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- Munthe, Christian, 1962
(författare)
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A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal
- 2015
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Ingår i: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 29:1, s. 36-45
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Tidskriftsartikel (refereegranskat)abstract
- A new landscape of prenatal testing (PNT) is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development supports a radical individualization of how PNT screening is organized. This reformation is, at the same time, difficult to reconcile with responsible spending of resources in a publicly funded healthcare context. Thus, while the ethical imperative of individualization holds and applies to PNT, the new landscape of PNT provides reasons to start rolling back the type of mass-screening programmes currently established in many countries. Instead, more limited offers are suggested, based on considerations of severity of conditions and optimized to simultaneously serve reproductive autonomy and public health within an acceptable frame of priorities. The new landscape of PNT furthermore underscores the ethical importance of supporting and including people with disabilities. For the very same reason, no ban on what may be analysed using PNT in the new landscape should be applied, although private offers must, of course, conform to strict requirements of respecting reproductive autonomy and what that means in terms of counselling.
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| 2. |
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| 3. |
- Munthe, Christian, 1962
(författare)
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Precaution, bioethics and normative justification
- 2015
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Ingår i: Monash Bioethics Review. - : Springer Science and Business Media LLC. - 1321-2753 .- 1836-6716. ; 33:2, s. 219-225
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Recension (övrigt vetenskapligt/konstnärligt)abstract
- Daniel Steel’s new book on the precautionary principle illustrates the need to work ahead to fuse perspectives of epistemology and philosophy of science with those of ethics to accomplish progress in the debate on the proper role of precaution in a broad selection of bioethical areas. Steel advances the territory greatly with regard to conceptual clarity and epistemology, but from a bioethics standpoint he is mistaken in discounting the need for ethical underpinnings of a sound theory of the precautionary principle.
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| 4. |
- Munthe, Christian, 1962
(författare)
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Precautionary Principle
- 2015
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Ingår i: Encyclopedia of Global Bioethics. - Dordrecht : Springer. - 9783319055442
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Bokkapitel (refereegranskat)abstract
- Precautionary reasoning has deep historical and wide cross-cultural roots in the ethics of health, health care, and medical research. As in general ethics, however, this side of bioethical thinking has not been the subject of focused critical analysis until recently. The emergence of the precautionary principle (PP) in general environmental and technology policy debate has, after an initial period of confusion, resulted in a range of possible ideas about the value of precaution and what sacrifices it may be worth. This has indicated some need for developments in ethical as well as decision theory. In bioethical debates, this process has left only vague traces, however. Although many issues exist where precautionary reasoning has a place, this is either often left unnoticed or arguments developed suffer from elementary flaws. Environmental and general public health ethics, the ethics of evidence-based practice in research, as well as clinical decision-making, management of normative or factual uncertainty, and the nature of clinical ethical virtues are all areas where precautionary ideas seem to have a place. Such reasoning moreover has specific relevance for global approaches to bioethics and health policy issues in a number of ways.
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| 5. |
- Munthe, Christian, 1962, et al.
(författare)
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The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening
- 2015
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Ingår i: Public Health Ethics. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 8:3, s. 270-283
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Tidskriftsartikel (refereegranskat)abstract
- The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.
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