Journal of Clinical Ethics最新文献

The Latest Data on Medical Aid in Dying in the United States and What It Tells Us. 美国死亡医疗救助的最新数据及其告诉我们的信息。

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740417

Karen S Greenberg, Madeline B Teisberg, Pablo Romano, Edmund G Howe, Michelle Hume, Theodore Fallon, Philip Candilis, Robert Nesheim, Jon A Van Loon, Karen G Gennaro

{"title":"The Latest Data on Medical Aid in Dying in the United States and What It Tells Us.","authors":"Karen S Greenberg, Madeline B Teisberg, Pablo Romano, Edmund G Howe, Michelle Hume, Theodore Fallon, Philip Candilis, Robert Nesheim, Jon A Van Loon, Karen G Gennaro","doi":"10.1086/740417","DOIUrl":"10.1086/740417","url":null,"abstract":"AbstractMedical aid in dying (MAID) is legal in 11 U.S. states and the District of Columbia, with 16 other states engaged in proposed legislation. Americans now have a meaningful opportunity to alter the quality of their final days. Fears that disadvantaged patients would be coerced into using MAID have been at the forefront of the legalization debate for decades. A total of 28 years have elapsed since Oregon first implemented its legal use in 1998. The most accurate narrative around the controversial practice emerges from examining the recent data from nine reporting states where MAID is legal. The details about patients who have used it shed light on the conversation; they include ethnicity, age, sex, level of education, socioeconomic status, hospice enrollment, diagnosis, rationale for choosing MAID, knowledge about it, interest in it, and rate of use. The numbers illustrate a story of access inequity and barriers to end-of-life care that mirror the inequities across U.S. healthcare. This article reviews the main arguments for and against MAID, presents reported data on MAID recipients, and discusses the implications. The debate continues unabated. The current data and ideas presented here aim to inform ethicists, healthcare professionals, and lawmakers, who together have an opportunity to reshape the narrative around end-of-life care in the United States.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"37 2","pages":"101-114"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934411","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}

引用次数: 0

A Primer on Epistemic Injustice and Patients with Non-English Language Preference. 认知不公与非英语语言偏好患者初探。

Journal of Clinical Ethics Pub Date : 2026-01-01 DOI: 10.1086/739005

Samantha A Chipman, Karen M Meagher, Ryan Marshall Felder, Amelia Barwise

{"title":"A Primer on Epistemic Injustice and Patients with Non-English Language Preference.","authors":"Samantha A Chipman, Karen M Meagher, Ryan Marshall Felder, Amelia Barwise","doi":"10.1086/739005","DOIUrl":"10.1086/739005","url":null,"abstract":"AbstractEpistemic injustice is a concept capturing the way people are treated as knowers. In healthcare, epistemic injustice involves evaluation of a series of underlying knowledge-based conditions at the core of patient interactions. This article describes a case study demonstrating different forms of epistemic injustice as it manifests for Hispanic and Spanish-speaking people in healthcare settings characterized by English language dominance. The analysis provided here differentiates epistemic injustice in terms of hermeneutical injustice, testimonial injustice (including testimonial smothering), epistemic oppression, and epistemic colonialism. This discussion is tailored to provide a resource for bioethicists and clinical teams at the bedside and to advance an increased voice for patients and families in U.S. healthcare. While potential avenues for pursuing and assuring epistemic justice in healthcare systems are beyond the scope of this examination, we focus on using epistemic injustice to name oppression and opportunities for resistance in the current healthcare environment. An overview of how patients can be treated unfairly as knowers is also situated within a broader national discourse about other forms of injustice and is imperative to redress U.S. health disparities.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"37 1","pages":"63-74"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207988","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}

引用次数: 0

How Should Pregnancy-Related Morbidity and Mortality in Abortion-Restricted States Be Documented, Collected, and Reported After Dobbs? 在多布斯之后，在限制堕胎的州，如何记录、收集和报告与妊娠相关的发病率和死亡率？

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740418

Luis A Arellano, Lorie M Harper

引用次数: 0

Clinical Ethics and Risk of Malpractice Liability. 临床伦理与医疗事故责任风险。

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740414

Sergio Huerta, Michael Makhinson

引用次数: 0

Which Harms to Patients Affect Family-Building Decision-Making in States in Which Legislatures Ban or Restrict Abortion Care? 在立法机构禁止或限制堕胎护理的州，哪些伤害会影响患者的家庭建设决策？

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740413

Alena Hoover, Carrie Cwiak

引用次数: 0

Case-Based Ethics Education for Medical Students: Discussing Reproductive Health Ethics in a Changing Landscape. 基于案例的医学生伦理教育：在变化的环境中探讨生殖健康伦理。

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740423

Emma M Smith, Wendy K Leung, Madeleine Schachter, Janice T John, Danielle M Fernandes

{"title":"Case-Based Ethics Education for Medical Students: Discussing Reproductive Health Ethics in a Changing Landscape.","authors":"Emma M Smith, Wendy K Leung, Madeleine Schachter, Janice T John, Danielle M Fernandes","doi":"10.1086/740423","DOIUrl":"10.1086/740423","url":null,"abstract":"AbstractBackground: Discussing reproductive health ethics in education settings can be challenging given personal views that students and educators may have related to reproductive healthcare, specifically regarding abortion access. Although this can be sensitive to discuss, it is important to engage with these topics in medical education so that students are prepared to take care of pregnant patients, especially given changes in the reproductive healthcare landscape since Roe v. Wade was overturned in 2022. Currently, however, there are limited curricula available focused on teaching reproductive health ethics in this environment.Methods: We designed an active-learning small-group session for medical students as part of their bioethics pre-clerkship curriculum. Students participated in a session to review important ethical dilemmas in the context of authentic cases related to caring for pregnant patients facilitated by interdisciplinary faculty. Following the session, students evaluated the session using a retrospective pre-post survey to collect quantitative and qualitative data.Results: 178 students participated in the curriculum, and 128 completed the survey. Students demonstrated a stronger understanding of the ethical dilemmas related to providing reproductive healthcare following this session (p < .0001). They also described the session as engaging and relevant. Thematic analysis of narrative responses showed that students appreciated the opportunity to better understand a physician's responsibility in these challenging situations.Conclusions: Students valued this novel curriculum and recommended that it be repeated in future years. They also appreciated having a discussion space to consider the ethical dilemmas that clinicians may face in practice related to reproductive health.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"37 2","pages":"172-179"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934463","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}

引用次数: 0

The Gray Zone Between Quality Improvement and Human Subject Research. 质量改进与人体实验研究之间的灰色地带。

Journal of Clinical Ethics Pub Date : 2026-01-01 DOI: 10.1086/739010

Baddr Shakhsheer, Michael O'Connor, Bita Makarachi, Peter Angelos

引用次数: 0

When Pigs Fly into Medicine: Navigating Ethical Challenges Posed by Animal-Derived Medical Products. 当猪飞进医学：导航动物源性医疗产品带来的伦理挑战。

Journal of Clinical Ethics Pub Date : 2026-01-01 DOI: 10.1086/739014

Chelsey Patten, Gianna Morales

{"title":"When Pigs Fly into Medicine: Navigating Ethical Challenges Posed by Animal-Derived Medical Products.","authors":"Chelsey Patten, Gianna Morales","doi":"10.1086/739014","DOIUrl":"10.1086/739014","url":null,"abstract":"AbstractThis article explores the ethical, religious, and process complexities surrounding the use of animal-derived products in medicine, using the case of a 19-year-old Muslim patient with homozygous familial hypercholesterolemia, receiving lifesaving LDL apheresis with porcine-derived heparin. Despite the critical role of LDL apheresis to manage her high cholesterol levels over the past year, the charge nurse has recently raised concerns owing to the porcine origin of the anticoagulant used in her treatment, recognizing that this may conflict with her religious beliefs. This case raises critical questions about the disclosure of ethically sensitive information during the consent process. Should providers disclose the origin of such products, even when they are essential and no alternatives exist? Balancing respect for patient autonomy with concerns about moral distress and potential treatment refusal highlights the challenges in culturally informed care. The article examines the broader implications of these dilemmas, emphasizing the necessity of cultural humility in healthcare. While Islamic bioethics and other faith traditions may permit the use of prohibited substances in lifesaving situations, interpretations vary widely. Providers must engage patients in open, respectful dialogues to understand their individual values, avoiding harmful generalizations.","PeriodicalId":39646,"journal":{"name":"Journal of Clinical Ethics","volume":"37 1","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208037","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}

引用次数: 0

How Should Researchers Study Abortion Care Later in Pregnancy After Dobbs? 研究人员应该如何研究多布斯后妊娠后期的流产护理？

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-13 DOI: 10.1086/740419

Julia Tasset, Shaalini Ramanadhan, Blair Darney

引用次数: 0

Even Resourceful Parents Lack Access to Ethics-Informed Resources. 即使是足智多谋的父母也无法获得伦理知识资源。

Journal of Clinical Ethics Pub Date : 2026-01-01 Epub Date: 2026-08-12 DOI: 10.1086/741893

Meaghann S Weaver, William Sveen, Caitlin McInerny, Renee D Boss

引用次数: 0