Carlos Gomez

COVID-19 has turned many ethical principles and presuppositions upside down. More precisely, the principle of respect for autonomy has been shown to be ill suited to face the ethical challenges posed by the current health crisis. Individual wishes and choices have been subordinated to public interests. Patients have received trial therapies under extraordinary procedures of informed consent. The principle of respect for autonomy, at least in its mainstream interpretation, has been particularly questioned during this pandemic. Further reflection on the nature and value of autonomy is urgently needed. Relational autonomy has been proposed as an alternative account of autonomy that can more adequately respond to contemporary ethical issues in general and to a pandemic such as the one we are currently facing in particular. As relational autonomy is an emerging notion in current bioethics, it requires further consideration and development to be properly operationalized. This paper aims to show how six different philosophical branches––namely, philosophy of nature, philosophical anthropology, existential phenomenology, discourse ethics, hermeneutics, and cultural anthropology––have incorporated the category of relation throughout the twentieth century. We first delve into primary philosophical sources and then apply their insights to the specific field of medical ethics. Learning from the historical developments of other philosophical fields may provide illumination that will enable bioethics to experience a successful “relational turn”, which has been partially initiated in contemporary bioethics but not yet achieved.

Deception scholars have argued that increasing the liar’s cognitive system artificially can produce deception cues. However, if too much load is imposed the truth tellers’ performance can also be impaired. To address this issue, we designed a veracity task that incorporated a secondary task to increase cognitive load gradually. Also, because deception has been associated with activity in the inferior frontal cortex (IFC), we examined the influence of transcranial direct current stimulation of the IFC on performance. During stimulation, participants truthfully or deceptively indicated whether each of a number of statements shown on screen was true or not. Higher load decreased recall but not general compliance or response times (RTs). Truthful trials yielded higher compliance rates and faster RTs than deceptive trials except for the highest load level. Anodal right stimulation decreased compliance in truthful trials when participants were not overloaded. Truth telling was more vulnerable to cognitive load and tDCS than lying.

La «filosofía de la conciencia» constituye el paradigma fundamental de la filosofía moderna de Descartes a Kant. Dicho paradigma ha sido sometido a sucesivas críticas, en primer lugar por parte de la denominada «filosofía de la sospecha» y, más tarde, por «el giro lingu..stico», aquí considerado desde la perspectiva de la ética discursiva habermasiana. Aunque esas críticas obligan a romper la primacía y el monologismo de la «filosofía de la conciencia», no deberían llevar a olvidar el valor de la conciencia (moral) misma, por resituada que quede. Así se trata de defender siguiendo los planteamientos de, entre otros, Wellmer, Muguerza, Bilbeny o Renaut, y reconsiderando desde ese horizonte la confrontación entre Hegel y Kant, retomada en nuestros días por la existente entre comunitaristas y liberales, para, finalmente, esbozar algunas perspectivas sobre la relación entre individualismo y cosmopolitismo.

It is pretended to show the influence Cervantes had on Freud. Freud was worried about the psychic disorders. He was also disappointed by the methods of psychiatry had at that time. Freud was very interested in the plays of Cervantes, especially in El coloquio de los perros and El Quixote, where reality and illusion, and the relationship between sanity and insanity are their central axes. One of the possible readings of the great play is the one where limits between reason and unreason are not clear, to the point of achieving “the reason of the unreasonableness”, which would make it understandable and explicable. Real fantasy, fantastic reality, the demarcation between them was one of the topics that worried Freud. Freud is not a simple lawyer of the irrationality, but he also tries to find “the reason of the unreasonableness” that neurotics show in the symptoms he tried to explain in detail

Tras señalar algunas razones de la vigencia de Pascal y analizar las líneas fundamentales de su contexto social e ideológico (con especial hincapié en el jansenismo y la polémica de Las provinciales), se consideran los problemas de edición y de interpretación de Pensées. Con posterioridad, se analizan algunos de sus principales núcleos temáticos, antropológicos y epistemológicos. Finalmente, se plantea una interpretación de le pari desde la que abordar las relaciones entre razón y religión, subrayando el lazo entre Pascal y Kant, que haría del primero (de manera similar a como Kant decía que, para él, Rousseau había sido el Newton de la moral) el Newton de la filosofía kantiana de la religión.

Tras la presentación y un esbozo biográfico, se consideran algunos ejes de la obra de Kolakowski: la crítica del marxismo, el interés por la religión y el cuestionamiento metafísico. El profundo conocimiento de los clásicos y de las principales tendencias de la filosofía contemporánea, así como el seguimiento de los debates nuestro tiempo, hacen de Kolakowski un pensador cosmopolita, a pesar de la independencia de su pensamiento, nutrido de tensiones que es preciso saber mantener en vez de decantarse unilateralmente por uno de los polos de las mismas. Aunque no podamos esperar un orden social y un sistema filosófico que logren resolver nuestros interrogantes, el pensamiento que los considera, en vez de procurar cancelarlos, tiene la ventaja de mostrarnos por qué, pese a que no podamos resolverlos de manera cabal, es importante que nos los sigamos planteando.

Tras recordar la intensa labor intelectual desarrollada por José Gómez Caffarena, se analizan la estructura y tesis fundamentales de su obra El enigma y el misterio. Una filosofía de la religión. A las consideraciones sobre la historia y estructura del hecho religioso se agrega un amplio estudio sobre las diversas posiciones ante lo religioso, conforme a una triple tipología inspirada en Dilthey, para articular finalmente una elaborada propuesta sobre la plausibilidad filosófica de la fe en Dios, en la que se abordan muy diversos problemas de la filosofía de la religión (panteísmo, providencia, mal físicio y moral, etc.). Con un sólido conocimiento de la tradición escolástica y de la filosofía moderna (de Kant a las principales tendencias del pensamiento del siglo XX), Caffarena ofrece una sobria y matizada propuesta en la que defiende la posible conjugación de las cautelas de la razón con el aliento de la esperanza.

The “philosophy of conscience” is the fundamental paradigm of modern philosophy from Descartes to Kant. Such paradigm has been the object of continuous criticism starting with the so call “philosophy of suspicion” and latter on by the “linguistic turn”, which in this article is considered from the perspective of the discursive ethics of Habermas. Although these criticisms force us to abandon the primacy and the monologism of the “philosophy of conscience”, we should not forget the value of the moral conscience itself in spite of all its resituations. This is what I try to claim in this work, following the arguments of Wellmer, Muguerza, Bilbeny or Renaut, among other critics, revisiting, from this perspective, the confrontation between Kant and Hegel, which has been brought up again by the liberal/communitarian debate, leading finally my discussion to the relation between individualism and cosmopolitanism.

Los textos hipocráticos y su vigencia: elementos para la formación humanística del médico en el siglo XXI Os textos hipocráticos e sua validade: elementos para a formação humanística do médico no século XXI By way of notes, comments are made on the validity of some Hippocratic works from the perspective of the learning and practice of medicine in the first decades of the 21st century, amidst a expanding technical-scientific and computer civilization. The paper highlights the affirmation of perennial truths —valid at all times— extracted from a selection of Hippocratic writings, which express the spirit of classic Greek medicine understood as tekhne iatrike. It was originally conceived as an activity of a rational, human, philanthropic and scientific nature aimed at serving the good of patients, following an ethos and some ethical principles and values of universal range, validity and application. It is proposed that taking in these concepts provides the medicine student with humanity, dignity, moral and intellectual growth, and improves their attitudes and aptitudes, skills and abilities to understand and face multiple existential situations that permeate daily clinical practice. This not only requires professional technical skills, but also humane attributes for better approaching interpersonal relationships with and attitudes towards the patient and their families. These ideas are introduced as a contribution of bioethics, characterized by its humanities-science-technology integration and educational mission of training critical consciences within the techno-scientific civilization, in order to foster respect for and openness towards diverse aspects of reality. Para citar este artículo / To reference this article / Para citar este artigo Gómez-Fajardo CA. Los textos hipocráticos y su vigencia: elementos para la formación humanística del médico en el siglo XXI. Pers Bioet. 2019;23:194-206. DOI: https://doi.org/10.5294/pebi.2019.23.2.3 Recibido: 20/04/2019 Aceptado: 18/07/2019