Journal of Medical Ethics最新文献

It is not that important if it is the role of the doctor to administer lethal drugs: a response to Barker et al. 如果使用致命药物是医生的职责，那就不那么重要了：对Barker等人的回应。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-24 DOI: 10.1136/jme-2025-111187

Jason Chen

引用次数: 0

Does normothermic regional perfusion harm donors after circulatory death? 循环性死亡后，常温局部灌注对供体有危害吗？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-24 DOI: 10.1136/jme-2025-110947

Jordan Liebman, Brendan Parent

{"title":"Does normothermic regional perfusion harm donors after circulatory death?","authors":"Jordan Liebman, Brendan Parent","doi":"10.1136/jme-2025-110947","DOIUrl":"https://doi.org/10.1136/jme-2025-110947","url":null,"abstract":"Normothermic regional perfusion during controlled donation after circulatory death has emerged as a means to increase the number and viability of organs available for transplant. Because normothermic regional perfusion uses extracorporeal membrane oxygenation, an intervention used for resuscitation under other circumstances, critics have concluded that organ donation using normothermic regional perfusion violates the dead donor rule. As such, the debate about normothermic regional perfusion has been framed as a binary choice between normothermic regional perfusion and the dead donor rule. In this paper, I argue that we should resist this binary framework and instead judge the permissibility of normothermic regional perfusion based on whether it harms organ donors. The obligations owed to organ donors derive from their moral status and include the obligation to prevent harm to donors, protect futures of value and satisfy donors' critical interests. When performed correctly, normothermic regional perfusion does not violate these moral obligations. Therefore, normothermic regional perfusion does not harm organ donors during controlled donation after circulatory death, making it ethically permissible when performed in accordance with standardised protocols.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707739","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

Competence for physician-assisted death of patients with mental disorders: theoretical and practical considerations. 医生协助精神障碍患者死亡的能力：理论和实践考虑。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2022-108829

Azgad Gold

引用次数: 0

Birth's transformative shift: a response to Waleszczyński. 出生的转变：对 Waleszczyński 的回应。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2024-110307

Prabhpal Singh

引用次数: 0

Report on an audit of two decades' activities of a clinical ethics committee: the Newcastle upon Tyne Hospitals NHS Foundation Trust Clinical Ethics Advisory Group (CEAG). 对临床伦理委员会二十年活动的审计报告：纽卡斯尔泰恩医院NHS基金会信托临床伦理咨询小组（CEAG）。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2024-110250

Raj K Mohindra, Stephen J Louw

{"title":"Report on an audit of two decades' activities of a clinical ethics committee: the Newcastle upon Tyne Hospitals NHS Foundation Trust Clinical Ethics Advisory Group (CEAG).","authors":"Raj K Mohindra, Stephen J Louw","doi":"10.1136/jme-2024-110250","DOIUrl":"10.1136/jme-2024-110250","url":null,"abstract":"Background: 'The Clinical Ethics Advisory Group' (CEAG) is the clinical ethics support body for Newcastle upon Tyne Hospitals National Health Service Foundation Trust. A significant change in CEAG's way of working occurred over the past 5 years as a result of Court decisions, increasing public expectations and an increase in CEAG's paediatric case flow.Purpose: Review historical data: (a) as a useful benchmark to look for the early impact of significant service changes and (b) to seek possible reference ('sentinel') cases for use with a posited practical (casuistic) case-based reasoning model.Methods: Audit of the minutes of the first 22 years' meetings was undertaken by the two chairs of CEAG over that period of time.Results: 223 matters discussed: 86 Trust policy issues; 117 clinical cases (84 adult (32 urgent), 33 child (8 urgent)); 12 CEAG procedural issues and 8 UK Clinical Ethics Network 'round robin' cases. The range of topic areas was wide. A broad range of ethical structures were deployed, principlism predominated. Quality was subjectively assessed by each reviewer, but different methods were used. This proved highly concordant between the two reviewers. 47% (105/223) of discussions were 'excellent' (*A4C4-A4C4) and 70% (156.5/223) 'good' or better (*A4C4-A3C3). By meeting the criteria of 'excellent' and 'prospective', 92/223 (41%) of matters were deemed potentially suitable as sentinel cases.Conclusions: The audit provides a rich vein of information. There is demand for CEAG's services, workload is becoming more complex. Formal funding for such services seems justified.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"533-540"},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780298","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

Ethics briefing. 道德简报。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2025-111104

Natalie Michaux

引用次数: 0

Assessing the impact of information on patient attitudes toward artificial intelligence-based clinical decision support (AI/CDS): a pilot web-based SMART vignette study. 评估信息对患者对基于人工智能的临床决策支持（AI/CDS）态度的影响：一项基于网络的试点SMART小故事研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2024-110080

Bohye Kim, Katie Ryan, Jane Paik Kim

{"title":"Assessing the impact of information on patient attitudes toward artificial intelligence-based clinical decision support (AI/CDS): a pilot web-based SMART vignette study.","authors":"Bohye Kim, Katie Ryan, Jane Paik Kim","doi":"10.1136/jme-2024-110080","DOIUrl":"10.1136/jme-2024-110080","url":null,"abstract":"Background: It is increasingly recognised that the success of artificial intelligence-based clinical decision support (AI/CDS) tools will depend on physician and patient trust, but factors impacting patients' views on clinical care reliant on AI have been less explored.Objective: This pilot study explores whether, and in what contexts, detail of explanation provided about AI/CDS tools impacts patients' attitudes toward the tools and their clinical care.Methods: We designed a Sequential Multiple Assignment Randomized Trial vignette web-based survey. Participants recruited through Amazon Mechanical Turk were presented with hypothetical vignettes describing health concerns and were sequentially randomised along three factors: (1) the level of detail of explanation regarding an AI/CDS tool; (2) the AI/CDS result; and (3) the physician's level of agreement with the AI/CDS result. We compared mean ratings of comfort and confidence by the level of detail of explanation using t-tests. Regression models were fit to confirm conditional effects of detail of explanation.Results: The detail of explanation provided regarding the AI/CDS tools was positively related to respondents' comfort and confidence in the usage of the tools and their perception of the physician's final decision. The effects of detail of explanation on their perception of the physician's final decision were different given the AI/CDS result and the physician's agreement or disagreement with the result.Conclusions: More information provided by physicians regarding the use of AI/CDS tools may improve patient attitudes toward healthcare involving AI/CDS tools in general and in certain contexts of the AI/CDS result and physician agreement.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"541-549"},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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 : 2025-07-23 DOI: 10.1136/jme-2024-110371

Michal Pruski

引用次数: 0

A qualitative study of true self judgments, epistemic access, and medical decision-making. 真实自我判断、认知获取和医疗决策的定性研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2025-110957

James Toomey, Jonathan Lewis, Ivar R Hannikainen, Brian D Earp

{"title":"A qualitative study of true self judgments, epistemic access, and medical decision-making.","authors":"James Toomey, Jonathan Lewis, Ivar R Hannikainen, Brian D Earp","doi":"10.1136/jme-2025-110957","DOIUrl":"https://doi.org/10.1136/jme-2025-110957","url":null,"abstract":"Background: Toomey et al (2024) found that US participants were more likely to follow a medical treatment preference-expressed after substantial cognitive decline-of a third person rather than their own future self. This correlated with a greater tendency to see the third person as still their true self. We hypothesised that the greater epistemic access one has to one's own true self as opposed to others might drive this difference.Methods: A codebook designed to capture different kinds of evidence and reasoning was developed, and participants' explanations for their treatment decisions in Toomey et al's study were coded and qualitatively analysed.Results: In first-person cases, participants were more likely to explain their treatment decision with reference to perceived direct access to their own true self. In contrast, in third-person cases, participants more often relied on proxies or heuristics, such as the presumption that an expressed preference is an authentic one or that preferences expressed with greater cognition tend to better reflect the true self.Conclusions: These findings support the hypothesis that differential epistemic access to the true self in first- and third-person cases may drive different medical treatment decisions. Participants may be trying to follow the patient's 'true' or 'authentic' preference in all cases, but relying on different kinds of evidence in so doing.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698843","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

Hope pluralism in antenatal palliative care. 产前姑息治疗中的希望多元化。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-23 DOI: 10.1136/jme-2024-110120

Sophie Bertaud, Mehrunisha Suleman, Dominic Wilkinson

{"title":"Hope pluralism in antenatal palliative care.","authors":"Sophie Bertaud, Mehrunisha Suleman, Dominic Wilkinson","doi":"10.1136/jme-2024-110120","DOIUrl":"10.1136/jme-2024-110120","url":null,"abstract":"When parents face the distressing news during pregnancy that their baby is affected by a serious medical condition that will likely lead to the baby's death before or soon after birth, they experience a range of complex emotions. Perhaps paradoxically, one common response is that of hope. Navigating such hope in antenatal interactions with parents can be difficult for healthcare professionals. That can stem from a desire to accurately communicate prognostic information and a fear of conveying 'false hope' to families. In this paper, we examine the role that hope plays when parents and healthcare professionals are grappling with a confirmed antenatal diagnosis of a life-limiting condition. We assess what it means to hope in this context and consider the different types of hopes held by both parents and healthcare professionals as well as why hopeful thinking might be helpful and not harmful. We propose 'hope pluralism' as a concept that might allow healthcare professionals to accommodate a multitude of parental and professional hopes, even where these conflict. Finally, we offer some practical suggestions for how professionals should evaluate and respond to hope in situations that might (from the outside) appear hopeless.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"521-525"},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467763","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