Hec Forum最新文献_第8页

Values Frameworks as Ideal Types: Navigating Ethics Conflicts with Normative Minorities : Values Frameworks as Ideal Types: Response to Critics of "Surrogate Wars". 作为理想类型的价值框架：与规范少数民族的伦理冲突导航；作为理想类型的价值框架：对“替代战争”批评的回应。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-12-01 Epub Date: 2025-10-15 DOI: 10.1007/s10730-025-09559-4

Autumn Fiester

{"title":"Values Frameworks as Ideal Types: Navigating Ethics Conflicts with Normative Minorities : Values Frameworks as Ideal Types: Response to Critics of \"Surrogate Wars\".","authors":"Autumn Fiester","doi":"10.1007/s10730-025-09559-4","DOIUrl":"10.1007/s10730-025-09559-4","url":null,"abstract":"In the piece, \"Surrogate Wars: The 'Best Interest Values' Hierarchy & End-of-Life Conflicts with Surrogate Decision-Makers,\" I argue that incommensurable value systems between healthcare providers (HCPs) and surrogate decision-makers (SDMs) lie at the root of many intractable end-of-life treatment disputes. I argue that the most prevalent value system of HCPs might be understood as a \"Best Interest Values\" (BIV) hierarchy and that this value system is irreconcilable with the set of \"Life-Continuation Values\" (LCV) held by a sizable minority of families in the United States. I believe that HCPs facing seemingly intractable conflict with SDMs would be aided by understanding their BIV values framework as just one of many cogent values systems in the context of US ethical pluralism. Five preeminent bioethicists provide insightful commentaries on my essay, offering pointed critiques, raising important challenges, and gesturing towards extensions and refinements of my argument. In this essay, I respond to those thoughtful and well-argued commentaries.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"517-532"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Life Extension and Overpopulation: Demography, Morals, and the Malthusian Objection. 生命延续与人口过剩：人口学、道德和马尔萨斯的反对意见。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2022-12-26 DOI: 10.1007/s10730-022-09504-9

Shahin Davoudpour, John K Davis

{"title":"Life Extension and Overpopulation: Demography, Morals, and the Malthusian Objection.","authors":"Shahin Davoudpour, John K Davis","doi":"10.1007/s10730-022-09504-9","DOIUrl":"10.1007/s10730-022-09504-9","url":null,"abstract":"One of the main objections to life extension is that life extension will cause severe overpopulation. This objection presents both moral and demographic issues. To explore the demographic issue, we present an updated and improved version of the formula in chapter six of New Methuselahs for projecting the demographic impact of life extension. The new version includes additional demographical factors such as non-aging related causes of death. According to projections generated with this revised formula, moderate life extension (a life expectancy of 120 years) will not significantly increase population at the fertility rates current in the developed world, but radical life expectancy (halting aging completely, leading to an average life expectancy of 1000 years) can lead to severe overpopulation even at very low fertility rates. This formula also enables us to ascertain what fertility rate and birth spacing will prevent life extension from causing severe overpopulation. The moral issues arise if radical life extension causes overpopulation severe enough to outweigh the benefits it brings. New Methuselahs proposed a reproductive policy for avoiding severe overpopulation by limiting reproduction for those who use life extension. We then consider a moral objection to this policy that was not discussed in New Methuselahs: it is not likely that society will succeed in imposing limits to reproduction, therefore, it is likely that radical life extension is morally wrong. We respond to this objection and defend our response against two further objections.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"305-331"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Ethics of Clinical Ethics. 临床伦理学。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-11-29 DOI: 10.1007/s10730-024-09544-3

Matthew Shea

引用次数: 0

Positioning Ethics When Direct Patient Care is Prioritized: Experiences from Implementing Ethics Case Reflection Rounds in Childhood Cancer Care. 在优先考虑直接患者护理时定位伦理：在儿童癌症护理中实施伦理案例反思查房的经验。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-11-02 DOI: 10.1007/s10730-024-09541-6

Pernilla Pergert, Bert Molewijk, Cecilia Bartholdson

{"title":"Positioning Ethics When Direct Patient Care is Prioritized: Experiences from Implementing Ethics Case Reflection Rounds in Childhood Cancer Care.","authors":"Pernilla Pergert, Bert Molewijk, Cecilia Bartholdson","doi":"10.1007/s10730-024-09541-6","DOIUrl":"10.1007/s10730-024-09541-6","url":null,"abstract":"Caring for children with cancer involves complex ethical challenges. Ethics Case Reflection (ECR) rounds can be offered to support teams to reflect on challenges and what should be done in patient care. A training course, for facilitators of ECR rounds, has been offered to healthcare professionals (HCPs) in childhood cancer care by a Nordic working group on ethics. During/after the course, the trainees implemented and facilitated ECR rounds in their clinical setting. The aim was to explore the trainees' experiences of implementing ECR rounds in childhood cancer care. HCPs, who participated as trainees in the course, participated in 3 focus group interviews (n = 22) and 27 individual interviews (n = 17). Interview data were analysed concurrently with data collection following classic grounded theory. Positioning ethics is the core category in this study, used to resolve the main concern of doing ethics in a context where direct patient care is prioritized. Being able to take time for ethics reflections, not perceived as the key priority, was considered a luxury in the clinical setting. Strategies for positioning ethics include allying, promoting ethics reflection, scheduling ethics reflection, and identifying ethical dilemmas. These strategies can be more or less successful and vary in intensity. The prioritisation of direct patient care is not surprising, but polarisation between care and ethics needs to be questioned and ethics reflection need to be integrated in standard care. Ethical competence seems to be central in doing ethics and more knowledge on the promotion of ethical competence in practice and education is needed.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"345-356"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Creating Barriers to Healthcare and Advance Care Planning by Requiring Hospitals to Ask Patients About Their Immigration Status. 通过要求医院询问患者的移民身份，为医疗保健和提前护理计划制造障碍。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-12-07 DOI: 10.1007/s10730-024-09542-5

Cathy L Purvis Lively

{"title":"Creating Barriers to Healthcare and Advance Care Planning by Requiring Hospitals to Ask Patients About Their Immigration Status.","authors":"Cathy L Purvis Lively","doi":"10.1007/s10730-024-09542-5","DOIUrl":"10.1007/s10730-024-09542-5","url":null,"abstract":"Florida is currently collecting data on the \"costs of uncompensated care for aliens who are not lawfully present in the U.S.\" (Statutes of Florida, 2023). The Florida data collection law, enacted in 2023, is part of aggressive anti-immigrant legislation. Hospitals accepting Medicaid must inquire about patients' immigration status and submit de-identified reports. In August 2024, the Governor of Texas signed an Executive Order comparable to the Florida statute. Although presented as a data-collection measure, the legal requirements have far-reaching consequences. The potential adverse impacts on immigrants' health pose bioethical concerns. Immigration-related inquiries create barriers to healthcare access and advance care planning, exacerbating healthcare disparities and presenting ethical concerns. This article examines the effects on immigrants and the resulting ethical challenges, including respect for persons, beneficence, non-maleficence, and justice. The article proposes recommendations for mitigating these challenges, including community outreach, patient education, policy development, in-service education, and advocacy. While the legal requirements apply specifically to Florida and Texas, the ethical issues have nationwide relevance.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"357-372"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MAiD: How Slippery is its Slope? 服务员：它的斜坡有多滑？

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2025-06-13 DOI: 10.1007/s10730-025-09551-y

Tom Koch

引用次数: 0

What's Left of Moral Bioenhancement? Reviewing a 15-Year Debate. 道德生物强化还剩下什么？回顾15年的辩论。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-12-27 DOI: 10.1007/s10730-024-09545-2

Hunter Bissette, Dario Cecchini, Ryan Sterner, Elizabeth Eskander, Veljko Dubljević

引用次数: 0

Survey of Moral Distress and Self-Awareness among Health Care Professionals. 医护人员道德压力和自我意识调查。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-09-27 DOI: 10.1007/s10730-024-09539-0

Sharoon Shahzad, Rehana Sajid, Joel Fakhar, Ayesha Saleem Khan, Nizar Ali, Ahtisham Younas

{"title":"Survey of Moral Distress and Self-Awareness among Health Care Professionals.","authors":"Sharoon Shahzad, Rehana Sajid, Joel Fakhar, Ayesha Saleem Khan, Nizar Ali, Ahtisham Younas","doi":"10.1007/s10730-024-09539-0","DOIUrl":"10.1007/s10730-024-09539-0","url":null,"abstract":"Health care professionals experience moral distress due to challenging ethical decision-making during patient care. Self-awareness can be associated with moral distress. This study determined the levels of and relationship between moral distress and self-awareness of health care professionals. A convenience sample of physicians and nurses was recruited. Data were collected using the Moral Distress and Self-Awareness Scales. In total, 168 physicians and 201 nurses participated with a mean age of 30.54 ± 7.87 and clinical experience of 6.40 ± 6.22 years. Moderate levels of moral distress (127.07 ± 71.90) and high levels of self-awareness (70.20 ± 11.37) were found. A weak positive correlation was found between self-awareness and moral distress (r = 0.21, p < 0.001) and weak negative correlation between moral distress (r = - 0.115, p = 0.03) and age. Nurses were more self-aware, but no differences were observed in moral distress based on sex and clinical settings. A weak correlation between self-awareness and moral distress may suggest that self-awareness can increase intrapersonal tensions, contributing to distress. Further research is needed to support any conclusive relationship between moral distress and self-awareness.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"333-344"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Assistance in Dying, Slippery Slopes, and Availability of Care: A Reply to Koch. 死亡中的医疗援助、滑坡和护理的可用性：对科赫的回复。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-09-01 Epub Date: 2024-12-09 DOI: 10.1007/s10730-024-09543-4

Don A Merrell

引用次数: 0

An Ethics Consult Documentation Simplification Project: Summation of Participatory Processes, User Perceptions, and Subsequent Use Patterns. 伦理咨询文件简化项目：对参与过程、用户感知和后续使用模式的总结。

IF 1.6 4区哲学

Hec Forum Pub Date : 2025-06-01 Epub Date: 2024-10-10 DOI: 10.1007/s10730-024-09537-2

Meaghann S Weaver, Anita J Tarzian, Hannah N Hester, Karinne R Davidson, Rodney P Dismukes, Mary Beth Foglia

{"title":"An Ethics Consult Documentation Simplification Project: Summation of Participatory Processes, User Perceptions, and Subsequent Use Patterns.","authors":"Meaghann S Weaver, Anita J Tarzian, Hannah N Hester, Karinne R Davidson, Rodney P Dismukes, Mary Beth Foglia","doi":"10.1007/s10730-024-09537-2","DOIUrl":"10.1007/s10730-024-09537-2","url":null,"abstract":"Healthcare ethics consultants in the Veterans Health Administration (VHA) document consults in an enterprise-wide web-based database entitled IEWeb, serving as a system of record for healthcare ethics documentation at 1300 VA facilities. The need arose to evolve the database from an ethics process training resource into a more streamlined documentation repository that captures essential consult elements. A VHA National Center for Ethics in Health Care (NCEHC) Improvement Team convened for three tasks: (1) Specify and prioritize IEWeb changes (occurred via six focus groups composed of \"new user\" and \"super user\" cohorts with analysis of existing documentation patterns); (2) Pilot the changes regionally (via regional communication, training, and reviews of pre-post use patterns); and (3) Measure the impact of national change implementation on user perspectives (via pre-and post-change implementation polls). Focus groups identified six implementable priority areas for ethics consult documentation improvement, including the development of a usable consult summary note for ready conversion from IEWeb fields into the electronic health record. Post-IEWeb updates showed an increased number of consults documented, a reduction in \"time to consult documentation closure\" by a mean of 4.5 days, and a clinically-meaningful improvement in the quality of documentation (78% of ethics questions scored \"above-bar\" on the validation tool pre- vs. 89% scored \"above-bar\" post-IEWeb changes, n = 140). According to national survey findings, the number of consultants documenting \"all\" consults in IEWeb increased, satisfaction increased, and perception of documentation difficulty decreased. IEWeb simplification enabled ethics consultants to re-focus their documentation completion efforts by decreasing perception of documentation burden while improving documentation frequency and quality in a clinically-meaningful way.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"249-265"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0