Journal of Medical Ethics最新文献_第8页

Artificial intelligence, existential risk and equity: the need for multigenerational bioethics. 人工智能、生存风险与公平：对多代生物伦理的需求。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-23 DOI: 10.1136/jme-2024-110583

Kyle Fiore Law, Stylianos Syropoulos, Brian D Earp

引用次数: 0

Ethical considerations for referral partnerships in clinical research. 临床研究中转诊伙伴关系的伦理考虑。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-20 DOI: 10.1136/jme-2024-109867

Isabella Li, Aisha T Langford, Christine Grady, Annette Rid

{"title":"Ethical considerations for referral partnerships in clinical research.","authors":"Isabella Li, Aisha T Langford, Christine Grady, Annette Rid","doi":"10.1136/jme-2024-109867","DOIUrl":"https://doi.org/10.1136/jme-2024-109867","url":null,"abstract":"Recruitment challenges in clinical research are widespread, particularly for traditionally under-represented groups. Referral relationships-in which research partners and clinical partners agree to collaborate on selected research studies or programmes, with the expectation that the clinical partners refer appropriate patients as potential participants-may help alleviate these challenges. Referral relationships allow research partners access to expanded and more diverse pools of participants by increasing the engagement of medical providers, leveraging providers' connections with patients and providing structural support for study participation. Clinical partners can also benefit from the resources offered by research involvement, and patients may benefit from improved access to studies. Yet despite their potential, referral relationships can raise ethical concerns. Here, we discuss ethical considerations for referral relationships in clinical research to address these concerns. When establishing relationships, fair participant selection should guide the sites and studies involved. When defining the terms of a relationship, partners should build trust and respect, collaborating so that health centres or hospitals and communities benefit from their research involvement with the mitigation of associated burdens. When implemented, referral relationships should continue to honour fair participant selection, reduce misunderstanding or miscommunication about research and protect patients' privacy and confidentiality. Overall, when conducted ethically, referral relationships can help address study recruitment challenges and promote fair access to research opportunities.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965204","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

Scaffolding informed consent. 脚手架知情同意。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-20 DOI: 10.1136/jme-2024-110105

Dominic Wilkinson, Neil Levy

引用次数: 0

A heart for everyone? The need to include diverse populations in first-in-human trials. 每个人都有一颗心？在首次人体试验中纳入不同人群的必要性。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-20 DOI: 10.1136/jme-2024-110492

Lieke van Kempen, Martine C de Vries, Nienke de Graeff

引用次数: 0

Revisiting medical oaths: how student-driven ethical codes reflect changing values. 重新审视医学誓言：学生驱动的道德规范如何反映不断变化的价值观。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-18 DOI: 10.1136/jme-2024-110460

Michael Stein, Shaun Evan Gruenbaum, Alan Jotkowitz

{"title":"Revisiting medical oaths: how student-driven ethical codes reflect changing values.","authors":"Michael Stein, Shaun Evan Gruenbaum, Alan Jotkowitz","doi":"10.1136/jme-2024-110460","DOIUrl":"https://doi.org/10.1136/jme-2024-110460","url":null,"abstract":"Background: Medical oaths and ethical codes play a crucial role in guiding physicians through their professional responsibilities. This study extends prior research on ethical codes created by students at the Medical School for International Health (MSIH) by analysing codes from the years 2007 to 2022.Objective: The objective of this study is to evaluate changes in the ethical principles emphasised by MSIH students over time and to compare these with previous cohorts.Methods: Ethical codes from MSIH classes (2007-2022) were analysed using the framework developed by Baker. This framework categorises oaths into four sections: preamble, covenant, code of duties to patients and peroration. The focus was primarily on the code of duties to patients. Quantitative analysis was used to assess the prevalence of specific ethical principles.Results: The study found an increased emphasis on principles such as 'respect for patients' and 'cultural competence/sensitivity', while traditional values like 'benevolence' and 'honesty' were mentioned less frequently. New themes, including 'patient autonomy' and 'cultural competence', emerged, reflecting a shift towards patient-centred care and justice, though emerging issues like artificial intelligence ethics were not addressed.Conclusions: MSIH students' ethical codes have evolved to emphasise patient respect and cultural competence. The findings suggest a maturation in the ethical perspectives of medical students, though gaps remain in addressing contemporary challenges. Future studies should explore how ethical codes can incorporate emerging issues in healthcare.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854052","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

When understanding fails: how diverging norms in medicine and research led to informed consent failures during the pandemic. 当理解失败时：大流行期间医学和研究规范的分歧如何导致知情同意失败。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-18 DOI: 10.1136/jme-2024-110440

Daniel Pinto

{"title":"When understanding fails: how diverging norms in medicine and research led to informed consent failures during the pandemic.","authors":"Daniel Pinto","doi":"10.1136/jme-2024-110440","DOIUrl":"https://doi.org/10.1136/jme-2024-110440","url":null,"abstract":"During the COVID-19 pandemic, there were many vaccine trials which had significant purposes which participants needed to understand to validly consent. For example, participants needed to understand that the purpose of dose-escalation vaccine trials was to give incremental doses of a vaccine until participants became ill. Likewise, participants needed to understand that even if they received placebos, they could not take a genuine vaccine to preserve the integrity of the trials. Yet, these intuitive judgements about what participants need to understand to validly consent are rejected by recent accounts of consent. According to these accounts, as long as participants were given a good opportunity to learn these purposes, they do not need to actually understand them to consent. In this paper, I reject this consensus, and I argue that participants who failed to understand these aims associated with vaccine trials failed to provide legitimate consent. I defend this claim by developing and defending a new understanding condition for valid consent. According to this understanding condition, a participant must understand when a consent transaction has features which violate the norms which govern the medical practice with which they are acquainted. I argue that this condition is independently plausible and best explains why participants needed to understand these aims associated with vaccine trials to validly consent.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854055","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 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-18 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":"https://doi.org/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":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","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 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-16 DOI: 10.1136/jme-2024-110145

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

引用次数: 0

Assessing the impact of information on patient attitudes toward artificial intelligence-based clinical decision support (AI/CDS): a pilot web-based SMART vignette study. 评估信息对患者对基于人工智能的临床决策支持（AI/CDS）态度的影响：一项基于网络的试点SMART小故事研究。

IF 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-12 DOI: 10.1136/jme-2024-110080

Bohye Kim, Katie Ryan, Jane Paik Kim

{"title":"Assessing the impact of information on patient attitudes toward artificial intelligence-based clinical decision support (AI/CDS): a pilot web-based SMART vignette study.","authors":"Bohye Kim, Katie Ryan, Jane Paik Kim","doi":"10.1136/jme-2024-110080","DOIUrl":"10.1136/jme-2024-110080","url":null,"abstract":"Background: It is increasingly recognised that the success of artificial intelligence-based clinical decision support (AI/CDS) tools will depend on physician and patient trust, but factors impacting patients' views on clinical care reliant on AI have been less explored.Objective: This pilot study explores whether, and in what contexts, detail of explanation provided about AI/CDS tools impacts patients' attitudes toward the tools and their clinical care.Methods: We designed a Sequential Multiple Assignment Randomized Trial vignette web-based survey. Participants recruited through Amazon Mechanical Turk were presented with hypothetical vignettes describing health concerns and were sequentially randomised along three factors: (1) the level of detail of explanation regarding an AI/CDS tool; (2) the AI/CDS result; and (3) the physician's level of agreement with the AI/CDS result. We compared mean ratings of comfort and confidence by the level of detail of explanation using t-tests. Regression models were fit to confirm conditional effects of detail of explanation.Results: The detail of explanation provided regarding the AI/CDS tools was positively related to respondents' comfort and confidence in the usage of the tools and their perception of the physician's final decision. The effects of detail of explanation on their perception of the physician's final decision were different given the AI/CDS result and the physician's agreement or disagreement with the result.Conclusions: More information provided by physicians regarding the use of AI/CDS tools may improve patient attitudes toward healthcare involving AI/CDS tools in general and in certain contexts of the AI/CDS result and physician agreement.","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818347","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

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 3.3 2区哲学

Journal of Medical Ethics Pub Date : 2024-12-06 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":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","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