Journal of Medical Ethics最新文献_第3页

Ghairat: navigating cultural morality in patient care. 格拉特：在病人护理中引导文化道德。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-18 DOI: 10.1136/jme-2025-111188

Ammar Younas, Yi Zeng

引用次数: 0

Using a lottery to resolve indeterminacy when allocating resources for drugs for rare diseases. 利用摇号来解决罕见疾病药物资源分配的不确定性。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-18 DOI: 10.1136/jme-2023-109723

Kenneth Bond, Lars Sandman, Erik Gustavsson

引用次数: 0

When to create embryos or organoids for research. 何时为研究创造胚胎或类器官。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-17 DOI: 10.1136/jme-2025-110821

Sebastian Porsdam Mann, Julian Savulescu, Brian D Earp

{"title":"When to create embryos or organoids for research.","authors":"Sebastian Porsdam Mann, Julian Savulescu, Brian D Earp","doi":"10.1136/jme-2025-110821","DOIUrl":"https://doi.org/10.1136/jme-2025-110821","url":null,"abstract":"The development of brain organoids and use of human embryonic neural structures for research each raise distinct ethical considerations that require careful analysis. We propose that rather than attempting to resolve longstanding debates about embryonic moral status, a more productive approach is to examine how different positions on this fundamental question lead to distinct conclusions about appropriate research strategies. For those who ground moral status in species membership or developmental potential, even early-stage embryo research may be ethically impermissible, suggesting focus on carefully bounded organoid development. Conversely, for those who ground moral status in current capacities, embryonic neural tissue studied before the emergence of consciousness may offer significant advantages over organoids while raising fewer novel ethical concerns. Our analysis reveals inadequacies in current policies, particularly the 14-day rule, which appears difficult to justify under either ethical framework. We demonstrate how careful attention to the relationship between ethical premises and research implications can advance both scientific progress and ethical oversight, while suggesting specific policy reforms including capacity-based research guidelines and sophisticated monitoring protocols.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659423","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

Bearing witness and the ethical place of the medical student. 作证和医学生的道德地位。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-16 DOI: 10.1136/jme-2025-110909

Lily Gryspeerdt

{"title":"Bearing witness and the ethical place of the medical student.","authors":"Lily Gryspeerdt","doi":"10.1136/jme-2025-110909","DOIUrl":"https://doi.org/10.1136/jme-2025-110909","url":null,"abstract":"Having a medical student present in a consultation is often seen as an imposition on the patient, with the key ethical concerns being around confidentiality and respect for the patient's dignity. The educational benefit for the student is primarily seen as being to enhance their clinical knowledge and experience, such that they develop, through observation and supervised practice, clinical and communication skills. However, through the paradigm of bearing witness, new aspects of this interaction can be explored. A witness is understood as a neutral third-party observer whose role is not based in action but to listen and remember. When applied to the role of a medical student on a clinical placement, two ethical aspects can be drawn out. First, this is of benefit to the patient in providing the time and space for them to be truly seen and heard. In turn, this signifies the possibility of being known. Second, this role enhances the ethical understanding of the student such that it is a form of moral education. Furthermore, this is within a social and political context which invokes a sense of responsibility. Studying the biology of a human is a process of alienation from engagement with humanity, turning a person into a set of biological processes. Through understanding a medical student's role as bearing witness, a clinical placement can be seen as having an ethical purpose in reconnecting them to their moral appreciation of individual human beings.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649698","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

Care in palliative care: a challenging concept with normative issues. 姑息治疗中的护理：具有规范性问题的具有挑战性的概念。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-16 DOI: 10.1136/jme-2024-110247

Michael Rechenmacher

引用次数: 0

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 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-16 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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age-based healthcare prioritisation and gender discrimination. 以年龄为基础的保健优先事项和性别歧视。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-14 DOI: 10.1136/jme-2024-110073

Viki Møller Lyngby Pedersen

{"title":"Age-based healthcare prioritisation and gender discrimination.","authors":"Viki Møller Lyngby Pedersen","doi":"10.1136/jme-2024-110073","DOIUrl":"https://doi.org/10.1136/jme-2024-110073","url":null,"abstract":"All over the world, women live longer lives than men. Accordingly, women make up the majority of the oldest age cohorts. This means that if health services for young people are prioritised over health services for older people, women will be deprioritised to a greater extent than men. In this article, I discuss whether disfavouring older people in the distribution of healthcare resources indirectly discriminates against women. Indirect discrimination requires disproportionate disadvantage. I argue that age-based prioritisation disadvantages women relative to men. However, this argument is based on certain assumptions about the actual effects of the policy. Subsequently, I discuss whether the disadvantages for living women are disproportionate by focusing on the strength of women's moral claim to health resources (assuming that the moral claim is stronger the worse off they are). On the one hand, women are only disadvantaged by age-based prioritisation because they already have an advantage in terms of life expectancy. On the other hand, partly because of their longevity, older women are in many respects a vulnerable group, which supports the view that it is disproportionate to burden them further. I conclude that age-based prioritisation risks discriminating against women in ways that should be avoided. The benefits of age-based prioritisation should not only justify disadvantageous treatment of older people relative to younger people; they should also justify disparate effects on women and men. In addition to shedding new light on age-based prioritisation, the article illustrates the nuance required for determining whether a policy indirectly discriminates.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637264","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

Do vaccine mandates impair the voluntariness of informed consent? 疫苗授权是否损害了知情同意的自愿性？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-14 DOI: 10.1136/jme-2025-110950

Maxwell J Smith, Evan Mackie

{"title":"Do vaccine mandates impair the voluntariness of informed consent?","authors":"Maxwell J Smith, Evan Mackie","doi":"10.1136/jme-2025-110950","DOIUrl":"https://doi.org/10.1136/jme-2025-110950","url":null,"abstract":"An ethical and legal obligation generally exists for informed consent to be obtained prior to the administration of medical interventions. This includes vaccinations. For an individual's informed consent to be valid, it must be given voluntarily Hence, when individuals are required to be vaccinated-for example, as a condition of employment-we might ask whether this impairs the voluntariness of their informed consent, thereby rendering it invalid. If this turns out to be the case, then this would count as a pro tanto reason to think vaccine mandates are unethical. Assuming vaccine mandates count as 'coercive', interrogating this question requires an account of consent under third-party coercion, since the pressure or coercion exerted by vaccine mandates is exerted by third parties, such as employers, rather than the recipients of consent. Accordingly, this paper draws on Maximilian Kiener's Interpersonal Consenter-Consentee Justification account of the voluntariness of medical consent under third-party coercion to develop an explicit argument as to why vaccine mandates do not vitiate the voluntariness of informed consent. Vaccine mandates do not necessarily impair the voluntariness of informed consent because, in such cases, the consent-receiver neither contributes to a vaccine mandate's coercive threat nor wrongs the consent-giver in any way. Consent is not obtained by coercion in such cases, even though it may be motivated by it. The mere presence of third-party coercion does not invalidate consent since third parties cannot directly negate the voluntariness of consent.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637265","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 risks of depersonalizing consent and the safe implementation of LLMs in medical decision-making. 关于去人格化同意的风险和法学硕士在医疗决策中的安全实施。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-11 DOI: 10.1136/jme-2025-111017

Carl Hildebrand

引用次数: 0

Disability in the neonatal intensive care unit: are current frameworks applicable? 新生儿重症监护病房的残疾：现行框架是否适用？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2025-07-10 DOI: 10.1136/jme-2025-110983

Peter D Murray

{"title":"Disability in the neonatal intensive care unit: are current frameworks applicable?","authors":"Peter D Murray","doi":"10.1136/jme-2025-110983","DOIUrl":"https://doi.org/10.1136/jme-2025-110983","url":null,"abstract":"Decisions for patients in the neonatal intensive care unit (NICU) are made under the auspices of the shared decision-making model, which uses the best interests standard as a guide. Decisions made regarding the withdrawal of life-sustaining measures (WLSM) are also made using the shared decision-making model with attention to either physiological parameters indicative of survival or the potential for disability. The two dominant frameworks for considering disability are the medical and social models. At its core, the medical model views disability as something broken within the person, something in need of being fixed. On the other hand, the social model of disability asserts that disability is a socially constructed process consisting of a multitude of barriers encountered by people with various impairments. The social and medical models of disability fail to represent disability in the NICU accurately. The former neglects the biological aspect, as a neonate in the NICU is primarily a physiological being. In contrast, the latter overlooks the possibility that the neonate may not yet be impacted by their impairment and, therefore, would technically not be considered disabled per specific criteria outlined in the medical model. An alternative framework that incorporates the neonate's current medical requirements in conjunction with the prognostication of disability as a method by which parents might make decisions regarding WLSM is desperately needed.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608589","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