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Biomedical subjects

Florencia Luna

Publications and source records attributed to Florencia Luna.

8 recordsLinked to original sources

Poverty and inequality: challenges for the IAB: IAB presidential address.

This paper focuses on poverty and inequality in the world today. First, it points out how this topic is a main concern for the IAB. Second, it proposes 'new' theoretical tools in order to analyze global justice and our obligations towards the needy. I present John Rawls's denial that the egalitarian principle can be applied to the global sphere, his proposed weak duty of assistance, and his consideration of endemic poverty as essentially homegrown. In opposition, I focus on Thomas Pogge as representative of a cosmopolitan view who also holds a critical position towards the international systems which allow and cause poverty. I endorse the general normative proposal that defends every human being as an ultimate unit of moral concern, as well as the strategy of moving away from the charity model of bilateral aid to the realm of rights and duties. These ideas should redesign and broaden the normative and practical roles of institutions, and should also help provide a new approach on bioethical issues such as drug patenting or the imbalance in global research and neglected diseases.

Bioethical Issues↗

Is physician-assisted death only for developed countries? Latin America as a case study.

The achievements of modern medicine are manifold and impressive. However, there is a broad recognition of the fact that continuing medical treatment is not always beneficial to the patient, nor is it always what the patient wants. This has led to a debate about the way physicians may or may not be involved in the end of life of patients. Could there be a justification for the active ending of a patient's life? This debate has a global character. In this article we will explore this debate for developing countries; we will focus on physician-assisted death (PAD) in Latin American countries. At stake is the moral relevance of differences, not the moral justification of PAD per se. We argue that arguments for PAD apply equally in affluent and in developing countries. Some of the counterarguments, however, would seem to hold more in developing countries than in affluent countries. Yet, under certain conditions, a policy tolerating PAD would be as acceptable in developing countries as in developed countries.

Attitude of Health Personnel↗

Corruption and research.

Last year there was a heated debate regarding clinical trials with AZT carried out in developing countries. AIDS vaccine trials also posed various dilemmas and ethical problems. In this paper I will consider the possibility of corruption in bioethics, and international multi-centre research will be taken as an example. International clinical trials will be seen from another perspective. I will try to show that the possibility of systemic corruption should be considered when designing an international multi-centre research trial which may involve countries in very different situations regarding corruption. I will analyze three different approaches to this problem and suggest some strategies regarding their capacity to exclude the possibility of corruption.

Biomedical Research↗

Paternalism and the argument from illiteracy.

Throughout this essay, I will consider an argument frequently used to justify paternalistic behavior toward a specific class of persons: illiterate people. The argument states that illiterate people are uneducated, lack information and understanding, and are thus unable to make decisions. Therefore, it is argued, paternalism in their case is justified. The conclusion is that illiterate persons cannot be autonomous. The justification for this view is based on an a priori attitude: since it is impossible to communicate, physicians should decide which kind of treatment the illiterate patient should receive. This argument is frequently used even though its proponents may not be aware of its implications. Given the importance and uncritical acceptance this argument has in Argentina, and also in other Latin American countries, I think it is relevant to analyze carefully what it means. I propose a thorough analysis of this argument, of its implications and an evaluation of whether it is acceptable.

Argentina↗

Vulnerable populations and morally tainted experiments.

This article addresses the dilemma facing an editor when he or she has to decide whether or not to publish a manuscript that describes unethical research. I will explore three options the editor may follow: a) publish the unethical research; b) publish it with an explicit condemnation of the methods used; c) reject the article on moral grounds. I will consider the importance of deterring unethical research, why the deterrence argument has been overlooked and the relevance it has in developing countries which seem to be more exposed to morally tainted experiments. I will suggest a combined policy. For cases in which the ethical problems are serious -- where basic human rights are not respected, where consent has been given without complete or proper information or voluntary participation by subjects, or where deceit has been practised -- I would support the strong policy of rejecting the article on moral grounds. For dubious cases, where the risk assessment can be doubted or where there are suspicions of ethical problems, I argue for a policy under which the article is published along with a serious discussion of the ethical problems suspected, allowing a rebuttal by the authors. In this way, while maintaining a strong deterrent policy, we recognize that sometimes it is not so clear if a research project was unethical, and only in such cases (where the ethical problems are dubious), the article may be published with an editorial.

Biomedical Research↗