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El estatuto epistemológico de la bioética

2019 , Agazzi, Evandro

La bioética no se presenta como una ciencia bien delimitada, sino más bien como un ámbito de cuestiones y problemas que se ha ido ampliando a partir de los años 70. En los inicios, la bioética abarcaba esencialmente la medicina y las biotecnologías, hoy incluye otros aspectos como el cuidado de los animales y la protección del medio ambiente, y muchos de sus temas conciernen a las políticas de salud y a la propuesta de normas legales. La novedad de la bioética, con respecto a la ética médica tradicional, se basa en el hecho de que el enorme progreso de las tecnologías en la práctica médica ha producido una gran cantidad de situaciones inéditas, en las que es posible y hasta necesario tomar decisiones para las cuales no existían normas en la ética tradicional. Esto depende también de la notable complejidad de las situaciones típicas de los debates bioéticos. Por estas razones, la bioética se presenta como un paradigma de lo que tiene que ser la ética en el contexto de una civilización tecnológica, es decir como la búsqueda de un punto de encuentro entre la tecnología y la conciencia moral. Si nos damos cuenta de esta característica fundamental, es posible reconocer en la bioética la presencia de un estatuto epistemológico propio, que consiste en la adopción del método interdisciplinar desde un enfoque sistémico y con capacidad de tomar en cuenta los fenómenos de la complejidad. De esta manera, la bioética conseguirá constituirse desde un punto de vista holístico que le permitirá relacionar los niveles más simples con los más complejos, así como aprovechar constructivamente las diferencias doctrinales y culturales que conlleva la globalización en nuestro tiempo. ©2019 Arbor, CSIC Consejo Superior de Investigaciones Científicas.

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Scientific objectivity and its contexts

2014 , Agazzi, Evandro

The first part of this book is of an epistemological nature and develops an original theory of scientific objectivity, understood in a weak sense (as intersubjective agreement among the specialists) and a strong sense (as having precise concrete referents). In both cases it relies upon the adoption of operational criteria designed within the particular perspective under which any single science considers reality. The “object” so attained has a proper ontological status, dependent on the specific character of the criteria of reference (regional ontologies). This justifies a form of scientific realism. Such perspectives are also the result of a complex cultural-historical situation. The awareness of such a “historical determinacy” of science justifies including in the philosophy of science the problems of ethics of science, relations of science with metaphysics and social dimensions of science that overstep the traditional restriction of the philosophy of science to an epistemology of science. It is to this “context” that the second part of the book is devoted.

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Truth between semantics and pragmatics

2015 , Agazzi, Evandro

Truth had been excluded from the requirements of science after the so-called "foundationa crisis" of the exact sciences (mathematics and physics) occurred between the end o the 19th and the beginning of the 20th century. A formalistic outlook had imposed itself i the philosophy of science, from which meaning and truth were excluded. This approach, however was seriously weakened after the discovery of the "internal limitations of formalisms entailed by Goedel's theorems, and Tarski almost at the same time advocated the legitimac of meaning and truth for the formalized languages, calling "semantics" this part of the metatheoretica investigations. This terminology has remained standard especially in mathematica logic. One must note, however, that semantics regards in a proper sense the level of meaning whereas truth implies in addition the reference of the language to some extralinguistic domai of entities. This domain is not accessible by means of logical, linguistic or conceptual analysis but can be attained through "operations" of some concrete kind, whose nature determines als the ontological status of the referents. Operations belong to praxis, and this is why the notio of truth is more properly attributed to "pragmatics", understood not in the original Morris sense, but rather in a sense closer to pragmatism, in which the performance of actions is considere essential for providing criteria of truth.

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The truth of theories and scientific realism

2017 , Agazzi, Evandro

The thesis maintained in this paper is that scientific anti-realism was the consequence of having lost the confidence in the capability of science to attain truth, something that historically occurred at the end of the nineteenth century. Therefore, the requirement of truth was removed from science and replaced by the requirement of objectivity. This has a ‘weak’ sense, according to which scientific knowledge is ‘independent of the single subjects’ (intersubjectivity) In addition, however, every science is considered to investigate not reality in general, but only its specific objects (‘strong’ ontological sense of objectivity). These specific objects are ‘clipped out’ of the reality of common sense ‘things’ by considering them from a specific point of view focusing only on certain attributes of reality. In order to determine these clips, the scientific community elaborates certain standardized operational procedures for establishing whether certain statements regarding things are immediately true or false. In such a way these operational procedures are ‘criteria of reference’ and ‘criteria of truth’ for a given science, and moreover turn out to be the same used for securing objectivity in the weak sense. This amounts to recovering the characteristic of truth for scientific knowledge, and giving it a realist interpretation both ontologically and epistemologically, at least for its empirically testable statements. The contemporary struggle about realism, however, regards the unobservable entities introduced in scientific theories, and the strategy proposed in the present paper is that of suitably ‘extending’ to theories the notion of truth, which is immediately and directly defined for single declarative statements. From the referential nature of truth follows that if we have reasons for admitting the truth of a theory, we must also admit, for the same reasons, the existence of its referents, even when they are unobservable entities. ©Springer International Publishing.

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Factors associated with the quality of the patient-doctor relationship: a cross-sectional study of ambulatory Mexican patients with rheumatic diseases

2021 , Pascual-Ramos, Virginia , Contreras-Yáñez, Irazú , Ortiz-Haro, Ana Belén , Molewijk, Albert Christiaan , Obrador, Gregorio , Agazzi, Evandro

Background: The patient-doctor relationship (PDR) is a complex phenomenon with strong cultural determinants, which impacts health-related outcomes and, accordingly, does have ethical implications. The study objective was to describe the PDR from medical encounters between 600 Mexican outpatients with rheumatic diseases and their attending rheumatologists, and to identify factors associated with a good PDR. Methods: A cross-sectional study was performed. Patients completed the PDRQ-9 (Patient-Doctor Relationship Questionnaire, 9 items), the HAQ-DI (Health Assessment Questionnaire Disability Index), the Short-Form 36 items (SF-36), a pain–visual analog scale, and the Ideal Patient Autonomy Scale. Relevant sociodemographic, disease-related, and treatment-related variables were obtained. Patients assigned a PDRQ-9 score to each patient-doctor encounter. Regression analysis was used to identify factors associated with a good PDR, which was defined based on a cutoff point established using the borderline performance method. Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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Considerazioni sull'equilibrio da un punto di vista sistemico

2016 , Agazzi, Evandro

The notion of equilibrium is polysemic and its most general meaning is that of a state in which opposite forces mutually neutralize themselves. Its most satisfactory treatment can be attained by resorting to the conceptual and technical tools of general system theory such as they are applied, for instance, in physics, chemistry and biology. In this last science equilibrium receives the deeper meaning of homeostasis from which, by introducing the notion of information, one attains the domain of cybernetics and its related models. In such a way extensions of the notion of equilibrium can be obtained, e.g., to psychology, historiography, political theory, economics. In these domains equilibrium can be used in order to study dynamically the evolution of complex systems and this is precisely the reason for expressing it in terms of general system theory. ©2016, Vita e Pensiero.

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Concordance among patients and physicians about their ideal of autonomy impacts the patient-doctor relationship: A cross-sectional study of Mexican patients with rheumatic diseases

2020 , Pascual-Ramos, Virginia , Contreras-Yáñez, Irazú , Ortiz-Haro, Ana Belén , Molewijk, Albert Christiaan , Obrador, Gregorio , Agazzi, Evandro

Introduction: In patient-doctor interaction both parties play a role. Primary objective was to determine if the concordance among rheumatologists and their patients of their ideal of autonomy was associated with a better patient-doctor relationship. Secondary objective was to describe factors associated to a patient paternalistic ideal of autonomy (PPIA). Materials and methods: This cross-sectional study had 3 steps. Step-1 consisted in translation/cultural local adaption of Ideal Patient Autonomy Scale (IPAS), a 14-items Dutch questionnaire. Step-2 consisted of IPAS validity and reliability in 201 outpatients. Step-3 consisted of the application of IPAS and the patient-doctor relationship questionnaire (PDRQ) to 601 outpatients with a medical encounter, and of IPAS to the 21 attending rheumatologists. Each patient-physician encounter was classified into with/without concordance in the ideal of autonomy and PRDQ scores were compared (Man Whitney U test). Regression analysis was used for associations. ©PLOS One

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Un enfoque sistémico de la bioética del medioambiente y la complejidad

2024 , Velázquez, Lourdes , Agazzi, Evandro

La teoría general de sistemas ofrece un marco conceptual y metodológico para integrar consideraciones bioéticas en la toma de decisiones ambientales y ecológicas, enmarcando clara y eficazmente muchos problemas y situaciones que suelen presentarse utilizando el lenguaje ordinario. Un sistema es una entidad estructurada internamente que se caracteriza por algunas propiedades y funciones específicas. Esta unidad se relaciona con varias de sus partes que también son sistemas y son, por tanto, sus subsistemas. A su vez, cada sistema es parte (es decir, subsistema) de sistemas de orden superior. Todos estos sistemas y subsistemas están relacionados entre sí de tal manera que cada uno se caracteriza por sus propiedades específicas, que, además, resultan de las correlaciones que los unen a sus subsistemas y sistemas de orden superior. Dentro de esta arquitectura general se inscriben fácilmente conceptos como entorno y complejidad, así como emergencia, con todos los problemas relativos a los límites de las posibilidades de predicción mostrando que los enfoques deterministas tradicionales en la ciencia son insuficientes para manejar tal complejidad. El artículo aborda los desafíos que plantea la impredecibilidad en los sistemas complejos, criticando las visiones fatalistas que aceptan de manera optimista o pesimista la naturaleza incontrolable de los desarrollos tecnológicos y ecológicos. Es precisamente la impredecibilidad de un sistema complejo como el entorno lo que requiere una dimensión bioética para guiar los valores que subyacen a nuestra toma de decisiones respecto a la vida misma.

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Freedom Versus Regulation in Science and Technology

2020 , Agazzi, Evandro

Almost half a century ago a strong controversy opposed the philosophers advocating an unrestricted freedom of science to those advocating a moral and legal regulation of science, that dispute did not produce significant results because it rested on a lack of distinction (that does not mean separation) between science and technology. The defining aim of science is acquisition of knowledge and that of technology is production of objects and performances. Humans have always developed a large display of techniques for the realization of different activities and technology can be defined as that special sector of technique that consists in the application of scientific knowledge. With reference to this clarification it is possible to see that pure science enjoys a substantial freedom, being ethically limited only in the case of particular means, conditions and consequences directly involved in experimental science. Applied science must be ethically evaluated also considering the goals of the application envisaged. In the case of technology ethical evaluations are much more pertinent and articulated because actions are involved and regulations are legitimate as far as they concern limitations of the freedom of action; they also can entail legal regulations. The concrete example of Medicine, that is a special technology according to the above definition, concludes the paper and it is shown that due to the fact that Medicine has to do with human persons, it is not sufficient to take into consideration its technical aspects but several other values of psychological, social and spiritual kind must contribute to the global assessment of the medical praxis in the different concrete situations. © 2020, Springer Nature B.V.

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The Multiple Aspects of the Philosophy of Science

2021 , Agazzi, Evandro

Philosophy of Science, understood as a special philosophical discipline, was born only at the beginning of the twentieth century as part of the effort for overcoming the “foundational crisis” that had affected especially mathematics and physics. Therefore, it was conceived as an investigation about the features and reliability of scientific knowledge and for a few decades was deeply marked by the philosophical approach of logical empiricism. This cognitive point of view persisted also when, after Kuhn’s work, the attention focused on the scientific activity in order to understand scientific change and a sociological model replaced the view that empirical adequacy and logical consistency are the factors that determine the change of scientific theories. Ethical, social and political considerations regarding science ware considered inappropriate and potentially dangerous since they violate the alleged “neutrality of science” with respect to values. Nevertheless, the strict intertwining of science and technology in contemporary “technoscience” has produced a wide debate regarding the practical aspect of technoscientific activity that has the intrinsic features of a philosophical debate. Therefore, it is natural and advisable that the entire wealth of the philosophical disciplines (and not just logic, ontology, epistemology and philosophy of language) be called to contribute to the specific complex discourse of the Philosophy of Science.