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Summary of Lectures

Palestrantes

OPENING CONFERENCE

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LAURA BISHOP (KIE/Georgetown)

Learning bioethics: a journey of formation​

Students in our bioethics classes learn about scientific facts, theoretical explanations, big concepts, the ideas of others, methods of reasoning, frameworks for decision making, numerous cases, and skills in critical thinking, careful writing and substantive discussion. When done well, however, education in bioethics is more than learning what others have thought and said and done; it is the effort to step into that flow of information and ideas, to learn and wrestle with what one’s own self thinks, will stand for, and hopes to do. Maybe the most important thing we can teach students is how to cultivate a sense of their own moral values and positions, and how to equip themselves to act in the clinic, the courtroom, the community, and their own lives. Actually all of us, whether students or professionals, are engaged in a continual effort to give an accounting of ourselves, our moral values and how we live into them.

In a world that focuses on the ability to “get a job,” I’ll explore the proposition that knowing oneself and developing empathy, “other-standing,” and moral agency are critical skills that enable one to not just get a job, but to live a life. I’ll reflect on some approaches to help undergraduates engage in their self-formation and transformation.

ROUND TABLE - BIOETHICS AND ENVIRONMENT

JELSON OLIVEIRA (PUCPR)

Nature under human responsibility​

It is about demonstrating how the work of Hans Jonas is situated in the field of bioethics, mainly in its concerns with the advance of biotechnology and its impacts in the field of medical ethics. Although he did not use the term “bioethics”, Jonas’ work can be considered one of the most important foundations of this area of knowledge, insofar as it highlights the need for the recent application of technology to the various spheres of life to be ethically oriented. , which implies recognizing the ontological value of living beings and human responsibility in the face of the risks brought by the new procedures. Jonas' problem has always been what he calls the “ethical vacuum”, that is, the nihilistic situation according to which “the greatest of powers joins the greatest of voids; the greatest of capacities, the least of knowledge about what to use that capacity for” (PR, 65). Bioethics would thus be, for him, an ethics applied to the task of “controlling extreme powers” in the face of what could also be an extreme risk, that of irreversibly affecting the integrity and authenticity of human life and even that of contribute to its disappearance. Innocence and ignorance cannot have the last word in the field of life and no bet can be made without taking into account the dangers integrated into the technological dynamics. For Jonas, if ethics is the science of acting, that is, if it “must exist because men act”, then bioethics would be the specific field of application on experiments with life in general, whose task is to “order their actions [of men] and regulate their power to act” and, therefore, “its existence is all the more necessary, therefore, the greater the powers of action it has to regulate” (PR, 65). This means that bioethics is born as a necessary response to the new magnitude of the powers of biotechnology, with the endorsement of consumption habits and the new socioeconomic diet that increases the risks insofar as it guides science merely according to the interests of large laboratories and research corporations.

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GABRIEL SANTOS (IFPA)

Search the Amazon about the Amazons: (re)exist to build​

The Amazon had a late “occupation”, dependent on the foreign market, and this is a characteristic linked to the way in which the occupation of what is now the Amazon, Brazil, and all of Latin America took place. The Amazon represents an episode in the broad process of maritime expansion of European commercial companies, with these regions forming the oldest peripheries of the capitalist world-economy. In other words, the region was constituted in the paradigm of society-nature, called “frontier economy”, in which progress is understood as economic growth and prosperity. This process continues to be reproduced in the 21st century in a post-colonial Brazil, as the North region, where much of the Amazon biome is located, has the lowest educational indicators in the country. How can popular/academic knowledge change the education landscape in the Amazon? How to (re)exist the world-system and build a “development” for those who really matter? 

ROUND TABLE - THEORETICAL-PHILOSOPHICAL FOUNDATIONS OF BIOETHICS

MARTA DIAS BARCELOS (UNLisboa)

The principlist bioethics, beyond the four principles ​

The principlism of Beauchamp and Childress is the first and most influential theoretical model of bioethics, advocating the use of four prima facie principles: respect for autonomy, non-maleficence, beneficence and justice (Principles of Biomedical Ethics, 1st ed., 1979). ). This theory has been progressively revised over the years, in terms of its theoretical formulation and practical application, having adapted to the different problems to which bioethics is dedicated. Nevertheless, the pandemic crisis has re-launched the debate on several fundamental issues in the field of health, namely the fair distribution of specific scarce resources and the restriction of basic individual freedoms. So, what will be the contribution of principlism to post-pandemic bioethics? Is it possible to point out new tensions arising from the use of the four principles? In particular, what arguments support the prevalence of the principles of beneficence and justice over that of personal autonomy, as a way of protecting community, public and global health? These are some of the challenges facing bioethics today, and their analysis will be based on the assumptions of principlist theory.

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GABRIEL BARROS (UnB)

Possible contributions of the sociology of science to the foundations of bioethics​

The social sciences have integrated the analytical and normative practices of Bioethics. However, with some exceptions, the proposals have been epistemically limited to the methodological scope and strictly directed to biomedical care practices. With regard to its theoretical foundation, Bioethics has demonstrated a self-referenced tendency that has dispensed with the theoretical and methodological richness produced by scientific disciplines that precede it and share objects of analysis and investigation with it, a position that I have named bioethical endogeny._cc781905- 5cde-3194-bb3b-136bad5cf58d_ In order to react to this trend, ideas, assumptions and concepts developed by some of the main currents of Social Studies of Science and Technology are presented, seeking to demonstrate the relevance of these contents to the reflections of bioethics on scientific practices and on the generation and diffusion of health technologies, especially in global dimensions. I conclude that at least three specific types of analyzes would benefit from this proximity: analyzes of the epistemological integrity of the health sciences; ethical-political analyzes around the production, diffusion, access and safety of health technologies; and ethical-philosophical analyzes of the work of the scientific community and health professionals. I also conclude that the dissolution of bioethical endogeny will be due to disputes of both an epistemological and political-institutional nature that need to start being fought.

ROUND TABLE - BIOETHICS AND HUMAN RIGHTS

ROBERTO ANDORNO (UZurique)

Towards new human rights for dealing with the challenges of neurotechnologies​

New developments in neurotechnology give us unprecedented knowledge about the brain’s functioning and open new possibilities for accessing, collecting, sharing and altering information from the human brain.  Brain imaging techniques, brain-computer interfaces, transcranial and intracranial electrical stimulation and other technologies have great potential to improve the wellbeing of neurological patients by providing new diagnostic, preventive and therapeutic tools. However, these same technologies create new and serious ethical and policy challenges to human rights and human dignity. After all, the brain is the organ most closely connected to our personality, thoughts, and memories. How can these technological advances be made compatible with values such as mental privacy, personal identity, and mental integrity? What would be the appropriate policies to guarantee this compatibility? Should these emerging values be embodied into new human rights (the so-called “neuro-rights”)? Should we move towards the development of an International Declaration of Neurotechnology and Human Rights, as suggested by UNESCO?

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ALINE ALBUQUERQUE (UnB)

Empathy in health care: a new perspective​

Empathy is a capacity that recruits simple and complex cognitive processes, thus presenting distinct components, such as emotional resonance, perspective taking, imagination, understanding the mental states of the other. Indeed, empathy is a construct that is still under study, this is the beauty of investigating it, much remains to be built and much can already be said. This also applies to the context of clinical empathy, although there is greater uniqueness around its three components: understanding the patient's mental states, including their emotions; verification of this understanding and a therapeutic action based on such understanding. In the same sense, there is abundant evidence that clinical empathy is a moral value, insofar as it brings benefits to patients and health professionals. On the other hand, in addition to these benefits, there are still few studies that reflect on the morality of clinical empathy. In an innovative way, this presentation focuses on discussing the three ethical functions of clinical empathy: (a) moral value, based on a consequentialist ethical perspective, as it increases the well-being of patients and health professionals; (b) promotion of PCC, based on the participation and engagement of the patient, that is, clinical empathy is a capacity that promotes the recognition of the patient's humanity by the professional, endowed with mental states and emotions, which places him on the same plane moral; (c) clinical empathy has an epistemic function that consists in the possibility of the professional acquiring knowledge about the patient, which would not be possible without the particular connection that empathy provides. Therefore, clinical empathy has the moral function of promoting a new ethic for the 21st century, an ethic that rejects egoistic behaviors and promotes altruists, an ethic that endorses our vulnerability and need for social connections. Clinical empathy is allied to an ethics that seeks to overcome the historical subordinate position of patients, amplify their voice and their space for participation in care. A new horizon is opening up in health care, it is time to place it at the heart of Bioethics and the daily life of institutions and health systems. 

WORKSHOP

KEINE ALVES (PUCSP)

Paideia - laboratory of ethics applied to the work environment​

Faced with an overloaded daily life and a challenging world, we end up facing different situations that lead us to seek solutions that truly contribute to our daily lives, as we are aware of the clear reality in which we live. With this we know that, without certain universal knowledge, the future can become even more uncertain. From this point of view, the Paidéia Workshop was conceived with the specific aim of getting to know together a little more the practical principles of applied (bio)ethics, therefore, educational and interdisciplinary. It is also intended to broaden our field of vision in favor of the science of decisions and conduct for life in society.

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ROUND TABLE - BIOETHICS AND EDUCATION

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MIRELLE FINKLER (UFSC)

Deliberative bioethics: in search of moral autonomy and responsibility​

Faced with the numerous problems we are experiencing today, deliberation presents itself as an important instrument for responsible decision-making in societies that claim to be democratic and that strive for civil and citizen ethics. Particularly in the field of health, ethical deliberation began to be required as a new professional excellence, necessary for the improvement of health systems and care practices of ethically competent professionals and teams. It is not a matter of understanding deliberation as a simple dialogue or an aid for making consensual decisions, even though the term is widely used and has different meanings in common sense, in the political, legal and philosophical spheres. In the bioethical literature, moral deliberation is a means and instrument for systematizing the management of ethical problems. It promotes the continuing education of professionals, through the stimulation of ethical sensitivity and the development of critical and dialogic knowledge and skills for a morally autonomous analysis and for the prudent resolution of moral conflicts in health. The concept of ethical deliberation has been anchored in different authors, as are the methods for structuring its process. We approach moral deliberation from the theoretical-philosophical conception and methodical proposal of Diego Gracia, who rescues it from Socrates and, especially, from Aristotle, who was the one who introduced and systematized it. This option is anchored in the wide dissemination of the method, successfully used in institutional, clinical-assistance and research ethics committees for about four decades; in our formative experiences and deliberative pedagogy in higher education in health; in the recognition of its practical-instrumental value and in the appreciation of its theoretical foundation which, unlike other bioethical references - deontological or utilitarian - is not used to certain morals, opening space for a truly plural dialogue.

The Bioethics of Responsibility or Deliberative Bioethics by Diego Gracia has globality as its fundamental characteristics - because it considers dignity a moral quality of all and because it takes bioethics as a way of thinking about ethics in a global way; autonomy in relation to religions, laws and technology; and its prudential and responsible character that considers the context, principles and consequences of every decision to be deliberated. Understanding that bioethics is in essence deliberation, it is configured as a powerful educational proposal for the transformation of practices from moral judgments based on a secular, plural, autonomous, reasonable and responsible perspective.

PATRÍCIA BATAGLIA (UNESP)

The ethical dimension in personality: relations between the cognitive, the affective and the conative​

This presentation will deal with a vision of the human phenomenon that takes as its central aspect the search of the being for the “good life” that can only be achieved if there is at the same time ipseity and otherness. The “good life” is understood here as the meaningful life. Meaning implies having and knowing what are the fundamental values of the existence of a being unique and different from all the others (hence the ipseity), and at the same time, it is part of a group with which it lives (with-lives) in a different way. respectful and recognized way (hence the otherness). In this brief presentation of the theme, the cognitive, affective and conative aspects have already been announced. Otherwise, let's see, knowledge of oneself, of the other and of values implies a level of intellectual differentiation that necessarily overcomes the egocentrism of early childhood, involves reflection and awareness of external rules and principles elaborated by reason itself, the ability to make judgments and the ability to form systems that enable decision making. In the affective aspect, it involves adherence to values elaborated from the initial fear and love to the possible self-respect. In the conative aspect, it is related to the disposition for action, to the quest to remain whole and integrated with the other in decision-making. We will approach the three dimensions mentioned in a constructivist perspective, dealing with the 2 axes that we consider fundamental for the understanding of the ethical personality.

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ROUND TABLE - BIOETHICS, ENVIRONMENT AND MEDIA

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FRANCISCO BELDA (UNESP)

Disinformation, journalism, science and health: how to distinguish reliable information online

The presentation relates challenges of scientific dissemination to the phenomena of disinformation in digital media, with an emphasis on the search for criteria capable of distinguishing the credibility of journalistic content on the internet. The theme is introduced from the credibility crisis of traditional media and contextualized with phenomena of disinformation disseminated in the midst of the Covid-19 pandemic, among other examples involving health themes portrayed using false information generated with the intention of deceiving and harming . Finally, a system of journalistic credibility indicators developed by The Trust Project is presented, which also operates at an algorithmic level and can serve as a parameter to distinguish reliable news and reports on the internet. 

JOÃO ADALBERTO JR (UB)

Environmental communication in the post-truth era: ethical implications​

Reflection on the ideological and discursive role of environmental communication in times of fake news and post-truth, in which appearing to be true proves to be, to a large extent, superior to the truth itself. In this context, the persuasive strategy of communication, especially pathetic, proves to be more decisive than going in search of supposed evidence and a rational support of the facts to be disclosed. Fake News, fabricated narratives, appeals to emotions and overvaluation of beliefs and values are, in effect, increasingly influencing the various spheres of public opinion formation, promoting a series of ethical questions, as well as generating problems that pose in check democracy and coexistence among people.

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CLOSING CONFERENCE

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CARLA BARBOSA (UCoimbra)

Jano's double face in new technologies applied to health: ethical-legal dilemmas​

The use of artificial intelligence in the health area is a reality that has been greatly enhanced by the pandemic that devastated the world at the end of 2019. The use of artificial intelligence brings benefits, but also risks. The challenge will be to reconcile these risks and benefits and allow this important instrument that can achieve “good”, but also “evil” to be used properly. One of the very interesting challenges will be the harmonization of the rules concerning artificial intelligence with the rules concerning health data. And, let's be realistic, without data there is no health…. In Europe, in April 2021, the European Commission presented the proposal for a Regulation of the European Parliament and of the Council on Artificial Intelligence (COM 2021, 206 final). The rules on artificial intelligence must be compatible with the rules on the protection of personal data. We propose to weigh these difficult balances by analyzing the rules and risks arising from the use of health data in the context of the development of algorithms, but also in health decision-making using artificial intelligence technologies with main relevance in the context of the pandemic.

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