RESUMO
Sediments from coal mine drainages (CMDs) contain large quantities of suspended pollutants (possibly numerous chemical substances) along with sulfates and hazardous elements (e.g., chromium, zinc, copper, lead) that irreversibly accumulate in the water. As this accumulation can continue for decades after discontinuation of coal extraction, it is necessary to employ multidisciplinary approaches to control the threat in such zones. The quantity of amorphous material in some CMDs was evaluated by X-ray powder diffraction (XRD) using the Rietveld-based SIROQUANT software package. Modern Dual Beam Focused Ion Beam (FIB), field emission scanning electron microscopy (FE-SEM), high-resolution transmission electron microscope (H-TEM), and energy-dispersive X-ray spectrometer (EDS) were used to evaluate the occurrence and transformation of nanophases (NPs). FIB is used to determine the 3D distribution of different species (internal structure) within individual NPs, whereas EDS is used to observe NP features (e.g., shape, constituent, range, assembly, and form of polymerization). The mineralogy of the sediment from the Brazilian CMDs, including the proportions of quartz, clays, Al-Fe-oxides, and amorphous NPs, appears to be related to the nature of the mineral matter in the relevant coal cleaning rejects (CCRs). The sediments of CMDs from the Brazilian coal area derived at a lower-pH range have different amorphous compositions as compared to those derived at a higher pH range. These special amorphous compositions are shown to be related to several other sediment properties such as particle surface area. The information gleaned in this study will be useful for further geochemical evaluation of CMDs in other parts of the world.
Assuntos
Monitoramento Ambiental/métodos , Brasil , Carvão Mineral/análise , Cinza de Carvão/análise , Cobre/química , Poluentes Ambientais , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Minerais/química , Mineração , Espectrometria por Raios X , Difração de Raios XRESUMO
In this article I explore the underlying political philosophy of public bioethics by comparing it to technocratic authority, particularly the technocratic authority claimed by economists in Mexico in the 1980s and 1990s. I find that public bioethics--at least in the dominant forms--is implicitly designed for and tries to use technocratic authority. I examine how this type of bioethics emerged and has continued. I finish by arguing that, as claims to technocratic authority go, bioethics is in an incredibly weak position, which partly explains why it has never gained the degree of public legitimacy that other technocracies have gained. I conclude by arguing for a "technocracy-lite" orientation for public bioethics.
Assuntos
Eticistas/psicologia , Princípios Morais , Política , Humanos , México , FilosofiaRESUMO
The possibility that organ sales by living adults might be made legal is morally distressing to many of us. However, powerful arguments have been provided recently supporting legalisation (I consider two of those arguments: the Consequentialist Argument and the Autonomy Argument). Is our instinctive reaction against a market of organs irrational then? The aim of this paper is not to prove that legalization would be immoral, all things considered, but rather to show, first, that there are some kinds of arguments, offered in favour of legalisation, that are, in an important sense, illegitimate, and second, that even if legalisation might not be wrong all things considered, there are good reasons for our negative moral intuitions. Moreover, identifying these reasons will help highlight some features of moral decisions in non-ideal situations, which in turn might be relevant to some other moral or policy choices.
Assuntos
Comércio/ética , Análise Ética , Doadores Vivos , Obtenção de Tecidos e Órgãos/economia , Teoria Ética , Humanos , Doadores Vivos/ética , Autonomia Pessoal , Filosofia , Política Pública , Justiça Social , Obtenção de Tecidos e Órgãos/éticaRESUMO
Human beings are essentially vulnerable in the view that their existence qua humans is not given but constructed. This vulnerability received basic protection from the State, expressed in the form of the universal rights all citizens are meant to enjoy. In addition, many individuals fall prey to destitution and deprivation, requiring social action aimed at recognising the specific harms they suffer and providing remedial assistance to palliate or remove their plights. Citizens receive protection against their biologic vulnerability by means of an in rem right to health [care], which is more an attitude of protection than a specific programme. When individuals become susceptible, that is, biologically weak or diseased, they also increase their predisposition to additional harm, and require social actions to treat their demeaned condition. Such assistance takes the form of positive healthcare rights. Research on human beings has been slow to observe that the subjects recruited are susceptible, especially so if research is done in less developed countries. By mislabelling them as vulnerable--a characteristic they share with all humans--sponsors avoid registering the deprivation these people suffer, and the ethical obligation to offer them remedial help. The distinction between vulnerability and susceptibility also marks the difference between being intact but fragile--vulnerable--and being injured and predisposed to compound additional harm--susceptible. Awareness of this difference should give additional force to the rejection of double standards in research ethics.
Assuntos
Atenção à Saúde/ética , Países em Desenvolvimento , Experimentação Humana/ética , Direitos Humanos , Internacionalidade , Filosofia , Sujeitos da Pesquisa , Justiça Social , Populações Vulneráveis , Bioética , Ética em Pesquisa , Humanos , Paternalismo , Sistemas PolíticosRESUMO
Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might be expected to use their energy and scholarship to explore and endorse the universalisability of ethics rather than to develop ad hoc arguments that would allow exceptions and variations from accepted moral standards. To this purpose, issue will be taken with arguments in three fields: medical and pharmaceutical practices, research strategies, and local application of research results.
Assuntos
Ensaios Clínicos como Assunto/normas , Países em Desenvolvimento , Experimentação Humana , Internacionalidade , Seleção de Pacientes , Bioética , Protocolos Clínicos/normas , Grupos Controle , Tomada de Decisões , Países Desenvolvidos , Relativismo Ético , Saúde Global , Declaração de Helsinki , Humanos , Consentimento Livre e Esclarecido , Cooperação Internacional , Avaliação das Necessidades , Defesa do PacienteRESUMO
In this article, I examine some proposals for modification of ethical documents regulating research, particularly, the problems that introducing certain economic clauses may pose. I evaluate suggestions that reject the notion of providing the 'best proven diagnostic and therapeutic method' in favor of 'the highest attainable therapeutic method' or 'the proven effective prophylactic, diagnostic and therapeutic methods.' I analyze the plausibility and problems of introducing a double standard and the consequences it may have in developing countries. Finally I highlight the impact these changes may imply for these countries.
Assuntos
Ensaios Clínicos como Assunto/normas , Países em Desenvolvimento , Ética em Pesquisa , Experimentação Humana , Ensaios Clínicos como Assunto/economia , Grupos Controle , Relativismo Ético , Acessibilidade aos Serviços de Saúde , Declaração de Helsinki , Experimentação Humana/economia , Humanos , Internacionalidade , Projetos de Pesquisa/normas , Sujeitos da Pesquisa , Justiça Social , Fatores SocioeconômicosRESUMO
An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.
Assuntos
Bioética , Análise Ética , Métodos , Filosofia , Emoções , Teoria Ética , Humanos , Princípios Morais , NarraçãoRESUMO
How might bioethics take account of cultural diversity? Can practical wisdom of an Aristotelian sort be applied across cultures? After showing that practical wisdom involves both intellectual cleverness and moral virtue, it is argued that both these components have universality. Hence practical wisdom must be universal as well. Hellenic ethical thought neither depended on outdated theoretical notions nor limited itself to the Greek world, but was in fact developed with constant awareness of cultural differences, so it arguably works as well in other times and places when formulated. Even the eudaemonistic setting for practical wisdom is unproblematic.
Assuntos
Bioética , Análise Ética , Filosofia , Diversidade Cultural , Mundo Grego , VirtudesAssuntos
Doação Dirigida de Tecido , Ética Médica , Consentimento Livre e Esclarecido , Doadores Vivos , Menores de Idade , Medição de Risco , Irmãos , Obtenção de Tecidos e Órgãos , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Coerção , Família , Feminino , Humanos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Função Jurisdicional , Transplante de Rim/normas , Transplante de Fígado/normas , Doadores Vivos/legislação & jurisprudência , Masculino , Obrigações Morais , Consentimento dos Pais , Autonomia Pessoal , Justiça Social , Doadores de Tecidos , Estados UnidosRESUMO
This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.
Assuntos
Países em Desenvolvimento , Relativismo Ético , Ética , Soropositividade para HIV , Experimentação Humana , Recém-Nascido , Placebos , Gravidez , Gestantes , Padrões de Referência , Projetos de Pesquisa , Síndrome da Imunodeficiência Adquirida , África , Altruísmo , Beneficência , Centers for Disease Control and Prevention, U.S. , Códigos de Ética , Grupos Controle , República Dominicana , Teoria Ética , Ética Profissional , Humanos , Consentimento Livre e Esclarecido , Cooperação Internacional , Internacionalidade , National Institutes of Health (U.S.) , Preparações Farmacêuticas , Medicina Preventiva , Distribuição Aleatória , Pesquisa , Sujeitos da Pesquisa , Justiça Social , Fatores Socioeconômicos , Tailândia , Experimentação Humana Terapêutica , Organização Mundial da Saúde , ZidovudinaRESUMO
Enhancement-line human genetic engineering has recurrently been targeted for bioethical discussion and is usually (if not always) illustrated by examples alluding to a genetic technology that is far beyond our current possibilities. By discussing an ambitious project related to solid tumor cancers--multidrug resistance (MDR)--the present paper places the question on a more realistic plane and draws bioethical conclusions to serve as guidelines in the field. The paper also establishes the inadequacy of the prevalent concept of genetic medicine as one of substitution.
Assuntos
Bioética , Técnicas de Transferência de Genes/normas , Melhoramento Genético , Princípios Morais , Qualidade de Vida , Resistência a Múltiplos Medicamentos/genética , Engenharia Genética/normas , Pesquisa em Genética , Terapia Genética , Características Humanas , Humanos , Medição de Risco , Valores SociaisRESUMO
Our objectives were to review and analyze the laws in the 50 states, the District of Columbia, and Puerto Rico that regulate the acquisition, storage, and use of public health data and to offer proposals for reform of the laws on public health information privacy. Virtually all states reported some statutory protection for governmentally maintained health data for public health information in general (49 states), communicable diseases (42 states), and sexually transmitted diseases (43 states). State statutes permitted disclosure of data for statistical purposes (42 states), contact tracing (39 states), epidemiologic investigations (22 states), and subpoena or court order (14 states). The survey revealed significant problems that affect both the development of fair and effective public health information systems and the protection of privacy. Statutes may be silent about the degree of privacy protection afforded, confer weaker privacy protection to certain kinds of information, or grant health officials broad discretion to disseminate personal information. Our proposals for law reform are based on a meeting of experts at the Carter Presidential Center under the auspices of the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists: (1) an independent data protection commission should be established, (2) health authorities should justify the collection of personally identifiable information, (3) subjects should be given basic information about data practices, (4) data should be held and used in accordance with fair information practices, (5) legally binding privacy and security assurances should attach to identifiable health information with significant penalties for breach of these assurances, (6) disclosure of data should be made only for purposes consistent with the original collection, and (7) secondary uses beyond those originally intended by the data collector should be permitted only with informed consent.
Assuntos
Segurança Computacional/legislação & jurisprudência , Confidencialidade/legislação & jurisprudência , Bases de Dados Factuais/legislação & jurisprudência , Revelação , Regulamentação Governamental , Privacidade/legislação & jurisprudência , Administração em Saúde Pública/legislação & jurisprudência , District of Columbia , Ética Institucional , Doenças Genéticas Inatas , Aplicação da Lei , Porto Rico , Estados UnidosAssuntos
Alocação de Recursos para a Atenção à Saúde/tendências , Reforma dos Serviços de Saúde/métodos , Seleção de Pacientes , Alocação de Recursos , Consenso , Controle de Custos/métodos , Análise Custo-Benefício , Diversidade Cultural , Alocação de Recursos para a Atenção à Saúde/economia , Comunicação Interdisciplinar , Oregon , Valores Sociais , Experimentação Humana Terapêutica , Estados Unidos , Suspensão de TratamentoRESUMO
The dead donor rule--that persons must be dead before their organs are taken--is a central part of the moral framework underlying organ procurement. Efforts to increase the pool of transplantable organs have been forced either to redefine death (e.g., anencephaly) or take advantage of ambiguities in the current definition of death (e.g., the Pittsburgh protocol). Society's growing acceptance of circumstances in which health care professionals can hasten a patient's death also may weaken the symbolic importance of the dead donor rule. We consider the implications of these efforts to continually revise the line between life and death and ask whether it would be preferable to abandon the dead donor rule and rely entirely on informed consent as a safeguard against abuse.
Assuntos
Morte , Cuidados para Prolongar a Vida/normas , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos/normas , Suspensão de Tratamento , Morte Encefálica , Encefalopatias , Teoria Ética , Eutanásia Ativa Voluntária , Homicídio , Corpo Humano , Humanos , Consentimento Livre e Esclarecido , Princípios Morais , Política Organizacional , Autonomia Pessoal , Obtenção de Tecidos e Órgãos/organização & administração , Estados UnidosAssuntos
Análise Ética , Ética Médica , Hepatectomia , Regeneração Hepática/fisiologia , Transplante de Fígado/legislação & jurisprudência , Medição de Risco , Doadores de Tecidos/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Adulto , Brasil , Pré-Escolar , Revelação , Revisão Ética , Teoria Ética , Comissão de Ética/legislação & jurisprudência , Comitês de Ética Clínica , Feminino , Humanos , Lactente , Masculino , Princípios Morais , Motivação , Autonomia Pessoal , Experimentação Humana TerapêuticaRESUMO
Increased availability of growth hormone (GH) because of increased production using recombinant DNA technology has led to increased demand. Many children who do not have classic GH deficiency may respond to GH therapy. These observations require rethinking of the medical indications for GH therapy, and raise two central ethical questions: (1) Is it justified to discriminate on the basis of GH deficiency? (2) Whatever the indication for GH treatment, at what height should GH therapy be considered an entitlement? We argue, first, that GH responsiveness, not GH deficiency, should be the criterion for GH treatment, and that prior arguments emphasizing GH deficiency are based on vague or faulty notions of disease, handicap, or potential. Second, we argue that children who are handicapped (arbitrarily defined as including those whose height is below the 1st percentile) and GH responsive are entitled to treatment. Children above that height, whether GH deficient or not, may permissibly be treated, but there is no societal obligation to do so. Such an approach would reduce, though not eliminate, some of the more severe burdens of short stature without aggravating the pernicious effects of "heightism" in American society.