Medicina e Morale https://www.medicinaemorale.it/index.php/mem <p><strong>Medicina e Morale. Rivista internazionale di Bioetica</strong>&nbsp;is a scientific bimonthly journal promoted by the Università Cattolica del Sacro Cuore (UCSC). The Journal publishes original articles on bioethics, moral philosophy, medical ethics, deontology, philosophy of law, and related disciplines, as well as case studies in which ethical dilemmas are relevant. Started up by Catholic Doctors of Turin, with the aim of reflecting on medico-moral issues, the Journal has published the first issue in 1951, under the direction of Fr. Agostino Gemelli (UCSC’s Rector), Peter Sisto (Professor of Special Pathology at the University of Turin) and Peter Swifts (Professor of Biological Chemistry at the University of Milan). Physicians Enzo De Lorenzi and Gian Pietro Ravera worked as Editorial Staff. From No. 1 on 1955 “Vita e Pensiero” publisher bought the Journal, but Editor-in-Chief and Editor Staff were unchanged. In 1973 the above-mentioned publisher tried to implement the Journal by a major involvement of the Faculty of Medicine. Prof. Angelo Fiori, forensic scientist, became the Editor-in-chief and the Editorial Committee and the Editorial Staff were enlarged. In 1974 Prof. Elio Sgreccia started to collaborate with the Journal, and later he became Editor, alongside Prof. Fiori. The Journal broadened its horizon, dealing with Bioethics. After some administrative difficulties in 1983, “Medicina e Morale”, managed by the Faculty of Medicine at UCSC, came quickly to the milestone of over 3000 subscribers, partly from foreign countries. In December 2015, the Rector of UCSC has issued a decree on the journal "Medicina and Morale. Rivista internazionale di Bioetica”, which, together with the Code of ethics previously published, outlines the new structure, defining in more detail the scope and the role of the different organs. Prof. Antonio G. Spagnolo, director of the Institute of Bioethics and Medical Humanities of the UCSC, has been appointed as director. We can say with justifiable satisfaction, that now the Journal has a credit in Italy and in other countries around the world and it is present in several important Universities and Cultural Institutions.</p> PAGEPress Publications, Pavia, Italy en-US Medicina e Morale 0025-7834 Medically assisted suicide and autonomy of medical ethics https://www.medicinaemorale.it/index.php/mem/article/view/593 <p>Not available.</p> Andrea Nicolussi Copyright (c) 2019-12-20 2019-12-20 68 4 367 374 10.4081/mem.2019.593 Bedside Bioethics Consultation: the experience of the Clinical Ethics Service at the “Agostino Gemelli” University Hospital Foundation – IRCCS – Rome https://www.medicinaemorale.it/index.php/mem/article/view/594 <p>The article deals with the experience of the Clinical Ethics Consultation Service (CEC Service) of the Institute of Bioethics and Medical Humanities of the Catholic University of the Sacred Heart for the University Hospital Foundation “Agostino Gemelli” IRCCS (FPG) of Rome (Italy), from 1992 to present. After a general introduction on the meaning and purpose of clinical ethics consultation (CEC), the article examines the CECs released by CEC Service. We conducted a retrospective survey of all CECs requested and performed since the beginning of the Service up to now. The trend of the Service was analyzed and the number of consultations carried out in the first 20 years was compared with the number of CECs performed since the inclusion of the Service on “Gemelli Intranet” from 1st January 2016. We have identified and analized data relating to number of CEC requests and released, clinical areas that required CECs, kinds of consultation (standard CEC or shared document), ethical questions – and not only ethical ones – that emerged.</p> Antonio G. Spagnolo Barbara Corsano Dario Sacchini Copyright (c) 2019-12-20 2019-12-20 68 4 376 395 10.4081/mem.2019.594 Dying while intentionally deeply sedated: how can we ethically justify continuous deep palliative sedation? https://www.medicinaemorale.it/index.php/mem/article/view/595 <p>Recent legislative efforts in Italy regarding end-of-life care have sought to extend the option of continuous deep palliative sedation to patients who do not have a terminal illness. Such developments call for further ethical reflection. This article emphasizes that recourse to continuous deep palliative sedation is ethically permissible and indeed an integral part of palliative care only when it comports with professional guidelines. We argue that ‘imminence of death’, generally understood as death anticipated within hours-to-days, is an important clinical criterion for determining the moral permissibility of the practice. In our discussion, we will (1) explain why the Doctrine of Double Effect, frequently referenced in these debates, does not necessarily apply; (2) identify an alternative clinical and ethical justification for recourse to end-of-life sedation; and (3) discuss the eventual permissibility of recourse to palliative sedation for existential suffering. In so doing, we aim to inform current bioethical debates.</p> Guido Miccinesi Joseph Raho Copyright (c) 2019-12-20 2019-12-20 68 4 397 410 10.4081/mem.2019.595 “Unsustainable drugs” and intergenerational healthcare justice https://www.medicinaemorale.it/index.php/mem/article/view/596 <p>The recent introduction of new direct-acting antiviral drugs for the treatment of patients with hepatitis C that are extremely effective in treating the disease but that are associated with exorbitant costs raised public debate about healthcare distributive justice. The aim of this article is to provide a brief discussion on the topic of the so-called “unsustainable drugs” examined under a specific model of distributive justice, i.e. egalitarianism, and from an intergenerational perspective. The conclusion is that to date healthcare systems are facing the issue of sustainability through the optimization of pharmaceutical spending, but they are not well equipped to face the possibility of an inevitable divergence between demand and supply of this kind of drugs. The latter should be addressed with reference to the conception of distributive justice of a certain society, and in particular, to the amount of resources that a society wishes to pay for the treatment of one of its member. Finally, in terms of distributive justice, the argument – which is often supported by pharmacoeconomic evaluations – according to which the vast amount of money spent now for this type of drugs will allow to have savings in the long run is not in itself coherent with the main theories of justice. Considerations that are extrinsic to the assumptions of the main theories of justice are needed in order to justify the argument above.</p> Pietro Refolo Dario Sacchini Filippo Rumi Americo Cicchetti Antonio G. Spagnolo Copyright (c) 2019-12-20 2019-12-20 68 4 411 422 10.4081/mem.2019.596 Post human e gene editing: Reflections on perfection and sense of limit https://www.medicinaemorale.it/index.php/mem/article/view/597 <p>Starting from the therapeutic and enhancement possibilities opened up by recent genetic editing techniques, the essay discusses the human sense of fragility and the desire for improvement, which have always been associated with the human experience. The notion of limit is the central element in this discussion, which combines technological innovation with anthropological reflection. Such a notion is hotly debated, as it is considered either as an evil to be removed or as an essential condition to be accepted. After reviewing the essential aspects of this debate, the essay affirms the need to chose between the myth of perfection and the vocation to fulfillment: it takes humility to accept us for what we are, without being captivated by the idea of a perfect and invulnerable humanity; it takes courage to challenge the obstacles that prevent the person from flourishing in fullness.</p> Luca Grion Copyright (c) 2019-12-20 2019-12-20 68 4 423 436 10.4081/mem.2019.597 The Opinion of the Italian Committee for Bioethics “Bioethical reflections on medically assisted suicide” https://www.medicinaemorale.it/index.php/mem/article/view/590 <p>In July 2019 the Italian Committee for Bioethics approved and published an Opinion entitled “Bioethical reflections on medically assisted suicide”. This paper, after a brief presentation of the institutional history of this document, seeks answers to some bioethical questions touched by the Opinion. What emerges is a critical reading that goes beyond individual questions (and especially the legal and juridical profiles involved), and refers to the need for a new meditation on the meaning of bioethics and its relationship with philosophical anthropology and identity issues.</p> Claudio Sartea Copyright (c) 2019 https://creativecommons.org/licenses/by-nc/4.0 2019-10-15 2019-10-15 68 4 437 454 10.4081/mem.2019.590 Healthcare advertising between hippocratic ethos, law and competition https://www.medicinaemorale.it/index.php/mem/article/view/598 <p>Healthcare advertising is an area of particular interest to verify the balancing proposed in the national and EU law between these two complementary dimensions of the health profession which, by recalling different and sometimes opposing values, allow us to shed light on the dangers of policies and interpretations of law not able to put the human nature and the protection of human dignity before the economic reasons. The present contribution, inspired by the recent intervention of the legislator in the field of healthcare advertising, intends to analyze the regulation of advertising within the health professions both from an exquisitely deontological and legal point of view, focusing on the problem of the functionality of the limits provided by the professional organization with respect to the protection of fundamental human rights and their compatibility with the protection of competition.</p> Fabio Giuseppe Angelini Copyright (c) 2019-12-20 2019-12-20 68 4 455 473 10.4081/mem.2019.598 Debate in Bioethcis - Which sort for human remains of abortion? Fetal burial in state and regional regulations https://www.medicinaemorale.it/index.php/mem/article/view/599 <p>Not available.</p> Fabio Persano Copyright (c) 2019-12-20 2019-12-20 68 4 475 480 10.4081/mem.2019.599