At least till the beginning of the present century, public health has been the stepchild of appli... more At least till the beginning of the present century, public health has been the stepchild of applied ethics. The American Journal of Bioethics is therefore to be commended for having initiated a regular feature on “Public Health and Bioethics,” which hopefully will evolve to a more symbiotic “Bioethics in Public Health.” Nevertheless the first contribution, M.K. Wynia’s “Consequentialism and Harsh Interrogations,” (Wynia 2005) is disquieting for it falls in line with two highly controversial conceptions:
El antecedente historico de la objecion de conciencia es la desobediencia civil, ejercida por ind... more El antecedente historico de la objecion de conciencia es la desobediencia civil, ejercida por individuos que invocan sus convicciones para eximirse de cumplir un mandato legal cuya legitimidad cuestionan desde su propia conciencia. La desobediencia civil se ejerce sin violencia ni provocacion de dano a otros, aceptando la eventual sancion por desacato. En materias bioeticas relacionadas con el comienzo y el final de la vida, existe o se anticipa una legislacion que concede el derecho a recibir una asistencia medica que algunos profesionales de la salud no estarian dispuestos a otorgar por ser contraria a sus convicciones, aunque pudiesen reconocer que la ley en si es legitima. La negativa de realizar un procedimiento a que un solicitante tiene derecho legal se conoce por objecion de conciencia, que a su vez se fundamenta en un derecho de autonomia y libertad de creencias de toda persona, a condicion que sea dada a conocer publicamente en forma coherente y consistente. Se contrapone el derecho legal del solicitante con el derecho a recurrir a la objecion de conciencia, permitiendo al profesional negarse a otorgar el servicio que se le solicita. Sin embargo, si esta negativa impidiese al solicitante recurrir a una instancia alternativa, quedando su derecho violado, el objetor de conciencia pierde justificacion etica porque su disenso, ademas de incumplir la ley, provoca danos indebidos al solicitante
Journal of Evaluation in Clinical Practice, Feb 1, 2002
Medicine is becoming increasingly confident that scientific advances, especially in the area of g... more Medicine is becoming increasingly confident that scientific advances, especially in the area of genetics, will allow a major improvement in the control and eradication of disease. This development seems to go hand in hand with health-enhancement strategies, erasing the distinction between the states of health and disease, and blurring the specific goals of medical services. Medicine tends to become an increasingly technocentric practice that relies heavily on expert knowledge and on epidemiological evidence, neglecting the lived-body experience of being ill, and tending to transform costly medical services into commodities only affordable by the affluent. This paper argues that disease is not merely a functional description, but rather a definitely value-laden organismic state that is experienced by the patient, needs to be explored and treated by medical practitioners, and requires the assessment and participation of social institutions concerned with the delivery and support of medical services. Each of these perspectives introduces its own set of values, both in the clinical encounter and in public health programmes. Bioethics seems to be the appropriate discipline to discuss all these values involved, and help assign them properly in order to rescue the caring concern of medicine for the sick, as well as uphold a principle of fairness in publicly funded medical services.
At least till the beginning of the present century, public health has been the stepchild of appli... more At least till the beginning of the present century, public health has been the stepchild of applied ethics. The American Journal of Bioethics is therefore to be commended for having initiated a regular feature on “Public Health and Bioethics,” which hopefully will evolve to a more symbiotic “Bioethics in Public Health.” Nevertheless the first contribution, M.K. Wynia’s “Consequentialism and Harsh Interrogations,” (Wynia 2005) is disquieting for it falls in line with two highly controversial conceptions:
El antecedente historico de la objecion de conciencia es la desobediencia civil, ejercida por ind... more El antecedente historico de la objecion de conciencia es la desobediencia civil, ejercida por individuos que invocan sus convicciones para eximirse de cumplir un mandato legal cuya legitimidad cuestionan desde su propia conciencia. La desobediencia civil se ejerce sin violencia ni provocacion de dano a otros, aceptando la eventual sancion por desacato. En materias bioeticas relacionadas con el comienzo y el final de la vida, existe o se anticipa una legislacion que concede el derecho a recibir una asistencia medica que algunos profesionales de la salud no estarian dispuestos a otorgar por ser contraria a sus convicciones, aunque pudiesen reconocer que la ley en si es legitima. La negativa de realizar un procedimiento a que un solicitante tiene derecho legal se conoce por objecion de conciencia, que a su vez se fundamenta en un derecho de autonomia y libertad de creencias de toda persona, a condicion que sea dada a conocer publicamente en forma coherente y consistente. Se contrapone el derecho legal del solicitante con el derecho a recurrir a la objecion de conciencia, permitiendo al profesional negarse a otorgar el servicio que se le solicita. Sin embargo, si esta negativa impidiese al solicitante recurrir a una instancia alternativa, quedando su derecho violado, el objetor de conciencia pierde justificacion etica porque su disenso, ademas de incumplir la ley, provoca danos indebidos al solicitante
Journal of Evaluation in Clinical Practice, Feb 1, 2002
Medicine is becoming increasingly confident that scientific advances, especially in the area of g... more Medicine is becoming increasingly confident that scientific advances, especially in the area of genetics, will allow a major improvement in the control and eradication of disease. This development seems to go hand in hand with health-enhancement strategies, erasing the distinction between the states of health and disease, and blurring the specific goals of medical services. Medicine tends to become an increasingly technocentric practice that relies heavily on expert knowledge and on epidemiological evidence, neglecting the lived-body experience of being ill, and tending to transform costly medical services into commodities only affordable by the affluent. This paper argues that disease is not merely a functional description, but rather a definitely value-laden organismic state that is experienced by the patient, needs to be explored and treated by medical practitioners, and requires the assessment and participation of social institutions concerned with the delivery and support of medical services. Each of these perspectives introduces its own set of values, both in the clinical encounter and in public health programmes. Bioethics seems to be the appropriate discipline to discuss all these values involved, and help assign them properly in order to rescue the caring concern of medicine for the sick, as well as uphold a principle of fairness in publicly funded medical services.
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Papers by miguel kottow