Our New Fragility: Pandemic, Ethics, and the "Biomedical Others”

This paper is dedicated to the concept of fragility as a constitutive structure of the contemporary subject of the pandemic period. COVID-19 has once again actualized the problems of modern philosophy: the boundaries between human and animal, nature and culture, "self” and "alien”. Based on Levinasian phenomenological ethics, I propose the concept of bioethics as the embodied science of "biomedical Others” — people whose experience cannot be normalized and inscribed in the intersubjective structure of the life world of healthy individuals. The negative consequences of coronavirus for psychophysical health show that during a pandemic every person can become different — by contracting an infection or interrupting habitual social ties due to self-isolation. This proves the work of destructive plasticity — a transformation of the subject in which she becomes radically different, examples of which can be considered not only with the brain injuries or neurodegenerative diseases but also with the consequences of coronavirus. The transformed subject is such a "biomedical Other”, she needs an empathic and hospitable bio-ethics based on an expanded understanding of the boundaries of "self” and "other”. This subject represents the "grounding” of contingency, which has become an important concept of recent philosophy. A brief outline of bio-ethics illustrates an attempt to "phenomenologize” contingency, linking it with the anthropological possibility of plastic transformation, which can have both creative and destructive dimensions. Bioethics works with contingency, without turning it into a metaphysical concept and without trying to fit it into the framework of biomedically drawn normativity. Immune hospitality provides a framework for the acceptance of "biomedical Others” as the realization of the diversity of the forms of human embodiment. © 2022, Russian Academy of Sciences. All rights reserved.

Moral Distress in Pediatric Palliative Care: Classic Problems and Challenges of the COVID-19 Pandemic

Moral distress is an actual problem of medical ethics, psychology and healthcare. Its direct effects are the persistence of negative affect, emotional burnout, doctors leaving the profession;indirect damage from moral distress includes a significant worsening of medical care, a decrease in the quality of life of patients and physicians. Pediatric palliative care is a particularly sensitive area to moral distress, rich in severe, intractable existential and moral problems. The article examines the basic concepts of the nature of moral distress in medical care in general and palliative care for children in particular, and analyzes the structure of the experience of moral distress by healthcare professionals. Based on the data of modern psychometric and phenomenological studies, the causes of experiencing moral distress are identified and generalized. The phenomenon of moral distress among patients of palliative care for children and their family members, which has so far rarely been in the focus of researchers, is considered separately. The study of moral distress is based on the sometimes antagonistic interaction of two research paradigms — phenomenological, focused on the analysis of people’s experiences and psychometric, objectified;their correlation and the possibility of integrating the results obtained into healthcare practice are also discussed in this article. © 2022, Russian Academy of Sciences. All rights reserved.