Monash Bioethics Review最新文献_第2页

Device reps in theatre: blurred boundaries or regulatory gaps? 影院中的设备代表：界限模糊还是监管空白？

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-24 DOI: 10.1007/s40592-025-00252-3

Bernadette Richards, Susannah Sage Jacobson, Brette Blakely, Jane Johnson

{"title":"Device reps in theatre: blurred boundaries or regulatory gaps?","authors":"Bernadette Richards, Susannah Sage Jacobson, Brette Blakely, Jane Johnson","doi":"10.1007/s40592-025-00252-3","DOIUrl":"https://doi.org/10.1007/s40592-025-00252-3","url":null,"abstract":"There has been a shift of dynamic in the relationship between technology and healthcare, with technological advancements progressively driving change in the delivery of care and, at times, causing disruption to the traditional doctor/patient partnership. This shift is significant in the context of medical devices. Increasingly complex devices are being introduced which require a level of technical expertise outside of the scope of the traditional training of doctors, with this knowledge gap progressively filled by medical device representatives (MDRs), a role that began as devoted to sales and has now expanded to that of adviser and trainer. This change in role represents a blurring of lines between sales and support and has potentially flourished within a regulatory gap. This paper addresses the challenge of the evolving relationship between MDRs, surgeons and patients and is based on the findings of a broader project \"Support or Sales? Medical device representatives in Australian hospitals\". It provides an overview of the outcomes of a series of interviews with stakeholders highlighting their perceptions and experiences at this point of intersection between care and sales. It then examines the existing regulatory framework and considers whether there is a real or perceived regulatory gap. This analysis of current regulatory measures in areas such as hospital safety, privacy and professional regulation and conflicts of interests, leads to a conclusion that the evolving relationship between MDRs and surgeons has not taken place in a regulatory vacuum and sufficient frameworks are in place to protect the public. However, they rely heavily on translation into local policies and concurrent adaptations to best practice behaviour which does appear to be lagging, resulting in insufficient transparency and recognition of emerging contexts requiring novel applications. This lag could threaten patient safety and patient trust in the healthcare system.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477158","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 limits of critique: toward a hermeneutic of humility within the medical humanities. 批判的局限：走向医学人文学科中谦卑的解释学。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-23 DOI: 10.1007/s40592-025-00254-1

Dominic Robin

引用次数: 0

The role of medical humanities in the formation of physicians who work with patients at the end-of-life. 医学人文学科在培养与临终病人一起工作的医生中的作用。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-12 DOI: 10.1007/s40592-025-00255-0

Xavier Symons, John Rhee

引用次数: 0

Ectogenesis, gestational preferences and the social coercion argument. 体外发生，妊娠偏好和社会强迫的争论。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-09 DOI: 10.1007/s40592-025-00253-2

Jolie Zhou

引用次数: 0

The new narrative medicine: ethical implications of artificial intelligence on healthcare narratives. 新叙事医学：人工智能对医疗叙事的伦理影响。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-08 DOI: 10.1007/s40592-025-00256-z

David Schwartz, Elizabeth Lanphier

{"title":"The new narrative medicine: ethical implications of artificial intelligence on healthcare narratives.","authors":"David Schwartz, Elizabeth Lanphier","doi":"10.1007/s40592-025-00256-z","DOIUrl":"10.1007/s40592-025-00256-z","url":null,"abstract":"While on the surface the rapid adoption of generative artificial intelligence (AI) in healthcare signals a new technological innovation that may sideline the social sciences, arts, and literature comprising the medical humanities, we argue that one way to understand the applications of AI based on large language models (LLM) in healthcare is as a deeply narrative project. LLM-based AI endorses narrative and humanistic value insofar as it is trained on vast amounts of narrative data as inputs and generates outputs in narrative formats. We contend that the medical humanities, rather than being replaced by AI in healthcare, are all the more essential to understand the practical and ethical opportunities and constraints for responsible use and integration of such tools. By analyzing two case studies of generative AI in healthcare reported in literature, we show that narrative medicine and the medical humanities provide crucial theoretical frameworks and disciplinary skills to assess, integrate, and critique the roles and impacts of such technologies in healthcare. Rather than offsetting narrative practice via AI, responsible use of LLM-based AI in healthcare requires attention to the functions of narrative in medicine and the importance of the medical humanities.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250136","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

Illustrating the contribution of Confucian philosophy through a reinterpretation of Beauchamp and Childress' principle of respect for autonomy. 通过对波尚和柴尔德里斯尊重自治原则的重新阐释，说明儒家哲学的贡献。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-07 DOI: 10.1007/s40592-025-00257-y

Charlene Tan, Ruth Neo

{"title":"Illustrating the contribution of Confucian philosophy through a reinterpretation of Beauchamp and Childress' principle of respect for autonomy.","authors":"Charlene Tan, Ruth Neo","doi":"10.1007/s40592-025-00257-y","DOIUrl":"https://doi.org/10.1007/s40592-025-00257-y","url":null,"abstract":"This article illustrates the contribution of Chinese philosophy to the field of medical humanities by focussing on the ideas and conduct of Confucius. Drawing on a Chinese philosophical classic, the Analects (Lunyu), this study proposes a Confucian reinterpretation of Beauchamp and Childress' principle of respect for autonomy in medical ethics. The paper begins by critiquing Beauchamp and Childress' three conditions of autonomous action, namely intentionality, understanding, and the absence of controlling influences that determine one's action. It is contended that the three conditions over-emphasise rationality and overlook the role of emotions and morality in autonomy. The second part of the article proposes a Confucian reformulation of the three conditions that is derived from the concepts of xin (heart-mind) and li (normative behaviour). The modified conditions are moral intentionality, the integration of understanding and emotions, and the absence of controlling influences that determine one's action and underlying values, beliefs, attitudes, feelings and predispositions. From a Confucian perspective, Beauchamp and Childress' positive obligation for the principle of respect for autonomy requires medical professionals to render empathetic treatment towards patients. By challenging and reconstructing major theories and assumptions in medical ethics, this paper demonstrates the saliency of non-Western philosophical traditions in medical humanities.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250135","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

Historical perspectives in medical humanities: two views on vaccination during the plague pandemic in Calcutta. 医学人文的历史观点：对加尔各答鼠疫大流行期间疫苗接种的两种看法。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-03 DOI: 10.1007/s40592-025-00251-4

Utsa Bose

{"title":"Historical perspectives in medical humanities: two views on vaccination during the plague pandemic in Calcutta.","authors":"Utsa Bose","doi":"10.1007/s40592-025-00251-4","DOIUrl":"10.1007/s40592-025-00251-4","url":null,"abstract":"The aim of this article is to complicate and rethink histories of non-Western responses to vaccination, as well as to see how a historical perspective may contribute to contemporary discussions of vaccines within the medical humanities. This is done through a case study approach. The focus of this article is a collection of essays written by a Bengali prophet-astrologer and published during the plague pandemic in Calcutta, British India, at the turn of the twentieth century (1899). While one essay in the collection was critical of the plague vaccine, another essay, in a later section of the same collection, celebrated the vaccine and its developer Waldemar M. Haffkine. The first part of the article situates the context of the text's production, as well as the background of the author. In the second part, it analyses the reasons why the plague vaccine was criticised. In the third part, it looks at how the author celebrated the plague vaccine in a later section of the collection. In the fourth section, it attempts to answer why the astrologer changed his view on vaccination. Finally, in the conclusion, it discusses how this case study intervenes historiographically, and how certain themes raised by the source persist today, reiterating the importance of a historical perspective.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217192","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

Thoracoabdominal normothermic regional perfusion: Is it ethical? 胸腹常温区域灌注：是否道德？

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-01 Epub Date: 2025-01-29 DOI: 10.1007/s40592-025-00229-2

Caner Turan

{"title":"Thoracoabdominal normothermic regional perfusion: Is it ethical?","authors":"Caner Turan","doi":"10.1007/s40592-025-00229-2","DOIUrl":"10.1007/s40592-025-00229-2","url":null,"abstract":"Thoracoabdominal normothermic regional perfusion (TA-NRP), a new method of controlled donation after circulatory death, seems to provide more and better organs for patients on organ transplant waiting lists compared to standard controlled donation after circulatory death. Despite its benefits, the ethical permissibility of TA-NRP is currently a highly debated issue. The recent statement published by the American College of Physicians (ACP) highlights the reasons for these debates. Critics' main concern is that TA-NRP violates the Dead Donor Rule. This paper presents an ethical analysis of the objections raised by the ACP against TA-NRP and argues that TA-NRP is not only morally permissible but also morally required where it is financially and technically feasible. To support this conclusion, the concepts of 'resuscitation,' 'intention,' 'irreversibility,' 'permanence,' 'impossibility,' and 'respect' in the context of TA-NRP are explored. Additionally, the ethical permissibility of this procedure is evaluated through the lenses of Utilitarianism, Kantianism, the core principles of bioethics, and the Doctrine of Double Effect. This ethical analysis demonstrates why the ACP's objection lacks a solid moral foundation and conflates moral and legal considerations. This paper also argues that extra measures are needed to ensure the moral permissibility of TA-NRP, emphasizing the importance of informed consent, additional brain blood flow and activity monitoring, and a contingency plan to abort the organ procurement process if a sign of morally relevant brain activity is detected.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":"166-189"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A duty to enhance? Genetic engineering for the human Mars settlement. 增强的责任？人类火星定居的基因工程。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-01 Epub Date: 2024-11-01 DOI: 10.1007/s40592-024-00221-2

Evie Kendal

{"title":"A duty to enhance? Genetic engineering for the human Mars settlement.","authors":"Evie Kendal","doi":"10.1007/s40592-024-00221-2","DOIUrl":"10.1007/s40592-024-00221-2","url":null,"abstract":"Humans living off-world will face numerous physical, psychological and social challenges and are likely to suffer negative health effects due to their lack of evolutionary adaptation to space environments. While some of the necessary adaptations may develop naturally over many generations, genetic technologies could be used to speed this process along, potentially improving the wellbeing of early space settlers and their offspring. With broad support, such a program could lead to significant genetic modification of off-world communities, for example, to limit radiation damage on body systems or prevent bone and muscle loss in reduced gravity conditions. Given the extreme stressors of living off-world, and the need to have a healthy workforce to support a fledgling human settlement, those in favour of using genetic technologies to enhance settlers might even claim there is a moral imperative to protect their health in the face of the unique threats of space travel, especially for children born in settlements who did not take on these risks voluntarily. For some, this might simply be an extension of procreative beneficence. However, ethical concerns arise regarding the risks of embracing a eugenicist agenda and the potential impacts on the rights of future settlers to refuse such genetic enhancements for themselves or their children.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":"128-149"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562892","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 role of the ethics expert in Spanish legislation on euthanasia and mental health. 伦理专家在西班牙安乐死和精神健康立法中的作用。

IF 1.6

Monash Bioethics Review Pub Date : 2025-06-01 Epub Date: 2025-02-16 DOI: 10.1007/s40592-025-00228-3

Sergio Ramos-Pozón

{"title":"The role of the ethics expert in Spanish legislation on euthanasia and mental health.","authors":"Sergio Ramos-Pozón","doi":"10.1007/s40592-025-00228-3","DOIUrl":"10.1007/s40592-025-00228-3","url":null,"abstract":"This article examines the assessment of mental capacity in the context of euthanasia, particularly when requested by patients with mental illnesses. It proposes a holistic alternative approach to the traditional functional model, arguing that the latter is insufficient to capture the complexity of these patients' decisions. Using approaches based on narrative, hermeneutic, and dialogical ethics, it offers an evaluation that considers the patient's life story, values, and context. Shared decision-making and empathy are identified as fundamental components to ensure informed and consensual decisions, promoting an environment of respect and mutual understanding. The article reviews Spanish legislation on euthanasia, highlighting the need to include medical ethics experts in the Guarantee and Evaluation Commissions. These experts provide a comprehensive ethical perspective essential for addressing the ethical complexities in euthanasia requests and ensuring fair decisions that reflect the patient's true will. It recommends reviewing and expanding current protocols, as well as including continuous ethics training to improve medical practice in this context. The conclusions suggest that an assessment of mental capacity based on ethical principles and an integrated narrative can significantly improve medical practice and decision-making in euthanasia, especially for these patients. Furthermore, the inclusion of ethics experts in the commissions can provide a more humane and just perspective, ensuring that decisions respect the patient's dignity and autonomy.","PeriodicalId":43628,"journal":{"name":"Monash Bioethics Review","volume":" ","pages":"82-96"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0