Recent developments in social neuroscience have stirred up increased interest within the bioethical debate (for a review see: Specker et al. 2014). Moral enhancement is a concept that directly embodies the idea of making brain science work for the social and moral good. In recent ethical discussions about biomedical means of moral enhancement, scholars have focused on so called ‘direct means of moral enhancement,’ discussing the ethical permissibility of modifying the emotional underpinnings of moral behaviour (Douglas, 2008; 2013; Persson and Savulescu, 2008; Savulescu and Persson, 2012). However, critics have argued that such modification only seems like moral enhancement, that behavioural modification is not ‘true’ moral enhancement, for the reason that it changes behaviours without making agents better moral agents. Critics have also noted that it can undermine freedom (e.g. Harris, 2011; see also: Douglas, 2014). This thesis addresses the ethical issues relating to enhancement. In the first part of this work I consider conceptual issues surrounding the concept of moral enhancement and argue that moral enhancement is plausible if we adjust our expectations to match those we have of cognitive enhancement. I examine the difference between pro-sociality and morality, and argue that an increase in empathy and reduction in anger cannot be seen as straightforward moral enhancements. The second part examines the objections related to moral disagreement, medicalization and narrative identity. The third part of this work focuses of the issues related to freedom and agency. I argue that voluntary direct emotion modulation, if embedded in appropriate reflection, is a prima facie desirable way of moral enhancement.

Student Number : 0353470 - MA research report - School of Philosophy - Faculty of Humanities / The South African Choice on Termination of Pregnancy Act 92 of 1996 is regarded as one of the most liberal abortion laws in the world. It aims to uphold the rights of women as equal citizens, give effect to their rights to reproductive healthcare and redress past discriminatory legislation. Conscientious objection by healthcare providers to terminating pregnancies is also allowed in terms of the act. This research report considers the justification for the right of conscientious objection by the healthcare provider in the face of the conflicting claims of a pregnant woman seeking abortion. There are good reasons for a pregnant woman’s right to terminate pregnancy, just as they exist for the healthcare provider who objects, on grounds of conscience, to involvement in the process. I will attempt to balance these sets of rights, weigh priorities, and offer possible solutions. A focus on the unique value of each individual demands that each one be accorded dignity and respect. Thus ways of minimizing conflict are explored. Though compromise may be required, it is important that healthcare workers have the freedom to live their lives with integrity.

This thesis is centered around Black maternal health disparities and the impact of Roe v Wade being overturned on the future of Black maternal health. I start off by first looking at the facts of maternal health disparities and how Black women are dying at a higher rate than their White counterparts. Then I draw on social determinants of health and how systemic racism plays a role in the health disparities we see today. I bring in literature that discusses different frameworks created to reduce the maternal health disparities gap. I use the literature to argue that more initiatives need to be done since the gap is still increasing. My intention for this thesis is to bring light to some solutions that may help decrease the maternal health disparities and highlight how Roe v Wade being overturned can cause a larger harm in Black maternal health. / Urban Bioethics

The health benefits of nature are numerous, wide-ranging, and often overlooked. An ever-growing body of research has started to document, substantiate, and even in some cases quantify the significance of interacting with nature and its effect on human health and well-being. These directly measurable health benefits are also compounded in urban environments by environmental and social benefits. For example, the inclusion of green spaces in urban communities has been shown to reduce violence. Green spaces are important for overall health, but also specifically for healing. The benefits of natural spaces in hospitals has been explored in the literature and shown to benefit not only patients but also family and visitors, as well as staff, by creating a healing and restorative environment that helps to reduce stress and alleviate anxiety. Lack of green space in urban communities is creating and exacerbating health disparities. Urban hospitals are often limited in their ability to include extra space, and particularly green space, in their campus, yet it is their patients who need these healing benefits the most. Particularly urban communities of low socioeconomic status are often those with the least access to green spaces, or only have access to low-quality, poorly maintained, unsafe green spaces. Yet the residents of these communities are those who stand to benefit the most from access to nature and a greener environment. Improving the accessibility, quality, safety, and square footage of natural green spaces in urban environments will help improve health equity by mitigating negative effects of the urban built environment on health and well-being, increasing the agency of these communities to live healthier lives, and allow them to reap the physical, emotional, and social benefits of green spaces. / Urban Bioethics

Social determinants of health have become a bit of a buzzword in today’s discussion of healthcare inequities. Social determinants of health are broadly defined as conditions in the places where people live, learn, work and play that affect a wide range of health and quality-of-life risks and outcomes. These factors almost always include education access and quality, health care access and quality, neighborhood and built environment, economic stability and social and community context. All of these factors play a role in how individuals and communities maintain their health. Social determinants of health plays into the black experience within healthcare, which is a factor in the increase in black maternal morbidity and mortality. An important note to highlight in the increase in black maternal morbidity and mortality is the growing public knowledge of the racial history within Obstetrics and Gynecology. We have these disparities and more and more Americans are learning about this health disparity, yet there are not many articles that highlight the ways to save black women from being just another statistic. I propose that if we focus on improving the public intellectualism of our country through social media, we are then all fighting for the survival of black women throughout pregnancy and post-partum. / Urban Bioethics

The field of bioethics originated from failures in medical research and provided a framework for medical decision-making and research ethics with the advent of its four core principles (justice, autonomy, non-maleficence, and beneficence). However, these core principles often overlook more complex issues related to health. In this thesis I take a critical look at traditional bioethics to demonstrate why more specific fields of bioethics, like public health ethics and urban bioethics, are necessary. I then look at the origins of urban bioethics to better understand the necessity for the field and the principles necessary for its implementation. Solidarity and agency are established principles of urban bioethics, and I will argue the need to add respect for community to the urban bioethics toolbox. Based on these principles; I argue the urban bioethicist has to understand the context of individuals and communities to properly apply agency, solidarity, and respect for community. The most appropriate way to build this context is through qualitative research. Qualitative research is uniquely suited for this task based on the nature of the field and the information it offers related to each of the principles of urban bioethics. / Urban Bioethics

Many women at academic medical centers experience gender-based microaggressions and sexual harassment during their careers. Women in surgical specialties experience a particularly high rate of these incidents, but these incidents occur across medical fields. As a result of microaggresions and sexual harassment in the workplace, women physicians experience a higher rate of burnout and moral injury, have fewer opportunities for promotion, and experience difficulty finding mentors when compared with their male colleagues. I argue that for these and myriad other reasons, microaggressions and sexual harassment of women physicians by their physician colleagues violates the bioethical principles of beneficence and non-maleficence. I also explore the importance of mentorship of women physicians by women physicians for navigating a career in academic medicine. / Urban Bioethics

Posthumous assisted reproduction (PAR), or conception after death, is of significant ethical debate. This thesis seeks to explore and evaluate the major ethical considerations concerning PAR. Autonomy, considered the most important ethical principle, holds a majority of the weight in this evaluation; it is not the sole topic on deciding whether to permit a request for PAR. In addition to the autonomy of the deceased, the discussion focuses on stakeholders, justice, and welfare of the child in regard to PAR. Application of these ethical principles allows for a holistic review of a PAR request, and ensures the best possible outcome for each request. / Urban Bioethics

The following work presents the ongoing philosophical debate regarding the use of biotechnology to improve human capabilities and attempts to apply the insights drawn from these debates to the regulation of non-medical uses of reproductive technology. After presenting the criticisms towards a hardline approach that would ban all attempts to enhance humans, we evaluate various alternative frameworks and adopt a framework called Genetic Justice, which can be understood as an application of Rawlsian distributive justice to biological assets. After improving on this moral framework by incorporating various institutional considerations into it, we apply it to the evaluation of non-medical uses of a screening technique called preimplantation genetic diagnosis and propose recommendations for its regulation.

Throughout the world, systems of life science governance carry historical, cultural, and political legacies, which now confront the revolutionary and pervasive advances of twenty-first century biotechnology. Nations' adaptability to the twin challenges of attempting to secure the benefits while reducing the risks and threats is a large and still burgeoning governance challenge. The legacy of the Soviet Union is particularly important in this regard, since its history of prolonged authoritarian rule and intense development of biological weapons in combination with the continuing scientific and technological prowess of Russia is a governance challenge, unprecedented in its nature and scale. The aim of the dissertation therefore is to examine to what extent and by what means it is possible for Russia to reconcile its on-going expansion in biotechnology with the institutional and normative inertia arising from its Soviet past. The first part of the dissertation (Chapters 1-4) seeks to uncover and analyse both the growth and consolidation of the governance of biotechnology and the multifaceted governance challenges brought about by the rapid advancement of the life sciences in the twenty-first century. The second part (Chapters 5-8) examines the extent to which the Soviet institutional and infrastructural legacies in the culture of life science research still persist in Russia and impact the governance of biotechnology in that country. The concluding chapter offers an assessment of the current state of the governance of biotechnology in Russia and outlines a scope for further research. / Wellcome Trust