Journal of Medical Ethics最新文献

Reframing the responsibility gap in medical artificial intelligence: insights from causal selection and authorship attribution. 重构医疗人工智能中的责任差距：来自因果选择和作者归属的见解。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-28 DOI: 10.1136/jme-2024-110600

Kristian G Barman, Pawel Pawlowski, Jasper Debrabander

引用次数: 0

Charting the ethical landscape of generative AI-augmented clinical documentation. 绘制生成人工智能增强临床文件的伦理景观。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-27 DOI: 10.1136/jme-2024-110656

Qiwei Wilton Sun, Jennifer Miller, Sarah C Hull

{"title":"Charting the ethical landscape of generative AI-augmented clinical documentation.","authors":"Qiwei Wilton Sun, Jennifer Miller, Sarah C Hull","doi":"10.1136/jme-2024-110656","DOIUrl":"https://doi.org/10.1136/jme-2024-110656","url":null,"abstract":"Generative artificial intelligence (AI) chatbots such as ChatGPT have several potential clinical applications, but their use for clinical documentation remains underexplored. AI-generated clinical documentation presents an appealing solution to administrative burden but raises new and old ethical concerns that may be overlooked. This article reviews the potential use of generative AI chatbots for purposes such as note-writing, handoffs, and prior authorisation letters, and the ethical considerations arising from their use in this context. AI-generated documentation may offer standardised and consistent documentation across encounters but may also embed biases that can spread across clinical teams relying on previous notes or handoffs, compromising clinical judgement, especially for vulnerable populations such as cognitively impaired or non-English-speaking patients. These tools may transform clinician-patient relationships by reducing administrative work and enhancing shared decision-making but may also compromise the emotional and moral elements of patient care. Moreover, the lack of algorithmic transparency raises concerns that may complicate the determination of responsibility when errors occur. To address these considerations, we propose notifying patients when the use of AI-generated clinical documentation meaningfully impacts their understanding of care, requiring clinician review of drafts, and clarifying areas of ambiguity to protect patient autonomy. Generative AI-specific legislation, error reporting databases and accountable measures for clinicians and AI developers can promote transparency. Equitable deployment requires careful procurement of training data representative of the populations served that incorporate social determinants while engaging stakeholders, ensuring cultural sensitivity in generated text, and enhancing medical education.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173959","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

Family consent to deceased organ donation in China: a participatory qualitative study. 中国死者器官捐献的家属同意：一项参与性质的研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-22 DOI: 10.1136/jme-2024-110630

Haiyan He, Chaojie Liu, Ying Huang, Wei Ouyang, Zirui Xin, Hanan Khalil, Aijing Luo, Wenzhao Xie

{"title":"Family consent to deceased organ donation in China: a participatory qualitative study.","authors":"Haiyan He, Chaojie Liu, Ying Huang, Wei Ouyang, Zirui Xin, Hanan Khalil, Aijing Luo, Wenzhao Xie","doi":"10.1136/jme-2024-110630","DOIUrl":"https://doi.org/10.1136/jme-2024-110630","url":null,"abstract":"Background: Organ donation improves patient survival and quality of life, yet family refusal is a major barrier. This study aimed to explore the role of family discussions in shaping attitudes and decisions about organ donation in China, while also examining the influencing factors at the individual, family, community and societal levels.Method: Participatory interviews with family members were conducted based on the social-ecological model (SEM). A snowball sampling strategy was adopted to recruit volunteer interviewers. Of 52 interviewers, 25 completed the family group interviews, involving 94 participants in total. Interviews were audio-recorded and transcribed verbatim within 24 hours. Two researchers coded the data in line with SEM. Themes were identified through an inductive process.Results: Four themes were identified out of family discussions about deceased organ donation: (i) individual perceptions on the value of lives and organ donation (value of organ donation, death attitudes, knowledge about organ donation), (ii) family consensus and conflicts (family structure, family altruism), (iii) collective conformity (conformity, individualism, negativity bias) and (IV) culture and social environment (traditional beliefs, incentive policy, education, media promotion).Conclusion: This study is the first to systematically examine the factors influencing deceased organ donation in the Chinese family context. Obtaining family consent for organ donation appears to be challenging in Chinese families due to limited knowledge and traditional beliefs. Incentive policies that benefit the family are crucial. While media promotion is effective in increasing awareness of organ donation, education and family discussions are critical in alleviating fears and misunderstandings about deceased organ donation.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127513","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

Good bioethics and a good bioethicist: John McMillan's contributions to JME's legacy. 优秀的生物伦理学和优秀的生物伦理学家：约翰·麦克米兰对JME遗产的贡献。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-21 DOI: 10.1136/jme-2025-111020

Zoë Fritz, Brian D Earp, Arianne Shahvisi, Mehrunisha Suleman, Lucy Frith, Kenneth Boyd

引用次数: 0

AI and XAI second opinion: the danger of false confirmation in human-AI collaboration. 人工智能和 XAI 第二意见：人类与人工智能合作中错误确认的危险。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-21 DOI: 10.1136/jme-2024-110074

Rikard Rosenbacke, Åsa Melhus, Martin McKee, David Stuckler

{"title":"AI and XAI second opinion: the danger of false confirmation in human-AI collaboration.","authors":"Rikard Rosenbacke, Åsa Melhus, Martin McKee, David Stuckler","doi":"10.1136/jme-2024-110074","DOIUrl":"10.1136/jme-2024-110074","url":null,"abstract":"Can AI substitute a human physician's second opinion? Recently the Journal of Medical Ethics published two contrasting views: Kempt and Nagel advocate for using artificial intelligence (AI) for a second opinion except when its conclusions significantly diverge from the initial physician's while Jongsma and Sand argue for a second human opinion irrespective of AI's concurrence or dissent. The crux of this debate hinges on the prevalence and impact of 'false confirmation'-a scenario where AI erroneously validates an incorrect human decision. These errors seem exceedingly difficult to detect, reminiscent of heuristics akin to confirmation bias. However, this debate has yet to engage with the emergence of explainable AI (XAI), which elaborates on why the AI tool reaches its diagnosis. To progress this debate, we outline a framework for conceptualising decision-making errors in physician-AI collaborations. We then review emerging evidence on the magnitude of false confirmation errors. Our simulations show that they are likely to be pervasive in clinical practice, decreasing diagnostic accuracy to between 5% and 30%. We conclude with a pragmatic approach to employing AI as a second opinion, emphasising the need for physicians to make clinical decisions before consulting AI; employing nudges to increase awareness of false confirmations and critically engaging with XAI explanations. This approach underscores the necessity for a cautious, evidence-based methodology when integrating AI into clinical decision-making.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"396-399"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792612","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

Reassessing 'good' medical practice and the climate crisis. 重新评估 "良好 "医疗实践与气候危机。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-21 DOI: 10.1136/jme-2023-109713

Rammina Yassaie, Lucy Brooks

{"title":"Reassessing 'good' medical practice and the climate crisis.","authors":"Rammina Yassaie, Lucy Brooks","doi":"10.1136/jme-2023-109713","DOIUrl":"10.1136/jme-2023-109713","url":null,"abstract":"In August 2023, the General Medical Council released the latest update of Good Medical Practice, which sets out the standards of patient care and professional behaviour to be expected of UK doctors. These updated guidelines offer some environmental considerations that previous standards did not include. This paper explores these latest additions to Good Medical Practice through the healthcare ethics lens of non-maleficence, beneficence, justice and autonomy, alongside trust and physician well-being, to make the case that the latest updates to Good Medical Practice do not go far enough in specifying the duties for doctors in responding to climate and ecological emergencies to be seen as ethically justifiable.The paper argues that given the health implications of the climate crisis and the harms associated with high-emission healthcare, as well as the co-benefits of climate action on health, there must be a stronger commitment from the medical regulator to ensure the groundwork is set for doctors to learn, understand and advocate for the importance and urgency of practicing sustainable healthcare. The case for this is strengthened by also examining the importance of maintaining public trust in the medical profession as advocates for public health, along with the notable societal and generational injustices that continue to deepen as the climate emergency escalates.The paper concludes by arguing that doctors can and should be a part of writing a new chapter for health in the climate era, but our standards for practice need to offer a strengthened starting point of consensus for what is expected of the medical profession for that to come to fruition and raise questions as to what doctors can and should do when they have questions over their own regulators' commitment to maintaining public health in relation to the climate and ecological crisis.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"365-370"},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317556","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

Virtuous procreation and ethical pronatalism. 美德生育与伦理代孕。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-21 DOI: 10.1136/jme-2025-110717

Sungwoo Um

引用次数: 0

If Marc is Suzanne's father, does it follow that Suzanne is Marc's child? An experimental philosophy study in reproductive ethics. 如果马克是苏珊娜的父亲，那么苏珊娜就是马克的孩子吗？生殖伦理实验哲学研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-05-21 DOI: 10.1136/jme-2023-109808

Kristien Hens, Emma Moormann, Anna Smajdor, Daniela Cutas

引用次数: 0

Antinatalist challenges to Korean pronatalism. 反出生主义对韩国出生主义的挑战。