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Macpherson I, Roqué MV, Segarra I. Moral enhancement, at the peak of pharmacology and at the limit of ethics. Bioethics 2019; 33:992-1001. [PMID: 31264244 DOI: 10.1111/bioe.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 11/12/2018] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
The debate over the improvement of moral capacity or moral enhancement through pharmacology has gained momentum in the last decade as a result of advances in neuroscience. These advances have led to the discovery and allowed the alteration of patterns of human behavior, and have permitted direct interventions on the neuronal structure of behavior. In recent years, this analysis has deepened regarding the anthropological foundations of morality and the reasons that would justify the acceptance or rejection of such technology. We present a review of proposals for pharmacological interventions directed directly towards moral enhancement. In addition, we identify the ethical dilemmas that such interventions may generate, as well as the moral assessment of the authors of these studies. There is a moderate consensus on the risks of any intervention on the intimate structure of the human condition, its autonomy and identity, but there are large differences in explaining the reasons for this concern and especially in justifying such interventions. These findings show that it is necessary to investigate the moral assessment of authors and the ethical dimension within the field of pharmacology in order to identify future trends.
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Affiliation(s)
- Ignacio Macpherson
- Faculty of Humanities, International University of Catalonia, Sant Cugat del Valles, Barcelona, Spain
| | - María Victoria Roqué
- Faculty of Humanities, International University of Catalonia, Sant Cugat del Valles, Barcelona, Spain
| | - Ignacio Segarra
- Department of Pharmacy, Faculty of Health Sciences, Catholic University of Murcia (UCAM), Murcia, Spain
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Neville PF. An ethical viewpoint: The role of veterinarians and behaviourists in ensuring good husbandry for cats. J Feline Med Surg 2016; 6:43-8. [PMID: 15123165 DOI: 10.1016/j.jfms.2003.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/18/2003] [Accepted: 09/25/2003] [Indexed: 11/17/2022]
Abstract
Cat owners commonly consider their pets to be members of their families, and many factors contribute to a high level of owner attachment to their cats. Suppression of a cat's emotional needs in favour of the emotional requirements of the owner may produce a less satisfactory relationship for the owner, and usually for the cat as well. Owners' failure to comprehend their cat's true demands of life, and their false expectation of their ability to fulfil human psychological demands lies at the heart of many feline behaviour problems.
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Affiliation(s)
- Peter F Neville
- Centre of Applied Pet Ethology, PO Box 6, Fortrose, Ross-shire, Scotland IV10 8WB, UK.
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Rodogno R, Krause-Jensen K, Ashcroft RE. 'Autism and the good life': a new approach to the study of well-being. J Med Ethics 2016; 42:401-8. [PMID: 27174806 DOI: 10.1136/medethics-2016-103595] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/18/2016] [Indexed: 05/28/2023]
Abstract
Medical, psychological, educational and social interventions to modify the behaviour of autistic people are only justified if they confer benefit on those people. However, it is not clear how 'benefit' should be understood. Most such interventions are justified by referring to the prospect that they will effect lasting improvements in the well-being and happiness of autistic people, so they can lead good lives. What does a good life for an autistic person consist in? Can we assume that his or her well-being is substantively the same as the well-being of non-autistic individuals? In this paper, we argue that, as it stands, the current approach to the study of well-being is for the most part unable to answer these questions. In particular, much effort is needed in order to improve the epistemology of well-being, especially so if we wish this epistemology to be 'autism-sensitive'. Towards the end of the paper, we sketch a new, autism-sensitive approach and apply it in order to begin answering our initial questions.
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Affiliation(s)
- Raffaele Rodogno
- Department of Philosophy & History of Ideas, Aarhus University, Aarhus C, Denmark
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Affiliation(s)
- Desmond O'Neill
- Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Ireland.
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Underhill K. Transferring behavioral interventions for global health: intellectual property barriers, information constraints, and possible solutions. Yale J Health Policy Law Ethics 2010; 10:357-398. [PMID: 20681439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Lippa CF. Caffeine, ethical and practical challenges, and nonpharmaceutical interventions for Alzheimer's and related dementias. Am J Alzheimers Dis Other Demen 2008; 23:415-6. [PMID: 19230120 PMCID: PMC11068154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Erickson SK, Erickson PE, Campbell A. Treatment compliance and child custody. Psychiatr Serv 2005; 56:756; author reply 756-7. [PMID: 15939963 DOI: 10.1176/appi.ps.56.6.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Knowing, either by the light of natural reason or by the light of Christian revelation, that homosexuality is a disordered condition is not sufficient for its being ethically permissible to direct self-identified homosexual persons toward just any treatment that aims to modify sexual orientation. For example, such an undertaking would be morally impermissible in cases where the available "treatments" are known to be both futile and potentially damaging to persons undertaking them. I, therefore, introduce this edition of Christian Bioethics by reflecting on (a) the position of homosexuality in our current psychiatric nosology, (b) problems with drawing causal inferences from the outcomes of psychotherapy studies, and (c) the advantages and disadvantages of appealing to traditional categories of sexual orientation in this discussion, all with an eye toward more deeply elucidating core ethical concerns involving the intentional psychotherapeutic modification of sexual orientation.
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Affiliation(s)
- A A Howsepian
- Fresno Medical Education Program, University of California, San Francisco, California, USA
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Howsepian AA. Treating homosexuality: a response to Yarhouse. Christ Bioeth 2004; 10:259-267. [PMID: 15764099 DOI: 10.1080/13803600490898092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Professor Mark A. Yarhouse proposes an 'identity synthesis' model of sexual modification therapy for homosexuals. This model is meant primarily to target the process by which one's sexual identity is synthesized, rather than the changing of sexual orientation itself. I highlight some of the advantages of Yarhouse's model along with some of its potential pitfalls. My primary point of departure with Yarhouse concerns how one ought to direct those self-identified homosexual clients who fall within our clinical sphere of influence and who, in the end, contrary to our better judgment, decide that they would like to pursue a course of "homosexualization." Based on the "autonomy" - emphasizing aspects of the identity synthesis model, it appears that Yarhouse is willing to sanction the referral of certain clients to "therapists" who are willing to facilitate these clients' homosexualization. I do not believe that Christians involved in the care of homosexuals can licitly participate in such referrals.
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Affiliation(s)
- A A Howsepian
- Fresno Medical Education Program University of California, San Francisco, California, USA
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Abstract
The ideal of virtue demands not only right choice and right behavior but also right desire in the emotions. Homosexual desire, then, even if it does not result in overt homosexual behavior, is contrary to virtue, and the completion of virtue demands right desire. If a homosexual has no plan to marry, then right desire implies only the removal of homosexual desire and not the revival of heterosexual desire at which reorientation therapy aims. On the other hands, if a homosexual is married or plans to marry, then right desire includes heterosexual desire for one's spouse. If homosexual desire is viewed as an emotional disorder, and not merely as a moral defect, then it may require reorientation therapy to bring about heterosexual desire. The pursuit of virtue, then, may recommend reorientation therapy, but even this recommendation is fairly limited, since reorientation therapy may be burdensome and may not be that effective. In conclusion, married homosexuals or homosexuals planning to marry may have a limited moral obligation to pursue reorientation therapy.
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Lutz D. The Catholic Church, the American military, and homosexual reorientation therapy. Christ Bioeth 2004; 10:189-226. [PMID: 15764096 DOI: 10.1080/13803600490898065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Homosexual activist groups have targeted the Catholic Church and the American military as institutions especially in need of transformation. Associations of healthcare professionals are also under assault from homosexual activists. It is, nevertheless, appropriate for the Church and the military to defend themselves against this assault, to affirm that homosexuality is incompatible with Christian ethics and military service, and to help homosexuals free themselves from the vice of homosexuality. Arguments that homosexual reorientation therapy is unethical are unsound. Such therapy is consistent with the Christian virtue of charity.
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Affiliation(s)
- David Lutz
- The Catholic University of Eastern Africa, Nairobi, Kenya
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Hierholzer R. Are we ready for sexual reorientation therapy in the U.S. military? A response to David W. Lutz. Christ Bioeth 2004; 10:227-238. [PMID: 15764097 DOI: 10.1080/13803600490898074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In his paper "The Catholic Church, the American Military, and Homosexual Reorientation Therapy," David W. Lutz ultimately concludes that it is "appropriate, and highly ethical" for the American military to offer reorientation therapy to help homosexuals overcome "the vice of sodomy." The major thrust of his paper, however, is to call for abandonment of the "Don't Ask/Don't Tell" policy currently in place in the military. Lutz's paper covers much ground, and this review begins by examining whether such a wide view is necessary for the ultimate conclusions. It goes on to ask whether Lutz has omitted to mention important considerations bearing on this issue, and whether Lutz's call for the introduction of reorientation therapy is a serious call or a symbolic response to homosexual activities. Lutz fails to address essential issues such as the actual experiences of other nations having homosexuals in the military, and issues regarding what constitutes "reorientation therapy," the latter leading to questions about how such a therapy would actually be implemented.
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Affiliation(s)
- Robert Hierholzer
- Veterans Administration Central California Health Care System, Fresno, California, USA
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Abstract
Implicit metaphysical assumptions concerning the nature of sexual orientation are reflected in the language used to frame ethical debates concerning "reorientation" therapies. An alternative metaphysical construal is presented concerning sexual orientation and sexual identity development and synthesis. This alternative construal allows for humility concerning what we know and do not know about sexual orientation, underscores the client's self-determination and autonomy, and demonstrates regard for personal and religious valuative frameworks. Rather than focusing on therapies aimed specifically at sexual reorientation, clinicians would do well to provide clients with informed consent and to facilitate identity development and synthesis in keeping with their clients' requests for professional services.
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Abstract
This article evaluates the phenomenon of sexual reorientation therapy from the standpoint of Orthodox Christian theology. It is argued that homosexual desire is the product of the fall of mankind and cannot be considered "normal." At the same time, however, reorientation therapies, whether secular or Christian, are inherently reductionistic and fail to address the underlying spiritual pathologies involved in homosexual desire (or any other deep-seated passion). The purpose of therapeia in the Orthodox Church is the psycho-somatic transfiguration of the whole person into the image of Christ, not merely the cessation of homosexual activity or the "reidentification" of one's "lifestyle."
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Affiliation(s)
- Clark Carlton
- Tennessee Technological University, Cookeville, Tennessee, USA
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Smith JE. Are natural and unnatural appetites equally controllable? A response to Jensen's "Is continence enough?". Christ Bioeth 2004; 10:177-188. [PMID: 15764095 DOI: 10.1080/13803600490898056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This response challenges Jensen's analysis in no substantial way. Rather, it explains more fully some of the moral character categories that Aristotle provides. It argues that Aristotle understood there to be two forms of continence: the continence that enables us to control natural appetites and"some form"of continence directed towards unnatural appetites, generally engendered by some pathology or abuse.
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Affiliation(s)
- Jonathan D Moreno
- Center for Biomedical Ethics, University of Virginia, PO Box 800758, Charlottesville, Virginia 22908-0758, USA.
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Reinders HS. The ethics of behavior modification. Ethics Intellect Disabil 2003; 7:1-3. [PMID: 16018106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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