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Contents

• Letter from the Editor Bo Peng
  
• Bioethics in the News Markley Foreman, Leila Glass, Tuua Ruutiainen
  
• Bioethical Issues Facing the Next President Sasha Riser-Kositsky
  
• Interview: Dr. Jesse Owens (University of Alaska)

Articles

• Reading minds? Ethical implications of recent advances in neuroimaging by Sheheryar Kabraji, Edmund Naylor, Daniel Wood Read Abstract

  Functional magnetic resonance imaging (fMRI) promises to reveal much about the way we think. Recently it has been used to better understand disorders of consciousness. Neuroscientists have used fMRI to ʻread the mindʼ of a patient in a vegetative state, arguably revealing previously inconceivable cognition that drastically alters the patientʼs diagnosis and prognosis. Technical issues stand in the way of a wholesale acceptance of fMRI as a window into our minds as there is no consensus on whetʼher the ʻflashesʼ of signal seen during fMRI actually correspond to thoughts or consciousness as we understand it. Even if such indicators of consciousness are taken at face value, considerable ethical challenges remain. Can we take fMRI at face value that may indicate a patientʼs wishes to refuse life-saving treatment? As it currently exists, fMRI may form part of the deductive toolkit that medical specialists employ to better understand the workings of their patientsʼ mind. Attempts to use fMRI as a prognostic tool should await more detailed studies of its accuracy and predictive power.

• The ethical considerations of nootropic drugs: memory boom or drug bust? by Courtney Boeff Read Abstract

  Memory is an integral part of what defines individuals, and diseases such as Alzheimerʼs disease are capable of robbing individuals of their identity. Nootropic drugs have been developed to fight the effects of Alzheimerʼs disease, but they also provide the possibility to enhance the memory capability of ordinary people. While a person might be able to improve his or her memory by so called “brain enhancing” games such as SuDoku, BrainAgeTM, and crossword puzzles or by natural remedies such as ginkgo biloba. The use of these drugs in healthy individuals presents some potential ethical concerns, recently highlighted by the steroid scandals in professional sports. Issues associated with nootropes need to be addressed prior to their usage in non-disease applications. Applying the principles of liberty, harm, autonomy, paternalism and the natural law argument and considering the efficacy and the availability of these treatments, I examine the potential ethical dilemmas that result from widespread use of these drugs in memory enhancement.

• Should fMRI lie-detection technology be admitted in courtrooms? by Janitza Montalvo-Ortiz Read Abstract

  Lying can be a complex, situation-dependant activity, with a variety of degrees and levels of falsehood (Wolpe, 2005).” Recently, functional magnetic resonance (fMRI) technology has been proposed as a new and prominent lie-detector device in the courtrooms. However, due to its uncertain reliability, accuracy and relevance in the law court and the societyʼs skepticism to “mind reading” devices, its admissibility and applications in a real world scenario has been questioned, as happened with polygraph techniques in the past. Moreover, there are also some other issues such as the inappropriate use due to the premature adoption, the misapplication through the misunderstanding of the results, and the invasion of privacy. This paper intends to assess some of the arguments that raise many ethical, civil and social concerns about the unregulated incorporation of the fMRI technology as a lie-detector device that can threatened the credibility of the science in our society.

• The ability of religiously affiliated hospitals to conscientiously object by Michelle Elizabeth Allain Read Abstract

  This article addresses the issue of conscientious objection amongst religiously-affiliated hospitals in rural Ontario, Canada. It is argued that when religious organizations endeavor to provide publicly funded healthcare services in rural areas, they must forgo any entitlement to deny services to which they may conscientiously object unless reasonable and timely access to those services is made available to the community through other facilities. Failure to do so creates an unacceptable barrier to access and it is therefore in direct violation of the Canada Health Act. It is further argued that mergers between secular and religiously-affiliated hospitals in areas where the newly formed corporation would be religiously governed and occupy sole provider status should be prevented, as this represents an infringement on personal autonomy and access entitlement. Should a merger be necessary, it must occur in a fashion that maintains or increases access to secular services rather than diminishing them.

• Extreme conditions triage by Andrew Bradley Read Abstract

  “Extreme conditions” triage is a phenomenon relatively unique to the battlefield. In these situations, the survival of the fighting force or perhaps even the medical facility is threatened. In these situations, military physicians may treat lightly injured casualties—the “walking wounded”—before others so they may return to combat and help repel the enemy. This triage differs from “austere” and “non-austere” conditions when there is no military reason to treat patients with consideration to anything besides medical need. Some authors and international organizations have voiced concern about including nonmedical considerations in triage decisions. This paper examines the ethics of battlefield triage and the justifiability of extreme conditions triage. Gross’s “salvage value” model is overly harsh if applied to anything besides extreme conditions. Ideally, there would be a consistent ethical framework underlying all of battlefield triage. A “limited social utility” model of triage that considers the ability of an individual to improve the current situation can provide this framework. This approach can identify the appropriate form of triage (non-austere, austere, and extreme conditions) in a variety of different circumstances. It is best implemented through enhanced training for physicians and commanders to facilitate honest and thoughtful communication regarding medical decisions.

• Distilling differences: contraception and natural family planning by Steven Baumstark, James A. Brown, Craig J. Iffland Read Abstract

  Is there really a difference between contraception and natural family planning? Isnʼt it the case that regardless of the means employed, those who engage in either desire the same thing-to eliminate the possibility of pregnancy from intercourse? If this desire is the source of the problem, then why does the Catholic Church permit natural family planning, but condemn contraception? In this essay, we spell out the differences between birth regulation via natural family planning and birth regulation via contraception. Above all, we intend to show how the Churchʼs teaching is consistent in supporting responsible birth regulation while at the same time condemning contraception.

• Female genital cutting: a philosophic approach by Gina Anne Vaz Read Abstract

  Much controversy surrounds the practice of female genital cutting (FGC). On the one hand, FGC is attributed much socio-cultural significance because it is intrinsically linked to the expression and maintenance of cultural norms and values. On the other hand, correlative relationships have been established between FGC and genitourinary and reproductive morbidity in women. These positive and negative consequences have engendered much debate about the ethics of FGC. While ʻuniversalistsʼ condemn FGC as being unethical, ʻrelativistsʼ rationalize the practice because it coheres within a culturally-specific web of moral beliefs. The clash between these two seemingly incommensurate ethics (universalistic and particularistic) makes FGC a living philosophic problem. It is hypothesized that, if these two opposing moral positions can be reconciled using philosophic concepts and reasoning, an ethical, culturally sensitive ʻsolutionʼ to FGC can be elucidated.

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