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Journal of Medical Ethics最新文献

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Existential spectrum of suffering: concepts and moral valuations for assessing intensity and tolerability. 痛苦的存在光谱：评估强度和容忍度的概念和道德评价。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-20 DOI: 10.1136/jme-2023-109183
Charlotte Duffee
{"title":"Existential spectrum of suffering: concepts and moral valuations for assessing intensity and tolerability.","authors":"Charlotte Duffee","doi":"10.1136/jme-2023-109183","DOIUrl":"10.1136/jme-2023-109183","url":null,"abstract":"<p><p>This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"636-641"},"PeriodicalIF":3.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900160","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
Is framing of treatment options misleading? Maybe, but not because of a lower-bound reading. 制定治疗方案是否具有误导性？也许吧，但不是因为下限读数。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-20 DOI: 10.1136/jme-2024-110640
Pepijn Al
{"title":"Is framing of treatment options misleading? Maybe, but not because of a lower-bound reading.","authors":"Pepijn Al","doi":"10.1136/jme-2024-110640","DOIUrl":"10.1136/jme-2024-110640","url":null,"abstract":"<p><p>In a recent paper, Yeo argues that the framing of treatment options by physicians in the contexts of patient's decision-making conflicts with a physician's duty of disclosure. I argue that this conclusion is drawn too quickly, as it is questionable whether the empirical research on which Yeo relies is applicable to the framing of treatment options. This means that Yeo's main assumption is undermined, and we should hold off on concluding that the framing of treatment options is misleading.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":"651-652"},"PeriodicalIF":3.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885658","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
How 'non-invasive' is non-invasive prenatal testing? 非侵入性产前检查是如何定义的？
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-19 DOI: 10.1136/jme-2025-110930
Chanelle Warton
{"title":"How 'non-invasive' is non-invasive prenatal testing?","authors":"Chanelle Warton","doi":"10.1136/jme-2025-110930","DOIUrl":"10.1136/jme-2025-110930","url":null,"abstract":"<p><p>The invasiveness of a medical intervention is considered to be morally important and can have a significant influence on acceptability and uptake. De Marco <i>et al</i> propose a novel account of the invasiveness of medical interventions that better reflects the common understanding of the term. Using the example of non-invasive prenatal testing, I develop this account and argue that comparisons should only occur between medical interventions of clinically and morally significant differences.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882985","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
Chat-IRB? How application-specific language models can enhance research ethics review. Chat-IRB吗?应用特定语言模型如何加强研究伦理审查。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-19 DOI: 10.1136/jme-2025-110845
Sebastian Porsdam Mann, Jiehao Joel Seah, Stephen Latham, Julian Savulescu, Mateo Aboy, Brian D Earp
{"title":"Chat-IRB? How application-specific language models can enhance research ethics review.","authors":"Sebastian Porsdam Mann, Jiehao Joel Seah, Stephen Latham, Julian Savulescu, Mateo Aboy, Brian D Earp","doi":"10.1136/jme-2025-110845","DOIUrl":"10.1136/jme-2025-110845","url":null,"abstract":"<p><p>Institutional review boards (IRBs) play a crucial role in ensuring the ethical conduct of human subjects research, but face challenges including inconsistency, delays, and inefficiencies. We propose the development and implementation of application-specific large language models (LLMs) to facilitate IRB review processes. These IRB-specific LLMs would be fine-tuned on IRB-specific literature and institutional datasets, and equipped with retrieval capabilities to access up-to-date, context-relevant information. We outline potential applications, including pre-review screening, preliminary analysis, consistency checking, and decision support. While addressing concerns about accuracy, context sensitivity, and human oversight, we acknowledge remaining challenges such as over-reliance on artificial intelligence and the need for transparency. By enhancing the efficiency and quality of ethical review while maintaining human judgement in critical decisions, IRB-specific LLMs offer a promising tool to improve research oversight. We call for pilot studies to evaluate the feasibility and impact of this approach.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789364","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
Synthetic DNA and mitochondrial donation: no need for donor eggs? 合成DNA和线粒体捐赠：不需要捐赠卵子？
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-17 DOI: 10.1136/jme-2024-110122
Adrian Villalba, Iain Brassington, Anna Smajdor, Daniela Cutas
{"title":"Synthetic DNA and mitochondrial donation: no need for donor eggs?","authors":"Adrian Villalba, Iain Brassington, Anna Smajdor, Daniela Cutas","doi":"10.1136/jme-2024-110122","DOIUrl":"10.1136/jme-2024-110122","url":null,"abstract":"<p><p>Mitochondrial replacement therapy has been developed in order to prevent the transmission of mitochondrial mutations, yet it raises ethical concerns, particularly regarding the involvement of third-party DNA and the risks associated with donor procedures. This paper explores an alternative approach using synthetic DNA (synDNA) to construct mitochondrial organelles, thereby bypassing the need for donor oocytes and bypassing risks to donors. We argue that those who support mitochondrial replacement techniques as an ethically acceptable means of preventing the transmission of mitochondrial disease should consider the use of synthetic mitochondria as a preferable ethical alternative, should it prove technically viable. That this will be viable is more than we can demonstrate here. However, progress in synDNA technology suggests that it is not unreasonable to think that synthetic mitochondria creation is feasible, and perhaps even probable.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024086","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
Tui'en: a Confucian concept for physicians' duties, rationing decisions and public health campaigns. 推恩：儒家关于医生职责、配给决策和公共卫生运动的概念。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-14 DOI: 10.1136/jme-2025-111036
Luís Cordeiro-Rodrigues, Li Xiao, Muyuan Yan
{"title":"<i>Tui'en</i>: a Confucian concept for physicians' duties, rationing decisions and public health campaigns.","authors":"Luís Cordeiro-Rodrigues, Li Xiao, Muyuan Yan","doi":"10.1136/jme-2025-111036","DOIUrl":"https://doi.org/10.1136/jme-2025-111036","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855523","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
Manipulating embryogenesis and testing for potential: two real problems for the regulation of stem cell-based embryo models. 操纵胚胎发生和测试潜能：干细胞胚胎模型调控的两个现实问题。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-14 DOI: 10.1136/jme-2025-110885
Jonathan Lewis, Soren Holm
{"title":"Manipulating embryogenesis and testing for potential: two real problems for the regulation of stem cell-based embryo models.","authors":"Jonathan Lewis, Soren Holm","doi":"10.1136/jme-2025-110885","DOIUrl":"https://doi.org/10.1136/jme-2025-110885","url":null,"abstract":"<p><p>Stem cell-based human embryo models (SCBEMs), generated in vitro from stem cells, currently exist outside the scope of regulatory frameworks that govern in vitro embryo research in most jurisdictions. A widely discussed proposal suggests using a 'Turing test' framework, whereby regulatory oversight is triggered if an SCBEM is found to be 'equivalent' to a human embryo. In this paper, we argue that such a proposal faces two major complications. First, sophisticated laboratory techniques such as trophoblast replacement allow researchers to manipulate normal embryogenesis, obscuring whether a given SCBEM meets embryo-like regulatory thresholds. Second, attempts to assess SCBEMs' developmental potential-especially through non-human analogues-rest on tenuous epistemic assumptions that may not align with human-specific developmental trajectories. Given SCBEMs' potential manipulability and uncertain biological and potentiality benchmarks, we argue that reliance on equivalence-based frameworks alone is highly problematic. We conclude by urging a cautious, flexible approach that recognises both the scientific promise of SCBEMs and the normative need to prevent the circumvention of regulatory safeguards.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855525","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
What if all participants get the same treatment? An ethical perspective on single arm trials. 如果所有参与者都得到同样的待遇呢？单臂试验的伦理观点。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-11 DOI: 10.1136/jme-2024-110159
Chiara Mannelli, Giuseppe Traversa
{"title":"What if all participants get the same treatment? An ethical perspective on single arm trials.","authors":"Chiara Mannelli, Giuseppe Traversa","doi":"10.1136/jme-2024-110159","DOIUrl":"https://doi.org/10.1136/jme-2024-110159","url":null,"abstract":"<p><p>Randomised controlled trials have traditionally been considered the gold standard for evidence on the efficacy of new treatments. However, applications to marketing authorisation are increasingly based on data stemming from single arm trials (SATs), which do not randomise to a control arm and in which all patients receive the treatment under study. This has generated debate over the characteristics and methodological limitations of SATs and the appropriateness of SATs' data to inform marketing authorisations.This paper discusses SATs from an ethical perspective by exploring (1) The ethical concerns raised by SATs' methodological limitations; (2) SATs' risk-benefit assessment; and (3) How to address ethical concerns raised by SATs with a favourable risk-benefit ratio.Given the ethical quandaries associated with SATs' methodological limitations, this analysis will highlight the relevance of (1) An independent and design-specific review from both scientific and ethical perspectives, and (2) An adequate informed consent process for prospective participants.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821580","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
Correction: Prioritisation and non-sentientist harms: reconsidering xenotransplantation ethics. 更正：优先排序和非感性伤害：重新考虑异种移植伦理。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-11 DOI: 10.1136/jme-2024-110202corr1
{"title":"Correction: Prioritisation and non-sentientist harms: reconsidering xenotransplantation ethics.","authors":"","doi":"10.1136/jme-2024-110202corr1","DOIUrl":"https://doi.org/10.1136/jme-2024-110202corr1","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821579","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
Balancing public health and individual autonomy: a study of China's vaccination policy. 平衡公共卫生与个人自主权：中国疫苗接种政策研究。
IF 3.4 2区 哲学
Journal of Medical Ethics Pub Date : 2025-08-11 DOI: 10.1136/jme-2025-110762
Jichao Wang, Xiaomei Zhai
{"title":"Balancing public health and individual autonomy: a study of China's vaccination policy.","authors":"Jichao Wang, Xiaomei Zhai","doi":"10.1136/jme-2025-110762","DOIUrl":"https://doi.org/10.1136/jme-2025-110762","url":null,"abstract":"<p><p>The article examines China's vaccination policy, focusing particularly on childhood immunisation and pandemic vaccines. Although China's laws require individuals to engage in the vaccination decision-making process, the policy does not enforce mandatory vaccination through penalties. Instead, it emphasises informed decision-making, allowing and supporting individuals to choose whether to vaccinate or adopt other preventive measures based on their best health interests. The legal framework includes obligations for guardians to make vaccination decisions for their children, with mechanisms to encourage compliance through checking vaccination status and guiding guardians to vaccination services, rather than punishing vaccine refusal. This approach aligns with the Siracusa Principles, advocating the least restrictive measures necessary to protect public health. The article concludes that China's vaccination policy is best understood as 'mandatory decision-making', a system that balances public health objectives with individual autonomy by making the decision-making process mandatory while keeping the actual vaccination decision voluntary.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821578","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
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