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Intro -- Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies -- Copyright -- Contents -- Contributors -- Chapter 1: Genomic editing: From human health to the ``perfect child´´ -- 1. Introduction -- 1.1. Beginnings -- 1.2. Definitions and context -- 1.3. Recombinant DNA technology: The basis for DNA modification -- 1.4. Genome editing -- 1.4.1. Meganucleases -- 1.5. Zinc finger nucleases (ZFNs) -- 1.5.1. Transcription activator-like nucleases (TALENs) -- 1.6. CRISPR/Cas9 technology -- 1.7. Base editing technology -- 1.8. Principles of using genome editing in research and clinical practice -- 2. Ethical issues in clinical genome editing -- 2.1. Nonmaleficence and risk/benefit assessment -- 2.1.1. Risk-to-benefit analysis -- 2.2. Beneficence in gene editing therapies -- 2.3. Respect for autonomy -- 2.4. Confidentiality -- 2.4.1. Germline editing -- 2.4.2. The He Jiankui affair and the aftermath -- 2.5. Applying the principle of justice in clinical genome editing -- 2.6. Eugenics, enhancement, and ``designer babies´´ -- 3. Conclusions -- References -- Chapter 2: Ethics of mitochondrial gene replacement therapy -- 1. Introduction -- 2. What is mitochondrial disease and mitochondrial donation? -- 3. The UK timeline -- 4. The international position -- 5. Are the techniques safe? -- 6. Ethical issues -- 7. ``Three parent babies´´ and identity -- 8. Genetic modification and the ``slippery slope´´ -- 9. Risks for egg donors -- 10. Ethical differences between PNT and MST -- 11. Mitochondrial disease as complex: Diagnosis, predicting risk, and genetic counseling -- 12. Alternative reproductive options -- 13. Polar body transfer and gene editing -- 14. Conclusion -- References -- Further reading -- Chapter 3: Reproductive technologies used by same-gender couples -- 1. Introduction -- 2. Procreative autonomy.

View of Volume 66, Special Issue, September 2021
Emerging viral or bacterial threats pose significant medical and ethical issues, caused not only by the management of the disease, but also by the uncontrolled dissemination of information, both true and fake. Even the most correct and impartially presented piece of information can be understood by the patients or by the public at large in ways that are opposite to those intended by the communicators. This, associated with the increased prevalence of fake news, may cause havoc and decrease the efficacy of the needed preventive measures that have to be taken to tackle the actual medical problem.
Within the context of the coronavirus outbreak, this has been coined as "infodemic", increasing the difficulty of finding an optimal solution to the actual problem. Medical data about an emerging medical threat is disseminated through mass – and social media, especially by public authorities and physicians. The latter have specific duties, appertaining to their professional codes of morals, toward minimizing the harms generated by diseases, both at a personal and at a populational level. In infodemics, the management of the information they present to the public is extremely important, as each wording can be improperly interpreted and cause opposite effects.
In this paper, we will discuss whether and which healthcare professionals should be involved in disseminating information about emerging healthcare threats, and which moral duties should prevail in these instances.

The physician-patient relationship is the core interpersonal relationship staying at the base of the contemporary medical ethics, most clinical issues causing ethical dilemmas being centered around it. This relationship can be analyzed from four main perspectives: legal, social, psychological and moral. In medical ethics literature, there are numerous models of physician-patient relationship, which are based, on variable degrees, on the legal, psychologic, sociologic and moral principles that will be briefly summarized here, the most well-known being the models developed by Szasz and Hollander, Roter and Hall, Ben-Sira, Thomasma, Mead and Bower, and especially Emanuel, whose models are currently considered the standard models and are being presented as such to medical student and residents in many countries (including Romania). However, the dental profession has some particularities that require, at least in some circumstances, some additional models that will be presented briefly in this unsystematised review. We will begin by performing a brief analysis of the professionalism of the dental-patient relationship, followed by a discussion regarding the most often cited models of relationship, namely those developed by Ozar, Coleman and Burton, Friedman and Bedos.
REZUMAT. Relația profesională dintre medicul dentist și pacient. Relația medic-pacient este una dintre interacțiunile profesionale esențiale ale medicilor, stând la baza eticii medicale contemporane, majoritatea dilemelor de etică clinică fiind centrate de aceasta. Relația medic-pacient poate fi analizată din patru perspective fundamentale: legală, socială, psihologică și morală. În literatura de specialitate sunt descrise numeroase modele de relație medic-pacient care sunt bazate, în grade variabile, pe principii legale, psihologice, sociologice și morale ce vor fi sumarizate aici, cele mai cunoscute fiind cele dezvoltate de Szasz și Hollander, Roter și Hall, Ben-Sira, Thomasma, Mead și Bower și mai ales Emanuel, ale cărui modele sunt considerate de mulți autori drept modelele standard și sunt predate ca atare studenților mediciniști și rezidenților din multe țări (inclusiv România). Medicina dentară are o serie de particularități care fac absolut necesară utilizarea, cel puțin în unele circumstanțe, a unor modele adiționale, care vor fi prezentate succint în acest review nesistematizat al literaturii de specialitate. Vom începe această analiză cu o scurtă discuție despre profesionalism în contextul relației medic dentist-pacient, după care vom analiza cele mai citate modele de relație, respectiv cele dezvoltate de Ozar, Coleman și Burton, Friedman și Bedos.
Cuvinte cheie: relația medic dentist-pacient, Ozar, profesionalism.

View of Volume 66, Special Issue, September 2021
Novel biotechnologies like brain banking pose a challenge in neurodegenerative diseases research, being not only a step towards a better understanding for these diseases, but also from a bioethical point of view.
Brain banks collect tissue for research purposes from deceased persons suffering from neurodegenerative diseases such as Parkinson's or Alzheimes's disease. In order to improve the quality in this research field, confidentiality and a detailed informed consent are aspects that should be emphasized. Moreover, given the fact that the brain collecting takes place during an autopsy, legal aspects also play an important role, hence a legal frame is also needed. The role of the deceased's family should also be taken into account, especially when and how they can decide if the autopsy can be performed in the first place. The research participant should sign a detailed informed consent that must remain the research basis to which extent the collected data should be disclosed.
Finally, only a framework of bioethical and legal norms can improve the quality of brain banking research. A comprehensive perspective for brain banking from obtaining, processing, and storage of brain material to bioethical and legal aspects should increase the scarce sapling of brain banking.

Veracity (or truth-telling) in healthcare ethics is defined as a comprehensive, accurate, and objective transmission of information, and also as the way the professional augments the understanding of the patient (in clinical/dental practice) or subject (in biomedical research). Veracity, as a moral principle guiding medical (and dental practice) has a long and complicated history; only recently the principle became stable and received a proper definition and differentiation from informed consent. The purposes of this article is to present a short history of veracity in clinical practice, followed by a normative and descriptive analysis of the principle, and finally, to offer some practical applications of the principle in dentistry.
REZUMAT. Veracitatea ca unul din principiile fundamentale ale eticii în stomatologie. Veracitatea (sau spunerea adevărului) este definită în etica medicală ca un mod de transmisie exhaustivă, obiectivă și corect științifică, dar reprezintă totodată și un mod prin care profesioniștii din domeniul sanitar augmentează capacitatatea de înțelegere a pacientului (în practica medicală/ stomatologică) sau a subiectului (în cercetarea biomedicală). Veracitatea, ca principiu moral al practicii medicale, are o istorie lungă și complicată;doar recent acest principiu s-a stabilizat normativ și a fost clar diferențiat de consimțământul informat. Scopurile acestui articol sunt: de a prezenta o scurtă istorie a veracității în practica medicală, de a realiza o analiză normativă și descriptivă a acestuia și în final de a prezenta câteva aplicații practice ale veracității în medicina dentară.
Cuvinte cheie: veractitate; medicină dentară; etică normativă; amalgam; comercializare.

The purpose of this article is to summarize the way young medical professionals view these modern biomedical procedures and their moral acceptability. Materials and methods: A survey, filled in online, analyzing items in four main areas: genetic techniques, cloning, stem cell research, and assisted reproduction. Results: Most subjects agreed that the right to the genetic material should be a fundamental human right and that genetic engineering should be used if it could lead to the elimination os severe genetic diseases like cystic fibrosis and thalassemia. The least acceptance rate was obtained for techniques that would either change physical traits (like eye or hair color) or augment them. Most subjects agreed that the prenatal screening should be mandatory, and if the screening detects a severe congenital malformation the physician should recommend therapeutic abortion. Most subjects disagreed that cloning of any type, either therapeutic or reproductive, using human, animal, or vegetal genetic material. Most subjects agreed with the collection and storage of cord blood stem cells and the use of adult stem cells, and most of them disagreed with the creation of embryos specifically for obtaining stem cells. Conclusions: Even if the national legislation in this area is very scarce, the responses have usually identified the highly controversial techniques. If however the national legislation has elements similar to the items from the survey, they tended to take the respective items as morally acceptable without trying to analyze them critically. ; El propósito de este artículo es conocer la forma en que jóvenes profesionales médicos ven los procedimientos biomédicos modernos y su aceptabilidad moral. Materiales y métodos: Una encuesta, rellenada online, que analiza elementos en cuatro áreas principales: técnicas genéticas, clonación, investigación con células madre y reproducción asistida. Resultados: La mayoría de los sujetos acepta que el derecho a material genético debería ser un derecho humano fundamental y ...

View of Volume 66, Special Issue, September 2021
Virtual reality (VR), initially a form of entertainment has begun to find its way in healthcare practice. One of its main areas of interest is the treatment of psychiatric disorders. When using VR, the basic ethical principles underlying the physician-patient relationship should be respected, but they should be customized by the presence of an additional layer of complexity generated by the interposition of the virtual world.
The physician-patient relationship is often multidirectional, often including a larger team of healthcare professionals, family members or acquaintances, working conjointly to optimize the medical care. Each time other participants are involved within this relationship, the complexity of the ethical issues tends to increase. For example, if the patient has decreased insight, it is possible that other persons must make some medical decisions – resulting a prioritization of beneficence compared to autonomy. Also, we must take into account the fact that many psychiatric symptoms can be seen as a form of "virtual reality" by the patient. The healthcare provider must take additional safety measures to minimize the harms made by VR techniques in psychiatric patients, by using methods that are individually tailored.
The main aim of this paper is to debate the ethical aspects surrounding the applicability of virtual reality in treating psychiatric patients, with an emphasis on the elements that were mentioned earlier.

Abstract Translational research tries to apply findings from basic science to enhance human health and well-being. Many phases of the translational research may include non-medical tasks (information technology, engineering, nanotechnology, biochemistry, animal research, economy, sociology, psychology, politics, and so on). Using common bioethics principles to these areas might sometimes be not feasible, or even impossible. However, the whole process must respect some fundamental, moral principles. The purpose of this paper is to argument the need for a different approach to the morality in translational bioethics, and to suggest some directions that might be followed when constructing such a bioethics. We will show that a new approach is needed and present a few ethical issues that are specific to the translational research.

Translational research tries to apply findings from basic science to enhance human health and well-being. Many phases of the translational research may include non-medical tasks (information technology, engineering, nanotechnology, biochemistry, animal research, economy, sociology, psychology, politics, and so on). Using common bioethics principles to these areas might sometimes be not feasible, or even impossible. However, the whole process must respect some fundamental, moral principles. The purpose of this paper is to argument the need for a different approach to the morality in translational bioethics, and to suggest some directions that might be followed when constructing such a bioethics. We will show that a new approach is needed and present a few ethical issues that are specific to the translational research. ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 643636 "Sound of Vision" for authors SH, AM, RU, OJ. The article was revised by HS while he was a scholar in the Research Ethics Education in the Balkans and Black Sea Countries program, financed by NIH, No 1R25TW008171-01A1. The work has been funded by the Sectoral Operational Programme Human Resources Development 2007–2013 of the Ministry of European Funds through the Financial Agreement POSDRU/159/1.5/S/132397 for author MD. ; Peer Reviewed

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access. ; Translational research tries to apply findings from basic science to enhance human health and well-being. Many phases of the translational research may include non-medical tasks (information technology, engineering, nanotechnology, biochemistry, animal research, economy, sociology, psychology, politics, and so on). Using common bioethics principles to these areas might sometimes be not feasible, or even impossible. However, the whole process must respect some fundamental, moral principles. The purpose of this paper is to argument the need for a different approach to the morality in translational bioethics, and to suggest some directions that might be followed when constructing such a bioethics. We will show that a new approach is needed and present a few ethical issues that are specific to the translational research. ; info:eu-repo/grantAgreement/EC/FP7/643636 NIH/1R25TW008171-01A1 Sectoral Operational Programme Human Resources Development of the Ministry of European Funds POSDRU/159/1.5/S/132397

Examination of a person who has been a victim of a physical or sexual assault may be very important for upcoming legal proceedings. In the context of a clinical forensic examination, physical findings are recorded and biological trace material is gathered and secured. Ideally, all forensic findings are documented in a detailed report combined with photographic documentation, which employs a forensic scale to depict the size of the injuries. However, the integrity of such forensic findings depends particularly on two factors. First, the examination needs to be conducted professionally to ensure that the findings are properly admissible as court evidence. Second, the examination should take place as soon as possible because the opportunity to successfully secure biological samples declines rapidly with time. Access to low-threshold clinical forensic examinations is not evenly provided in all member states of the European Union (EU); in some states, they are not available at all. As part of the JUSTeU! (Juridical standards for clinical forensic examinations of victims of violence in Europe) project, the Ludwig Boltzmann Institute for Clinical Forensic Imaging in Graz, Austria created (in cooperation with its international partner consortium) a questionnaire: the purpose was to collect information about support for victims of physical and/or sexual assault in obtaining a low-threshold clinical forensic examination in various countries of the EU. Our paper provides a summary of the responses and an overview of the current situation concerning provided clinical forensic services.