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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
{"title":"AI diagnoses terminal illness care limits: just, or just stingy?","authors":"Leonard Michael Fleck","doi":"10.1136/jme-2024-110170","DOIUrl":"https://doi.org/10.1136/jme-2024-110170","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108134","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
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。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-29 DOI: 10.1136/jme-2024-110015
Shang Long Yeo
{"title":"Framing effects from misleading implicatures: an empirically based case against some purported nudges.","authors":"Shang Long Yeo","doi":"10.1136/jme-2024-110015","DOIUrl":"https://doi.org/10.1136/jme-2024-110015","url":null,"abstract":"<p><p>Some bioethicists argue that a doctor may frame treatment options in terms of effects on survival rather than on mortality in order to influence patients to choose the better option. The debate over such framing typically assumes that the survival and mortality frames convey the same numerical information. However, certain empirical findings contest this numerical equivalence assumption, demonstrating that framing effects may in fact be due to the two frames implying different information about the numerical bounds of survival and mortality rates. In this paper, I use these findings to argue that framing is presumptively wrong because it violates the duty of proper disclosure. Along the way, I highlight morally relevant features affecting the permissibility of framing, tackle three objections and draw some general lessons for the ethics of nudging.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108138","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
Address health inequities among human beings is an ethical matter of urgency, whether or not to develop more powerful AI. 无论是否要开发更强大的人工智能，解决人类健康不平等问题都是一个紧迫的伦理问题。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-28 DOI: 10.1136/jme-2024-110171
Hongnan Ye
{"title":"Address health inequities among human beings is an ethical matter of urgency, whether or not to develop more powerful AI.","authors":"Hongnan Ye","doi":"10.1136/jme-2024-110171","DOIUrl":"https://doi.org/10.1136/jme-2024-110171","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108133","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
Artificial intelligence risks, attention allocation and priorities. 人工智能风险、注意力分配和优先事项。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-28 DOI: 10.1136/jme-2024-110279
Aorigele Bao, Yi Zeng
{"title":"Artificial intelligence risks, attention allocation and priorities.","authors":"Aorigele Bao, Yi Zeng","doi":"10.1136/jme-2024-110279","DOIUrl":"https://doi.org/10.1136/jme-2024-110279","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108135","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
A Sleight of Hand. 巧夺天工。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-28 DOI: 10.1136/jme-2024-110219
Emma Tumilty
{"title":"A Sleight of Hand.","authors":"Emma Tumilty","doi":"10.1136/jme-2024-110219","DOIUrl":"https://doi.org/10.1136/jme-2024-110219","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108132","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
Pharmacological and ethical comparisons of lung cancer medicine accessibility in Australia and New Zealand. 澳大利亚和新西兰肺癌药物可及性的药理学和伦理学比较。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-28 DOI: 10.1136/jme-2023-109758
Elizabeth Fenton, John Ashton
{"title":"Pharmacological and ethical comparisons of lung cancer medicine accessibility in Australia and New Zealand.","authors":"Elizabeth Fenton, John Ashton","doi":"10.1136/jme-2023-109758","DOIUrl":"https://doi.org/10.1136/jme-2023-109758","url":null,"abstract":"<p><p>Gaps in funded cancer medicines between New Zealand and Australia can have significant implications for patients and their families. Pharmac, the New Zealand pharmaceutical funding agency, has been criticised for not funding enough cancer medicines, and a 2022 review identified ethical concerns about its utilitarian focus on efficiency. However, as the costs of new cancer medicines rise along with public and political pressure to fund them, questions about value for money remain critical for health systems worldwide. In this paper, we compare funding for cancer medicines in New Zealand and Australia, specifically medicines for non-small cell lung cancer. We argue that the ethical imperatives on funding agencies to get value for money and provide medicines for patients with cancer underscore the importance of transparent decision-making processes, including identifying and explaining intercountry differences in funded medicines.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108140","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
Providing medically assisted dying in Canada: a qualitative study of emotional and moral impact. 在加拿大提供医学协助死亡：关于情感和道德影响的定性研究。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-28 DOI: 10.1136/jme-2024-110137
Janine Penfield Winters, Chrystal Jaye, Neil John Pickering, Simon Walker
{"title":"Providing medically assisted dying in Canada: a qualitative study of emotional and moral impact.","authors":"Janine Penfield Winters, Chrystal Jaye, Neil John Pickering, Simon Walker","doi":"10.1136/jme-2024-110137","DOIUrl":"https://doi.org/10.1136/jme-2024-110137","url":null,"abstract":"<p><strong>Purpose: </strong>Medical assistance in dying (MAiD) in Canada places the medical provider at the centre of the process. The MAiD provider holds primary responsibility for determining eligibility and becomes acquainted with patients' inner desires and expressions of suffering. This is followed by the MAiD procedure of administering the lethal agent and being present at the death of eligible patients. We report participants' perceptions of the emotional and moral impacts of this role.</p><p><strong>Methodology: </strong>Two years after MAiD was legalised in Canada, 22 early-adopting physician providers were interviewed. Data were examined using both phenomenological analysis and a novel ChatGPT-enhanced analysis of an anonymised subset of interview excerpts.</p><p><strong>Findings: </strong>Participants described MAiD as emotionally provocative with both challenges and rewards. Providers expressed a positive moral impact when helping to optimise a patient's autonomy and moral comfort with their role in relieving suffering. Providers experienced tensions around professional duty and balancing self with service to others. Personal choice and patient gratitude enhanced the provider experience, while uncertainty and conflict added difficulty.</p><p><strong>Conclusions: </strong>Participants described MAiD provision as strongly aligned with a patient-centred ethos of practice. This study suggests that, despite challenges, providing MAiD can be a meaningful and satisfying practice for physicians. Understanding the emotional and moral impact and factors that enhance or detract from the providers' experience allows future stakeholders to design and regulate assisted dying in ways congruent with the interests of patients, providers, families and society.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108141","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
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 : 2024-08-22 DOI: 10.1136/jme-2023-109808
Kristien Hens, Emma Moormann, Anna Smajdor, Daniela Cutas
{"title":"If Marc is Suzanne's father, does it follow that Suzanne is Marc's child? An experimental philosophy study in reproductive ethics.","authors":"Kristien Hens, Emma Moormann, Anna Smajdor, Daniela Cutas","doi":"10.1136/jme-2023-109808","DOIUrl":"https://doi.org/10.1136/jme-2023-109808","url":null,"abstract":"<p><p>In this paper, we report the results from an experimental reproductive ethics study exploring questions about reproduction and parenthood. The main finding in our study is that, while we may assume that everyone understands these concepts and their relationship in the same way, this assumption may be unwarranted. For example, we may assume that if 'x is y's father', it follows that 'y is x's child'. However, the participants in our study did not necessarily agree that it does follow. This means, at the very least, that we need to make sure all parties in a debate have the same relationships in mind when talking about reproduction and parenthood. Moreover, it gives us reason to explore more carefully the conditions which support or undermine the connections between these concepts. This cannot come from purely theoretical reasoning, nor from empirical research alone, but from the alliance between the two.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036046","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
If it walks like a duck…: Monitored Emergency Use of Unregistered and Experimental Interventions (MEURI) is research. 如果它像鸭子一样走路…:监测未注册和实验性干预措施的紧急使用(MEURI)是一项研究。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-21 DOI: 10.1136/jme-2023-109169
G Owen Schaefer
{"title":"If it walks like a duck…: Monitored Emergency Use of Unregistered and Experimental Interventions (MEURI) is research.","authors":"G Owen Schaefer","doi":"10.1136/jme-2023-109169","DOIUrl":"10.1136/jme-2023-109169","url":null,"abstract":"<p><p>Monitored Emergency Use of Unregistered and Experimental Interventions (MEURI) is an ethical framework developed by the WHO for using unproven interventions in public health emergencies outside the context of medical research. It is mainly intended for use when medical research would be impracticable, but there is still a need to systematically gather data about unproven interventions. As such, it is designed as something of a middle ground between clinical and research ethical frameworks.However, I argue that MEURI does not truly lie at the intersection of clinical care and research. Due to its intent, structure and oversight requirements, it takes on most of the crucial features of research, to the point that it is best understood as a form of research. As a result, cases where MEURI could practicably be applied should instead make use of existing research frameworks. For those circumstances where research is truly impracticable, a more straightforward oversight system than MEURI is needed. While existing practices of compassionate use have some applicability, proposals to make use of clinical ethics committees to oversee unproven interventions may help achieve the right balance in acting in a patient's best interests when the relevant evidence base is weak.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"606-611"},"PeriodicalIF":3.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482473","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
Negotiating cultural sensitivity in medical AI. 协商医疗人工智能中的文化敏感性。
IF 3.3 2区 哲学
Journal of Medical Ethics Pub Date : 2024-08-21 DOI: 10.1136/jme-2024-110037
Ji-Young Lee
{"title":"Negotiating cultural sensitivity in medical AI.","authors":"Ji-Young Lee","doi":"10.1136/jme-2024-110037","DOIUrl":"10.1136/jme-2024-110037","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"602-603"},"PeriodicalIF":3.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158407","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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