Who Deserves a Ventilator Amidst the Covid-19 Pandemic? Sorting the Moral, Ethical and Legal Dilemma in Indian Scenario

The novel coronavirus disease (COVID-19) has rampaged into a second wave and shook the health infrastructure of several countries with India being among one of the worst-hit nations. In consideration of the current immense scarcity of ventilators in India, cautious resource allocation is the need of the hour. Hence, the Intensive care units and the ventilator allocation triage need to be formulated by a central public policy. This is due to the clinical implications, subjective judgments, ethical controversy, evidentiary weaknesses, and organizational complexities. This article suggests few approaches to suitably acknowledge everyone’s rights and judiciously allocate the ventilators for maximum benefit. This will ensure that the “maximum life years” are saved and no patient dies unlawfully.

Making sense of it all: Ethical reflections on the conditions surrounding the first genome-edited babies

In November 2018 the birth of the first genome-edited human beings was announced by Chinese scientist, He Jiankui. The ensuing ethical controversy, institutional investigations and legal proceedings led to the revision of standards, rules and procedures at many levels. Arguably, however, these developments have not fundamentally changed the conditions or the culture that nourished He Jiankui’s vaulting ambition in the first place and enabled it to find expression. In this paper we explore the clinical, regulatory and societal circumstances of the ‘gene-edited baby’ case, the political, cultural and economic conditions that created a radical and dangerous climate for biotechnology innovation, and the responsibilities of the international research community, many of whose members were apprised of Dr He’s intentions. The aim is not to heap anathemas on the heads of implicated individuals but to draw attention to the need for different communities (researchers, authorities and domestic publics) to play a part actively in the governance of biomedical innovation and for research to be bridled by human values.

Waste on the Tip of the Tongue: Social Eating Livestreams (Chibo) in the Age of Chinese Affluence

This article investigates Chinese social eating livestreams (chibo) in the context of China’s 2020 campaign against food waste. It argues that the subgenre ‘big stomach kings’, a target of the campaign, evinces the moral implications of Chinese affluence, of which food waste is exemplary. The emerging affluence in China has normalized conspicuous, wasteful consumption and given rise to a local form of flaunting wealth called ‘xuanfu’. Chinese social media are inundated with xuanfu images, a symptom of the necessary psychosocial adaptation to affluence. Isolating the ‘big stomach kings’ livestreams from the social context of xuanfu, the anti-waste campaign glosses over the underlying social issue of the vast wealth gap between the affluent and the poor. To expose the ethical controversy of these livestreams, the article also analyzes their gender politics by parsing the mystifying image of female ‘big stomach kings’, whose slim bodies are in stark contrast to their enormous appetites.

Microsurgical Anastomosis Rating Scale (MARS10): A Final Product Scoring System for Initial Microsurgical Training

Background: High cost and ethical controversy of using living models in microsurgical training made non-living models more popular. However, non-living models don’t provide appropriate feedback of microsurgical performance. Currently existing Global Rating Scales used for advanced microsurgical skills validation are difficult to apply on non-living model. This study presents a simple instrument for basic assessment of microsurgical anastomosis on non-living model. Methods: Seventy medical students were divided into 2 groups depending on their prior microsurgical experience. Each participant performed 3 end-to-end anastomoses on chicken femoral artery model. Anastomoses were reviewed by 3 blinded experts and then photographed. Evaluation included a patency tests, longitudinal cut of anastomosis, and the newly proposed tool 10 Point Microsurgical Anastomosis Rating Scale (MARS10). Presented scale consists of 5 factors important for anastomosis closure (anastomosis closure, suture spacing, bites size, knot tying, and cut ends length), graded on 3 point scale (0-2 points). Results were analyzed with analysis of variance, Spearman correlation, and t Student test. Results: Anastomoses evaluated by experts as patent significantly correlated with a high summary score in MARS10 scale (r = 0.73 P < .0001). There was a significant difference in MARS10 score between groups (P < .0001). There were no significant inter-rater differences in scoring among all 3 evaluators (p > .05). Conclusions: 10 Point Microsurgical Anastomosis Rating Scale is a quick, valid, and reliable tool to assess microsurgical end-to-end arterial anastomoses on non-living model.

A Puzzling Anomaly

Any ethical inquiry into addiction research is faced with the preliminary challenge that the term “addiction” is itself a matter of scientific and ethical controversy. Accordingly, the chapter begins with a brief history of the term “addiction.” The chapter then turns to ethical issues surrounding consent and decision-making capacity viewed from the perspective of the current opioid epidemic. One concern is the neglect of the cyclical nature of addiction and the implications of this for the validity of current psychometric instruments used to evaluate decision-making capacity in addiction. Another is the apparent discrepancy—possibly an ethical double standard—in the manner in which society and addiction researchers view the mental capacity and vulnerability of individuals who suffer from severe addiction. On the whole, the main ethical concern of the chapter is the puzzling lack of clinical research on decision-making capacity in research on addiction.

Making sense of it all: Ethical reflections on the conditions surrounding the first genome-edited babies

In November 2018 the birth of the first genome-edited human beings was announced. The ensuing ethical controversy, institutional investigations and legal proceedings led to the revision of standards, rules and procedures at many levels. Arguably, however, these developments have not fundamentally changed the conditions or the culture that nourished He Jiankui’s vaulting ambition in the first place and enabled it to find expression. In this paper we explore the clinical, regulatory and societal circumstances of the ‘gene-edited baby’ case, the political, cultural and economic conditions that created a radical and dangerous climate for biotechnology innovation, and the responsibilities of the international research community, many of whose members were apprised of Dr He’s intentions. The aim is not to heap anathemas on the heads of implicated individuals but to draw attention to the need for different communities (researchers, authorities and domestic publics) actively to play a part in the governance of biomedical innovation and for research to be bridled by human values.

The Skeleton in the Closet: Faults and Strengths of Public Versus Private Genetic Biobanks

Direct-to-consumer (DTC) genetic testing has been a major ethical controversy related to clinical utility, the availability of pre- and post-genetic counseling, privacy concerns, and the risk of discrimination and stigmatization. The development of direct-to-consumer genetic testing cannot leave aside some considerations on how the samples are managed once the analyses have been completed and the customer has received a response. The possibility that these samples are maintained by the structure for future research uses, explains the definition, which has been proposed in the literature, of these structures such as private genetic biobanks. The most relevant aspects that may impact ethical aspects, allowing a comparison between the public and private dimensions of genetic biobanks, are mainly transparency and participant/donor trust. The article aims to analyze the main line of ethical debate related to the mentioned practices and to explore whether market-based and consumer rights regarding DTC genetic testing can be counterbalanced by healthcare system developments based on policies that encourage the donation of samples in the context of public biobanks. A platform for dialogue, both technical–scientific and ethical, is indispensable between the public sector, the private sector and citizens to truly maximize both transparency and public trust in both contexts.

Hukuman Mati Dalam Lingkaran Kontroversi Etis Kristen

In the implementation of the death sentence is not a sentence given as a criminal offender sentenced to life imprisonment. However, the death penalty is the loss of a person's life due to an error proven guilty based on a court decision (jurisprudence). This right to life maps the death penalty as an ethical issue. The most noble right in life as a gift from God, the applicable legal regulations also place human life in a valuable position both in their roles and positions as well as in their social responsibilities or legal responsibilities and also regarding their rights and obligations. From this impact arose the pros and cons of both secular people and in Christianity itself. The researcher determines a qualitative descriptive method for studying, collecting and compiling data through literature studies that relate to the paradigm of the death penalty in a circle of Christian ethical controversy. Therefore, this article will describe the elements of power, love, truth and justice as the government's duty in showing its identity to enforce the execution of the death penalty and will explain the Christian ethical attitude and perspective of the Christian community towards the execution of the death penalty. Abstrak Dalam pelaksanaan hukuman mati bukanlah hukuman yang diberikan sebagai pelaku kejahatan dihukum dengan penjara seumur hidup. Namun hukuman mati merupakan penghilangan nyawa seseorang akibat kesalahan yang terbukti bersalah berdasarkan keputusan pengadilan (jurisprudensi). Hak hidup inilah memetakan hukuman mati sebagai persoalan etis. Hak tersebut paling mulia dalam kehidupan sebagai pemberian Tuhan, peraturan hukum yang berlaku juga menempatkan hidup manusia pada posisi yang berharga baik dalam peran dan posisi maupun dalam tanggung jawab sosial atau tanggng jawab hukumnya dan juga menyangkut hak maupun kewajiban-kewajibannya. Dari dampak ini pun timbul pro dan kontra baik orang sekuler maupun dalam kekristenan sendiri. Peneliti menentukan metode deskriptif kualitatif untuk mempelajari, mengumpulkan dan menyusun data melalui studi pustaka yang berhubungan dengan paradigma hukuman mati dalam lingkaran kontroversi etika Kristen. Oleh karena itu, artikel ini akan menguraikan unsur-unsur kekuasaan, kasih, kebenaran dan keadilan sebagai tugas pemerintah dalam memperlihatkan jatidirinya untuk menegakkan pelaksanaan hukuman mati dan akan menjelaskan sikap etis Kristen dan perpektif masyarakat Kristen terhadap pelaksanaan hukuman mati.