Journal of Medical Ethics最新文献_第3页

Self-harm in immigration detention: political, not (just) medical. 移民拘留中的自我伤害：政治问题，而不仅仅是医疗问题。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2022-108366

Guy Aitchison, Ryan Essex

{"title":"Self-harm in immigration detention: political, not (just) medical.","authors":"Guy Aitchison, Ryan Essex","doi":"10.1136/jme-2022-108366","DOIUrl":"10.1136/jme-2022-108366","url":null,"abstract":"Self-harm within immigration detention centres has been a widely documented phenomenon, occurring at far higher rates than the wider community. Evidence suggests that factors such as the conditions of detention and uncertainty about refugee status are among the most prominent precipitators of self-harm. While important in explaining self-harm, this is not the entire story. In this paper, we argue for a more overtly political interpretation of detainee self-harm as resistance and assess the ethical implications of this view, drawing on interviews with detainees from Australia's offshore system. Self-harm by detainees is not only a medical 'condition' arising in response to oppression but a form of political action to lessen or contest it. We first establish how self-harm could be conceptualised as resistance. We then discuss its political purpose, noting it serves at least three functions: intrinsic, instrumental and disruptive or coercive. Viewing detainee self-harm as political resistance is a supplement to (rather than a substitute for) a medical approach. However, conceptualising self-harm this way has several advantages, namely, moving away from the idea that such behaviour is 'maladaptive', recognising detainees as political agents, combatting government claims of 'manipulation' and 'blackmail' and clarifying the duties of healthcare workers who work in detention.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"786-793"},"PeriodicalIF":3.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10444657","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

Genetic disenhancement and xenotransplantation: diminishing pigs' capacity to experience suffering through genetic engineering. 基因强化和异种移植：通过基因工程降低猪的受苦能力。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2023-109594

Daniel Rodger, Daniel J Hurst, Christopher A Bobier, Xavier Symons

引用次数: 0

How should China set ethical guardrails for medical research? 中国应如何为医学研究设置伦理警戒线？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2023-109621

Jingyi Xu, Zhongxuan Liu, Jiayou Shi, Yue Wang

引用次数: 0

Animus: human-embodied animals. Animus：人类化身的动物。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2022-108817

Julian Savulescu, Tsutomu Sawai

引用次数: 0

Prioritisation and non-sentientist harms: reconsidering xenotransplantation ethics. 优先顺序和非有情主义危害：重新考虑异种移植伦理。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2024-110202

Christian Rodriguez Perez, Edwin Louis-Maerten, Samuel Camenzind, Matthias Eggel, Kirsten Persson, David Shaw

引用次数: 0

This little piggy can't leave the open market. 这只小猪不能离开公开市场。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2024-110199

Richard B Gibson

引用次数: 0

Why the irremediability requirement is not sufficient to deny psychiatric euthanasia for patients with treatment-resistant depression. 为什么不可救药的要求不足以拒绝为耐药抑郁症患者实施精神安乐死？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2023-109644

Marcus T L Teo

{"title":"Why the irremediability requirement is not sufficient to deny psychiatric euthanasia for patients with treatment-resistant depression.","authors":"Marcus T L Teo","doi":"10.1136/jme-2023-109644","DOIUrl":"10.1136/jme-2023-109644","url":null,"abstract":"Treatment-resistant depression (TRD) holds centrality in many debates regarding psychiatric euthanasia. Among the strongest reasons cited by opponents of psychiatric euthanasia is the uncertainty behind the irremediability of psychiatric illnesses. According to this argument, conditions that cannot be considered irremediable imply that there are possible remedies that remain for the condition. If there are possible remedies that remain for the condition, then patients with that condition cannot be considered for access to euthanasia. I call this the irremediability requirement (IR). I argue that patients with TRD can, indeed, meet the operationalisation of irremediability in the IR. This is because the irremediability it asks for is not some global or absolute irremediability, but rather a present irremediability based on the current state of medical science. I show this by considering irremediability relating to (1) possible future treatments and (2) not trying presently available alternative treatments. I extend Schuklenk nd van de Vathorst's argument from parity to terminal malignancies, to show that (1) is an unreasonable expectation for all cases of euthanasia. Taking (2) as a more serious opponent to psychiatric euthanasia, I show how the IR, based on how it is presently operationalised, can be realistically applied to cases of TRD. I do this by further developing Tully's argument on broad-sense treatment resistance with the robust empirical data from the STAR*D trials. If my argument from Tully's is valid, then we have reasons to, again, seek parity between the operationalisations of irremediability in terminal malignancies and TRD.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"753-757"},"PeriodicalIF":3.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432047","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

Advance directives for oral feeding in dementia: a response to Shelton and Geppert. 痴呆症患者口喂预嘱：对 Shelton 和 Geppert 的回应。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2024-109909

Paul T Menzel

引用次数: 0

Jiren (): Daoism, healthcare and atypical bodies. 集人():道教、保健和非典型体。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2023-109590

Luís Cordeiro-Rodrigues, Qian Zhang, Lei Pang, Zhibin Chen

引用次数: 0

Consent with complications in mind. 同意时要考虑到并发症。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-10-22 DOI: 10.1136/jme-2023-109731

Edwin Jesudason

{"title":"Consent with complications in mind.","authors":"Edwin Jesudason","doi":"10.1136/jme-2023-109731","DOIUrl":"10.1136/jme-2023-109731","url":null,"abstract":"Parity of esteem describes an aspiration to see mental health valued as much as physical. Proponents point to poorer funding of mental health services, greater stigma and poorer physical health for those with mental illness. Stubborn persistence of such disparities suggests a need to do more than stipulate ethical and legal obligations toward justice or fairness. Here, I propose that we should rely more on our legal obligations toward informed consent. The latter requires clinicians to disclose information about risks in a way that is sufficient to satisfy what a prudent patient would reasonably want to understand in their circumstances. I argue that inadequate disclosure of the mental health complications of common surgeries risks exposing the craft specialists performing them to clinical negligence claims. Patients could argue they were counselled about said risks, improperly or not at all: improperly, if advised by a craft specialist lacking sufficient expertise in mental health; not at all, if mental health complications were simply forgotten. From this, I argue that a prudent approach for craft specialists would be to support and fund 'integrative' specialists (from rehabilitation medicine, liaison psychiatry and health psychology), more often to work alongside them within a multidisciplinary team that is better placed to navigate consent (via a prehabilitation process, for example). Based on duties toward consent, the extension of this type of coworking is another way to improve the resource and understanding accorded to mental health-but by starting within the citadels of physical health.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"758-761"},"PeriodicalIF":3.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520917","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