Journal of Medical Ethics最新文献_第8页

The revised International Code of Medical Ethics: an exercise in international professional ethical self-regulation. 修订后的《国际医学伦理守则》：国际专业伦理自律的实践。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-20 DOI: 10.1136/jme-2023-109027

Ramin W Parsa-Parsi, Raanan Gillon, Urban Wiesing

引用次数: 0

Addressing bias in artificial intelligence for public health surveillance. 解决公共卫生监测人工智能中的偏见问题。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-20 DOI: 10.1136/jme-2022-108875

Lidia Flores, Seungjun Kim, Sean D Young

{"title":"Addressing bias in artificial intelligence for public health surveillance.","authors":"Lidia Flores, Seungjun Kim, Sean D Young","doi":"10.1136/jme-2022-108875","DOIUrl":"10.1136/jme-2022-108875","url":null,"abstract":"Components of artificial intelligence (AI) for analysing social big data, such as natural language processing (NLP) algorithms, have improved the timeliness and robustness of health data. NLP techniques have been implemented to analyse large volumes of text from social media platforms to gain insights on disease symptoms, understand barriers to care and predict disease outbreaks. However, AI-based decisions may contain biases that could misrepresent populations, skew results or lead to errors. Bias, within the scope of this paper, is described as the difference between the predictive values and true values within the modelling of an algorithm. Bias within algorithms may lead to inaccurate healthcare outcomes and exacerbate health disparities when results derived from these biased algorithms are applied to health interventions. Researchers who implement these algorithms must consider when and how bias may arise. This paper explores algorithmic biases as a result of data collection, labelling and modelling of NLP algorithms. Researchers have a role in ensuring that efforts towards combating bias are enforced, especially when drawing health conclusions derived from social media posts that are linguistically diverse. Through the implementation of open collaboration, auditing processes and the development of guidelines, researchers may be able to reduce bias and improve NLP algorithms that improve health surveillance.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"190-194"},"PeriodicalIF":4.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9399010","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

Abortion restrictions: the case for conscientious non-compliance on the part of providers. 堕胎限制：服务提供者出于良心不遵守规定的理由。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-20 DOI: 10.1136/jme-2023-108964

Pierce Randall, Jacob Mago

引用次数: 0

Gillick competence: an inadequate guide to the ethics of involving adolescents in decision-making. 吉利克能力：让青少年参与决策的伦理指导不足。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-20 DOI: 10.1136/jme-2023-108930

Avraham Bart, Georgina Antonia Hall, Lynn Gillam

{"title":"Gillick competence: an inadequate guide to the ethics of involving adolescents in decision-making.","authors":"Avraham Bart, Georgina Antonia Hall, Lynn Gillam","doi":"10.1136/jme-2023-108930","DOIUrl":"10.1136/jme-2023-108930","url":null,"abstract":"Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive. In this paper, we argue that its utility is far more limited, and hence over-reliance on Gillick risks undermining rather than promoting ethically appropriate adolescent involvement. We demonstrate that Gillick only provides guidance in the limited range of cases where legal decisional authority needs to be clarified. The range of cases where use of Gillick actually promotes adolescent involvement is narrower still, because several features must be present for Gillick to be enacted. Each of these features can, and do, act as barriers to adolescent involvement. Within these limited situations, we argue that Gillick is not specific or strong enough and is reliant on ethically contestable principles. Moreover, in most situations in adolescent healthcare, Gillick is silent on the ethical questions around involving adolescents. This is because it focuses on decisional authority-having the final say in decision-making-which is one small subset of the many ways adolescents could be involved in decision-making. The implication of our analysis is that use of Gillick competence tends to limit or undermine adolescent involvement opportunities. We propose that those working with adolescents should be judicious in seeking Gillick's guidance, instead drawing on and developing alternative frameworks that provide a comprehensive model for adolescent involvement.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"157-162"},"PeriodicalIF":4.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9448355","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

Justification of principles for healthcare priority setting: the relevance and roles of empirical studies exploring public values. 医疗保健优先事项制定原则的合理性：探索公共价值的实证研究的相关性和作用。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-08 DOI: 10.1136/jme-2022-108702

Erik Gustavsson, Lars Lindblom

引用次数: 0

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-08 DOI: 10.1136/jme-2022-108812

Mike McNamee, Lynley C Anderson, Pascal Borry, Silvia Camporesi, Wayne Derman, Soren Holm, Taryn Rebecca Knox, Bert Leuridan, Sigmund Loland, Francisco Javier Lopez Frias, Ludovica Lorusso, Dominic Malcolm, David McArdle, Brad Partridge, Thomas Schramme, Mike Weed

{"title":"Sport-related concussion research agenda beyond medical science: culture, ethics, science, policy.","authors":"Mike McNamee, Lynley C Anderson, Pascal Borry, Silvia Camporesi, Wayne Derman, Soren Holm, Taryn Rebecca Knox, Bert Leuridan, Sigmund Loland, Francisco Javier Lopez Frias, Ludovica Lorusso, Dominic Malcolm, David McArdle, Brad Partridge, Thomas Schramme, Mike Weed","doi":"10.1136/jme-2022-108812","DOIUrl":"10.1136/jme-2022-108812","url":null,"abstract":"The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10824394","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

Restraint in somatic healthcare: how should it be regulated? 身体保健中的约束：应该如何监管？

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-02-08 DOI: 10.1136/jme-2023-109240

Amina Guenna Holmgren, Ann-Christin von Vogelsang, Anna Lindblad, Niklas Juth

引用次数: 0

Consent-GPT: is it ethical to delegate procedural consent to conversational AI? 同意GPT：将程序同意委托给对话人工智能是否合乎道德？

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-01-23 DOI: 10.1136/jme-2023-109347

Jemima Winifred Allen, Brian D Earp, Julian Koplin, Dominic Wilkinson

{"title":"Consent-GPT: is it ethical to delegate procedural consent to conversational AI?","authors":"Jemima Winifred Allen, Brian D Earp, Julian Koplin, Dominic Wilkinson","doi":"10.1136/jme-2023-109347","DOIUrl":"10.1136/jme-2023-109347","url":null,"abstract":"Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients' access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"77-83"},"PeriodicalIF":4.1,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10850653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66783976","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

University-age vaccine mandates: reply to Lam and Nichols. 大学适龄儿童疫苗接种规定：答复 Lam 和 Nichols。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-01-23 DOI: 10.1136/jme-2023-109163

Tracy Beth Høeg, Allison Krug, Stefan Baral, Euzebiusz Jamrozik, Salmaan Keshavjee, Trudo Lemmens, Vinay Prasad, Martin A Makary, Kevin Bardosh

引用次数: 0

COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities. 青壮年 COVID-19 疫苗强化剂：大学授权政策的风险效益评估和伦理分析。

IF 4.1 2区哲学

Journal of Medical Ethics Pub Date : 2024-01-23 DOI: 10.1136/jme-2022-108449

Kevin Bardosh, Allison Krug, Euzebiusz Jamrozik, Trudo Lemmens, Salmaan Keshavjee, Vinay Prasad, Marty A Makary, Stefan Baral, Tracy Beth Høeg

{"title":"COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities.","authors":"Kevin Bardosh, Allison Krug, Euzebiusz Jamrozik, Trudo Lemmens, Salmaan Keshavjee, Vinay Prasad, Marty A Makary, Stefan Baral, Tracy Beth Høeg","doi":"10.1136/jme-2022-108449","DOIUrl":"10.1136/jme-2022-108449","url":null,"abstract":"In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207-42 836 young adults aged 18-29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least 18.5 serious adverse events from mRNA vaccines, including 1.5-4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430-4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"126-138"},"PeriodicalIF":4.1,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10850707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472563","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