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Journal of Medical Ethics最新文献

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To what extent should doctors communicate diagnostic uncertainty with their patients? An empirical ethics vignette study.
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-26 DOI: 10.1136/jme-2024-109932
Caitríona Cox, Thea Hatfield, Matthew Parry, Zoë Fritz
{"title":"To what extent should doctors communicate diagnostic uncertainty with their patients? An empirical ethics vignette study.","authors":"Caitríona Cox, Thea Hatfield, Matthew Parry, Zoë Fritz","doi":"10.1136/jme-2024-109932","DOIUrl":"https://doi.org/10.1136/jme-2024-109932","url":null,"abstract":"<p><strong>Background/aims: </strong>Although diagnostic uncertainty is common, patient-focused research examining its communication is lacking. We aimed to determine patient preferences for the communication of diagnostic uncertainty, and examine the effects of such communication on patients.</p><p><strong>Methods: </strong>We applied an empirical ethics approach, integrating the data collected with ethical analysis to form normative recommendations about diagnostic uncertainty communication. In this randomised crossover study, n=111 members of the public sequentially watched two video vignettes depicting either high or low communicated diagnostic uncertainty, in one of two clinical scenarios. After watching videos, participants completed online questionnaires. Primary outcome was preferred video (high vs low communicated uncertainty); secondary outcomes included satisfaction, trust, worry and understanding. Quantitative data were analysed using logistic regression and a linear mixed effects model; qualitative data were analysed thematically.</p><p><strong>Results: </strong>Quantitative analysis demonstrated that participants preferred greater diagnostic uncertainty communication, even though these vignettes were more worrying. Qualitative data revealed heterogeneous participant views justifying their communication preferences. These data raise issues relating to how doctors might balance harms versus benefits in diagnostic uncertainty communication and how doctors might communicate in the face of heterogeneous patient information preferences.</p><p><strong>Conclusions: </strong>We argue that doctors should err on the side of greater diagnostic uncertainty communication: to not do so (eg, based on benign paternalistic ideas about avoiding patient worry) or to do so variably (eg, based on unevidenced assumptions about patient information preferences) risks depriving patients of information they may value and may create or exacerbate inequalities.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515991","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
Antinatalist challenges to Korean pronatalism.
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-26 DOI: 10.1136/jme-2025-110713
Junsik Yoon
{"title":"Antinatalist challenges to Korean pronatalism.","authors":"Junsik Yoon","doi":"10.1136/jme-2025-110713","DOIUrl":"https://doi.org/10.1136/jme-2025-110713","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515939","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
States' responsibilities regarding birth rates.
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-26 DOI: 10.1136/jme-2025-110710
Arnav Shandilya, Timothy F Murphy
{"title":"States' responsibilities regarding birth rates.","authors":"Arnav Shandilya, Timothy F Murphy","doi":"10.1136/jme-2025-110710","DOIUrl":"https://doi.org/10.1136/jme-2025-110710","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515989","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
Singaporean attitudes to cognitive enhancement: a cross-sectional survey.
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-25 DOI: 10.1136/jme-2024-110490
Casey M Haining, Hui Jin Toh, Julian Savulescu, G Owen Schaefer
{"title":"Singaporean attitudes to cognitive enhancement: a cross-sectional survey.","authors":"Casey M Haining, Hui Jin Toh, Julian Savulescu, G Owen Schaefer","doi":"10.1136/jme-2024-110490","DOIUrl":"https://doi.org/10.1136/jme-2024-110490","url":null,"abstract":"<p><p>Recent developments in genetic technologies have provided prospective parents with increasing opportunities to influence their future child's phenotype. This study aimed to understand public attitudes towards gene-based technologies and services, with a particular focus on improving educational outcomes. We conducted a cross-sectional survey among a Singaporean population (n=1438), adapting a survey instrument previously used in the US context. Our results suggested that Singaporeans had a greater moral acceptance of, and willingness to use, genetic technologies and services compared with the US population. Among the technologies examined, the use of polygenic embryo screening was considered more acceptable than gene editing. While these public attitudes show some support for the use of these technologies, further research and consultation among multiple stakeholder groups is necessary to determine whether such technology should be used and how it should be regulated.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501976","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
On the difficulties of universalizing an ethics of state-sponsored pronatalism.
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-25 DOI: 10.1136/jme-2025-110708
James J Cordeiro
{"title":"On the difficulties of universalizing an ethics of state-sponsored pronatalism.","authors":"James J Cordeiro","doi":"10.1136/jme-2025-110708","DOIUrl":"https://doi.org/10.1136/jme-2025-110708","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501975","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 : 2025-02-23 DOI: 10.1136/jme-2025-110717
Sungwoo Um
{"title":"Virtuous procreation and ethical pronatalism.","authors":"Sungwoo Um","doi":"10.1136/jme-2025-110717","DOIUrl":"https://doi.org/10.1136/jme-2025-110717","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483455","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
Why not coercive pronatalism?
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-23 DOI: 10.1136/jme-2025-110705
Joona Räsänen, Anna Smajdor
{"title":"Why not coercive pronatalism?","authors":"Joona Räsänen, Anna Smajdor","doi":"10.1136/jme-2025-110705","DOIUrl":"https://doi.org/10.1136/jme-2025-110705","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483456","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
Dying in a terminal society: a response to Maung. 临终社会中的死亡：对 Maung 的回应。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-21 DOI: 10.1136/jme-2022-108777
Harry Hudson
{"title":"Dying in a terminal society: a response to Maung.","authors":"Harry Hudson","doi":"10.1136/jme-2022-108777","DOIUrl":"10.1136/jme-2022-108777","url":null,"abstract":"<p><p>Maung argues that an externalist understanding of mental disorder exposes how, if society was more just for the most deprived, patterns of access to assisted dying might be different. I counter that reducing inequality lacks relevance to the immediate permissibility of assisted dying for mental disorder, owing to the need for solutions for those in distress. I suggest that the question of assistance in death for mental disorders is one of pragmatic politics, not for obfuscatory philosophy.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"201-202"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138885125","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
Storing paediatric genomic data for sequential interrogation across the lifespan. 存储儿童基因组数据，以便在整个生命周期中进行顺序询问。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-21 DOI: 10.1136/jme-2022-108471
Christopher Gyngell, Fiona Lynch, Danya Vears, Hilary Bowman-Smart, Julian Savulescu, John Christodoulou
{"title":"Storing paediatric genomic data for sequential interrogation across the lifespan.","authors":"Christopher Gyngell, Fiona Lynch, Danya Vears, Hilary Bowman-Smart, Julian Savulescu, John Christodoulou","doi":"10.1136/jme-2022-108471","DOIUrl":"10.1136/jme-2022-108471","url":null,"abstract":"<p><p>Genomic sequencing (GS) is increasingly used in paediatric medicine to aid in screening, research and treatment. Some health systems are trialling GS as a first-line test in newborn screening programmes. Questions about what to do with genomic data after it has been generated are becoming more pertinent. While other research has outlined the ethical reasons for storing deidentified genomic data to be used in research, the ethical case for storing data for future clinical use has not been explicated. In this paper, we examine the ethical case for storing genomic data with the intention of using it as a lifetime health resource. In this model, genomic data would be stored with the intention of reanalysis at certain points through one's life. We argue this could benefit individuals and create an important public resource. However, several ethical challenges must first be met to achieve these benefits. We explore issues related to privacy, consent, justice and equality. We conclude by arguing that health systems should be moving towards futures that allow for the sequential interrogation of genomic data throughout the lifespan.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"205-211"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561685","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
Pass the tissue: restoring researcher access to legal human donations. 传递组织：恢复研究人员获得合法人体捐赠的途径。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2025-02-21 DOI: 10.1136/jme-2023-109033
Meredith Leston, Simon De Lusignan, Richard Frederick Hobbs
{"title":"Pass the tissue: restoring researcher access to legal human donations.","authors":"Meredith Leston, Simon De Lusignan, Richard Frederick Hobbs","doi":"10.1136/jme-2023-109033","DOIUrl":"10.1136/jme-2023-109033","url":null,"abstract":"<p><p>The sensitivity of human tissue and previous instances of misuse have, rightfully, led to the introduction of far-reaching oversight and regulatory mechanisms for accessing, storing and sharing samples. However, these restrictions, in tandem with more broad-based privacy regulations, have had the unintended consequence of obstructing legitimate requests for medical materials. This is of real detriment to ambitions for biomedical research, most notably the precision medicine agenda. As such, this paper makes the case for facilitating authorised researcher access to human tissue and associated data along practical medical ethics lines, detailing how liberating samples from unfit regulations, re-evaluating biobanks, diversifying considerations for donor benefit-risk, future proofing donor consent and flattening hierarchies of donation acceptability equate to a more cohesive and respectful means of managing biological samples and information than is achieved at present.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"174-177"},"PeriodicalIF":3.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534599","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
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