Asian Bioethics Review最新文献

{"title":"Assessing Risk in Implementing New Artificial Intelligence Triage Tools—How Much Risk is Reasonable in an Already Risky World?","authors":"Alexa Nord-Bronzyk,&nbsp;Julian Savulescu,&nbsp;Angela Ballantyne,&nbsp;Annette Braunack-Mayer,&nbsp;Pavitra Krishnaswamy,&nbsp;Tamra Lysaght,&nbsp;Marcus E. H. Ong,&nbsp;Nan Liu,&nbsp;Jerry Menikoff,&nbsp;Mayli Mertens,&nbsp;Michael Dunn","doi":"10.1007/s41649-024-00348-8","DOIUrl":"10.1007/s41649-024-00348-8","url":null,"abstract":"<div><p>Risk prediction in emergency medicine (EM) holds unique challenges due to issues surrounding urgency, blurry research-practise distinctions, and the high-pressure environment in emergency departments (ED). Artificial intelligence (AI) risk prediction tools have been developed with the aim of streamlining triaging processes and mitigating perennial issues affecting EDs globally, such as overcrowding and delays. The implementation of these tools is complicated by the potential risks associated with over-triage and under-triage, untraceable false positives, as well as the potential for the biases of healthcare professionals toward technology leading to the incorrect usage of such tools. This paper explores risk surrounding these issues in an analysis of a case study involving a machine learning triage tool called the Score for Emergency Risk Prediction (SERP) in Singapore. This tool is used for estimating mortality risk in presentation at the ED. After two successful retrospective studies demonstrating SERP’s strong predictive accuracy, researchers decided that the pre-implementation randomised controlled trial (RCT) would not be feasible due to how the tool interacts with clinical judgement, complicating the blinded arm of the trial. This led them to consider other methods of testing SERP’s real-world capabilities, such as ongoing-evaluation type studies. We discuss the outcomes of a risk–benefit analysis to argue that the proposed implementation strategy is ethically appropriate and aligns with improvement-focused and systemic approaches to implementation, especially the learning health systems framework (LHS) to ensure safety, efficacy, and ongoing learning.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 1","pages":"187 - 205"},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081559","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":"Four Key Questions to Guide Human Rights–based Social Listening during Infodemics","authors":"Lisa Forman","doi":"10.1007/s41649-024-00324-2","DOIUrl":"10.1007/s41649-024-00324-2","url":null,"abstract":"<div><p>This paper considers what a human rights–based approach to the use of social listening to counter infodemics during a serious health threat might entail, using COVID-19 as a primary example. The paper considers social listening in the context of human rights including health, life, free speech, and privacy, and outlines what a rights-compliant form of social listening to infodemics might entail. The paper argues that human rights offer guardrails against illicit and unethical forms of social listening as well as signposts towards a more equitable, ethical, and effective public health tool. The paper first expands on the human rights dimensions of COVID-19, infodemics, and social listening. Second, it considers the human rights dimensions of social listening in relation to rights to health, life, and free speech, given international human rights law principles for limiting these rights. Finally, using this framework, the paper poses four key questions to frame a rights-based approach to social listening: Why do we listen? How do we listen? Who do we listen to and who is doing the listening? And what are the outcomes of such listening?</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 3","pages":"449 - 462"},"PeriodicalIF":1.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754718","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":"New Beginnings for the Asian Bioethics Review","authors":"Graeme T. Laurie","doi":"10.1007/s41649-024-00349-7","DOIUrl":"10.1007/s41649-024-00349-7","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 1","pages":"1 - 7"},"PeriodicalIF":1.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081570","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":"Journeying with the Dying—Lessons from Palliative Care Physicians","authors":"Lalit Kumar Radha Krishna,&nbsp;Nur Amira Binte Abdul Hamid,&nbsp;Nicole-Ann Lim,&nbsp;Chong Yao Ho,&nbsp;Halah Ibrahim","doi":"10.1007/s41649-024-00321-5","DOIUrl":"10.1007/s41649-024-00321-5","url":null,"abstract":"<div><p>Witnessing suffering and death in palliative care can cause moral distress, emotional exhaustion and maladaptive coping strategies. How sense and meaning is made from these experiences influences how physicians think, feel and act as professionals (professional identity formation or PIF). It also determines how they cope with their roles, care for patients and interact with other professionals. Timely, personalised and appropriate support is key as shaping how these physicians develop and contend with sometimes competing beliefs and roles. The Ring Theory of Personhood (RToP) and the Krishna-Pisupati Model (KPM) offer a means of mapping PIF and thus moulding, coping and meaning making. This study uses the RToP and KPM to explore how caring for end-of-life patients impacts the personhood of palliative care physicians. Semi-structured interviews with a purposive sample of 13 palliative care physicians—eleven females and two males aged between 35 and 50 years—at a cancer specialist centre were conducted. Transcripts of the audio-recorded interviews underwent content and thematic analysis where complementary themes and categories identified were combined to form domains that highlighted the physicians’ key experience of providing end-of-life care. The domains identified were (1) identity formation, (2) conflicts, (3) KPM elements and (4) support systems. Together, results revealed that palliative care physicians are driven by Innate, Individual, Relational and Societal belief systems that create an intertwined professional and personal identity, enabling them to find meaning in their experiences and adapt to present contexts within cultural norms and professional expectations. However, their failure to recognise their need for support when hampered by evolving personal, existential and clinical factors underlines the exigency for ongoing surveillance and a potential role for a RToP-based tool and portfolio system that can detect and direct timely, appropriate support to in-need physicians.</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 3","pages":"591 - 613"},"PeriodicalIF":1.1,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754752","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":"Response to Nakamura et al.","authors":"Kathryn Muyskens,&nbsp;Yonghui Ma,&nbsp;Jerry Menikoff,&nbsp;James Hallinan,&nbsp;Julian Savulescu","doi":"10.1007/s41649-024-00343-z","DOIUrl":"10.1007/s41649-024-00343-z","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 1","pages":"17 - 19"},"PeriodicalIF":1.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081571","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":"Navigating Artificial Intelligence in Malaysian Healthcare: Research Developments, Ethical Dilemmas, and Governance Strategies","authors":"Kean Chang Phang,&nbsp;Tze Chang Ng,&nbsp;Sharon Kaur Gurmukh Singh,&nbsp;Teck Chuan Voo,&nbsp;Wellester Anak Alvis","doi":"10.1007/s41649-024-00314-4","DOIUrl":"10.1007/s41649-024-00314-4","url":null,"abstract":"<div><p>In the ever-evolving landscape of Artificial Intelligence in Healthcare (AIH), understanding the entities and legal frameworks governing its research and development is crucial. This report delves into the intricacies of AIH in Malaysia, undertaking a comprehensive literature search on scientific databases, government portals, and news sources. Additionally, bibliometric analysis has been concurrently conducted to discern trends and developments in AIH over the years. Notably, the interest in AIH has seen a consistent rise since 2017, marked by a growing number of use cases (25 reported here) developed by both local and foreign innovators and applicators. Despite this surge in research and adoption, Malaysia lacks direct legislation specifically addressing AIH technologies, leaving them subject to 11 existing laws. This lack of clear oversight is compounded by the insufficient expertise within local regulatory and ethical bodies to effectively assess AIH research and deployment. The resultant challenges include bureaucratic hurdles for AIH innovators and applicators, raising ethical concerns related to patient autonomy, privacy, data management, AI robustness, and liability. To address these issues, this paper recommends: (1) adopting international ethical guidelines for AIH, (2) enhancing public awareness and education on AI technologies, and (3) promoting AIH research through clinical or silent trials to improve oversight and foster innovation.\u0000</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 3","pages":"631 - 665"},"PeriodicalIF":1.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754754","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":"Editorial Expression of Concern: National Regulation on Processing Data for Scientific Research Purposes and Biobanking Activities: Reflections on the Experience in Austria","authors":"Joanna Osiejewicz,&nbsp;Dmytro M. Zherlitsyn,&nbsp;Svitlana M. Zadorozhna,&nbsp;Oleksii V. Tavolzhanskyi,&nbsp;Maryna O. Dei","doi":"10.1007/s41649-024-00346-w","DOIUrl":"10.1007/s41649-024-00346-w","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 1","pages":"225 - 226"},"PeriodicalIF":1.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081562","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":"Nonscientific Members of Institutional Review Boards","authors":"Joshua Cedric A. Gundayao,&nbsp;Julia Patrick Engkasan,&nbsp;Sharon Kaur","doi":"10.1007/s41649-024-00319-z","DOIUrl":"10.1007/s41649-024-00319-z","url":null,"abstract":"<div><p>Given ICH-GCP’s role in shaping IRB standards in most jurisdictions, clarifying the function and definition of nonscientific members is crucial. ICH-GCP 3.2.1 requires a nonscientific member but its definition focuses on who they are not rather than who they are, creating ambiguity and varied interpretations. This paper reviews the idea of nonscientific members of the IRB to understand their definitions and roles based on current literature. This is because, despite the ICH-GCP’s mandate, recent research is scarce. Our review identifies that in the current literature, various definitions and roles are ascribed to nonscientific members, resulting in a lack of clarity. Following our thematic analysis, we highlight two main interpretations of the nonscientific member’s definition: one as a distinct perspective from scientific members and another as an embodiment of “ordinariness” to minimize bias. In addition, we also highlight three primary roles: reviewing consent forms, representing public and participant interests, and providing oversight. Some findings may not align with current IRB practices, and without clear definitions, adherence to ICH-GCP guidelines may be inconsistent.\u0000</p></div>","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 3","pages":"615 - 630"},"PeriodicalIF":1.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754755","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":"Correction to: Understanding COVID‑19 Vaccine Hesitancy among the General Population in Japan from Public Health Ethical Perspectives: Findings from a Narrative Review","authors":"Moe Kuroda,&nbsp;Md Koushik Ahmed,&nbsp;Kaku Kuroda,&nbsp;Sandra D. Lane","doi":"10.1007/s41649-024-00345-x","DOIUrl":"10.1007/s41649-024-00345-x","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 4","pages":"767 - 768"},"PeriodicalIF":1.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s41649-024-00345-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236889","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":"It is Not Time to Kick Out Radiologists","authors":"Yuta Nakamura,&nbsp;Yuki Sonoda,&nbsp;Yosuke Yamagishi,&nbsp;Tomohiro Kikuchi,&nbsp;Takahiro Nakao,&nbsp;Soichiro Miki,&nbsp;Shouhei Hanaoka,&nbsp;Takeharu Yoshikawa,&nbsp;Osamu Abe","doi":"10.1007/s41649-024-00325-1","DOIUrl":"10.1007/s41649-024-00325-1","url":null,"abstract":"","PeriodicalId":44520,"journal":{"name":"Asian Bioethics Review","volume":"17 1","pages":"9 - 15"},"PeriodicalIF":1.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081569","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}