Giving Body to the Body: Predictive Genetic Testing and Self-desomatization / Darle cuerpo al cuerpo: pruebas genéticas predictivas y autodesomatización / Dar corpo ao corpo: testes genéticos preditivos e autodesomatização

Abstract Genetics test in predictive medicine seems to take charge of the uniqueness of any human being. Unlike preventive medicine it moves from the theoretical assumption of the knowledge of a specific individual's genetic structure and potential fragility. However, the attention paid to the gene risks placing the living and experienced body in the shadow. Sometimes, "genetic news" can make the subject in the present act like a sick person without being so, read every event in that direction, and, ultimately, fulfill the prophecy. The article goes beyond the alleged non-exceptionalism of genetic data and discusses the symbolic value that the gene has assumed and its role in reflexivity and self-perception.

Resumen Las pruebas genéticas en la medicina predictiva parecen encargarse de la singularidad del ser humano, a diferencia de la medicina preventiva parte del supuesto teórico del conocimiento de la estructura genética y de la fragilidad potencial de un individuo específico. Sin embargo, la atención que se presta al dato genético tiene el riesgo ensombrecer el cuerpo vívido y la experiencia en primera persona. En ocasiones, las "noticias genéticas" pueden llevar al sujeto en el presente a actuar como un enfermo sin serlo, a leer cada evento en ese sentido y, por último, a cumplir la predicción. El artículo va más allá de la supuesta no excepcionalidad de los datos genéticos y analiza el valor simbólico que ha asumido el gen y su papel en la reflexividad y la autopercepción.

Resumo Os testes genéticos em medicina preditiva parecem se responsabilizar pela singularidade de qualquer ser humano, enquanto a medicina preventiva se move a partir do suposto teórico do conhecimento da estrutura genética e da fragilidade potencial de um indivíduo específico. Contudo, a atenção prestada ao dado genético está arriscada a agravar o corpo vívido e a experiência em primeira pessoa. Em ocasiões, as "notícias genéticas" podem levar o sujeito no presente a atuar como um doente sem ser isso, a ler cada evento nesse sentido e, definitivamente, a cumprir o predito. Este artigo vai mais além da suposta não excepcionalidade dos dados genéticos e analisa o valor simbólico que o gene assume e seu papel na reflexividade e na autopercepção.

Contemporaty psot-Humanism: Technological and human singularity / Posthumanismo contemporáneo: tecnología y singularidad humana

Posthumanism entails the idea of transcendence of the human being achieved through technology. The article begins by distinguishing perfection and change (or growth). It also attempts to show the anthropological premises of posthumanism itself and suggests that we can identify two roots: the liberal humanistic subject (autonomous and unrelated that simply realizes herself/himself through her/his own project) and the interpretation of thought as a computable process. Starting from these premises, many authors call for the loosening of the clear boundaries of one’s own subject in favour of blending with other beings. According to these theories, we should become post-human: if the human being is thought and thought is a computable process, whatever is able to process information broader and faster is better than the actual human being and has to be considered as the way towards the real completeness of the human being itself. The paper endeavours to discuss the adequacy of these premises highlighting the structural dependency of the human being, the role of the human body, the difference between thought and a computational process, the singularity of some useless and unexpected human acts. It also puts forward the need for axiological criteria to define growth as perfectionism

El Posthumanismo lleva consigo la idea que la trascendencia del ser humano debe ser obtenida a través de la tecnología. El artículo empieza distinguiendo los conceptos de perfección y de cambio (o crecimiento). También intenta monstrar las premisas antropológicas del mismo post-humanismo, sosteniendo que tiene dos raíces: la de sujeto del humanismo liberal (autónomo, sin relaciones y que, simplemente, se realiza a si mismo a través su propio proyecto) y la interpretación del pensamiento como un proceso computacional. Desde esas premisas muchos autores afirman la necesidad de que el sujeto ya no tenga confines bien definidos y que se contamine con otros seres. Según estas teorías, tenemos que llegar a ser post-humanos: si el ser humano es pensamiento y el pensamiento es un proceso computacional, todo lo que pueda tratar la información más amplia y rápidamente es mejor que el actual ser humano y, al mismo tiempo, tiene que ser considerado la vía para realizar su verdadera plenitud. El artículo intenta discutir la adecuación de estas premisas, y lo hace teniendo en cuenta la dependencia estructural del ser humano, el papel del cuerpo, la diferencia que hay entre el pensamiento y un proceso computacional, la singularidad de algunos actos humanos inútiles e inesperados. También propone la necesidad de identificar criterios axiológicos para que se pueda decir que un crecimiento es un perfeccionamiento

Contemporary post-humanism: technological and human singularity.

Posthumanism entails the idea of transcendence of the human being achieved through technology. The article begins by distinguishing perfection and change (or growth). It also attempts to show the anthropological premises of posthumanism itself and suggests that we can identify two roots: the liberal humanistic subject (autonomous and unrelated that simply realizes herself/himself through her/his own project) and the interpretation of thought as a computable process. Starting from these premises, many authors call for the loosening of the clear boundaries of one's own subject in favour of blending with other beings. According to these theories, we should become post-human: if the human being is thought and thought is a computable process, whatever is able to process information broader and faster is better than the actual human being and has to be considered as the way towards the real completeness of the human being itself. The paper endeavours to discuss the adequacy of these premises highlighting the structural dependency of the human being, the role of the human body, the difference between thought and a computational process, the singularity of some useless and unexpected human acts. It also puts forward the need for axiological criteria to define growth as perfectionism.

[Language and metalanguage in bioethics]. / Lenguaje y metalenguaje en bioética.

The language of Bioethics is situated in a context of singular terminological complexity. On the one hand, if we look at the epistemological status of this discipline, we can realize that the knowledge of their material object (which refers to the Bios and transformations that technology involves) requires the assistance of several sciences, whose contribution is indispensable for understanding the empirical data. At the same time, the question which constitutes its formal object is clearly philosophical, and therefore requires moving at the level of ethics. This paper attempts to deal with some problematic knots of the issue, gathered around two axes: the role of techno-scientific language in bioethics and its explanatory ability and the characteristics of philosophical language. As for the second point, it also discusses the tentative to find a neutral language (structuring the same Bioethics as a lingua franca); the recourse to indirect speech that shifts the focus from the truth of the arguments to the framework of models; the rhetorical use of the language.

Lenguaje y metalenguaje en bioética / Language and metalanguage en bioethics

El lenguaje de la Bioética se sitúa en un contexto de singular complejidad terminológica. Por un lado, si contemplamos el estatuto epistemológico de esta disciplina, podemos darnos cuenta de que el conocimiento de su objeto material (lo que se refiere al Bios y a las transformaciones que la tecnología implica) requiere el concurso de varias ciencias, cuya aportación es indispensable para comprender el dato empírico. Al mismo tiempo, la pregunta que constituye su objeto formal es claramente filosófica, y, por lo tanto, requiere moverse al nivel de la ética. El presente trabajo intenta afrontar algunos nudos problemáticos de la cuestión, agrupados en torno a dos ejes: el papel del lenguaje técno-científico en la Bioética y su capacidad explicativa; las características del lenguaje filosófico. En relación con este segundo punto, discute también los tentativos de encontrar un lenguaje neutro (estructurando la propria Bioética como una lengua franca); el recurso al discurso indirecto que traslada la atención desde la verdad de las argumentaciones hacia el marco de los modelos; el uso retórico del lenguaje (AU)

The language of Bioethics is situated in a context of singular terminological complexity. On the one hand, if we look at the epistemological status of this discipline, we can realize that the knowledge of their material object (which refers to the Bios and transformations that technology involves) requires the assistance of several sciences, whose contribution is indispensable for understanding the empirical data. At the same time, the question which constitutes its formal object is clearly philosophical, and therefore requires moving at the level of ethics. This paper attempts to deal with some problematic knots of the issue, gathered around two axes: the role of techno-scientific language in bioethics and its explanatory ability and the characteristics of philosophical language. As for the second point, it also discusses the tentative to find a neutral language (structuring the same Bioethics as a lingua franca); the recourse to indirect speech that shifts the focus from the truth of the arguments to the framework of models; the rhetorical use of the language (AU)

Disability, human rights, and the International Classification of Functioning, Disability, and Health: systematic review.

This literature review focuses on the literature on disability from the ethical and human rights perspective in the light of the International Classification of Functioning, Disability, and Health in the period from January 1, 2008, to June 30, 2010. This article identifies and examines studies that deal with the subject of disability with reference to rights, ethical issues, and justice. A total of 42 articles and 33 books were selected. The subject most frequently dealt with in studies on disability is that of human rights (76% of the articles and 79% of the books examined), followed by topics relating to welfare (52% of articles and 64% of books), International Classification of Functioning, Disability, and Health (38% of articles and 45% of books), justice (24% of articles and 48% of books), education (21% of articles and 61% of books), and work (19% of articles and 39% of books). The subject of disability is dealt with in various fields of study and various disciplines. Most of the studies are based on the legal approach. It is to be hoped that there will be an increase in the philosophical and ethical study of disability, which has only recently entered the European debate.

To cure e to caee in situazioni di fine vita: la proporzionalità e le cure palliative

Per affrontare i temi bioetici inerenti alla fine della vita occorre mettere a fuoco la questione della proporzionalità dei trattamenti. Spesso la dimenticanza del limite intrínseco all'arte medica può sfociare in un duplice e contraddittorio atteggiamento: l'accanimento terapeutico da una lato, l'abbandono terapeutico dall'altro. L'incapacità di riconoscere nel concreto la finitezza porta infatti a non accettare la morte, a negare la sua ineluttabilità o a sfuggirla nella sua complessità antropologica ed esistenziale. La negazione del limite, inoltre, ha come esito anche un possibile rapporto conflittuale tra i medico e il paziente, con il risultato della strutturazione di una medicina difensiva e di stampo contrattualistico. La proporzionalità di cui si parla è un criterio, e come tale richiede una valutazione puntuale, nella situazione, senza una rigida e aprioristica codificazione. Spesso, comunque, la ritrosia ad accettare, a livello sociale o nella comunità scientifica medica, il criterio di sospensione dei trattamenti quando questi si rivelano sproporzionati, nasce dalla confusione concettuale tra uccidere e permettere di morire, nonché tra omissione e sospensione. La differenza tra queste azioni sfuma solo se si sposta il peso della valutazione sull'intenzione o sulle conseguenze, la cui omogeneità veicolerebbe l'equivalenza morale degli atti. Nelle pagine che seguono si mostra inoltre la connessione della cura con il tema della qualità di vita e con l'importante campo delle cure palliative.

An effort to address the bioethical issues inherent in the process of dying requires a focus on the proportional aspect of treatment. Failing to bear in mind the intrinsic limit to the art of medicine can result in dual and contradictory behavior: artificial support therapy on the one hand and therapeutic abandonment on the other. In real situations, the inability to recognize the limits of the power of medicine is, in one way or another, equivalent to not accepting death, to denying its inevitable role or to evading its anthropological and existential complexity. Moreover, denying that limit can lead to a possible conflict between the physician and the patient, resulting in medicine that is defensive and contractual in nature. The proportionality in question is a criterion and, as such, it demands a particular assessment of the situation, without rigid and dogmatic codification. However, the reluctance that exists at the social level or within the medical scientific community to accept suspension of treatment when it is shown to be disproportionate is born of the conceptual confusion between unlawful death and permitting death; that is, between omission and suspension. The difference between these two acts disappears only if the weight of the assessment is shifted to the intention or the consequences, the oneness of which would unite the moral equivalent of the acts. The article also shows the relationship between treatment and quality of life and the important field of palliative care.

Para afrontar los temas bioéticos inherentes al proceso de fin de la existencia es necesario enfocar el tema de la proporcionalidad de los tratamientos. Con frecuencia el olvido del límite intrínseco del arte de la medicina puede desembocar en un doble y contradictorio comportamiento: de una parte la terapia de mantenimiento artificial y de otro lado el abandono terapéutico. La incapacidad de reconocer en la realidad concreta el límite del poder médico conlleva, de una forma o de otra, a no aceptar la muerte, a negar su parte ineluctable o a evadir su complejidad antropológica y existencial. Además, la negación del límite tiene como efecto una posible relación de conflicto entre el médico y el paciente, dando como resultado la estructuración de una medicina defensiva y de tipo contractual. La proporcionalidad de la cual se habla es un criterio, y como tal exige una evaluación puntual en la situación, sin una codificación rígida y a priori. Sin embargo, la reticencia a aceptar a nivel social o en la comunidad científica médica, el criterio de suspensión de los tratamientos cuando estos demuestran ser desproporcionados, nace de la confusión conceptual entre asesinar o permitir morir, entre omisión y suspensión. La diferencia entre estas dos acciones desaparece solamente si se desplaza el peso de la evaluación hacía la intención o hacía las consecuencias, cuya homogeneidad uniría la equivalencia moral de los actos. En las siguientes páginas también se muestra la relación del tratamiento con el tema de la calidad de vida y con el importante campo de los cuidados paliativos.