Journal of Medical Ethics最新文献_第2页

Licensing competent children to assist institutional review boards. 授权有能力的儿童协助机构审查委员会。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2024-109910

Samuel Asiedu Owusu, Claudia Passos-Ferreira

{"title":"Licensing competent children to assist institutional review boards.","authors":"Samuel Asiedu Owusu, Claudia Passos-Ferreira","doi":"10.1136/jme-2024-109910","DOIUrl":"10.1136/jme-2024-109910","url":null,"abstract":"Adults are not always capable of representing children's views and interests, and many ethical issues in paediatric research could be better approached if children's perspectives are taken into consideration. Children do not currently serve as institutional review board (IRB) members or provide support to IRBs who review and decide on paediatric research proposals. Based on research on moral development, however, many children are competent and could play expert roles in the IRB process with significant benefits to the latter. In this article, we argue that competent children should be permitted to assist members of IRBs in reviewing proposed paediatric research. We present three reasons in favour of involving children in IRB activities: (1) this allows children to be more adequately represented; (2) this yields a more sensitive approach to ethical complexities in paediatric research; and (3) this can improve the quality of paediatric research and enhance the well-being of research subjects. We offer a model of how competent children could play a role in the IRB process and we discuss the application of this model in the context of global paediatric research in Ghana. We address some worries about involving children in IRBs, focusing on different stakeholders involved in the research review process: the impact on children, IRB members and paediatric researchers.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"683-690"},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649700","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

Scaffolding informed consent. 脚手架知情同意。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2024-110105

Dominic Wilkinson, Neil Levy

引用次数: 0

When is suicide a public health issue? 什么时候自杀会成为公共卫生问题？

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2025-111201

Tessa Jane Holzman, Julian Savulescu

引用次数: 0

Humanitarianism or toxic colonialism? The burdens of unusable drug donations during crises. 人道主义还是有毒的殖民主义？危机期间捐赠的药品无法使用带来的负担。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2026-112619

Arianne Shahvisi, Patricia Kingori

引用次数: 0

Embryo models and the regulatory void: ethical imperatives before legal action. 胚胎模型和监管空白：法律行动之前的道德要求。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2025-111132

Martí Vila-Pérez, David Lorenzo-Izquierdo, Montserrat Esquerda-Aresté

{"title":"Embryo models and the regulatory void: ethical imperatives before legal action.","authors":"Martí Vila-Pérez, David Lorenzo-Izquierdo, Montserrat Esquerda-Aresté","doi":"10.1136/jme-2025-111132","DOIUrl":"10.1136/jme-2025-111132","url":null,"abstract":"Advances in stem cell research have enabled the creation of embryo models that challenge existing definitions and regulatory boundaries in embryo research. The scientific community has struggled to establish a coherent nomenclature for these models, leading to confusion and sensationalism about their nature and applications. Moreover, recent publications by the Nuffield Council on Bioethics and the Ethics Committee of the European Society of Human Reproduction and Embryology have argued that embryonic models derived from stem cells are ineligible to be included in the definition of an embryo. However, some countries had already enacted legislation addressing the classification of certain models derived from stem cells as embryos prior to the issuance of these guidelines. This discrepancy engenders considerable tension among the scientific viewpoints of the countries safeguarded by these laws, with suggestions emerging from authoritative agencies. This research seeks to recognise the regulatory and ethical void created by inconsistent definitions of embryo-like entities and to advocate for a framework fostering interdisciplinary agreement in response to recent advancements. Alternatively, we aim to promote a bioethics that not only supports legislative decisions but also guarantees their validation before their implementation. We argue that without a unified interdisciplinary framework, legal structures may become fragmented, jeopardising both research integrity and public trust.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"678-682"},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471399","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

Moral equivalence and the grounds of moral status in stem cell-derived embryo models: a response to de Graeff and De Proost. 干细胞衍生胚胎模型中的道德对等和道德地位的基础：对de Graeff和de Proost的回应。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2026-111712

Johnny Sakr

{"title":"Moral equivalence and the grounds of moral status in stem cell-derived embryo models: a response to de Graeff and De Proost.","authors":"Johnny Sakr","doi":"10.1136/jme-2026-111712","DOIUrl":"10.1136/jme-2026-111712","url":null,"abstract":"Gyngell et al argue that no intrinsic differences exist between embryos derived from fertilisation and stem cell-derived embryo models (SCEMs) that would justify attributing a higher moral status to the former. Nienke de Graeff and Lien De Proost challenge this claim by emphasising the diversity of SCEMs and by broadening moral evaluation beyond direct moral status to include relational, symbolic and instrumental value. This response argues that their pluralistic framework does not, in fact, undermine moral equivalence in cases where SCEMs successfully instantiate embryo-like human developmental organisation. Once the distinction between properties that ground moral status and considerations that merely shape social or regulatory responses is made explicit, no principled basis remains for differential moral standing. Variation among SCEMs defeats equivalence only where embryo-like organisation is absent; where it is present, moral parity follows. Likewise, relational and instrumental values may justify different governance strategies, but they cannot ground differences in moral worth without collapsing into policy convenience. Rejecting binary thinking does not require denying equivalence where morally relevant features coincide. Either SCEMs fail to model embryos, in which case equivalence never arises, or they succeed and must be treated as morally equivalent in respect of status. What cannot be coherently sustained is embryo-likeness without moral parity.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"718-720"},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933678","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

Retraction: Panem, corticoids and circenses: the ethical fallout of Enhanced Games. 《Panem，皮质激素和执照：增强型游戏的道德后果》

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2025-111085ret

引用次数: 0

Respecting the right to refuse: is decision-making capacity disproportionately challenged in patients declining medical care in order to treat? 尊重拒绝的权利：病人为了治疗而拒绝医疗护理的决策能力是否受到不成比例的挑战？

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2025-111141

Yekaterina Angelova, Stephanie Cheung, Marie S Thearle, Gregg A Robbins-Welty, Omar Farooq Mirza

{"title":"Respecting the right to refuse: is decision-making capacity disproportionately challenged in patients declining medical care in order to treat?","authors":"Yekaterina Angelova, Stephanie Cheung, Marie S Thearle, Gregg A Robbins-Welty, Omar Farooq Mirza","doi":"10.1136/jme-2025-111141","DOIUrl":"10.1136/jme-2025-111141","url":null,"abstract":"Objective: This study aimed to determine the proportion of capacity challenges for refusal of care, the risk factors that may trigger challenges to capacity and to consider the implications of challenging capacity.Methods: This retrospective cohort study examined all psychiatric consults placed for decision-making capacity assessment over a 2-year period in an urban community hospital. Data were collected on the reasons for consultation, patient demographics and whether treatment occurred. Statistical analysis, including χ2 test for equal proportions, was done to determine whether the proportion of capacity challenges for refusal of care differed from 50%.Results: 122 consults questioning capacity were identified during the 2-year period, of which 112 (91.8%) were placed in the setting of refusal of care. Males were over-represented (68.9%) in the consults placed for capacity assessment compared with the proportion of males in all hospital admissions (48.8%) (p<0.0001). The odds of being treated increased in the cohort of patients who lacked decision-making capacity compared with those who were deemed to have capacity (OR 4.2 (95% CI 1.4 to 10.4); p=0.002).Conclusion: This study shows that capacity is challenged overwhelmingly in patients declining medical care. When these patients are decentred from decision making, the odds of completing treatment were more than four times higher.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"662-666"},"PeriodicalIF":4.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337157","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

Response to: Correspondence on 'No, pregnancy is not a disease' by Colgrove and Rodger. 回复：科尔格罗夫和罗杰关于“不，怀孕不是一种疾病”的信件。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-22 DOI: 10.1136/jme-2026-111711

Ognjen Arandjelović

引用次数: 0

Agentic AI, medical morality and the transformation of the patient-physician relationship. 人工智能、医德与医患关系的转变。

IF 4.4 2区哲学

Journal of Medical Ethics Pub Date : 2026-09-21 DOI: 10.1136/jme-2026-112004

Robert Ranisch, Sabine Salloch

引用次数: 0