Cuadernos de bioética : revista oficial de la Asociación Española de Bioética y Ética Médica
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This article tries to assess the potentials and limits of neuroethics. It argues that neuroscience and ethics should collaborate each other with mutual respect and preservation of their respective identities, scientific in the first case and philosophical in the second one ( neuroethics as cooperation). The text develops also a criticism in front of any attempt to replace the philosophical ethics by the neurosciences ( neuroethics as substitution). ⋯ These bases enable our moral behavior without determining it. By studying them our vulnerability as moral agents emerges as evidence. This vulnerability, which is rooted in the very human nature, must be, as it is argued along the last pages of the text, recognized as well as mitigated.
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The neurobiological processes underlying moral judgement have been the focus of Neuroethics. Neurosciences demonstrate which cerebral areas are active and inactive whilst people decide how to act when facing a moral dilemma; in this way we know the correlation between determined cerebral areas and our human acts. ⋯ The outcome of man's natural inclinations is on one hand linked to instinctive systems of animal survival and to basic emotions, and on the other, to the life of each individual human uninhibited by automatism of the biological laws, because he is governed by the laws of freedom. The capacity to formulate an ethical judgement is an innate asset of the human mind.
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Palliative sedation in defined as the deliberate reduction in the level of consciousness of the patient by administering the appropriate drugs in order to avoid intense suffering caused by one or more refractory symptoms; sedation in the patient who is in his last days or hours of life is assumed to be continuous and as deep as needed. Clinical experience shows specific situations where it is likely that there is some confusion of terms. We could erroneously understand as palliative sedation the cases of symptomatic treatment of hyperactive delirium in a patient in its last days (a situation that sometimes is presented as the first cause of palliative sedation) or those in which it is carried out a progressive increase in the palliative treatment that often have a sedative effect, parallel to the increased severity of symptoms because of disease progression in severe ill patients. In both scenarios, sedating drugs are used to relieve end-of-life clinical complications and suffering but the circumstances of the patient, the goal of these treatments, and the way they are used do not match the definition of sedation.
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This paper shows the insufficiency of a bioethics which would intend to derive its proposals from Utilitarianism, identifying some inadequacies in the ethics of John Stuart Mill, e.g., the difficulties of the utilitarian commitment with instrumentalism, the deficiency of an utilitarian moral psychology and the naiveté of the forensic dimension of the utilitarian submission.