditions to enable and legitimize the future exercise of standardized procedures for redress.

Palliative Sedation, Compassionate Extubation, and the Principle of Double Effect: An Ethical Analysis

Palliative sedation is a well-recognized and commonly used medical practice at the end of life for patients who are experiencing refractory symptoms that cannot be controlled by other means of medical management. Given concerns about potentially hastening death by suppressing patients’ respiratory drive, traditionally this medical practice has been considered ethically justifiable via application of the ethical doctrine known as the Principle of Double Effect. And even though most recent evidence suggests that palliative sedation is a safe and effective practice that does not hasten death when the sedative medications are properly titrated, the Principle of Double Effect is still commonly utilized to justify the practice of palliative sedation and any risk—however small—it may entail of hastening the death of patients. One less common clinical scenario where the Principle of Double Effect may still be appropriate ethical justification for palliative sedation is when the practice of palliative sedation is pursued concurrently with the active withdrawal of life-sustaining treatment—particularly the practice of compassionate extubation. This case study then describes an unconventional case of palliative sedation with concurrent compassionate extubation where Principle of Double Effect reasoning was effectively employed to ethically justify continuing to palliatively sedate a patient during compassionate extubation.

At the limits of patient autonomy: an ethical re-evaluation of coroner’s postmortems

Patient autonomy is one of the four pillars of modern medical ethics. In some cases, however, its value is not absolute and autonomy may be overridden by sufficiently important matters of public interest. Coroner’s autopsies represent an example of when the wishes of the deceased and their family may come in conflict with the benefits of knowledge gained from understanding the cause of death. Current legislation governing coroner’s autopsies relies on the assumption of their obvious public benefit, hence consent for them need not be sought. This interpretation has attracted controversy, as exemplified by the case of Rotsztein vs HM Senior Coroner and a recent study questioning the prevalent use of invasive autopsy. However, this issue has received little recent attention in ethical literature. In this essay, the ethical nature of coroner’s autopsies in cases of natural deaths with unexplained causes is examined as a balance between patient autonomy and the value of knowledge gained from them. This is done by analysing a case which under current legislation warrants coroner’s autopsy, however, its ethical justification remains contentious. This discussion is expanded by discussion of non-invasive alternatives and comparison to another situation which balances individual autonomy with public benefits—organ donation. The conclusion of this analysis is a moral middle ground in which objection to invasive autopsy could be respected once issues of overriding public interest are excluded, or at least non-invasive alternatives should be considered, with coroners left responsible for demonstrating specific public needs that could override objection.

Verteilung knapper lebensrettender Ressourcen. Überlegungen zur Debatte um die „Triage“

The article deals with the ethical justification of distribution procedures in case of a shortage of life-saving resources, as they have been discussed since spring 2020 under the keyword ‘triage’. Considering individual human dignity and the equal right to life for all people, widespread approaches to justification are critically reflected. The author examines arguments for an overall benefit-maximising distribution (saving the greater number at the expense of the smaller number) as well as some of the qualitative distribution criteria discussed in the current debate. The article concludes that there are narrow ethical and constitutional limits to both the utilitarian maximisation of life interests and the application of qualitative criteria such as age or presumed “remaining lifespan” after recovery.