Asian Bioethics Review最新文献

{"title":"Contours of Life and Death: A Comparative Review of Western and East Asian Philosophical Conceptions, with Implications for Bioethics","authors":"Jacob Nagler","doi":"10.1007/s41649-025-00406-9","DOIUrl":"10.1007/s41649-025-00406-9","url":null,"abstract":"<div><p>This manuscript reconceives debates about life and death by integrating conceptual clarification, methodological innovation, comparative exegesis, and an actionable empirical-normative protocol. Motivated by persistent clinical, legal, and cross-cultural conflicts; most visibly in controversies over brain-death determinations and organ procurement, this paper advances two interlocking contributions. The first is a clarified and operationalized theoretical instrument: The Three-Sense Taxonomy (physiological, organismal, social/interest-based), reworked as a policy-ready diagnostic tool with explicit indicators, institutional consequences, and safeguards. The second is a novel methodological innovation, the Integrative Deliberative Empirical-Normative (IDEN) framework which prescribes how mixed empirical methods, structured public deliberation, and explicit normative synthesis should be combined to generate legitimate and implementable policy in plural societies. After a focused literature review drawing on contemporary clinical guidelines, empirical studies of relatives’ dilemmas, and comparative philosophical sources, the paper applies the taxonomy and IDEN to three case studies: brain death and transplantation in Western medicine, familial decision-making in Confucian contexts, and soteriological considerations in Indian contexts (Advaita Vedānta and Buddhist frameworks). Each case demonstrates how conceptual ambiguity and institutional opacity produce moral harms, and how IDEN-guided pilots can produce transparent, defensible compromises (an organismal legal default plus bounded, deliberatively ratified accommodations). The paper concludes with detailed pilot designs, evaluation metrics, ethical safeguards, and a research agenda. It argues that conceptual rigor without democratic legitimacy is brittle, and legitimacy without conceptual clarity is muddled; the IDEN framework seeks the necessary marriage of the two.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 4","pages":"741 - 760"},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099272","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 Legal Framework for Reducing Violence in Healthcare Institutions: A Comparative Study and Policy Recommendations","authors":"Narong Kiettikunwong,&nbsp;Pongmanut Deeod","doi":"10.1007/s41649-025-00400-1","DOIUrl":"10.1007/s41649-025-00400-1","url":null,"abstract":"<p>Violence against healthcare workers poses a serious global threat to both individual safety and institutional integrity. Yet, many legal systems still rely on general criminal statutes that fail to address the specific vulnerabilities of healthcare settings. This study employs a comparative legal analysis, integrating normative philosophical frameworks—specifically consequentialism and retributivism—to evaluate how seven jurisdictions (Canada, India, Oklahoma–USA, England, Thailand, Bangladesh, and China) respond to healthcare violence. Findings show that jurisdictions with healthcare-specific legislation, such as Canada, China, and England, more effectively align legal sanctions with deterrence, institutional resilience, and moral accountability. In contrast, countries relying solely on general criminal law, such as Thailand and Bangladesh, provide limited normative clarity and protection. Intermediate models, such as India and Oklahoma, offer context-specific responses but lack comprehensive continuity. Synthesizing these insights, the study proposes a unified legal framework grounded in legal specificity, proportionality, and a balanced normative rationale. The model contributes to ethical discourse, informs legal reform, and supports Sustainable Development Goals (SDGs) 3, 8, and 16. By bridging comparative law and moral philosophy, this study provides actionable strategies to safeguard healthcare workers and strengthen justice within health systems.</p>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 3","pages":"521 - 547"},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424669","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":"Ethics and Regulation of Human Brain Organoid Research: Recommendations from the Asia Pacific Neuroethics Working Group","authors":"Shu Ishida,&nbsp;Brett J. Kagan,&nbsp;Masanori Kataoka,&nbsp;Julian Koplin,&nbsp;Sebastian Porsdam Mann,&nbsp;Jonathan Lewis,&nbsp;Heather Browning,&nbsp;Alexandre Erler,&nbsp;Faisal Feroz,&nbsp;Tamami Fukushi,&nbsp;Søren Holm,&nbsp;Masatoshi Kokubo,&nbsp;Stephen Latham,&nbsp;Andrea Lavazza,&nbsp;Ilhak Lee,&nbsp;Tsung-Ling Lee,&nbsp;David Lyreskog,&nbsp;Jerry Menikoff,&nbsp;Takuya Niikawa,&nbsp;Naoya Nagaishi,&nbsp;Eisuke Nakazawa,&nbsp;Serene Ong,&nbsp;Koji Ota,&nbsp;Christopher Register,&nbsp;Walter Veit,&nbsp;Ji Hyun Yang,&nbsp;Shang Long Yeo,&nbsp;Tsutomu Sawai,&nbsp;Julian Savulescu,&nbsp;Brian D. Earp","doi":"10.1007/s41649-025-00398-6","DOIUrl":"10.1007/s41649-025-00398-6","url":null,"abstract":"<div><p> Human brain organoids (HBOs) are three-dimensional structures derived from human stem cells that model aspects of brain development and function, offering potentially unprecedented opportunities for studying neurological disorders and for developing treatments. This consensus paper presents recommendations from the Asia Pacific Neuroethics Working Group, developed through interdisciplinary collaboration among scientists, bioethicists, philosophers, and legal scholars who convened in Singapore in November 2024. We provide a comprehensive analysis of the ethical, legal, and sociocultural dimensions of HBO research, addressing both current realities and future possibilities. The paper examines key ethical considerations, including the potential moral status of HBOs, particularly regarding sentience and consciousness, while identifying and dispelling common misconceptions and “ethical red herrings” arising from sensationalized portrayals. We analyze consent frameworks for cell donation, privacy concerns, dual-use risks, and questions of distributive justice. Legal challenges are explored, including the categorical ambiguity of HBOs within existing regulatory frameworks, intellectual property issues, and cross-border inconsistencies in standards. Sociocultural perspectives emphasize the importance of public understanding, cross-cultural engagement, and empirical research on diverse community attitudes toward HBO research. In our recommendations, we advocate for evidence-based ethical discussions, anticipatory frameworks addressing potential future developments, contextualized analysis comparing HBOs to related experimental models, robust informed consent processes, proportionate responses to consciousness concerns, development of adaptive regulatory frameworks, responsible science communication to manage public expectations, and sustained interdisciplinary collaboration. We emphasize a balanced approach that promotes scientific innovation while maintaining rigorous ethical oversight, recognizing HBOs’ significant potential for advancing neuroscience and medicine. This represents the first comprehensive ethical framework for HBO research from the Asia Pacific region, helping to establish foundational principles for responsible development of this rapidly advancing field.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 3","pages":"649 - 679"},"PeriodicalIF":1.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424942","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":"Reflections and Practical Insights on Communication and Care for Patients and Families in Japanese Intensive Care Units During COVID-19: A Semi-structured Interview Study of Healthcare Providers","authors":"Yusuke Seino,&nbsp;Atsushi Kogetsu,&nbsp;Kazuto Kato","doi":"10.1007/s41649-025-00402-z","DOIUrl":"10.1007/s41649-025-00402-z","url":null,"abstract":"<div><p>This study explored challenges experienced by healthcare providers (HCPs) in intensive care units (ICUs) during the COVID-19 pandemic, focusing specifically on communication and care interactions, and examined how these experiences impacted ICU practices and provided opportunities for improvements. Semi-structured interviews were conducted with 16 ICU physicians and nurses from October 2022 to March 2023. Interview data were analyzed through thematic analysis. Nine themes emerged, categorized into three key areas. (1) “Challenges and Adaptations Experienced by HCPs” described how stringent infection-control measures created emotional and practical difficulties, prompting adaptive strategies to maintain effective care. The pandemic reinforced the critical role of interdisciplinary cooperation; in response, an interdisciplinary conference was organized, and HCPs intentionally sought closer collaboration than was usual to ensure coordinated decision-making and the continuity of care. (2) “Interactions Among Patients, Families, and HCPs” emphasized that visitation restrictions impaired family involvement, although proactive measures by nurses, such as the introduction of remote visits, significantly facilitated family engagement and emotional support. (3) “Lessons Learned from the Pandemic” highlighted improved healthcare practices and reinforced the value of interdisciplinary collaboration and family-centered approaches in ICU care. The findings underscore the necessity of robust communication practices and interdisciplinary teamwork within ICUs. These pandemic-related experiences offer valuable insights for improving communication, supporting flexible visitation policies, and promoting patient- and family-centered approaches. Collectively, these lessons offer essential guidance for developing more resilient and compassionate ICU care strategies, applicable in future crises and in everyday practice.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 3","pages":"549 - 567"},"PeriodicalIF":1.8,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425152","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":"Care, Consent, and Compromise: An Ethical Cartography of Physical Therapy Practice in the Global South","authors":"Mark Loubert A. Hernandez","doi":"10.1007/s41649-025-00390-0","DOIUrl":"10.1007/s41649-025-00390-0","url":null,"abstract":"<div><p>Although ethical decision-making in rehabilitation is increasingly complex, physical therapy remains marginal in mainstream philosophical bioethics. This paper critically interrogates the normative limitations of principlism, particularly the framework articulated by Beauchamp and Childress, in addressing moral dilemmas within physical therapy practice, especially in contexts characterized by systemic inequities, cultural plurality, and hierarchical institutional structures. Drawing upon my clinical experience as a licensed physical therapist in both the Philippines and the United States, I analyze ethically charged scenarios involving premature discharge, coerced consent, and institutional practices that undermine therapeutic justice. While principlism offers a widely accepted ethical schema, its abstraction and proceduralism often render it inadequate in morally ambiguous and relationally complex clinical situations. To respond to these limitations, I propose a more context-sensitive and philosophically robust framework by integrating Hare’s two-level utilitarianism, Habermas’s discourse ethics, feminist care ethics, and Kohlberg’s theory of moral development. These perspectives collectively reconceptualize ethical reasoning as dialogical, developmental, and attentive to the affective and political dimensions of care. Through philosophical analysis, narrative reflection, and engagement with lived clinical experience, I argue that physical therapists must be recognized not merely as technical practitioners, but as moral agents engaged in situated ethical judgment. This paper contributes to the evolving discourse on bioethics in allied health professions by foregrounding moral ingenuity, structural critique, and relational accountability as essential to ethical excellence in rehabilitative practice.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 3","pages":"569 - 582"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424915","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 Ethics of Tawas and Other Rituals in Medical Practices","authors":"Jairus Diesta Espiritu","doi":"10.1007/s41649-025-00388-8","DOIUrl":"10.1007/s41649-025-00388-8","url":null,"abstract":"<div><p>Rituals in medical practice have either been seen as an anthropological aspect of current biomedical processes or as a pre-scientific aspect of complementary and alternative medicine (CAM). In either tendency, the literature has since failed to account for these rituals <i>as</i> rituals—conveyors of meaning, expressions of identity, and even as a rite of passage from illness to wellness. As an alternative to current discussions, this paper presents the case study of <i>tawas</i>, a diagnostic ritual from Philippine traditional medicine that determines personalistic and mystical causes of illnesses. As a non-intrusive procedure, <i>tawas</i> involves incantations and some ritual objects, e.g., rice, candle, axe, etc., that do not pose any direct harm nor benefit to the patient. While complete reliance on <i>tawas</i> at the expense of proper medical procedures could harm patients, the very ritual of <i>tawas</i> itself occupies a limbo within non-beneficence and non-maleficence. Following a Wittgensteinian perspective of treating rituals as meaning-laden human activities, this paper argues that rituals like <i>tawas</i>, much like other rituals embedded in biomedical practices, should be understood as rituals and not as empirical cures, thereby allowing their tolerance in medical practice in general.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 3","pages":"637 - 648"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425107","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":"Rethinking Ethics and History Education in Japanese Medical Schools: Reflections from a Medical Student’s Visit to the Site of Unit 731","authors":"Seiichiro Nagai,&nbsp;Yasuharu Tokuda","doi":"10.1007/s41649-025-00391-z","DOIUrl":"10.1007/s41649-025-00391-z","url":null,"abstract":"<div><p>This article examines the ethical and pedagogical significance of integrating historical memory into medical education, drawing on the author’s visit to the former site of Unit 731 in Harbin, China, and a subsequent dialogue with a Chinese medical student. Unit 731 was a covert division of the Imperial Japanese Army that conducted fatal biological experiments during World War II. Despite its historical gravity, this topic remains largely absent from Japanese medical curricula. Through a reflective narrative, the article explores how experiential learning at historical sites and cross-cultural peer engagement can promote ethical sensitivity, emotional awareness, and professional identity formation among medical students. The paper situates this case within broader debates surrounding academic freedom, political restraint, and moral responsibility in ethics education. It highlights the dilemmas of balancing psychological safety with the necessity of confronting historical wrongdoing and of maintaining educator neutrality while taking moral stances. Drawing on frameworks such as narrative medicine and Hans Jonas’s imperative of responsibility, the author argues for a model of ethics education that transcends rote normative instruction, emphasizing reflective engagement with ethically complex histories. While based on a single case, the paper offers a broader call to rethink how ethically sensitive history can be addressed in medical training. Ethics education that critically engages with the past and fosters international dialogue is indispensable for nurturing physicians with ethical autonomy, committed to human rights, peace, and global responsibility.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 4","pages":"799 - 806"},"PeriodicalIF":1.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149098723","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 with Comprehensive, Integrated, and Universal Preimplantation Genetic Testing Platforms Utilizing Whole Genome Sequencing (PGT-WGS)","authors":"Alexis Heng Boon Chin,&nbsp;Ido Alon,&nbsp;Jean Didier Bosenge-Nguma,&nbsp;Ningyu Sun,&nbsp;Jiao Yang","doi":"10.1007/s41649-025-00368-y","DOIUrl":"10.1007/s41649-025-00368-y","url":null,"abstract":"<div><p>Recent advances in preimplantation genetic testing (PGT) and whole genome amplification technologies have resulted in the development of comprehensive platforms that integrate multiple types of PGT utilizing whole genome sequencing (PGT-WGS). These platforms combine PGT-A, PGT-M, PGT-SR, and PGT-P into a single universal genetic screening system for IVF embryos. Leveraging cutting-edge computing and artificial intelligence technologies, PGT-WGS allows simultaneous screening for aneuploidies, monogenic disorders, chromosomal structural rearrangements, and polygenic disease risks using a single trophectoderm biopsy from a blastocyst-stage embryo. The popularization of Newborn Genomic Sequencing (NBSeq) for the early diagnosis and treatment of rare genetic disorders will likely promote extensive uptake of PGT-WGS among IVF patients because many prospective parents will rationalize that “prevention is better than cure.” While this technology platform provides the opportunity to select the “best and healthiest” IVF embryo based on the optimal genetic profile, it also raises profound ethical issues. Due to commercial interests, profit-driven private fertility clinics will likely advocate for extensive, indiscriminate, and non-judicious use of universal PGT-WGS in the future, regardless of appropriate medical indications, such as family history of genetic diseases, recurrent miscarriages, or repeated IVF failures. This concern is amplified by findings from large randomized clinical trials, which have repeatedly demonstrated that the broad application of PGT-A does not significantly improve IVF success rates, which can be extrapolated to PGT-WGS in the future. There are also concerns about the lack of evidence for the usefulness and effectiveness of the PGT-P component of PGT-WGS. Moreover, the identification of recessive monogenic disease gene loci in a significant number of IVF embryos via PGT-WGS may cause unnecessary confusion and distress to some ill-informed patients. Hence, the ethical implications of the potential widespread, indiscriminate, and non-judicious use of universal PGT-WGS will be examined, focusing on its possible harms and the need for balanced and comprehensive patient counseling.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 4","pages":"829 - 845"},"PeriodicalIF":1.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099237","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":"Capturing the Lived Experience of Bioethics","authors":"Graeme T. Laurie","doi":"10.1007/s41649-026-00411-6","DOIUrl":"10.1007/s41649-026-00411-6","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 2","pages":"225 - 230"},"PeriodicalIF":1.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147661882","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":"How a Zhuangzian Lens Might Shape the Doctor-Patient Relationship—A Critical Analysis","authors":"Alexa Nord-Bronzyk,&nbsp;Kathryn Muyskens","doi":"10.1007/s41649-025-00404-x","DOIUrl":"10.1007/s41649-025-00404-x","url":null,"abstract":"<div><p>In this paper, we set out to examine the implications of a Daoist philosophical perspective within the clinical encounter. Specifically, we will explore how the unique and sometimes radical views of the Ancient Daoist philosopher Zhuangzi (and the concepts of <i>ziran</i> 自然 “nature” or “spontaneity”, the fasting of the “heart-mind” <i>cheng xin</i> 成心, and <i>wuwe</i>i 無為 “non-action”) can invite us to reframe and reconceptualize some of the common assumptions that currently govern the doctor-patient relationship, as well as prompt us to reflect anew upon the proper goals and scope of medical practice itself. We take the view that ethics need not be limited to a set of rules. Ethics can be thought of as a set of skills and abilities that include perspective taking, tolerance and openness to experiences. This allows us to explore and critically engage with Zhuangzi’s unique philosophy and appreciate its contribution to the bioethics literature, in particular with its applications in caring for patients with disability and chronic illness. Our analysis leads us to coin the term “reciprocal-emerging” to express the dynamic and transformational of nature of the doctor-patient relationship through a Zhuangzian lens.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"18 2","pages":"413 - 432"},"PeriodicalIF":1.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147661889","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}