In the wake of the 2001 anthrax attacks in the US, States Parties to the Biological and Toxin Weapons Convention started to discuss the potential malign application of biological research and technology. This thesis examines how this issue of dual-use has been developed, discussed, and how solutions have been proposed. In order to do so, the thesis follows a neopragmatist approach. As a neopragmatist methodology is largely underdeveloped, the thesis explores some of the key aspects of neopragmatism, specifically its openness to various methods and theories, by directly applying it to the topic. As a result of this approach, the thesis starts with exploratory empirical research, which follows Bruno Latour’s Actor Network Theory. This research reviews how the problem of dual-use has been discussed in three communities: politics and security, ethics, and science. One of the results is that dual-use has primarily been discussed in the security community while the other two were only marginally involved. The proposed solution to the problem by the security community is to place the burden of responsibility on the scientific community. The second part of the thesis then uses theory, Niklas Luhmann’s social systems theory and Martin Heidegger’s work on questioning technology, to critically challenge this solution developed in the security community. The thesis concludes by identifying approaches to help deal with the dual-use issue. It also examines how the adoption of a neopragmatist methodology has influenced and guided the thesis.

La recherche sur les cellules souches, enjeux d'une future médecine régénérative, est emblématique à la fois des opportunités liées au progrès scientifique et des nouvelles questions que ce progrès pose à la société. Recherche sur l'embryon humain, clonage thérapeutique, clonage reproductif sont autant de sujets au coeur d'une actualité brûlante.Quels sont les enjeux scientifiques, éthiques, économiques et juridiques de ces recherches ? En quête d’un équilibre entre le respect de la dignité de l'être humain et la liberté de la recherche, malgré la disparité des pratiques et des législations nationales, l'Europe est devenue le cadre du développement d'un nouveau corpus juridique. Cette étude se propose de montrer de quelle manière la controverse autour de la recherche sur les cellules souches s’intègre «dans une aventure politique européenne» dans laquelle se trouvent impliqués individus, institutions et autorités publiques, engagés dans un processus de «décision ouverte». S’inscrivant dans une perspective comparative, pluridisciplinaire et transdisciplinaire, ce travail a comme objectif de montrer l’évolution et le fonctionnement du droit européen de la bioéthique et surtout de dévoiler le processus qui a amené à l’adoption des règles dans ce domaine. L’importance de cette nouvelle branche du droit pour l’Europe, appelée à répondre aux nouveaux défis scientifiques, économiques et de société, est ainsi mise en évidence. / Research on stem cells, challenges for of a future regenerative medicine, is emblematic of the opportunities related to scientific progress and the new questions that it implies for society. Research on human embryo, therapeutic cloning and reproductive cloning are burning issues.What are scientific, ethical, economic and legal aspects of this research at stake? Looking for a balance between the respect of the dignity of the human being and the freedom of research, in spite of the disparity of national practices and legislations, Europe became the framework for the development of a new legal corpus. This study aims at showing how the controversy related to research on stem cells come within “a European political adventure” in which individuals, institutions and public authorities, engaged in a process of “open decision”, are implied. In a comparative, multidisciplinary and trans-disciplinary perspective, this work has the objective to highlight the evolution and functioning of the European law of bioethics and especially to reveal the process which brought to the adoption of European rules in this field. The importance of this new sector of law for Europe, called to face the new scientific, economic and society challenges, is also emphasized.

Cette thèse analysera l'émergence des nanotechnologies en médecine qui pose le problème de l'introduction de composants artificiels et miniaturisés dans le corps humain pour soigner, pallier des insuffisances physiologiques voire améliorer les performances du corps humain. Ces technologies permettent de dresser un diagnostic sûr et précoce des maladies comme le cancer ainsi que des traitements ciblés et même des reconstructions ex nihilo d'organes. Ce domaine du progrès scientifique reste en grande partie encore à appréhender et à analyser. La réflexion se concentrera sur l'élaboration d'une nano-éthique adéquate, sur la notion de transgression des limites qu'implique le discours transhumaniste sur les nanotechnologies d'un point de vue psychanalytique, sur une tension fructueuse des discours entre science et théologie. / This thesis will analyze the emergence of nanotechnology in medicine that poses the problem of the introduction of artificial and miniaturized components in the human body to heal or to alleviate physiological deficiencies or to improve the performance of the human body. These technologies allow the establishment of safe and early diagnosis of diseases such as cancer as well as targeted therapies and reconstructions ex nihilo of organs. This area of scientific progress still remains largely to be understood and analyzed. The study will focus on the development of an adequate ethic for the nanotechnology, the idea of transgression of limits implied in the transhumanist discourse on nanotechnology from a psychoanalytic point of view, and a fruitful tension between scientific and theological discourses.

Thesis advisor: James Keenan / Environmental conservation is a pressing issue for modern humans. Health care systems and the consumption of medical goods should therefore be assessed in light of environmental sustainability. While the primary focus of environmental bioethics has been hospitals and health care facilities, ethicists must also address the offerings of the medical industry going forward. My dissertation proposes four principles to assess the environmental sustainability of current and future medical developments, techniques, and procedures. The four principles of green bioethics are: 1. General allocation of resources should precede special interest access: distributive justice 2. Current human needs over current human wants: environmental conservation 3. Simplicity before complexity: reducing dependence on medical intervention 4. The common good should drive health care instead of financial profit: ethical economics. The four principles of green bioethics will move environmental bioethics into the 21st century in a responsible and sustainable manner. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Theology.

Trata-se de uma pesquisa qualitativa que buscou compreender a vivência dos trabalhadores no universo do Instituto Médico Legal (IML) de Londrina Pr. Teve por objetivos analisar as experiências dos funcionários no IML com morte, identificar os desafios advindos e as percepções sobre a humanização no cotidiano do processo de trabalho em seu ambiente profissional. O referencial teórico adotado foi a Bioética Personalista. Para a coleta de dados optou-se por utilizar a entrevista semiestruturada. A saturação das entrevistas foi atingida com a participação de 12 profissionais do Instituto Médico Legal, incluindo representantes de todos os segmentos funcionais. As entrevistas foram realizadas de abril de 2008 a março de 2009. Para a construção das categorias empíricas foi utilizada a análise de conteúdo proposta por Bardin. Esta análise seguindo um ordenamento conceitual conduziu à definição de três categorias temáticas: (1) o objeto do trabalho no Instituto Médico Legal; (2) a experiência do trabalhador do Instituto Médico Legal com morte e; (3) o cotidiano no processo de trabalho no Instituto Médico Legal. As três categorias versam sobre o processo de trabalho dos funcionários do Instituto Médico Legal de Londrina, cujas atividades laborativas são interdisciplinares. Nela estão incluídas as características do trabalho pericial em cadáveres, a representação do cadáver enquanto objeto de trabalho e os sentimentos vividos pelos funcionários em atuação. O cadáver enquanto objeto de trabalho foi percebido como uma pessoa num corpo calado, resultado de escolhas de vida e como membro de uma família. A família do cadáver também foi percebida como um objeto de trabalho, na perspectiva do atendimento e acolhimento que esta necessita neste momento de morte abrupta, em suas diferentes formas de reação. A segunda categoria versa sobre as percepções do fato da morte em si; seus significados agrupados nas dimensões biológica, religiosa e filosófica e; os sentimentos vivenciados frente ao final da vida. A terceira categoria abrange as características do processo de trabalho pericial e os sentimentos frente a esta prática. Emergem nas características do processo pericial os aspectos legais, o desconhecimento social, a repercussão pública, a ignorância do resultado final, as situações inesperadas e inusitadas, o trabalho em equipe e a carga laborativa. Entre os sentimentos surgem a tristeza, a compaixão, a dor, o medo, a surpresa, a exaustão, a impotência, a realização profissional e o resgate como ser humano. Nesse trabalho insurgiram desafios enquanto pessoas e enquanto profissionais técnicos, no atendimento pericial tanto às vítimas como aos familiares, no momento de morte. Resultados deste estudo evidenciam que os funcionários do IML são impelidos ao resgate de suas crenças e valores enquanto pessoas, desde o momento em que, conceituam morte, recordam-se de suas vivências, trabalham em equipe, relacionam-se com o cadáver e com os familiares deste. / This is a qualitative research that aimed to understand the experience of workers in the universe of the Institute of Forensic Medicine in Londrina-PR. The three objectives were to analyze the experiences of these workers with death, identify the challenges sprung from this work and their perceptions about humanization in their daily work process at the work environment. The Personalistic Bioethics theoretical reference was used. Semi-structured interviews were chosen for data collection. The interviews saturation was reached by the participation of 12 Institute of Forensic Medicine workers, representing all functional sectors. The interviews were conducted from April 2008 to March 2009. The Bardin Content Analysis was used to build empirical categories. By following a conceptual ordering, this analysis led to three thematic categories: (1): the object of work at the Institute of Forensic Medicine; (2) the Institute of Forensic Medicine workers experience with death and; (3) the daily routine in the work process at the Institute of Forensic Medicine. These three categories approach the work process of the Institute of Forensic Medicine workers in Londrina, whose work activities are interdisciplinary. These activities include forensic procedures in corpses, the representation of the corpse as object of work and the feelings expressed by the workers in action. The corpse, as object of work, was acknowledged as a person in a quiet body, the result of choices made in life and as a member of a family. The corpse family was also acknowledged as object of work, regarding reception and acceptance that this family needs in this moment of abrupt death, considering their different reactions towards it. The second category approaches the perceptions about death as a fact; its meanings grouped in the biological, religious and philosophical dimensions; and the feelings experienced towards the end of life. The third category regards the characteristics of forensic work process and the feelings towards this activity. These characteristics include the legal aspects, the social unrecognition, the media repercussion, the ignorance about the final result, the unexpected and peculiar situations, the team work and the work load. Among the feelings there are sadness, compassion, pain, fear, surprise, exhaustion, impotence, professional accomplishment and the recalling as a human being. In this work there were challenges regarding people as human beings and as technical workers, while conducting forensic work in victims or receptioning family members, during the moment of death. The results of this study highlight that the Institute of Forensic Medicine workers are impelled to regain their beliefs and values as people, since they define death, remember their experiences, work as a team, relate to the corpse and to its family members.

Este estudo teve como proposições: compreender o processo da interação entre profissionais de saúde e usuários estrangeiros nas Unidades Básicas de Saúde (UBS) e Programa Saúde da Família (PSF); conhecer o significado da experiência dos profissionais de saúde ao interagir com os usuários estrangeiros; evidenciar questões bioéticas na experiência de interação entre profissionais e usuários estrangeiros. Utilizou-se como referencial teórico o Interacionismo Simbólico e como referencial metodológico a Teoria Fundamentada nos Dados, até a codificação axial. A análise dos dados, apresentada como ordenamento conceitual, levou à definição de quatro grandes temas: (1) procurando comunicar-se; (2) percebendo limites; (3) percebendo interação como processo; (4) percebendo perspectivas diferentes. O percurso de interação profissional usuário estrangeiro foi desencadeado a partir de uma escolha: atender a todos indiscriminadamente, tornando possível a aproximação. Perceber ou não no usuário estrangeiro sua dignidade de pessoa humana parece ser determinante na abertura do profissional à interação, na sua disposição a buscar estratégias. / This study had the following objectives: to understand the interaction processes among health professionals and foreign users in the Unidades Básicas de Saúde (UBS) and the Program for Family Health (PSF); to get to know the significance of the health professionals experience as they interact with foreign users; to put in evidence bioetiques issues in the experience of professionals and foreign users interaction.It was used as a theorical referential the Symbolic Interacionism and as methodological reference a Grounded Theory up to an axial coding. Data analysis presented as conceptual ordering, lead to the definition of four great issues: (1) trying to communicate; (2) detecting limits; (3) recognizing interaction as a process; (4) recognizing different perspectives. The route of professional foreign users interaction was developed from one choice: attend everyone (indiscriminately) making approximation possible. To recognize or fail to recognize in the foreign user the dignity of human person seems to be the determining factor for the openness of the professional to the interaction, in his disposition to seek strategies.

O objetivo deste trabalho foi analisar os variados aspectos que envolvem o serviço de atendimento domiciliário odontológico, especialmente aqueles relacionados à humanização da relação profissional-paciente, ao respeito à dignidade humana quando do exercício da profissão que não em ambiente hospitalar e, ainda, os aspectos éticos relacionados a esse tipo de atividade. Ressalte-se que a presente análise não se limita a explicitar as características do serviço de atendimento domiciliário odontológico, mas dedica-se, ainda, a refletir acerca de questões bioéticas que surgem quando do exercício dessa atividade. E vai um pouco mais além, na medida em que enfoca essas questões sob a óptica do modelo personalista de bioética, que adota como ponto de partida de reflexão o ser humano enquanto pessoa única em corpo e espírito, um ser considerado na sua totalidade, pois ao mesmo tempo em que somos tão diferentes uns dos outros, somos iguais nos nossos desejos e anseios mais primitivos: viver e ser feliz. / The main purpose of this thesis is to analyze some of the aspects related to the odontological homecare program, specially those related to humanization of the relations between doctor and his patients, the respect to human dignity principle when dealing with a patient in non-hospital place, such as his home, and, also, the ethics aspects related to this kind of job. It is also important to mention that this whole analysis is also dedicated to study and reflect about some important bioethics issues related to the odontological homecare program, always having in mind that every Human Being is unique, as a body, a spirit, and as a person, as thought by personalist bioethics. At the same time we, all human beings, are so different from each other, but also so similar especially concerning our most primitive desires and hopes: To live and to be happy.

A presente pesquisa tem como objetivo verificar se a legislação pós Segunda Guerra Mundial foi apta a inibir o comportamento maleficente de médicos no auxílio em especializar, dissimular e acobertar a tortura. Nesse sentido, pretende-se demonstrar o envolvimento médico com experimentos em seres humanos durante a Segunda Guerra Mundial e corroborar que a maleficência médica, todavia, ainda nos dias de hoje é empregada na sociedade contemporânea, permitindo aos profissionais de saúde, desde o período da Guerra Fria, o envolvimento com a tortura e a consequente violação dos princípios da Bioética, especialmente, na conjuntura atualíssima da guerra norte-americana contra o terrorismo. Em um segundo momento, o intuito é propor soluções, caso se verifique que a legislação e os demais esforços se demonstrem contraproducentes, tendo em vista as noções de Bioética, as normas de Direito Internacional e os Direitos Humanos. / The present research aims to verify if legislation created after World War II was able to inhibit maleficent behavior from medical doctors in the improvement and cover-up of torture. This study aims to demonstrate the medical involvement in experiments with human beings during World War II and confirm that medical maleficence was and still is part of our reality, allowing doctors to involve with torture since the Cold War until current days, especially in the United States war on terrorism, violating the basic principles of Bioethics. Secondly, if legislation and overall efforts prove to be inoperative and inefficient, the objective is to propose solutions, in light of notions of Bioethics, rules of International Law and Human Rights.

Thesis advisor: James F. Keenan / This study investigates the recent paradigm shift in bioethics to an approach that uses the language of human rights to work towards social justice and health equity. It follows the three stages of Kuhn's "paradigm shift": recognizing the fallibility of the first paradigm and proving its destructiveness, presenting the theoretical particulars of a new paradigm, and demonstrating how the new paradigm becomes operational. The case study of the organ trade shows the failure of the first model of bioethics, based on autonomy and non-maleficence. This model falsely depicts the true ethical challenges while shadowing the enormous harms it causes. An emerging bioethical model centered on human rights is presented as the best theoretical option to remedy the ills of the first paradigm and make sense of bioethical dilemmas across the globe. But the second paradigm cannot simply look better, it must be operational. Applying the human rights model, the Treatment Action Campaign in South Africa achieved universal access to antiretroviral treatment, thus confirming the theory of the new paradigm in action. The study concludes with a call for an ethics of implementation within the new paradigm that balances the radical ideal of health as a human right with concrete and pragmatic improvements in healthcare; an ethics of "being on the way" to the ultimate goal of justice and equity in health. / Thesis (BA) — Boston College, 2007. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: International Studies. / Discipline: College Honors Program.

Trata-se de um estudo exploratório-descritivo de abordagem qualitativa, com o objetivo de analisar o conhecimento do usuário com diabetes mellitus acerca dos direitos e benefícios em saúde advindos da legislação vigente. O estudo foi realizado no Centro de Pesquisa e Extensão Universitária do interior paulista com 12 usuários com diabetes mellitus, vinculados ao Grupo de Educação em Diabetes. A coleta de dados ocorreu no período de setembro a dezembro de 2008, através de entrevista semi-estruturada, norteada pela questão relacionada ao conhecimento do usuário com diabetes mellitus e percepção dos benefícios em saúde advindos da legislação vigente. Utilizou-se também, um questionário contendo variáveis sóciodemográficas, variáveis clínicas e variáveis relacionadas ao monitorização da glicemia capilar para caracterização dos participantes da pesquisa. A análise dos temas foi fundamentada nos documentos oficiais identificados através do levantamento acerca dos direitos do usuário em diabetes e dos princípios da Bioética. Os dados obtidos foram agrupados em três temas: a não-consciência dos usuários com diabetes mellitus acerca dos seus direitos; a co-responsabilidade em saúde no que diz respeito ao fornecimento de informações e à efetivação dos direitos dos usuários e, a qualidade da interação profissional-usuário nos serviços de saúde. Apesar dos avanços legalmente alcançados pelas políticas públicas, os usuários com diabetes mellitus em sua maioria desconhecem seus direitos, mas utilizam de maneira não-consciente os benefícios advindos da legislação, tais como, a aquisição gratuita de medicamentos, glicosímetros e tiras para a monitorização da glicemia capilar em domicílio. No entanto, eles percebem o benefício como um favor ou doação. Assim, é de suma importância que haja informação sobre os direitos dos usuários com diabetes, uma vez que, sem a necessária e suficiente informação, torna-se difícil o usuário ser capaz de reivindicar e/ou lutar pelos seus direitos. O desconhecimento dos usuários com diabetes sobre seus direitos resulta na falta de efetivação do exercício de autonomia. As dificuldades apontadas, tais como o acesso a consultas médicas, a impessoalidade da relação entre profissionais de saúde e usuários, apontam para o desejo de humanização no atendimento nos serviços de saúde. Esperamos que os resultados aqui apresentados sobre o conhecimento dos usuários com diabetes mellitus acerca dos seus direitos e benefícios da legislação vigente possam contribuir para a assistência de Enfermagem e dos profissionais da saúde. Para tanto, a necessidade de informação adequada aos usuários dos serviços de saúde nos remete ao papel social que a Enfermagem possui, como um elo entre os usuários e os atuais modelos de saúde vigentes. / This is an exploratory-descriptive study of qualitative approach, aiming to analyze the user\'s knowledge with diabetes about the rights and benefits in health resulting from legislation. The study was conducted at a Center for Research and Extension University of São Paulo with 12 users with diabetes mellitus, related to the Group for Education in Diabetes. Data collection occurred during September-December 2008, through semi-structured, guided by the question related to the user\'s knowledge with diabetes mellitus and perception of health benefits derived from the law. It also used a questionnaire containing socio-demographic variables, clinical variables and variables related to the capillary blood glucose monitoring to characterize the participants in the research. The analysis of the themes was based on official documents identified by the survey about user rights in diabetes and the principles of bioethics. The data were grouped into three themes: the non-conscious users with diabetes about their rights, the co-responsibility in health as regards the provision of information and the realization of the rights of users and the quality of interaction professional-user in health services. Despite legal advances made by public policies, users with diabetes mellitus in the majority know their rights, but use of a non-aware of the benefits arising from legislation such as the acquisition of free medications, glucometers and strips for monitoring the capillary blood glucose at home. However, they perceive the benefit as a favor or gift. Thus, it is critical that there is information on the rights of users with diabetes, since without the necessary and sufficient information, it becomes difficult for the user to be able to claim and / or fight for their rights. The unfamiliarity of users with diabetes on their rights results in the lack of effective exercise of autonomy. The difficulties pointed out, such as access to medical consultations, the impersonality of the relationship between health professionals and users point to the desire of humanization of care in health services. We hope that the results presented here on the knowledge of users with diabetes about their rights and benefits of the legislation can contribute to the assistance of nursing and health professionals. Thus, the need for adequate information to users of health services refers to the social role that nursing has, as a link between users and the current existing models of health.