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Impairment Arguments, Interests, and Circularity. 减值论证、利益和循环性。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae023
Stephen Napier
{"title":"Impairment Arguments, Interests, and Circularity.","authors":"Stephen Napier","doi":"10.1093/jmp/jhae023","DOIUrl":"10.1093/jmp/jhae023","url":null,"abstract":"<p><p>A common justification for abortion rights is that the death of the fetus does not violate any of the fetus's time-relative interests. The time-relative interest account (TRIA) of harm and wrongdoing tells us that a necessary condition for harming someone is that his or her time-relative interests are frustrated. Regarding the justification for abortion, this account falls prey to impairment arguments. Impairment arguments entertain cases of prenatal injury, such as the mother using illicit drugs that disable the child. The intuition is that the child who is born with such disabilities is harmed by the mother's drug use. But it is unclear what time-relative interest is violated in cases of prenatal harm. Typical responses to impairment arguments point out that the abortion case is different because the child does not exist to experience such harms; but in prenatal injury + survival cases, the child does live to experience those harms. Thus, the TRIA justification for abortion is not impugned by impairment counter-examples. This article argues that this response to impairment arguments is viciously circular. The response must say that so long as you kill the child, no harm is done. But this assumes that killing itself is morally inconsequential and is not itself a case of harm. The response to impairment arguments, then, assumes the permissibility of abortion.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"470-480"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
To Know Me Is to Exonerate Me: Appeals to Character in Defense of the Willowbrook Hepatitis Study. 认识我就是为我开脱罪责：为威洛布鲁克肝炎研究辩护的人格诉求》。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae024
John Lynch
{"title":"To Know Me Is to Exonerate Me: Appeals to Character in Defense of the Willowbrook Hepatitis Study.","authors":"John Lynch","doi":"10.1093/jmp/jhae024","DOIUrl":"10.1093/jmp/jhae024","url":null,"abstract":"<p><p>The Willowbrook Hepatitis Study is one of the best-known examples of unethical medical research, but the research has always had defenders. One of the more intriguing defenses continually used was that critics did not know the researchers on the study and, therefore, could not assess their ethics. This essay traces the appeal to the researchers' characters across published research and archival sources from the 1960s through today. These appeals reflect the observation as old as Aristotle that one of the most potent modes of persuasion is ethos or character. The specific types of character in these appeals develop out of the paternalistic nature of clinical and research practice in the mid-twentieth century. If the individual physician is the locus of medical judgment, then the physician's character becomes a key concern for bioethics. These appeals still appear and have implications for bioethics in the present day.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"499-511"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Is Cryocide an Ethically Feasible Alternative to Euthanasia? 冷冻杀戮在伦理上是否可以替代安乐死？
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae027
Gabriel Andrade, Maria Campo Redondo
{"title":"Is Cryocide an Ethically Feasible Alternative to Euthanasia?","authors":"Gabriel Andrade, Maria Campo Redondo","doi":"10.1093/jmp/jhae027","DOIUrl":"10.1093/jmp/jhae027","url":null,"abstract":"<p><p>While some countries are moving toward legalization, euthanasia is still criticized on various fronts. Most importantly, it is considered a violation of the medical ethics principle of non-maleficence, because it actively seeks a patient's death. But, medical ethicists should consider an ethical alternative to euthanasia. In this article, we defend cryocide as one such alternative. Under this procedure, with the consent of terminally-ill patients, their clinical death is induced, in order to prevent the further advance of their brain's deterioration. Their body is then cryogenically preserved, in the hope that in the future, there will be a technology to reanimate it. This prospect is ethically distinct from euthanasia if a different criterion of death is assumed. In the information-theoretic criterion of death, a person is not considered dead when brain and cardiopulmonary functions cease, but rather, when information constituting psychology and memory is lost.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"443-457"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Disability and Achievement: A Reply to Campbell, Nyholm, and Walter. 残疾与成就：答复坎贝尔、尼霍尔姆和沃尔特》。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae026
Ian D Dunkle
{"title":"Disability and Achievement: A Reply to Campbell, Nyholm, and Walter.","authors":"Ian D Dunkle","doi":"10.1093/jmp/jhae026","DOIUrl":"10.1093/jmp/jhae026","url":null,"abstract":"<p><p>In this article, I explore the impact of disability on one of life's goods: achievement. Contra Campbell, Nyholm, and Walter. I argue that construing the magnitude of achievements in terms of subjective effort trivializes what it means to achieve. This poses a problem for the authors' argument that disability, in general, does not reduce access to this good. I draw on an alternative construal of achievement that I have proposed elsewhere to show that, indeed, many disabilities do not restrict access to achievement. I defend this argument against an objection that it problematically relativizes the achievements of persons with disability, and I close with general lessons for future work.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"481-487"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Organ Donation by the Imminently Dead: Addressing the Organ Shortage and the Dead Donor Rule. 濒死者器官捐献：解决器官短缺和死亡捐献者规则。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae028
Sarah Chen, Robert M Sade, John W Entwistle
{"title":"Organ Donation by the Imminently Dead: Addressing the Organ Shortage and the Dead Donor Rule.","authors":"Sarah Chen, Robert M Sade, John W Entwistle","doi":"10.1093/jmp/jhae028","DOIUrl":"10.1093/jmp/jhae028","url":null,"abstract":"<p><p>The dead donor rule (DDR) has facilitated the saving of hundreds of thousands of lives. Recent advances in heart donation, however, have exposed how DDR has limited donation of all organs. We propose advancing the moment in the dying process at which death can be determined to increase substantially the supply of organs for transplantation. We justify this approach by identifying certain flaws in the Uniform Determination of Death Act and proposing a modification of that law that permits earlier procurement of healthier organs in greater numbers.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"458-469"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Cognitive Enhancement, Hyperagency, and Responsibility Explosion. 认知增强、超代理和责任爆炸。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-09-03 DOI: 10.1093/jmp/jhae025
Emma C Gordon
{"title":"Cognitive Enhancement, Hyperagency, and Responsibility Explosion.","authors":"Emma C Gordon","doi":"10.1093/jmp/jhae025","DOIUrl":"10.1093/jmp/jhae025","url":null,"abstract":"<p><p>Hyperagency objections appeal to the risk that cognitive enhancement may negatively impact our well-being by giving us too much control. I charitably formulate and engage with a prominent version of this objection due to Sandel (2009) -viz., that cognitive enhancement may negatively impact our well-being by creating an \"explosion\" of responsibilities. I first outline why this worry might look prima facie persuasive, and then I show that it can ultimately be defended against. At the end of the day, if we are to resist cognitive enhancement, it should not be based on a Sandel-style hyperagency argument.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"488-498"},"PeriodicalIF":1.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Do Not Risk Homicide: Abortion After 10 Weeks Gestation. 不要冒险杀人：怀孕 10 周后堕胎。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-07-11 DOI: 10.1093/jmp/jhae018
Matthew Braddock
{"title":"Do Not Risk Homicide: Abortion After 10 Weeks Gestation.","authors":"Matthew Braddock","doi":"10.1093/jmp/jhae018","DOIUrl":"10.1093/jmp/jhae018","url":null,"abstract":"<p><p>When an abortion is performed, someone dies. Are we killing a human person? Widespread disagreement exists. However, it is not necessary to establish personhood in order to establish the wrongness of abortion: a substantial chance of personhood is enough. We defend The Do Not Risk Homicide Argument: abortions are wrong after 10 weeks gestation because they substantially and unjustifiably risk homicide, the unjust killing of a human person. Why 10 weeks? Because the cumulative evidence establishes a substantial chance (a more than one in five chance) that preborn human beings are persons after 10 weeks (if not before then). We submit evidence from our bad track record, widespread disagreement about personhood (after 10 weeks gestation), problems with theories of personhood, the similarity between preborn human beings and premature newborns, miscalculations of gestational age, and the common intuitive responses of women to their pregnancies and miscarriages. Our argument is cogent because it bypasses the stalemate over preborn personhood and rests on common ground rather than contentious metaphysics. It also strongly suggests that society must do more to protect preborn human beings. We briefly discuss its practical implications for fetal pain relief, social policy, and abortion law.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"414-432"},"PeriodicalIF":1.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
What Happens When the Zygote Divides? On the Metaphysics of Monozygotic Twinning. 当胎儿分裂时会发生什么？论单卵双生的形而上学。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-07-11 DOI: 10.1093/jmp/jhae022
Jeremy W Skrzypek
{"title":"What Happens When the Zygote Divides? On the Metaphysics of Monozygotic Twinning.","authors":"Jeremy W Skrzypek","doi":"10.1093/jmp/jhae022","DOIUrl":"10.1093/jmp/jhae022","url":null,"abstract":"<p><p>It is often argued that certain metaphysical complications surrounding the phenomenon of monozygotic twinning force us to conclude that, prior to the point at which twinning is no longer possible, the zygote or early embryo cannot be considered an individual human organism. In this essay, I argue, on the contrary, that there are in fact several ways of making sense of monozygotic twinning that uphold the humanity of the original zygote, but also that there is no easy answer to what happens when the human zygote twins. All of the options available carry with them one or more surprising, alarming, or otherwise counterintuitive implications. All things considered, I conclude that the \"budding option,\" according to which the original human organism present before twinning carries on as one of the resulting embryos but not the other, is the most plausible explanation of what happens when a human zygote twins.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"336-353"},"PeriodicalIF":1.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Wakefield's Harm-Based Critique of the Biostatistical Theory. 韦克菲尔德对生物统计理论的基于伤害的批判。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-07-11 DOI: 10.1093/jmp/jhae017
Christopher Boorse
{"title":"Wakefield's Harm-Based Critique of the Biostatistical Theory.","authors":"Christopher Boorse","doi":"10.1093/jmp/jhae017","DOIUrl":"10.1093/jmp/jhae017","url":null,"abstract":"<p><p>Jerome Wakefield criticizes my biostatistical analysis of the pathological-as statistically subnormal biological part-functional ability relative to species, sex, and age-for its lack of a harm clause. He first charges me with ignoring two general distinctions: biological versus medical pathology, and disease of a part versus disease of a whole organism. He then offers 10 counterexamples that, he says, are harmless dysfunctions but not medical disorders. Wakefield ends by arguing that we need a harm clause to explain American psychiatry's 1973 decision to declassify homosexuality. I reply, first, that his two distinctions are philosophic fantasies alien to medical usage, invented only to save his own harmful-dysfunction analysis (HDA) from a host of obvious counterexamples. In any case, they do not coincide with the harmless/harmful distinction. In reality, medicine admits countless chronic diseases that are, contrary to Wakefield, subclinical for most of their course, as well as many kinds of typically harmless skin pathology. As for his 10 counterexamples, no medical source he cites describes them as he does. I argue that none of his examples contradicts the biostatistical analysis: all either are not part-dysfunctions (situs inversus, incompetent sperm, normal-flora infection) or are indeed classified as medical disorders (donated kidney, Typhoid Mary's carrier status, latent tuberculosis or HIV, cherry angiomas). And if Wakefield's HDA fits psychiatry, the fact that it does not fit medicine casts doubt on psychiatry's status as a medical specialty.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"367-388"},"PeriodicalIF":1.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Ethical Problems of Observational Studies and Big Data Compared to Randomized Trials. 观察研究和大数据与随机试验相比存在的伦理问题。
IF 1.3 3区 哲学
Journal of Medicine and Philosophy Pub Date : 2024-07-11 DOI: 10.1093/jmp/jhae021
Jean Raymond, Robert Fahed, Tim E Darsaut
{"title":"Ethical Problems of Observational Studies and Big Data Compared to Randomized Trials.","authors":"Jean Raymond, Robert Fahed, Tim E Darsaut","doi":"10.1093/jmp/jhae021","DOIUrl":"10.1093/jmp/jhae021","url":null,"abstract":"<p><p>The temptation to use prospective observational studies (POS) instead of conducting difficult trials (RCTs) has always existed, but with the advent of powerful computers and large databases, it can become almost irresistible. We examine the potential consequences, were this to occur, by comparing two hypothetical studies of a new treatment: one RCT, and one POS. The POS inevitably submits more patients to inferior research methodology. In RCTs, patients are clearly informed of the research context, and 1:1 randomized allocation between experimental and validated treatment balances risks for each patient. In POS, for each patient, the risks of receiving inferior treatment are impossible to estimate. The research context and the uncertainty are down-played, and patients and clinicians are at risk of becoming passive research subjects in studies performed from an outsider's view, which potentially has extraneous objectives, and is conducted without their explicit, autonomous, and voluntary involvement and consent.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":"389-398"},"PeriodicalIF":1.3,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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