Relational bodies

This article argues that debates over the legal status of bodies reveal a much deeper dispute over the nature of the self. In these discussions lawyers and ethicists have much to learn from a more profound understanding of the biological nature of the body. Far from being a static entity, the body is constantly recreating itself. It contains parts that are organisms in their own right. Bodies are dependent upon other bodies and the external environment for survival. The complex biological picture reflects a philosophical truth that bodies are interdependent and "leaky". We should not, therefore, expect a single legal regime, such as property to capture the biological and ethical values that are at stake in relation to every part of the body. A more complex statutory regime is required to recognise the complexity of the interests in, and nature of, different body parts.

Gene patents: a broken incentives system

The proliferation of patents on human genes has raised important ethical questions centered on the conflict of patient rights and intellectual property rights. With the Supreme Court's June 2013 decision that altered the patent eligibility of genetic material, it is important to reexamine the ethical implications of gene patents as a concept. Such patents suggest an ownership of genetic material that may hinder access to healthcare and inhibit medical progress. The application of the current patent system to genetic material thus violates patients' rights without fulfilling the system's goal of promoting innovation, suggesting a need for a revised incentives infrastructure.

Laboratory specimens and genetic privacy: evolution of legal theory

Although laboratory specimens are an important resource for biomedical research, controversy has arisen when research has been conducted without the knowledge or consent of the individuals who were the source of the specimens. This paper summarizes the most important litigation regarding the research use of laboratory specimens and traces the evolution of legal theory from property claims to claims related to genetic privacy interests.

Geographical factors affecting bed net ownership, a tool for the elimination of Anopheles-transmitted lymphatic filariasis in hard-to-reach communities

Vector control, including the use of bed nets, is recommended as a possible strategy for eliminating lymphatic filariasis (LF) in post-conflict countries such as the Democratic Republic of Congo (DRC). This study examined the geographical factors that influence bed net ownership in DRC in order to identify hard-to-reach communities that need to be better targeted. In particular, urban/rural differences and the influence of population density, proximity to cities and health facilities, plus access to major transport networks were investigated. Demographic and Health Survey geo-referenced cluster level data were used to map bed net coverage (proportion of households with at least one of any type of bed net or at least one insecticide-treated net (ITN)), and ITN density (ITNs per person) for 260 clusters. Bivariate and multiple logistic or Poisson regression analyses were used to determine significant relationships. Overall, bed net (30%) and ITN (9%) coverage were very low with significant differences found between urban and rural clusters. In rural clusters, ITN coverage/density was positively correlated with population density (r = 0.25, 0.27 respectively, p<0.01), and negatively with the distance to the two largest cities, Kinshasa or Lubumbashi (r = -0.28, -0.30 respectively, p<0.0001). Further, ownership was significantly negatively correlated with distance to primary national roads and railways (all three measures), distance to main rivers (any bed net only) and distance to the nearest health facility (ITNs only). Logistic and Poisson regression models fitted to the rural cluster data indicated that, after controlling for measured covariates, ownership levels in the Bas-Congo province close to Kinshasa were much larger than that of other provinces. This was most noticeable when considering ITN coverage (odds ratio: 5.3, 95% CI: 3.67-7.70). This analysis provides key insights into the barriers of bed net ownership, which will help inform both LF and malaria bed net distribution campaigns as part of an integrated vector management strategy.

This is my kidney, I should be able to do with it what I want: towards a legal framework for organ transplants in South Africa

In 2010 illegal kidney transplants performed in South African hospitals were exposed. Living donors (actually sellers) from Brazil and Romania were flown into South Africa where a kidney was harvested from each and transplanted into Israeli patients. The media reports that followed indicated an outcry against the sale of human kidneys. But by analysing the whole transplantation process from the point of view of each person involved in the transplantation, namely the recipient, the donor, the doctor and the black market in the background the feeling is created that a process of payment for a kidney seems fairer than the current way of procuring organs either legally or illegally.

Biobanks for research. Ethical and legal aspects in human biological samples collections in France

Because they gather huge quantities of human biological samples and information allowing for better understanding of diseases, biobanks appear as a very powerful tool for boosting both medical research and public health as a whole. Although France does not really appear as a leader in biobanking compared to China or UK, biobanks and other samples collections abound in our country and have then been regulated, even though french law does not use the term biobank as such. The present article gives an overview of the current legal framework and explores the remaining ethical and legal issues, concerning particularly the protection of donors, the sharing of biobanks content and the sharing of biobanks benefits. The article explains how these universal questions arise in this country and what answers (sometimes specific) they get or could get in the following years.

The four principles: can they be measured and do they predict ethical decision making?

BACKGROUND

The four principles of Beauchamp and Childress--autonomy, non-maleficence, beneficence and justice--have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas.

METHODS

The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation.

RESULTS

Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas.

CONCLUSIONS

People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed.

Lost property? Legal compensation for destroyed sperm: a reflection and comparison drawing on UK and French perspectives

In a recent case in the UK, six men stored their sperm before undergoing chemotherapy treatment for cancer in case they proved to be infertile after the treatment. The sperm was not properly stored and as a result was inadvertently destroyed. The men sued the NHS Trust that stored the sperm and were in the end successful. This paper questions the basis on which the judgement was made and the rationale behind it, namely that the men 'had ownership' of the sperm, and that compensation was thus due on the grounds that the men's property had been destroyed. We first argue that the claim is erroneous and enhances the tendency towards the commodification of body parts. We then suggest that the men could have been compensated for the harm done to them without granting property rights, and that this would, at least in philosophical and ethical terms, have been more appropriate. To help illustrate this, we draw on a parallel case in French law in which a couple whose embryos had been destroyed were overtly denied ownership rights in them. Finally, we suggest some possible ethical and practical problems if the proprietary view expressed in the UK ruling were to become dominant in law, with particular focus on the storing of genetic information in biobanks. We conclude that, although compensation claims should not necessarily be ruled out, a 'no property in the body' approach should be the default position in cases of detached bodily materials, the alternative being significantly ethically problematic.

The social disutility of software ownership

Software ownership allows the owner to restrict the distribution of software and to prevent others from reading the software's source code and building upon it. However, free software is released to users under software licenses that give them the right to read the source code, modify it, reuse it, and distribute the software to others. Proponents of free software such as Richard M. Stallman and Eben Moglen argue that the social disutility of software ownership is a sufficient justification for prohibiting it. This social disutility includes the social instability of disregarding laws and agreements covering software use and distribution, inequality of software access, and the inability to help others by sharing software with them. Here I consider these and other social disutility claims against withholding specific software rights from users, in particular, the rights to read the source code, duplicate, distribute, modify, imitate, and reuse portions of the software within new programs. I find that generally while withholding these rights from software users does cause some degree of social disutility, only the rights to duplicate, modify and imitate cannot legitimately be denied to users on this basis. The social disutility of withholding the rights to distribute the software, read its source code and reuse portions of it in new programs is insufficient to prohibit software owners from denying them to users. A compromise between the software owner and user can minimise the social disutility of withholding these particular rights from users. However, the social disutility caused by software patents is sufficient for rejecting such patents as they restrict the methods of reducing social disutility possible with other forms of software ownership.

Meanings of the embryo in Japan: narratives of IVF experience and embryo ownership

This article explores the sociocultural meanings of the embryo implied in the narratives of 58 women who have undergone in vitro fertilisation in Japan over a period from 2006 to 2008. We argue that a lack of sufficient analysis of the sociocultural meanings of the embryo result in a situation where the use of reproductive technologies in Japan advances without reflecting upon the voices of women and couples that use them. Additionally, we argue that the often-heard view that pre-implantation genetic diagnosis causes less pain to women and couples than selective abortion in which foetuses are discarded, should be reviewed in the light of the new empirical evidence offered in this article. Furthermore, this article shows that the view often expounded by Japanese scientists that in Japan the cultural meanings attached to the embryo are insignificant, is incorrect. Consequently, the argument that Japan has no need for an active national debate on the status of embryos should be questioned. Though agreeing with some feminist views on the embryo debate, this article is also critical of feminist views that discuss embryo donation in terms of the loss of ownership of the embryo and the alienation of the embryo due to commodification.

Why should we respect the privacy of donors of biological material?

Why should we respect the privacy of donors of biological material? The question is answered in the present article in general philosophical terms from the point of view of an ethics of honour, a libertarian theory of rights, a view of respect for privacy based on the idea that autonomy is of value in itself, and utilitarianism respectively. For different reasons the ethics of honour and the idea of the value of autonomy are set to one side. It surfaces that the moral rights theory and utilitarianism present conflicting answers to the question. The main thrust of the argument is that there is no way of finding an overlapping consensus, so politicians have to take decisions that are bound to be controversial in that they can be questioned on reasonable philosophical grounds.

The challenges of oral-based diagnostics in extending the role of dentistry as a health care profession: property rights, privacy, and informed consent

Saliva may be a legal and ethical counterpart of other bodily fluids in diagnostic testing to blood and urine, with regard to its role in diagnostic testing. Two paradigms that have been proposed in the literature to address these challenges are reviewed in this paper. The first is centered on ownership and property rights to saliva, including financial compensation from commercially developed products using saliva. The commodification of saliva as property is also discussed. The second paradigm is related to privacy and the potential for genetic discrimination, given the unwarranted disclosure of confidential information. The management of saliva specimens from dental patients and research participants will also require the implementation of innovative approaches to obtain informed consent.

Why own an exotic pet?

Even though people have owned a wide variety of companion animals since times of old, the modern craze for increasingly exotic and little-known species raises a number of questions, including some of an ethical nature. While trade in exotic animals is certainly profitable for these who practise it, it poses great risks of varying types: ecological risks, threats to biodiversity conservation and health risks. Several introduced animal populations have gone on to establish a line in their new host country. We are just starting to measure the adverse impact this has had, in some cases on a very large scale. The veterinary profession doubtless has a major role to play in endeavouring to reform this trade in living creatures that unfortunately results in many losses.

The social construction of copyright ethics and values

This study is based on analysis of copyright policies and 26 interviews with science and engineering faculty at three research universities on the topic of copyright beliefs, values, and practices, with emphasis on copyright of instructional materials, courseware, tools, and texts. Given that research universities now emphasize increasing external revenue flows through marketing of intellectual property, we expected copyright to follow the path of patents and lead to institutional emphasis of policies and practices that enhanced universities' intellectual property portfolios, accompanied by an increase in copyrighting by professors. Although this pattern occurred with regard to institutions, professors offered a more varied pattern, with some fully participating in commercialization of copyright and embracing entrepreneurial values, while others resisted or subverted commercial activity in favor of traditional science and engineering values.

Property and privacy paradigms of "marketable spit": an ethical and legal counterpart to blood?

Major advances in the testing of oral fluid (e.g., saliva) may lead to the diagnosis and treatment of previously undiagnosed conditions and may enable dentists to manage oral disease more effectively. Such use of another body fluid, blood, is already well established. Blood is a complex tissue that has been extensively researched and is now used for a wide variety of diagnostic tests. It is also regarded as a form of property with ethical and legal dimensions. If saliva is to fulfill a similar role, it should perhaps be granted those same protections. This paper advances the concept that saliva should be considered a form of property, possibly within personal biological materials law. The emerging potential for the development of marketable products from oral fluids raises the issue of protecting the research participant's ethical and legal rights. In particular, violation of privacy and genetic discrimination may arise from the testing of salivary DNA. Respect for autonomy requires that the clinician inform a patient or research participant about his or her rights to property and privacy as these may pertain to oral fluid.