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

{"title":"Ethical basics for the caring professions","authors":"Toni C Saad","doi":"10.1080/20502877.2023.2247880","DOIUrl":"https://doi.org/10.1080/20502877.2023.2247880","url":null,"abstract":"","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"1 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45096316","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":"Why conscience matters: a defence of conscientious objection in healthcare","authors":"Toni C Saad","doi":"10.1080/20502877.2023.2219023","DOIUrl":"https://doi.org/10.1080/20502877.2023.2219023","url":null,"abstract":"Why conscience matters is a landmark in the literature on conscientious objection in healthcare. In it, Xavier Symons, bioethicist and postdoctoral research fellow at Harvard University, makes the case for the fundamental role of conscience in healthcare, and rebuts the arguments of those who, over the last two decades, have attempted to undermine rights to conscientious objection. This book now succeeds Mark Wicclair’s Conscientious objection in health care: an ethical analysis (2011) as the required reading on the subject. Daniel Sulmasy makes a point in his forward whose correctness is clear to those following the debates around conscientious objection: ‘it may just be that conscience is not the issue’ (p. vii). He means that the debate hinges not on questions of the nature of conscience and the purposes of medicine but on questions of pluralism and tolerance – politics rather than ethics. Opponents of conscientious objection tend to elide the substantive philosophical questions, and view it solely as a hindrance to medical services, before proposing management solutions filtered through an authoritarian cultural lens. Although Symons’ work is not one of political philosophy, his account of the substantive philosophical questions is illuminating. Chapter 1, Introduction, sets out the book’s purpose and direction. Symons says of conscience:","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 1","pages":"296 - 300"},"PeriodicalIF":1.2,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44330327","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":"Understanding Conscientious Objection and the Acceptability of its Practice in Primary Care.","authors":"Anne Williams","doi":"10.1080/20502877.2022.2155099","DOIUrl":"https://doi.org/10.1080/20502877.2022.2155099","url":null,"abstract":"<p><p>Ethically challenging or controversial medical procedures have prompted increasing requests for the exercise of conscientious objection, and caused concerns about how and when it should be practised. This paper clarifies definitions, especially with regard to discrimination, and explores the restrictions, duties, and practical limitations, in order to suggest criteria for its practice. It also argues that a conscientious refusal to treat, where there is therapeutic doubt, is a valid form of conscientious objection. An email survey sent to General Practitioners (GPs), explored the adherence to the suggested criteria, and assessed the outcomes, in terms of acceptability, impact, and difficulties experienced by the GPs, their colleagues and their patients. The results demonstrate high acceptability of conscientious objection, and better outcomes when the suggested criteria are adhered to. The GPs would support education to improve the practice of conscientious objection to a professional level, which could further improve outcomes and acceptability.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"156-180"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9570437","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":"Toward a Standard of Medical Care: Why Medical Professionals Can Refuse to Prescribe Puberty Blockers.","authors":"Ryan Kulesa","doi":"10.1080/20502877.2022.2137906","DOIUrl":"https://doi.org/10.1080/20502877.2022.2137906","url":null,"abstract":"<p><p>That a standard of medical care must outline services that benefit the patient is relatively uncontroversial. However, one must determine <i>how</i> the practices outlined in a medical standard of care should benefit the patient. I will argue that practices outlined in a standard of medical care must not detract from the patient's well-functioning and that clinicians can refuse to provide services that do. This paper, therefore, will advance the following two claims: (1) a standard of medical care must not cause dysfunction, and (2) if a physician is medically rational to not provide some service which fails to meet the above condition (i.e. fails to be a standard of medical care), then she may refuse to do so. I then apply my thesis to the prescription of puberty blockers to children with gender dysphoria.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"139-155"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9593751","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":"What are We Asking Patients to Do? A Critical Ethical Review of the Limits of Patient Self-Advocacy in the Oncology Setting.","authors":"Daniel A Wilkenfeld, Teresa Hagan Thomas","doi":"10.1080/20502877.2022.2143742","DOIUrl":"10.1080/20502877.2022.2143742","url":null,"abstract":"<p><p>Increasing emphasis on patient self-management, including having patients advocate for their needs and priorities, is generally a good thing, but it is not always wanted or attainable by patients. The aim of this critical ethical review is to deepen the current discourse in patient self-advocacy by exposing various situations in which patients struggle to self-advocate. Using examples from oncology patient populations, we disambiguate different notions of self-advocacy and then present limits to the more demanding varieties (i.e., health-related, trust-based, and psychological); we argue that these limits create ethical dilemmas with respect to whether it is always desirable to encourage patients to self-advocate. We conclude that self-advocacy can be both under and overrated with respect to how much it benefits the patient with cancer, with many instances being indeterminate. Ultimately, providers must understand the patient's perspective relative to the challenges they are experiencing and work with them to meet their needs.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"181-190"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10183048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9572277","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}

{"title":"Sunni Islamic perspectives on lab-grown sperm and eggs derived from stem cells - in vitro gametogenesis (IVG).","authors":"Gamal Serour,&nbsp;Mohammed Ghaly,&nbsp;Shaikh Mohd Saifuddeen,&nbsp;Ayaz Anwar,&nbsp;Noor Munirah Isa,&nbsp;Alexis Heng Boon Chin","doi":"10.1080/20502877.2022.2142094","DOIUrl":"https://doi.org/10.1080/20502877.2022.2142094","url":null,"abstract":"<p><p>An exciting development in the field of assisted reproductive technologies is <i>In Vitro</i> Gametogenesis (IVG) that enables production of functional gametes from stem cells in the laboratory. Currently, development of this technology is still at an early stage and has demonstrated to work only in rodents. Upon critically examining the ethical dimensions of various possible IVG applications in human fertility treatment from a <i>Sunni</i> Islamic perspective, together with benefit-harm (<i>maslahah-mafsadah</i>) assessment; it is concluded that utilization of IVG, once its efficacy and safety are guaranteed, could be permissible by strictly adhering to Islamic ethical principles related to marriage, biological/genetic relatedness, sexual intercourse, and moral status of the embryo/fetus versus that of the gamete. As a result, IVG will be acceptable for treating primary infertility, age-related infertility, and preventing genetic diseases. However, it will be unacceptable for application in posthumous reproduction, donor gametes, genetic enhancement, and procreation in same-sex couples.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"108-120"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561231","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":"Life Is All About Choices.","authors":"Matt James","doi":"10.1080/20502877.2023.2214772","DOIUrl":"https://doi.org/10.1080/20502877.2023.2214772","url":null,"abstract":"As we attempt to move on from the Covid-19 pandemic, the mounting pressures on health and social care are striking for all to see. Many of the articles in this issue speak to this theme: access to treatment, standards of care and practice and what it means to deliver patient-centred care. Pike’s article helps to bring some valuable insight to the collective understanding concerning Reproductive Coercion (RC). Much has been written in the literature about reproductive autonomy and how this can be influenced and impeded by others, but use of the term RC has opened up the discussion still further concerning decision making in the realm of reproductive health. As Pike notes, whilst research in the field is helpful in illuminating the extent of the issue, it is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. Pike helpfully unpacks and explores the fact that coercion and reproductive autonomy are each ‘conceptually complex ideas as much as they are pragmatically complex ones’. Discussion cannot simply be reduced to stating that one is good or bad. More precision is needed as to the severity and detail of the coercion to better understand the extent of the problem. To this end, Pike argues that to do this survey questions should aim not only to equally address all elements of RC, but also to distinguish between actions that intentionally coerce someone into pregnancy and those that override autonomy but without intent to induce pregnancy. In cases where contraceptive interference takes place, with no intention to induce pregnancy, it may even be better understood not as RC, but instead as behaviours impinging on sexual consent and openness between partners and deserving separate consideration. The degree of recognition and understanding of RC as pregnancy pressure and contraceptive sabotage has improved, yet the same cannot be said of coerced abortion. It is hoped that a response to this takes place far quicker than the time it has taken to recognize and respond to coerced adoption. As Pike comments, ‘The first step is to recognize that it does happen, that it is relatively common, and that it not only leads to more adverse outcomes than when coercion is absent, but also denies women their fundamental right to informed consent.’ Keeping with this theme of reproductive health, if the arrival of the first ‘test tube’ baby in 1978 is recognized as transforming human fertility, then advances in In Vitro Gametogenesis (IVG) look set to usher in a new era of assisted reproduction. the new bioethics, Vol. 29 No. 2, 2023, 81–84","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"81-84"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878034","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":"Coerced Abortion - The Neglected Face of Reproductive Coercion.","authors":"Gregory K Pike","doi":"10.1080/20502877.2022.2136026","DOIUrl":"https://doi.org/10.1080/20502877.2022.2136026","url":null,"abstract":"<p><p>Reproductive coercion encompasses a collection of pregnancy promoting and pregnancy avoiding behaviours. Coercion may vary in severity and be perpetrated by intimate partners or others. Research is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. These behaviours are the most common, but are not always included in survey instruments. This may explain why the prevalence of reproductive coercion varies widely. Prevalence also varies when coerced abortion is included in survey instruments. When it is, it seems roughly comparable in prevalence to coercion intended to impregnate. The extent and nature of coerced abortion can also be derived from studies that explore the reasons why women access abortion, the relationship between abortion and intimate partner violence, and online blogs and forums. This narrative review of reproductive coercion examines the evidence and attempts to comprehend why coerced abortion has been neglected.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"85-107"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9622887","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":"'Swear by Thy Gracious Self': North American Medical Oath-Taking in 2014/2015.","authors":"Nathan Gamble,&nbsp;Benjamin Holler,&nbsp;Stephen Murata","doi":"10.1080/20502877.2022.2150129","DOIUrl":"https://doi.org/10.1080/20502877.2022.2150129","url":null,"abstract":"<p><p>Over the past century, six studies - the most recent data from 2000 - and one review have comprehensively examined the content of medical oaths and oath-taking practices, all focusing on North America, providing an insight into the ethical beliefs of each era. Our study sought to establish a new point of reference. In 2014/2015, oaths from 150 of all 153 US and Canadian medical schools were collected and analyzed. All but one school administered medical oaths and most schools administered more than one. Since 2000, student-written oaths became more popular, and new themes, such as <i>self-care</i> and <i>professionalism</i>, were identified in the oaths for the first time. However, as was identified in 2000, the oaths' contents are disparate and even conflicting at times, raising questions as to whether medicine is being taught or practiced with a coherent ethical worldview.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 2","pages":"121-138"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925314","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":"Ethical Challenges Associated with Pathogen and Host Genetics in Infectious Disease.","authors":"Richard Milne,&nbsp;Christine Patch","doi":"10.1080/20502877.2022.2109697","DOIUrl":"https://doi.org/10.1080/20502877.2022.2109697","url":null,"abstract":"<p><p>The Covid-19 pandemic has demonstrated the potential of genomic technologies for the detection and surveillance of infectious diseases. Pathogen genomics is likely to play a major role in the future of research and clinical implementation of genomic technologies. However, unlike human genetics, the specific ethical and social challenges associated with the implementation of infectious disease genomics has received comparatively little attention. In this paper, we contribute to this literature, focusing on the potential consequences for individuals and communities of the use of these technologies. We concentrate on areas of challenges related to privacy, stigma, discrimination and the return of results in the cases of the surveillance of known pathogens, metagenomics and host genomics.</p>","PeriodicalId":43760,"journal":{"name":"New Bioethics-A Multidisciplinary Journal of Biotechnology and the Body","volume":"29 1","pages":"24-36"},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10840412","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}