Journal of Medical Ethics最新文献

Strengthening harm-theoretic pro-life views. 加强伤害理论的支持生命观点。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-11-14 DOI: 10.1136/jme-2024-110222

Julian I Kanu

引用次数: 0

Wish to die trying to live: unwise or incapacitous? The case of University Hospitals Birmingham NHS Foundation Trust versus 'ST'. 死而求生：不明智还是无能力？伯明翰大学医院 NHS 基金会信托与 "ST "的案例。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-11-14 DOI: 10.1136/jme-2024-110365

Johnna Wellesley, Dominic Wilkinson, Bryanna Moore

{"title":"Wish to die trying to live: unwise or incapacitous? The case of University Hospitals Birmingham NHS Foundation Trust versus 'ST'.","authors":"Johnna Wellesley, Dominic Wilkinson, Bryanna Moore","doi":"10.1136/jme-2024-110365","DOIUrl":"10.1136/jme-2024-110365","url":null,"abstract":"The recent legal dispute about medical treatment for a 19-year-old patient, Sudiksha Thirumalesh, (known initially by the Court of Protection as 'ST') in A NHS Trust versus ST & Ors (2023) raised several challenging ethical issues. While Sudiksha's case bears similarities to other high-profile cases in England and Wales, there are key differences. Crucially, Sudiksha herself was part of the disagreement. She was alert, communicative and sought to advocate for herself. Furthermore, this case was framed in the courts as pivoting not on considerations of best interests but on a determination of decisional capacity. Sudiksha was deemed to lack capacity because she did not believe her doctors' view of her prognosis.While the legal questions in the case were central to a recent Court of Appeal decision (which overturned the original finding), in this commentary, we focus on the ethical questions therein. We start by describing Sudiksha's court case and the initial judgment. We then offer an ethical analysis of the relationship between false beliefs, values and the 'capacity' to make decisions, arguing for a need for particular care when judging patients to lack capacity based purely on 'false and fixed beliefs'. After briefly noting the legal basis for the appeal finding, we offer ethical implications for future cases. Although it appears that Sudiksha had decision-making capacity, this did not settle the ethical question of whether health professionals were obliged to continue treatment that they believed to have no prospect of success.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622376","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

Taking a moral holiday? Physicians' practical identities at the margins of professional ethics. 放道德假？医生在职业道德边缘的实际身份。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-21 DOI: 10.1136/jme-2022-108500

Henk Jasper van Gils-Schmidt, Sabine Salloch

引用次数: 0

How do US orthopaedic surgeons view placebo-controlled surgical trials? A pilot online survey study. 美国骨科医生如何看待安慰剂对照手术试验？一项试点在线调查研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-08-21 DOI: 10.1136/jme-2022-108221

Michael H Bernstein, Maayan N Rosenfield, Charlotte Blease, Molly Magill, Richard M Terek, Julian Savulescu, Francesca L Beaudoin, Josiah D Rich, Karolina Wartolowska

{"title":"How do US orthopaedic surgeons view placebo-controlled surgical trials? A pilot online survey study.","authors":"Michael H Bernstein, Maayan N Rosenfield, Charlotte Blease, Molly Magill, Richard M Terek, Julian Savulescu, Francesca L Beaudoin, Josiah D Rich, Karolina Wartolowska","doi":"10.1136/jme-2022-108221","DOIUrl":"10.1136/jme-2022-108221","url":null,"abstract":"Randomised placebo-controlled trials (RPCTs) are the gold standard for evaluating novel treatments. However, this design is rarely used in the context of orthopaedic interventions where participants are assigned to a real or placebo surgery. The present study examines attitudes towards RPCTs for orthopaedic surgery among 687 orthopaedic surgeons across the USA. When presented with a vignette describing an RPCT for orthopaedic surgery, 52.3% of participants viewed it as 'completely' or 'mostly' unethical. Participants were also asked to rank-order the value of five different types of evidence supporting the efficacy of a surgery, ranging from RPCT to an anecdotal report. Responses regarding RPCTs were polarised with 26.4% viewing it as the least valuable (even less valuable than an anecdote) and 35.7 .% viewing it as the most valuable. Where equipoise exists, if we want to subject orthopaedic surgeries to the highest standard of evidence (RPCTs) before they are implemented in clinical practice, it will be necessary to educate physicians on the value and ethics of placebo surgery control conditions. Otherwise, invasive procedures may be performed without any benefits beyond possible placebo effects.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"643-646"},"PeriodicalIF":3.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10050223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9554255","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

Please wear a mask: a systematic case for mask wearing mandates. 请戴口罩：强制佩戴口罩的系统性案例。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-06-21 DOI: 10.1136/jme-2022-108736

Roberto Fumagalli

引用次数: 0

Lowering the age limit of access to the identity of the gamete donor by donor offspring: the argument against. 降低捐献者后代了解配子捐献者身份的年龄限制：反对的理由。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-05-09 DOI: 10.1136/jme-2023-108935

Guido Pennings

引用次数: 0

On the importance of consistency: a response to Giubilini et al. 关于一致性的重要性：对 Giubilini 等人的回应

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-05-09 DOI: 10.1136/jme-2023-109152

Xavier Symons

引用次数: 0

Ethical considerations for psychedelic-assisted therapy in military clinical settings. 军事临床环境中迷幻辅助疗法的伦理考虑。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-03-20 DOI: 10.1136/jme-2023-108943

Scott Hoener, Aaron Wolfgang, David Nissan, Edmund Howe

{"title":"Ethical considerations for psychedelic-assisted therapy in military clinical settings.","authors":"Scott Hoener, Aaron Wolfgang, David Nissan, Edmund Howe","doi":"10.1136/jme-2023-108943","DOIUrl":"10.1136/jme-2023-108943","url":null,"abstract":"Psychedelic treatments, particularly 3,4-methylenedioxymethamphetamine (MDMA)-assisted and psilocybin-assisted therapies, have recently seen renewed interest in their clinical potential to treat various mental health conditions. Clinical trials for both MDMA-assisted and psilocybin-assisted therapies have shown to be highly efficacious for post-traumatic stress disorder and major depression. Recent research trials for psychedelic-assisted therapies (PAT) have demonstrated that although they are resource-intensive, their effects are rapid-acting, durable and cost-effective. These results have generated enthusiasm among researchers seeking to investigate psychedelic therapies in active-duty service members of the US military, particularly those with treatment refractory mental health conditions. At the same time, psychedelics remain in early stages of clinical investigation, have not yet achieved regulatory approval for general clinical use and may confer unique psychological and neurobiological effects that could raise novel ethical considerations when treating active-duty service members. Should psychedelics achieve regulatory approval, military relevant considerations may include issues of access to these treatments, appropriate procedures for informed consent, confidentiality standards, and possible unanticipated mental health risks and other psychological sequelae. A service member's deployability, as well as their ability to return to full military duty following PAT, may also be of unique concern. The authors argue that MDMA-assisted therapy currently represents a promising treatment that should be more rapidly investigated as a clinical therapy for service members while still taking a measured approach that accounts for the many military-specific uncertainties that remain.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"258-262"},"PeriodicalIF":4.1,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546319","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

The ethics of firing unvaccinated employees. 解雇未接种疫苗员工的道德问题。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-03-20 DOI: 10.1136/jme-2022-108866

Maxwell J Smith

{"title":"The ethics of firing unvaccinated employees.","authors":"Maxwell J Smith","doi":"10.1136/jme-2022-108866","DOIUrl":"10.1136/jme-2022-108866","url":null,"abstract":"Some organisations make vaccination a condition of employment. This means prospective employees must demonstrate they have been vaccinated (eg, against measles) to be hired. But it also means organisations must decide whether existing employees should be expected to meet newly introduced vaccination conditions (eg, against COVID-19). Unlike prospective employees who will not be hired if they do not meet vaccination conditions, existing employees who fail to meet new vaccination conditions risk being fired The latter seems worse than the former. Hence, objections to vaccination mandates commonly centre on the harms that will be visited on existing employees who are unwilling to be vaccinated. However, because this objection does not necessarily entail the claim that vaccination is unnecessary for the effective and safe performance of certain jobs, those making this objection should have less of an objection, or no objection at all (at least on these grounds), to introducing vaccination requirements in some cases for prospective employees. Yet, in this paper, I shall argue that if one has reason to believe vaccination requirements can be justified for prospective employees, one should also believe they are justified for existing employees despite any asymmetry in consequences experienced by the two groups. As a consequence, common objections made against vaccination mandates grounded solely in the harms that may be experienced by existing employees who are unwilling to be vaccinated should be considered unpersuasive.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"268-271"},"PeriodicalIF":4.1,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546321","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

A human right to pleasure? Sexuality, autonomy and egalitarian strategies. 享受快乐的人权？性、自主和平等主义战略。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-03-20 DOI: 10.1136/jme-2023-109011

Jon Wittrock

{"title":"A human right to pleasure? Sexuality, autonomy and egalitarian strategies.","authors":"Jon Wittrock","doi":"10.1136/jme-2023-109011","DOIUrl":"10.1136/jme-2023-109011","url":null,"abstract":"A growing focus on pleasure in human rights discourse has been used to address patterns of sexual exclusion, often when addressing the problems of people with disabilities (PWD). As convincingly argued by Liberman, however, not all PWD suffer from sexual exclusion, and not all who suffer from sexual exclusion are PWD. Danaher and Liberman have thus argued in various ways for a broader range of measures, addressing sexual exclusion. This article builds on previous research and offers a conceptual framework for addressing sexual pleasure and exclusion in terms of human rights. It argues that human rights aim to safeguard autonomy, which is interpreted as multidimensional. It, thus, divides autonomy into the four dimensions of liberty (freedom from threat and coercion), opportunity (options to choose between), capacity (what an agent is capable of doing) and authenticity (the extent to which choices are genuine). Furthermore, it distinguishes between distinct egalitarian strategies, which offer different problems and possibilities, and may be combined. Thus, there is direct egalitarian distribution, indirect egalitarian distribution, baseline or threshold strategies and general promotion strategies. By way of conclusion, the importance of sexual authenticity as the ultimate aim of sexual rights is emphasised.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"263-267"},"PeriodicalIF":3.3,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579395","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