Journal of Medical Ethics最新文献_第6页

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 : 2024-12-23 DOI: 10.1136/jme-2024-110170

Leonard Michael Fleck

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 : 2024-12-23 DOI: 10.1136/jme-2024-110171

Hongnan Ye

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Medical ethics in China and making tacit publication criteria explicit: tips on getting your paper accepted. 中国的医学伦理与明确默示的发表标准：让论文被接受的技巧。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2024-110623

John McMillan, Julian Savulescu

引用次数: 0

Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy. 支持有性别焦虑的年轻人的自主性:心理治疗不是转化治疗。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2023-109282

Roberto D'Angelo

{"title":"Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy.","authors":"Roberto D'Angelo","doi":"10.1136/jme-2023-109282","DOIUrl":"10.1136/jme-2023-109282","url":null,"abstract":"Opinion is divided about the certainty of the evidence base for gender-affirming medical interventions in youth. Proponents claim that these treatments are well supported, while critics claim the poor-quality evidence base warrants extreme caution. Psychotherapy is one of the only available alternatives to the gender-affirming approach. Discussion of the treatment of gender dysphoria in young people is generally framed in terms of two binary approaches: affirmation or conversion. Psychotherapy/exploratory therapy offers a treatment option that lies outside this binary, although it is mistakenly conflated with conversion therapies. Psychotherapy does not impose restrictive gender stereotypes, as is sometimes claimed, but critically examines them. It empowers young people to develop creative solutions to their difficulties and promotes agency and autonomy. Importantly, an exploratory psychotherapeutic process can help to clarify whether gender dysphoria is a carrier for other psychological or social problems that may not be immediately apparent. Psychotherapy can therefore make a significant contribution to the optimal, ethical care of gender-dysphoric young people by ensuring that patients make appropriate, informed decisions about medical interventions which carry risks of harm and have a contested evidence base.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"3-9"},"PeriodicalIF":3.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047085","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

Defending the disease view of pregnancy: a reply to our critics. 捍卫孕期疾病观：答复我们的批评者。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2024-110459

Joona Räsänen, Anna Smajdor

引用次数: 0

The ethical canary: narrow reflective equilibrium as a source of moral justification in healthcare priority-setting. 道德金丝雀：狭隘的反思平衡作为医疗保健优先级设定中的道德理由来源。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2023-109467

Victoria Charlton, Michael J DiStefano

{"title":"The ethical canary: narrow reflective equilibrium as a source of moral justification in healthcare priority-setting.","authors":"Victoria Charlton, Michael J DiStefano","doi":"10.1136/jme-2023-109467","DOIUrl":"10.1136/jme-2023-109467","url":null,"abstract":"Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified-and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds for allocating resources, while procedural approaches may be indeterminate and insufficient to ensure a just distribution. In this paper, we set out a complementary, coherence-based approach to the evaluation of healthcare priority-setting. Drawing on Rawls, we argue that an institutional priority-setter's claim to moral justification can be assessed, in part, based on the extent to which its many normative commitments are mutually supportive and free from dissonance; that is, on the ability to establish narrow reflective equilibrium across the normative content of a priority-setter's policy and practice. While we do not suggest that the establishment of such equilibrium is sufficient for moral justification, we argue that failure to do so might-like the proverbial canary in the coalmine-act as a generalised warning that something is awry. We offer a theoretical argument in support of this view and briefly outline a practical method for systematically examining coherence across priority-setting policy and practice.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"835-840"},"PeriodicalIF":3.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905780","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

Artificial intelligence in medicine and the negative outcome penalty paradox. 医学中的人工智能与负结果惩罚悖论。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2023-109848

Jacob M Appel

引用次数: 0

Critical dialogue method of ethics consultation: making clinical ethics facilitation visible and accessible. 伦理咨询的批判性对话方法：让临床伦理促进工作变得可见和可及。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2024-109927

Clare Delany, Sharon Feldman, Barbara Kameniar, Lynn Gillam

{"title":"Critical dialogue method of ethics consultation: making clinical ethics facilitation visible and accessible.","authors":"Clare Delany, Sharon Feldman, Barbara Kameniar, Lynn Gillam","doi":"10.1136/jme-2024-109927","DOIUrl":"10.1136/jme-2024-109927","url":null,"abstract":"In clinical ethics consultations, clinical ethicists bring moral reasoning to bear on concrete and complex clinical ethical problems by undertaking ethical deliberation in collaboration with others. The reasoning process involves identifying and clarifying ethical values which are at stake or contested, and guiding clinicians, and sometimes patients and families, to think through ethically justifiable and available courses of action in clinical situations. There is, however, ongoing discussion about the various methods ethicists use to do this ethical deliberation work. In this paper, we make visible and accessible seven steps of facilitation used in the critical dialogue method of ethics consultation.We describe how the facilitation techniques serve two overall purposes. First, to identify ethically justified responses to ethical questions. Second, to assist participants to gain greater moral clarity, understanding and confidence to respond to ethical challenges as independent moral agents.By describing in detail facilitation steps for clinical ethics consultation, we aim to advance the scholarship of 'clinical ethics facilitation methods' and to demystify the ethical deliberation work undertaken by clinical ethicists.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"10-16"},"PeriodicalIF":3.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558957","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

Going high and low: on pluralism and neutrality in human embryology policy-making. 忽高忽低：人类胚胎学决策的多元化和中立性。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2022-108515

Hafez Ismaili M'hamdi, Nicolas C Rivron, Eva Ca Asscher

引用次数: 0

The Supreme Court's decision in McCulloch v Forth Valley Health Board: Does it condone healthcare injustice? 最高法院在McCulloch诉Forth Valley Health Board一案中的裁决：它是否宽恕了医疗不公正？

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2023-109510

Abeezar I Sarela

{"title":"The Supreme Court's decision in McCulloch v Forth Valley Health Board: Does it condone healthcare injustice?","authors":"Abeezar I Sarela","doi":"10.1136/jme-2023-109510","DOIUrl":"10.1136/jme-2023-109510","url":null,"abstract":"The UK Supreme Court's recent judgement in McCulloch v Forth Valley Health Board clarifies the standard for the identification of 'reasonable' alternative medical treatments. The required standard is that of a reasonable doctor: treatments that would be accepted as proper by a responsible body of medical opinion. Accordingly, the assessment of consent involves a two-stage test: first, a 'reasonable doctor' test for identifying alternative treatments; followed by a 'reasonable person in the patient's position' test for identifying the material risks of these reasonable alternative treatments. The separation of consent into two stages is consistent with not only a certain conception of freedom but also a nuanced construct of respect for autonomy that has a normative base. Furthermore, reliance on a reasonable doctor in the first stage is in keeping with a sociological account of medical professionalism, which posits that only doctors, and none others, can determine what is a proper treatment. Yet, reliance on a reasonable doctor permits a plurality of standards for reasonableness, because differences in opinion among doctors are pervasive. The reasons for some differences might be acceptable as unavoidable imperfections in medical decision-making to a reasonable person. But reasons for other differences might be objectionable; and the resultant inequalities in medical treatments would be considered unfair. One solution is to make the plurality of reasonable alternatives available to the patient, but this would introduce practical uncertainty and it is rejected by the Court. The Court's approach may be pragmatic; however, it seems to allow avoidable injustice in healthcare.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"806-810"},"PeriodicalIF":3.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49678421","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