New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body最新文献

{"title":"Conscience and Vaccines: Lessons from Babylon 5 and COVID-19.","authors":"Michal Pruski","doi":"10.1080/20502877.2021.1959789","DOIUrl":"https://doi.org/10.1080/20502877.2021.1959789","url":null,"abstract":"<p><p>Babylon 5, like other great sci-fi franchises, touched on important ethical questions. Two ethical conundrums relating to the series' main characters included providing life-saving treatment to a child against their parents' wishes and potential involvement with a highly beneficial but morally dubious medication. I use these cases to discuss some aspects of the COVID-19 vaccines' development and roll-out, demonstrating that people (be it patients or clinicians) might object to some vaccines due to reasonable ethics and safety-based concerns rather than due to an anti-vaxxer mind-set. I highlight that it would be disingenuous to lump these two groups of objections together for not all objections to specific vaccines are objections to vaccination in general. Rather, governments and pharmaceutical companies should seriously engage with the concerns of reasonable objectors to provide citizens with the appropriate products and ensure large vaccination uptake - in the case of COVID-19 this should include giving patients the choice of the product they will be inoculated with.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 3","pages":"266-284"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1959789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39290154","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":"Chirality, clarification and caution.","authors":"Trevor Stammers","doi":"10.1080/20502877.2021.1970939","DOIUrl":"https://doi.org/10.1080/20502877.2021.1970939","url":null,"abstract":"I suspect that most readers will, like me, be unfamiliar with the concept of chirality. Indeed I had never heard of the term before reading Dahlen’s paper proposing the completely novel concept of ‘chiral equipoise’ in considering the outcomes of comparative therapeutic research in clinical trials. Chirality refers to ‘handedness,’ as in whether we are right or left-handed. Building on Freedman’s (1987) influential concept of ‘clinical equipoise’ which stipulates that research trials on humans can only be considered ethical when there is general disagreement among experts as to which treatment is the best, she asks if we need to go even further than this. She considers ‘any tendency to reductively consider the human participants of clinical research as a group of imagined ‘sex-neutral persons’ (most often male), rather than fully seeking to understand the variable of the unique needs of females, is an ethical error.’ Using chirality as a term to encompass her view that though ‘female and male are equally human,... knowledge of the biology of one sex cannot be completely superimposed onto the other,’ she argues that in addition to clinical equipoise, we need to consider chiral equipoise as something not just to receive practical attention but ethical attention as well in our approach to clinical research. Just as Freedman’s original concept of clinical equipoise was not only influential but highly contested even 30 years later (Hey et al 2017), I suspect that Dahlen’s chiral equipoise will raise considerable controversy also. Some terms not only generate controversy but also confusion. There are two papers in this issue examining this problem. The first of these examines the concept, popularized by, though not originating with Pellegrino, of ‘the internal morality of medicine.’ In a deft analysis of various competing accounts of what they call ‘essentialist’ and ‘evolutionist’ application of the term, Ng and Saad discuss the competing and contrasting elements of each position and outline what they see as the shortcomings of previous accounts. They recommend the term ‘internal morality’ should be jettisoned altogether, since ‘if its essence is its sole source of authority, the morality it derives from this essence alone is no more authoritative in such matters than the rules of chess are to cricket.’ They then suggest ways in which their examination of medical morality might be carried forward, concluding with admirable candour that ‘to fully develop it into a robust and clear argument is for another day.’ It sounds as if another paper to savour is already in the making there? the new bioethics, Vol. 27 No. 3, 2021, 195–196","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 3","pages":"195-196"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390084","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":"Posthumanism: Creation of 'New Men' Through Technological Innovation.","authors":"George L Mendz,&nbsp;Michael Cook","doi":"10.1080/20502877.2021.1953266","DOIUrl":"https://doi.org/10.1080/20502877.2021.1953266","url":null,"abstract":"<p><p>The posthumanist project proposes directing the evolution of human beings by promoting their improvement through technological means to create a variety of entities that will have few or no common characteristics with current humans. Its agenda is extremely broad and this study mostly addresses enhancement of the human organism through genetic modification techniques. An overview of posthumanist values and a brief discussion of its philosophical background provide a framework to understand its ideals. Genetics and ethics are employed to assess some claims of the posthumanist program of creating evolved humans; in particular, the capabilities and limitations of techniques for somatic and germline genome editing. Consequences of the creation of posthumans are discussed in relation to accepted current human beings and values. It is concluded that the posthumanist program rests on a large number of hypotheses without sufficient evidence and with little or no consideration of the consequences of its implementation.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 3","pages":"197-218"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1953266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39222422","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":"Dual Uncertainties: On Equipoise, Sex Differences and Chirality in Clinical Research.","authors":"Sara Dahlen","doi":"10.1080/20502877.2021.1917100","DOIUrl":"https://doi.org/10.1080/20502877.2021.1917100","url":null,"abstract":"<p><p>Ethical justification for clinical research may invoke equipoise, an element of scientific uncertainty regarding the superior choice if presented with different therapeutic options. Given a relative lack of scientific knowledge available for females related to historic tendencies for research to focus predominantly on males, clinical equipoise alone when applied to the context of sex differences may not be sufficient for us to appreciate whether or how a therapy might vary in its effects depending upon participant sex. I explore the analogy of chirality or 'handedness,' arguing we might think of the two sexes as possessing this property: female and male are equally human, yet knowledge of the biology of one sex cannot be completely superimposed onto the other. I propose the concept of chiral equipoise, suggesting that in ethical deliberations around clinical research we consider not only the uncertainty between therapeutic options, but also ask: for which sex?</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 3","pages":"219-229"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1917100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38956057","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":"Re-Examining the idea of internal morality in medicine.","authors":"Christopher Chen-Wei Ng,&nbsp;Toni C Saad","doi":"10.1080/20502877.2021.1959788","DOIUrl":"https://doi.org/10.1080/20502877.2021.1959788","url":null,"abstract":"<p><p>This article considers the idea of medicine's internal morality as it is understood by its various proponents. Although the use of the phrase 'internal morality' in relation to medicine predates Edmund Pellegrino, he can be credited with cementing its place in the vocabulary of medical ethics. Yet, while 'internal morality' and its related terms are now readily recognizable, they are used to denote irreconcilable ideas. Our aims, therefore, are to, firstly, clarify and, secondly, evaluate the different uses of 'internal morality', showing that there is little agreement on its definition. Thirdly, we argue that the terminology relating to 'internal morality' requires substantial revision, and that the term itself should be jettisoned. Finally, we briefly set out our own account of how morality should be understood in relation to the practice of medicine along similar but clearer lines to Pellegrino.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 3","pages":"230-244"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1959788","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39267313","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 Pro-Life Pregnancy Help Movement: Serving Women or Saving Babies?","authors":"Calum Miller","doi":"10.1080/20502877.2021.1951494","DOIUrl":"https://doi.org/10.1080/20502877.2021.1951494","url":null,"abstract":"","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 1","pages":"368 - 371"},"PeriodicalIF":1.2,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1951494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240195","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 Short History of British Medical Ethics","authors":"Toni C Saad","doi":"10.1080/20502877.2021.1951493","DOIUrl":"https://doi.org/10.1080/20502877.2021.1951493","url":null,"abstract":"from its content. It is not an easy read. The writing is highly technical and will be difficult to follow for those previously unacquainted with this particular branch of philosophy. This is particularly true of the sections explaining the phenomenological work of Levinas and Kierkegaard, which make up the majority of the book. Technical terms are introduced and used without proper definition. Moreover, it is not clear that the length and complexity of these passages are justified by the conclusions drawn from them in later sections when they are applied to addiction. Such difficulties might in part be accounted for by the complexities in the writings of Levinas and Kierkegaard themselves, but one would have hoped that these concepts could have been simplified and made more accessible. Finally, Westin could surely have been served better by her editor in this book’s production. The text is marred by an unusual number of grammatical errors. On one occasion, almost an entire paragraph is duplicated at two different points in a section (pp. 102–103). It would be remiss to overlook such shortcomings, which make this book on such an important topic into a somewhat onerous read. Nevertheless, Westin has embarked on an ambitious project, engaging with the large corpus of work of two eminent thinkers. By bringing their thought into contemporary discourse she shows us how a new perspective can give us a broader and deeper understanding of the experience of addiction. In this respect at least, it is a valuable contribution to the literature.","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 1","pages":"365 - 368"},"PeriodicalIF":1.2,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41439056","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":"COVID-19 Pandemic Healthcare Resource Allocation, Age and Frailty.","authors":"David G Smithard,&nbsp;James Haslam","doi":"10.1080/20502877.2021.1917101","DOIUrl":"https://doi.org/10.1080/20502877.2021.1917101","url":null,"abstract":"<p><p>The current coronavirus pandemic presents the greatest healthcare crisis in living memory. Hospitals across the world have faced unprecedented pressure. In the face of this tidal wave of demand for limited healthcare resources, how are clinicians to identify patients most likely to benefit? Should age or frailty be discriminators? This paper seeks to analyse the current evidence-base, seeking a nuanced approach to pandemic decision-making, such as admission to critical care.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 2","pages":"127-132"},"PeriodicalIF":1.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1917101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38919979","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 year of Covid.","authors":"Trevor Stammers","doi":"10.1080/20502877.2021.1926065","DOIUrl":"https://doi.org/10.1080/20502877.2021.1926065","url":null,"abstract":"In last June’s themed issue on environmental bioethics, presciently planned in early 2019, we published in addition our very first paper on Covid-19 – a critique of the British Medical Association’s then recently released guidance on treating the disease (Hurford 2020). In this current issue, a paper by two UK NHS consultants, an intensivist and a specialist in the care of the elderly, questions whether in the face of Covid-19, it is ethical that older people should not be ventilated. The authors consider that,","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 2","pages":"103-104"},"PeriodicalIF":1.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1926065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39021166","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 Principlist Justification of Physical Restraint in the Emergency Department.","authors":"Hugo Hall,&nbsp;David G Smithard","doi":"10.1080/20502877.2021.1903152","DOIUrl":"https://doi.org/10.1080/20502877.2021.1903152","url":null,"abstract":"<p><p>The ethics of physical restraint in the Emergency Department (and elsewhere) has always been an emotive and controversial issue. Recently a vanguard of advocacy groups and regulatory agencies have been aiming to reduce and optimize its use, resulting in new guidance around physical restraint. This article considers prevailing opinions surrounding physical restraint in the Emergency Department using a Principlist model of medical ethics (specifically that of Beauchamp and Childress' four pillars). It also examines the ethical underpinning of the new guidance on the usage of restraint. Ultimately, examination from a Principlist perspective suggests the use of physical restraint in the Emergency Department is justified, as long as it is used carefully. Despite this, physical restraint can have severe physical and psychological consequences for patients, and work needs to be continued into its reduction and optimization.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"27 2","pages":"176-184"},"PeriodicalIF":1.2,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20502877.2021.1903152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25560865","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}