Journal of Medical Ethics最新文献

Who shall go first? A multicriteria approach to patient selection for first clinical trials of cardiac xenotransplantation. 谁应先行？心脏异种移植首次临床试验患者选择的多标准方法。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-09-06 DOI: 10.1136/jme-2024-110056

Johannes Kögel, Michael Schmoeckel, Georg Marckmann

{"title":"Who shall go first? A multicriteria approach to patient selection for first clinical trials of cardiac xenotransplantation.","authors":"Johannes Kögel, Michael Schmoeckel, Georg Marckmann","doi":"10.1136/jme-2024-110056","DOIUrl":"https://doi.org/10.1136/jme-2024-110056","url":null,"abstract":"After achieving sustained graft functioning in animal studies, the next step in the progression of xenotransplantation towards clinical application is the initiation of the first clinical trials. This raises the question according to which criteria patients shall be selected for these trials. While the discussion regarding medical criteria has already commenced, ethical considerations must also be taken into account. This is essential, first, to establish a procedure that is ethically reasonable and justified. Second, it is a prerequisite for a publicly acceptable and comprehensible implementation. This paper outlines a multicriteria approach for the selection of patients in first-in-human clinical trials of cardiac xenotransplantation with four ethical criteria: medical need, capacity to benefit, patient choice and compliance (as an exclusion criterion). Consequently, these criteria identify a primary target group of patients who exhibit a high medical need for cardiac xenotransplantation, face a high risk of morbidity and mortality without an organ replcaement therapy, have a substantial chance of benefiting from xenotransplantation, thereby also enhancing the scientific value of the trial, and qualify for an allotransplant to have a real choice between participating in a first-in-human xenotransplantation trial and waiting for a human organ. A secondary group would include patients for whom only the first two criteria are met, that is, who have a high medical need and a good capacity to benefit from xenotransplantation but who have a restricted choice because they do not qualify for an allotransplant.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nrima - a particular Javanese value and its impact on healthcare. Nrima - 爪哇语的一种特殊价值观及其对医疗保健的影响。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-09-05 DOI: 10.1136/jme-2023-109815

Agnes Bhakti Pratiwi, Retna Siwi Padmawati, Dick L Willems

引用次数: 0

Existential risk and the justice turn in bioethics. 生命伦理学中的生存风险与正义转向。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-31 DOI: 10.1136/jme-2024-110282

Paolo Corsico

引用次数: 0

Bioethics and the value of disagreement. 生物伦理学与分歧的价值。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-31 DOI: 10.1136/jme-2024-110174

Michael J Parker

{"title":"Bioethics and the value of disagreement.","authors":"Michael J Parker","doi":"10.1136/jme-2024-110174","DOIUrl":"https://doi.org/10.1136/jme-2024-110174","url":null,"abstract":"What does it mean to be a bioethicist? How should the role(s) of bioethics be understood in the context of a world of intense value conflict and polarisation? Bioethics is-in all its various forms and traditions-potentially well-positioned to contribute to addressing many of the most pressing challenges of value polarisation and conflict in diverse societies. However, realising this potential is going to require moving beyond currently foregrounded methods and developing new models for engaging with moral disagreement. This paper proposes an approach, 'adversarial cooperation,' drawing on the concepts of 'adversarial collaboration' from the sciences and 'antagonistic cooperation' from the humanities. Adversarial cooperation aims to combine the rigour and structured methodology of adversarial collaboration with the cultural sensitivity and expansive vision of antagonistic cooperation. The paper also addresses key challenges to adversarial cooperation, including ethical considerations, tensions between substantive and procedural values, the problem of misinformation and the need for decision-making amidst ongoing disagreement. Ultimately, adversarial cooperation suggests a reimagining of bioethical expertise, emphasising skills in mediation, the arts and humanities and participatory decision-making alongside established philosophical competencies. This implies a model of normative bioethical authority grounded in the ability to facilitate inclusive and trustworthy processes of moral deliberation. Realising the potential of adversarial cooperation will require significant changes in bioethics training and practice, as well as a commitment to reflexivity, humility and the amplification of marginalised voices. By embracing this approach, bioethics can play a vital role in navigating the complex moral landscapes of pluralistic societies.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Materiality and practicality: a response to - are clinicians ethically obligated to disclose their use of medical machine learning systems to patients? 物质性与实用性：对 "临床医生是否有道德义务向患者披露其使用医疗机器学习系统的情况？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-30 DOI: 10.1136/jme-2024-110371

Michal Pruski

引用次数: 0

AI diagnoses terminal illness care limits: just, or just stingy? 人工智能诊断绝症护理限制：是公正，还是吝啬？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-29 DOI: 10.1136/jme-2024-110170

Leonard Michael Fleck

引用次数: 0

Framing effects from misleading implicatures: an empirically based case against some purported nudges. 误导性暗示的框架效应：以经验为基础，反对某些所谓的暗示。