Canadian Journal of Bioethics最新文献

{"title":"Conceptualizing Ethical Issues of Humanitarian Work: Results From a Critical Literature Review","authors":"L. Côté, M. Drolet","doi":"10.7202/1077631AR","DOIUrl":"https://doi.org/10.7202/1077631AR","url":null,"abstract":"This article presents results of a critical review of the literature discussing the ethical issues arising in humanitarian work, following the method proposed by McCullough, Coverdale and Chervenak. Our aim was primarily to focus on how the ethical issues arising in humanitarian work are conceptualized within the literature we reviewed. We think that properly conceptualizing the ethical issues which humanitarian workers may face can provide avenues to better respond to them. We analysed 61 documents, as part of a literature review, which revealed that there truly is a need, amongst the authors and in Résumé Abstract Cet article présente les résultats d’une revue critique de la littérature traitant des questions éthiques soulevées par le travail humanitaire, suivant la méthode proposée par McCullough, Coverdale et Chervenak. Notre objectif était principalement de nous concentrer sur la façon dont les questions éthiques soulevées par le travail humanitaire sont conceptualisées dans la littérature que nous avons examinée. Nous pensons qu’une conceptualisation correcte des problèmes éthiques auxquels les travailleurs humanitaires peuvent être confrontés peut fournir des pistes pour mieux y répondre. Nous avons analysé 61 documents, dans le cadre de la revue de la littérature, qui révèlent qu’il existe réellement un besoin, chez les auteurs et dans le travail humanitaire, de discuter de l’éthique. En effet, même si seul un petit nombre d’auteurs définit explicitement les mots qu’ils utilisent pour parler d’éthique, la grande quantité de mots que nous avons découverts dans les documents semble suggérer des terrains vastes et riches sur lesquels aborder les questions éthiques. Nous pensons qu’il est bon que les questions éthiques du travail humanitaire soient de plus en plus abordées dans la littérature et qu’il serait pertinent que le vocabulaire utilisé par les auteurs soit employé et développé de manière encore plus rigoureuse, afin que leurs discussions soient plus précises, cohérentes, pertinentes, exhaustives et suffisantes. La revue de la littérature, ainsi que l’analyse qui en découle dans cet article, s’inscrit dans un projet plus large visant à proposer une manière de conceptualiser les enjeux éthiques du travail humanitaire en se basant sur les forces et les innovations de cette étude et d’autres. This article presents results of a critical review of the literature discussing the ethical issues arising in humanitarian work, following the method proposed by McCullough, Coverdale and Chervenak. Our aim was primarily to focus on how the ethical issues arising in humanitarian work are conceptualized within the literature we reviewed. We think that properly conceptualizing the ethical issues which humanitarian workers may face can provide avenues to better respond to them. We analysed 61 documents, as part of a literature review, which revealed that there truly is a need, amongst the authors and in humanitarian work, to discuss ethics. Indeed, eve","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71205762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La stérilisation forcée de population autochtone dans le Mexique des années 1990","authors":"P. Gaussens","doi":"10.7202/1073797ar","DOIUrl":"https://doi.org/10.7202/1073797ar","url":null,"abstract":"Cet article cherche a explorer la question de la sterilisation forcee de population autochtone comme probleme bioethique d’un point de vue interdisciplinaire, a partir de la sociologie historique et en dialogue avec l’anthropologie medicale, les etudes de genre et les droits humains. Sa methodologie est basee sur l’etude d’un cas empirique, en lien avec un travail de terrain realise dans une municipalite du sud du Mexique, dans l’etat de Guerrero. Elle est complementee par une recherche documentaire qui a permis, entre autres, la construction d’un cas theorique a partir des evenements survenus au Perou, a la meme epoque que le cas mexicain, dans les annees 1990. Le principal resultat de ce travail de recherche historique est que la sterilisation forcee, bien que largement due a une politique de controle demographique ainsi qu’a certaines pratiques de planification familiale, est egalement liee, dans le cas particulier de la population autochtone, a des processus contre-insurrectionnels deployes face a l’activite de guerillas, caracteristique de ces annees-la en Amerique Latine.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43553762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Partial Defense of the Non-Commercialization of Surrogacy","authors":"Katy Fulfer","doi":"10.7202/1073783ar","DOIUrl":"https://doi.org/10.7202/1073783ar","url":null,"abstract":"Canada’s Assisted Human Reproduction Act justifies its non-commercialization approach to surrogacy on the grounds that commercial payments for surrogacy commodify women and are exploitative. However, empirical evidence suggests that payments in surrogacy are not exploitative, at least not to an extent that would warrant criminalizing payments. Given skepticism about the connection between exploitation and commodification, I explore whether commodification critiques can ground an alternative justification for the non-commercialization of surrogacy. First, I examine Vida Panitch’s argument that commodification critiques are flawed for being absolutist, that is, they cannot identify what makes some surrogacy transactions better or worse than others. Second, I examine Anne Phillips’ rearticulation of a commodification critique: Commercial surrogacy is problematic because it undermines equality in a democratic society. I argue that Phillips’ revision can escape absolutism and provide a better justification for Canada’s non-commercialization stance. However, it also entails that the preference for criminalizing payments is weakened, as other policy solutions might be effectively implemented to protect equality. As a result, I propose a shift in how commodification is appealed to: Less attention should be paid to abstract values and more attention should be given to how those values are enacted relationally between members of a political community. I also tentatively suggest that commodification critiques might provide a normative basis in Canadian policy for a self-sufficiency regulatory framework, which centres on values such as solidarity and the public good.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47119978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigational Therapies and Patients’ Autonomy","authors":"Trisevgeni Papakonstantinou, T. Kolettis","doi":"10.7202/1073786ar","DOIUrl":"https://doi.org/10.7202/1073786ar","url":null,"abstract":"The growing demand for novel therapies has raised new ethical dilemmas for society. Vigorous debates have been initiated, especially after the recent Right to Try Act in the US, which aims to facilitate access to new agents, even at an early stage of the investigation process. This article explores the concept of patient’s autonomy in accessing investigational treatments, and discusses the implications of autonomy for patients, researchers and regulatory authorities. We propose that, in cases of adequate understanding of the anticipated risks and benefits, society should accept patients’ autonomy in choosing to try new therapies, even in the absence of firm data. However, basic ethical principles should not be compromised, as the medical community and society as a whole retain the right to properly evaluate the accumulated experience from such cases. These thoughts may contribute to the ongoing discussions on ethical policies in clinical research.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44658932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Serological Tests and Immunity Policies: Addressing Ethical Implications for Healthcare Providers and the Healthcare System as a Priority","authors":"Marie-Alexia Masella, Hortense Gallois, J. Bélisle-Pipon","doi":"10.7202/1073796ar","DOIUrl":"https://doi.org/10.7202/1073796ar","url":null,"abstract":"Healthcare providers (HCP) have been central actors in containing the COVID-19 pandemic Although potentially very beneficial, the implementation of large-scale rapid serological tests raises ethical dilemmas and affects HCPs' capacity to work in optimal conditions In this regard, we call for attention to address specific and urgent ethical issues distinctively affecting HCPs following the availability and possible mandatory use of rapid serological tests for COVID-19 © 2020 University of Montreal All rights reserved","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Meaning and Importance of Genetic Relatedness: Fertility Preservation Decision Making Among Israeli Adolescent Cancer Survivors and Their Parents","authors":"Dorit Barlevy, B. Elger, T. Wangmo, S. Ash, V. Ravitsky","doi":"10.7202/1073782ar","DOIUrl":"https://doi.org/10.7202/1073782ar","url":null,"abstract":"Background: With multiple options available today to become a parent, how does the matter of genetic relatedness factor into adolescent cancer patients’ fertility preservation (FP) decision making? This study reports on and normatively analyzes this aspect of FP decision making. Methods: A convenience sample of Israeli adolescent cancer survivors and their parents were invited to participate in individual, semi-structured interviews. Results: In discussing the importance of genetic relatedness to future children or grandchildren, participants repeatedly brought up the interrelated issues of nature, normalcy, and personal identity. Regardless of preference or ambivalence for genetic relatedness, the majority of participants were aware of alternative parenting options and noted both their advantages and disadvantages. However, knowledge of alternative parenting options was not uniform. Conclusions: To ensure that adolescent patients and their parents make informed FP decisions that meet their personal goals and values, it is important for physicians to discuss alternative parenting options with them in a culturally sensitive manner. Greater credence also should be given to those who question the importance of genetic relatedness.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42460392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Research Authorships: Ethics and Problem-Solving","authors":"Atif Katib","doi":"10.7202/1073787ar","DOIUrl":"https://doi.org/10.7202/1073787ar","url":null,"abstract":"The article helps resolve the intricate authorship issue based on global organizations’ regulations. It draws a fine line between authorship and contributorship from the research ethics perspective.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42716737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soins de santé gratuits pour les uns, payants pour les autres : perceptions et stratégies d’adaptation dans le district de Boulsa (Burkina Faso)","authors":"A. Bila, Frank Bicaba, C. Tiendrebeogo, A. Bicaba, Thomas Druetz","doi":"10.7202/1073784ar","DOIUrl":"https://doi.org/10.7202/1073784ar","url":null,"abstract":"Contexte : Les preuves des bienfaits des politiques de gratuite des soins sont reunies, mais les enjeux ethiques que ces politiques soulevent dans les pays a faibles revenus ont ete peu examines. Au Burkina Faso, la gratuite a ete introduite en juillet 2016 pour les enfants de moins de 5 ans et les femmes enceintes, en ce qui concerne les soins en sante reproductive. Il a ete rapporte que les criteres d’eligibilite sont parfois difficiles a interpreter ou a mettre en application. L’objectif de cette etude est double : 1) comprendre les perceptions et les pratiques du personnel de sante et des beneficiaires a l’egard du respect des criteres d’eligibilite a la gratuite et 2) explorer les tensions ethiques qui en ont decoule et les eventuels modes de resolution. Methodologie : En 2018, une etude qualitative transversale a ete menee dans cinq communautes rurales de Boulsa, au Burkina Faso, Des entrevues individuelles semi-dirigees ont ete realisees aupres du personnel soignant (n=10) et de meres de jeunes enfants (n=10), qui ont ete selectionnees avec l’aide d’agents de sante a base communautaire. Les enregistrements audios ont ete traduits et retranscrits. Une analyse thematique de contenu a ete realisee sur l’ensemble du materiel. Les themes qui sont ressortis de l’analyse thematique ont ete identifies par les membres de l’equipe, qui en ont discute et les ont reformules. Resultats : L’etude suggere que les criteres d’eligibilite a la gratuite ne sont pas toujours bien connus des beneficiaires, ce qui peut entrainer des debordements involontaires. Elle revele aussi l’adoption de pratiques pour contourner le respect strict des criteres d’eligibilite a la gratuite, notamment pour en faire beneficier les enfants de 5 ans et plus. Ces debordements deliberes resultent de tensions ethiques vecues par les beneficiaires, et en soulevent d’autres chez le personnel soignant. Des mecanismes sont mis en oeuvre officieusement pour reconcilier les dissonances ressenties par les prestataires. Conclusion : La mise en oeuvre de la politique de gratuite au Burkina Faso s’opere grâce a des mecanismes de reinvention locale pour surmonter les tensions ethiques liees au respect des criteres d’eligibilite.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47778006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Habiliter l’ergothérapeute-chercheur à résoudre les enjeux éthiques de la recherche","authors":"Marie-Josée Drolet, Karoline Girard","doi":"10.7202/1073780ar","DOIUrl":"https://doi.org/10.7202/1073780ar","url":null,"abstract":"La recherche est une occupation propice a l’emergence d’enjeux ethiques, en outre parce qu’elle est liee a des conflits d’interets parfois difficiles a gerer et se realise dans un contexte hautement competitif qui valorise la performance. Alors que les enjeux ethiques de la pratique clinique de l’ergotherapie commencent a etre documentes, les enjeux ethiques vecus par les chercheurs en ergotherapie et les moyens qu’ils utilisent pour gerer ces enjeux ne sont quasiment pas documentes. Cet article presente les resultats d’une etude qualitative qui a documente les moyens (macro, meso et micro) qui sont proposes par des ergotherapeutes-chercheurs pour resoudre les enjeux ethiques de la recherche. Onze ergotherapeutes (n=11) ont participe a la recherche et partagent les moyens qu’ils utilisent ou envisagent pour gerer les enjeux ethiques de la recherche qu’ils vivent comme chercheur. Les moyens proposes par les ergotherapeutes rejoignent plusieurs moyens suggeres dans les ecrits, quoique certains moyens proposes dans les ecrits relatifs a la relation a etablir avec les participants de recherche soient peu abordes par les participants, ce qui est surprenant compte tenu des valeurs humanistes au fondement de la profession d’ergotherapeute. Au final, cet article qui presente une synthese a la fois des moyens repertories dans des ecrits pour resoudre les enjeux ethiques de la recherche et ceux discutes par les participants vise a habiliter l’ergotherapeute-chercheur a resoudre les enjeux que pose la recherche academique tout en restant fidele aux valeurs de la profession.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48080972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioethical Principles in Home-Based Virtual Care","authors":"N. Bendahan, Sophy Chan, R. Appireddy","doi":"10.7202/1073788ar","DOIUrl":"https://doi.org/10.7202/1073788ar","url":null,"abstract":"Virtual care (VC), a novel method of healthcare delivery, allows patients to stay home or at their preferred location and use personal internet-enabled devices to video-conference with their healthcare provider. VC is becoming ubiquitous across the US and Canada, particularly in response to COVID-19. In this paper, we discuss the benefits and limitations of VC and explore how it may align with or detract from the four principles of bioethics through case studies. Overall, we argue that it allows for greater accessibility, availability, and affordability of healthcare. However, certain clinical scenarios may not be suitable for VC, particularly when a thorough physical examination is required. While it may not always be clear when to use digital health technologies, it is prudent to have an honest and open conversation with the patient when offering this option.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43438825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}