Medicina e Morale <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 The new Code of Ethics for Nursing Professions <p>Not available.</p> Antonio G. Spagnolo Copyright (c) 2019-10-15 2019-10-15 68 3 243 247 10.4081/mem.2019.584 Hippocrates is dead, long live Hippocrates. Rethinking the Hippocratic medical paradigm <p>For many bioethicists, Hippocrates is dead, in the sense that the Hippocratic medical tradition is a thing of the past and its ethical principles are no longer acceptable. Veatch, for instance, says: «I argue that the Hippocratic Oath is unacceptable to any thinking person. It should offend the patient and challenge any health care professional to look elsewhere for moral authority». Such anti-Hippocratism is probably because in its original form the oath prohibits both euthanasia and abortion, and because of the later influence of Christian Ethics. In my opinion, anti-Hippocratic authors engage in the “straw man” fallacy. In fact, such anti-Hippocratism creates the illusion of having completely refuted or defeated the value of the Hippocratic tradition through the replacement of it with an exceptionable reconstruction of Hippocratism, and the subsequent refutation of that false idea of Hippocratism, instead of the genuine one. After looking at the origins of Hippocratic medicine, by examining the first Aphorism of Hippocrates, which is considered to be the epistemological manifesto of Hippocratism, and the Hippocratic Oath, which is considered to be the ethical manifesto of Hippocratism, I will try to re-discover the genuine concept of Hippocratic medicine. Finally, I will defend the persistent value of Hippocratism, by considering its being a “classic”. In fact, the broader significance of the Hippocratic Ethics lies in their unyielding devotion to the preservation of individual human life and to the preservation of humanism in medicine.</p> Letizia Mingardo Copyright (c) 2019-10-15 2019-10-15 68 3 249 263 10.4081/mem.2019.585 Moral distress from human to veterinary medicine: a comparative analysis <p>Studies on professional hardship in the healthcare professions are constantly growing. These studies have identified various ethical discomforts, such as moral distress, whose diagnosis and treatment is of critical importance. However, in the field of animal care professions, such as that of the veterinary surgeon, these studies have rarely been studied in depth, with serious repercussions on professional practice. In general, society struggles to understand how difficult it is for those who work with animals to manage the ethical conflicts that arise between the needs of the profession, the needs of the animals and the demands of those who are owners or proxies for the animal. Moral distress has only recently been recognized in veterinary medicine and is provoked, as in the field of human medicine, by the inability to find an agreement between one’s vocation and the moral tensions that the exercise of the profession brings every day. In this contribution, through a comparison with the studies carried out in the field of healthcare professions in human medicine, moral distress is explored in the context of the veterinary medical profession, focusing attention on the specific ethical issues that are involved in the triadic relationship between surgeon, animal patient and owner.</p> Barbara De Mori Copyright (c) 2019-10-15 2019-10-15 68 3 265 280 10.4081/mem.2019.586 The false analogy between refusal-renunciation of treatments and physician-assisted suicide. Bioethical considerations about the Constitutional Court Ordinance No. 207/2018 <p>The paper provides some bioethical considerations that are particularly lacking within Ordinance n. 207/2018 issued by the Constitutional Court. With reference to the case of Fabiano Antoniani, better known as DJ Fabo, who requested and subsequently committed assisted suicide after being accompanied by Marco Cappato to Switzerland, the ordinance deals with the dubious constitutional illegitimacy of Article 580 of the Italian Criminal Code. On the one hand, the paper brings attention to the Constitutional Court’s thesis that criminal provision on assisted suicide is not incompatible with the Constitution. On the other hand, it criticizes how the Court justifies medical aid to suicide – albeit in relation to certain exceptional situations. This justification is based on the erroneous assumption that there are not significant differences between refusal-renunciation of treatments and physician-assisted suicide. On the basis of this assumption, the Court has come up with the highly questionable proposal of modifying the recent law, n. 219/2017, titled “Norme in materia di consenso informato e di disposizioni anticipate di trattamento”. The paper then argues that Ordinance n. 207/2018 is characterized by the logical fallacy of false analogy. The fallacy is developed in four phases in which different concepts and situations are erroneously equalized. The four phases concern 1) the binomial of killing–letting die; 2) the meaning of death; 3) the meaning of drug treatment; 4) the value of the patient-physician relationship.</p> Antonio Da Re Copyright (c) 2019-10-15 2019-10-15 68 3 281 295 10.4081/mem.2019.587 Human vulnerability and practical rationality. A MacIntyrean bioethical perspective <p>This article focuses on some essays by Alasdair MacIntyre published in the course of thirty years. They are the main sources for the reconstruction of a bioethical perspective based on virtue ethics. This perspective “centers” bioethics on medicine as a social practice and therefore on the relation between the patient and the doctor considered within the effective social network where both alienating and liberating forms of dependency can be found. Human flourishing dos not require an utopian emancipation from all kinds of dependency; on the contrary it requires the practice of ethical and dianoethical virtues which the biological and rational relations of dependency make possible. The exercise of independent practical rationality, which is a relevant factor for realizing the human good, is not meant as an absolute autonomy but as the ability to justify choices and acts from a narrative viewpoint. According to this bioethical perspective disability, considered as the manifestation of human dependence and vulnerability, becomes an opportunity for exercising the “virtues of giving and receiving”, which realize the individual good and the common good; disability therefore encourages to re-think both the human condition and the nature of the social bonds and of social justice.</p> Sante Maletta Copyright (c) 2019-10-15 2019-10-15 68 3 297 312 10.4081/mem.2019.588 Deliberative models for the allocation of resources in healthcare: the case of dengue in Tanzania <p>In decision-making processes in support of health systems in developing countries, the predominant use of technical approaches (based on economic instruments) has been the main roadmap for identifying health priorities. However, these approaches reveal the limitations, from an ethical point of view, of failing to include an analysis of values and the cultural context and of being scarcely responsive to the real health demands of the population. They also conceal a significant conflict between the underlying values, such as efficiency and equity. Our analysis addresses the participated and deliberative models of resource allocation, and especially the approach developed by Norman Daniels – known as Accountability for Reasonableness (A4R) – with the aim of offering a method for identifying “correct” priorities, which are not defined on the basis of pre-established choices of values, but deriving from a legitimate decision- making process (transparent and negotiated between all the stakeholders involved). To test the enforceability in real circumstances (especially for low-income countries) of the A4R model, the article proposes the analysis of a case study. Specifically, a practical application of the A4R on the prioritisation of Dengue law enforcement interventions in Tanzania is being examined, in order to illustrate what was successful in this particular case, what difficulties were encountered and what reactions were generated by the population.</p> Elena Mancini Roberta Martina Zagarella Copyright (c) 2019-10-15 2019-10-15 68 3 313 335 10.4081/mem.2019.589