Journal of Medical Ethics最新文献_第3页

Ethical reflection of Chinese scientists on the dual-use concerns of emerging medical biotechnology. 中国科学家对新兴医学生物技术军民两用问题的伦理反思。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110404

Xiaonan Wang, Mingtao Huang, Hui Shao, Kun Li, Xiaomei Zhai

{"title":"Ethical reflection of Chinese scientists on the dual-use concerns of emerging medical biotechnology.","authors":"Xiaonan Wang, Mingtao Huang, Hui Shao, Kun Li, Xiaomei Zhai","doi":"10.1136/jme-2024-110404","DOIUrl":"10.1136/jme-2024-110404","url":null,"abstract":"Emerging medical biotechnology typically exhibits a 'dual-use' nature, which, while promoting human well-being, concurrently presents potential risks of misuse or abuse, thereby posing significant threats. Globally, including in China, emerging medical biotechnology is developing rapidly. To understand the views and perspectives of Chinese scientists on dual-use concerns, this empirical study conducted semistructured qualitative interviews with researchers (n=14) from various specialties within the Chinese medical field, analysing their perspectives and ethical considerations regarding dual-use concerns. The findings of this study reveal a spectrum of attitudes among interviewees towards the exploration and application of emerging medical biotechnology, ranging from aggressive to conservative. This tension reflects the complexity and challenges of seeking a balance between promoting scientific innovation and maintaining ethical boundaries. Furthermore, while there is a consensus among scientists that the development and application of biotechnology encompass both risks and benefits, their stances on weighing these factors differ, reflecting how risk perception is influenced by professional limitations. Moreover, although scientists recognise the indispensability of both self-regulation and external oversight in practice, they also exhibit misunderstandings in ethical cognition and misinterpretations of regulatory measures. In light of these findings, it is imperative for us to urgently fortify national regulatory mechanisms and the construction of legal and ethical frameworks while also enhancing the ethical awareness and risk assessment capabilities of researchers. These measures are crucial for minimising the potential risks associated with dual use and fostering the sustainable and responsible development of emerging medical biotechnology.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"662-667"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791710","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

Late-onset diseases and patient education: additional considerations for polygenic risk score regulation. 迟发性疾病和患者教育：多基因风险评分调节的额外考虑。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110688

Alexandra Midler

引用次数: 0

Genetic research and the collective good: participants as leaders to reconcile individual and public interests. 基因研究与集体利益：参与者作为协调个人和公共利益的领导者。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2022-108867

Ilaria Galasso, Susi Geiger

{"title":"Genetic research and the collective good: participants as leaders to reconcile individual and public interests.","authors":"Ilaria Galasso, Susi Geiger","doi":"10.1136/jme-2022-108867","DOIUrl":"10.1136/jme-2022-108867","url":null,"abstract":"This paper problematises the notions of public or common good as weighed against individual sovereignty in the context of medical research by focusing on genetic research. We propose the notion of collective good as the good of the particular collective in which the research was conducted. We conducted documentary and interview-based research with participant representatives and research leaders concerned with participant involvement in leading genetic research projects and around two recent genetic data controversies: the case of the UK Wellcome Sanger Institute, accused of planning unauthorised commercialisation of African DNA samples, and the case of the company Genuity Science, which planned genetic research on brain tumour samples in Ireland with no explicit patient consent. We advocate for greater specificity in circumscribing the collective to which genetic research relates and for greater efforts in including representatives of this collective as research coleaders in order to enable a more inclusive framing of the good arising from such research. Such community-based participant cogovernance and coleadership in genetic research is vital especially when minorities or vulnerable groups are involved, and it centrally requires community capacity building to help collectives articulate their own notions of the collective good.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"710-718"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160790","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

Assessing the performance of ChatGPT in medical ethical decision-making: a comparative study with USMLE-based scenarios. 评估ChatGPT在医学伦理决策中的表现：与基于usmle的场景的比较研究

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110240

Ali A Khan, Ali R Khan, Saminah Munshi, Hari Dandapani, Mohamed Jimale, Franck M Bogni, Hussain Khawaja

{"title":"Assessing the performance of ChatGPT in medical ethical decision-making: a comparative study with USMLE-based scenarios.","authors":"Ali A Khan, Ali R Khan, Saminah Munshi, Hari Dandapani, Mohamed Jimale, Franck M Bogni, Hussain Khawaja","doi":"10.1136/jme-2024-110240","DOIUrl":"10.1136/jme-2024-110240","url":null,"abstract":"Introduction: The integration of artificial intelligence (AI) into healthcare introduces innovative possibilities but raises ethical, legal and professional concerns. Assessing the performance of AI in core components of the United States Medical Licensing Examination (USMLE), such as communication skills, ethics, empathy and professionalism, is crucial. This study evaluates how well ChatGPT versions 3.5 and 4.0 handle complex medical scenarios using USMLE-Rx, AMBOSS and UWorld question banks, aiming to understand its ability to navigate patient interactions according to medical ethics and standards.Methods: We compiled 273 questions from AMBOSS, USMLE-Rx and UWorld, focusing on communication, social sciences, healthcare policy and ethics. GPT-3.5 and GPT-4 were tasked with answering and justifying their choices in new chat sessions to minimise model interference. Responses were compared against question bank rationales and average student performance to evaluate AI effectiveness in medical ethical decision-making.Results: GPT-3.5 answered 38.9% correctly in AMBOSS, 54.1% in USMLE-Rx and 57.4% in UWorld, with rationale accuracy rates of 83.3%, 90.0% and 87.0%, respectively. GPT-4 answered 75.9% correctly in AMBOSS, 64.9% in USMLE-Rx and 79.6% in UWorld, with rationale accuracy rates of 85.4%, 88.9%, and 98.8%, respectively. Both versions generally scored below average student performance, except GPT-4 in UWorld.Conclusion: ChatGPT, particularly version 4.0, shows potential in navigating ethical and interpersonal medical scenarios. However, human reasoning currently surpasses AI in average performance. Continued development and training of AI systems can enhance proficiency in these critical healthcare aspects.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"693-699"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039611","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

Dark side of the principles of non-discrimination and proportionality: the case of mandatory vaccination. 非歧视和相称性原则的阴暗面：强制疫苗接种案例。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2023-108998

Filip Horák, Jakub Dienstbier

{"title":"Dark side of the principles of non-discrimination and proportionality: the case of mandatory vaccination.","authors":"Filip Horák, Jakub Dienstbier","doi":"10.1136/jme-2023-108998","DOIUrl":"10.1136/jme-2023-108998","url":null,"abstract":"Deciding the conflict between various rights and interests, especially in medical ethics where health and lives are in question, has significant challenges, and to obtain appropriate outcomes, it is necessary to properly apply the principles of non-discrimination and proportionality. Using the example of mandatory vaccination policies, we show that this task becomes even more difficult when these principles lead us to counterintuitive and paradoxical results. Although the general purpose of these principles is to ensure that decisions and policies seek the highest and broadest possible enjoyment of rights for all (ie, the least restrictive solution), they achieve the complete opposite when applied to mandatory vaccination policies. To highlight and explain these paradoxical results, we present a typology of fifteen hypothetical mandatory vaccination policies containing various degrees of restriction and apply well-established non-discrimination and proportionality tests from constitutional law to each. We argue that mandatory vaccination policies exhibit two characteristics, namely the non-linear relationship between their general purposes and specific goals and the involvement of life and health, suggesting that more restrictive policies should prevail even though less restrictive policies might fail these tests. Using clearly structured and rigorous methodology from constitutional law, the proposed approach delivers a fresh view on the core ethical principles of non-discrimination and proportionality and a potentially useful tool in helping resolve also other challenges encountered in medical ethics beyond mandatory vaccination policies.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"700-709"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013785","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

Navigating the consent river: questions to consider before waiving consent requirements in pragmatic cluster randomised trials. 在同意河中航行：在实用的集群随机试验中放弃同意要求之前要考虑的问题。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110392

Cory E Goldstein, Monica Taljaard, Stephanie N Dixon, Charles Weijer

{"title":"Navigating the consent river: questions to consider before waiving consent requirements in pragmatic cluster randomised trials.","authors":"Cory E Goldstein, Monica Taljaard, Stephanie N Dixon, Charles Weijer","doi":"10.1136/jme-2024-110392","DOIUrl":"10.1136/jme-2024-110392","url":null,"abstract":"The robust design and conduct of pragmatic cluster randomised trials may be in tension with the ethical requirement to obtain written informed consent from prospective research participants. In our experience, researchers tend to focus on whether a waiver of consent is appropriate for their studies. However, pragmatic cluster randomised trials raise other important questions that have direct implications for determining when an alteration or waiver of consent is permissible. To assist those involved in the design, conduct and review of pragmatic cluster randomised trials, we outline four critical questions to consider: (1) What is the nature of the intervention being evaluated? (2) Is the choice to use cluster randomisation justified? (3) Can the risk of recruitment bias be addressed? and (4) Is an alteration or waiver of consent appropriately justified? We recommend that researchers and research ethics committees conduct a stepwise analysis of a planned cluster randomised trial using these questions. To illustrate the application of this stepwise analysis, we use three pragmatic cluster randomised trials in the haemodialysis setting as case studies.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"672-678"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853958","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

Polygenic risk scores and embryonic screening: considerations for regulation. 多基因风险评分和胚胎筛选：监管考虑因素。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110145

Casey M Haining, Julian Savulescu, Louise Keogh, G Owen Schaefer

引用次数: 0

A worthwhile wager: the ethics of open-label placebo treatment in clinical practice. 值得打赌的是：临床实践中开放标签安慰剂治疗的伦理问题。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110270

Doug Hardman, Franklin Miller

引用次数: 0

Assessing ethics and law in medical schools: there is no single best answer. 评估医学院的道德和法律：没有单一的最佳答案。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-22 DOI: 10.1136/jme-2024-110298

Greg Moorlock, Zuzana Deans, Michael Trimble

引用次数: 0

Non-identity problem and the 'all-things-considered' moral obligation to have genetically related children. 非同一性问题和“考虑一切”的道德义务，有基因相关的孩子。

IF 3.4 2区哲学

Journal of Medical Ethics Pub Date : 2025-09-18 DOI: 10.1136/jme-2025-111372

Guido Pennings

{"title":"Non-identity problem and the 'all-things-considered' moral obligation to have genetically related children.","authors":"Guido Pennings","doi":"10.1136/jme-2025-111372","DOIUrl":"https://doi.org/10.1136/jme-2025-111372","url":null,"abstract":"Dr Marcus Teo states that my claim that prospective parents have a moral obligation to have genetically related children is invalid because I have ignored the non-identity problem. He maintains that donor-conceived persons (DCPs) cannot be harmed by their conception, as they would not exist otherwise. However, an analysis of his argument shows that the reason why he does not recognise such moral obligation is not the non-identity problem but his rejection of the Principle of Procreative Beneficence. He instead adopts a 'minimal threshold' principle: as long as a child's life is worth living, there is no obligation to select the child with the best possible life.Teo also claims that my article may cause unnecessary anxiety in parents. However, these concerns have mostly been raised by psychological professionals who have highlighted the complexities of donor conception. Nevertheless, to address these concerns, the original claim could be refined into an 'all-things-considered' moral obligation, which would acknowledge more explicitly that it can be overridden by stronger moral reasons.Talbot et al state that my conclusion regarding the future well-being of DCPs is premature and based on selective evidence. However, their literature review does not contradict my claim that a substantial number of DCPs experience negative psychosocial effects. Societal trends such as ancestry testing and increasing focus on genetic ties may worsen these outcomes in the future.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086248","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