Journal of Law Medicine & Ethics最新文献

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"I Want to Be Interdependent": An Exploratory Study on the Use of Supported Decision-Making for People with Serious Mental Illness. “我要相互依赖”:重度精神疾病患者辅助决策应用的探索性研究
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2025.10189
Fitore Hyseni, Jonathan G Martinis, Fatma Altunkol Wise, Nanette J Goodman, Elyn R Saks, Peter Blanck
{"title":"\"I Want to Be Interdependent\": An Exploratory Study on the Use of Supported Decision-Making for People with Serious Mental Illness.","authors":"Fitore Hyseni, Jonathan G Martinis, Fatma Altunkol Wise, Nanette J Goodman, Elyn R Saks, Peter Blanck","doi":"10.1017/jme.2025.10189","DOIUrl":"10.1017/jme.2025.10189","url":null,"abstract":"<p><p>This exploratory study aimed to empower people with serious mental illness to create and implement supported decision-making plans and study the impact on their decision-making process. We found that study participants were able to: (1) use supported decision-making once empowered to do so; (2) decide when and how to use supported decision-making; and (3) develop individualized decision-making strategies based upon their unique characteristics and situations. The adoption of supported decision-making in clinical practice, research, and policy is essential to ensure the rights and well-being of adults with decisional incapacity. In particular, integrating supported decision-making into clinical research protocols can enhance informed consent processes and promote meaningful participation of individuals with serious mental illness, balancing respect for their autonomy with appropriate protections.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"74-84"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534341","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
Using Supported Decision-Making to Promote Value-Aligned Research Participation. 使用支持决策促进价值一致的研究参与。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 Epub Date: 2026-05-28 DOI: 10.1017/jme.2025.10188
Shen Pan, Robert D Dinerstein, David Wendler
{"title":"Using Supported Decision-Making to Promote Value-Aligned Research Participation.","authors":"Shen Pan, Robert D Dinerstein, David Wendler","doi":"10.1017/jme.2025.10188","DOIUrl":"10.1017/jme.2025.10188","url":null,"abstract":"<p><p>This article explores the potential of supported decision-making for helping individuals with intellectual or cognitive disabilities to make value-aligned or authentic decisions with respect to participation in clinical research. We argue that supported decision-making is valuable in this context not merely because it promotes self-determination, but also because it increases the likelihood that individuals' decisions align with what matters to them. To realize this potential, it is important to recognize and address situations in which individuals with intellectual or cognitive disabilities are at increased risk of making decisions that are contrary to their values. We focus on two such situations in particular: when the individual must integrate multiple, potentially competing values, and when the relevant values are insufficiently specified and require unpacking. These challenges can be met, we propose, by integrating dialectical support - a form of structured, dialogue-based assistance designed to help individuals explore and apply their values - into supported decision-making practices.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 S2","pages":"27-36"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044480","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
Dignity as Sovereignty. 尊严即主权。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 Epub Date: 2026-03-25 DOI: 10.1017/jme.2025.10212
Jennifer Hardes Dvorak
{"title":"Dignity as Sovereignty.","authors":"Jennifer Hardes Dvorak","doi":"10.1017/jme.2025.10212","DOIUrl":"10.1017/jme.2025.10212","url":null,"abstract":"<p><p>This commentary suggests that the meaning and content of dignity is bound to the broader question of who is said to have personhood and sovereignty, and thus protection and rights under the law, and who is excluded from our legal community.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 1","pages":"34-35"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516150","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
Sociolegal Reproductive Coercion: A Framework for Understanding Structural Pressures on Reproductive Decision-Making. 社会法律生育强制:一个理解生育决策结构性压力的框架。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2026.10266
Laura E T Swan, Klaira Lerma, Lindsay M Cannon, Fran Linkin
{"title":"Sociolegal Reproductive Coercion: A Framework for Understanding Structural Pressures on Reproductive Decision-Making.","authors":"Laura E T Swan, Klaira Lerma, Lindsay M Cannon, Fran Linkin","doi":"10.1017/jme.2026.10266","DOIUrl":"10.1017/jme.2026.10266","url":null,"abstract":"<p><p>Recent US policy changes, including abortion bans and reductions to social safety nets, have intensified structural pressures on reproductive decision-making. Research has examined interpersonal and clinical forms of reproductive coercion, but legal and policy forces remain undertheorized. This commentary introduces and defines sociolegal reproductive coercion as occurring when individuals feel pressured or constrained in their reproductive choices due to legal and policy landscapes that are reinforced and reified by social and cultural forces. These pressures operate collectively to make certain options, such as long-acting reversible contraception, feel obligatory even when undesired, by amplifying risks associated with pregnancy, abortion, and parenting. Sociolegal coercion interacts with clinical practice, shaping provider counseling and narrowing perceived options, and disproportionately affects marginalized communities already subject to systemic inequities. We situate this construct within existing scholarship on constrained choice and social control, propose a conceptual framework, and outline implications for research, clinical care, and policy. Recognizing sociolegal reproductive coercion is critical for understanding how health policy and sociocultural dynamics jointly constrain autonomy and for informing reforms that advance reproductive justice in a post-<i>Roe</i> landscape.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"255-258"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876346","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
Body and Soul: How Neuroimaging Should Revise Tort Perspectives on PTSD. 身体与灵魂:神经影像如何修正创伤后应激障碍的侵权观点。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2026.10247
Alexandra Midler
{"title":"Body <i>and</i> Soul: How Neuroimaging Should Revise Tort Perspectives on PTSD.","authors":"Alexandra Midler","doi":"10.1017/jme.2026.10247","DOIUrl":"10.1017/jme.2026.10247","url":null,"abstract":"<p><p>Tort law has traditionally prioritized physical over emotional injury claims, due in part to insufficient methods of quantifying the latter. But advances in neuroimaging now make it possible to measure the distinct (and often chronic) neurological damage caused by PTSD, suggesting that it should be treated as both a physical and emotional harm. I argue that this recategorization may help PTSD victims win just restitution, especially for those from marginalized groups whose suffering has traditionally been overlooked and underappreciated by the legal system. Lingering probative and prejudicial flaws will likely limit current judicial applications of PTSD neuroimaging to citations of aggregate research. Until the technology improves in accuracy and sensitivity, individual PTSD neuroimaging on tort plaintiffs will fail to meet most state and federal evidentiary standards. When it does achieve sufficient reliability, neuroimaging precedent for traumatic brain injury may offer guidance on how to incorporate the technology without creating a \"CSI effect\" that harms plaintiffs unable to access or afford brain scans. PTSD neuroimaging may ultimately foster a greater appreciation for the physical toll of psychological illnesses, catalyzing the movement to dismantle the mind-body divide in tort jurisprudence.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"263-274"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366915","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
Minding the Gap: The Absence of Pennsylvania's Involuntary Commitment Data. 注意差距:宾夕法尼亚州非自愿承诺数据的缺失。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2026.10264
Ari Gluckman, Michele Mekel, Laura Cabrera
{"title":"Minding the Gap: The Absence of Pennsylvania's Involuntary Commitment Data.","authors":"Ari Gluckman, Michele Mekel, Laura Cabrera","doi":"10.1017/jme.2026.10264","DOIUrl":"10.1017/jme.2026.10264","url":null,"abstract":"<p><p>An involuntary commitment is a rights-restrictive procedure that is rarely afforded visibility through useful data. Pennsylvania is a nationally relevant case study on the promises, perils, and misconceptions surrounding involuntary commitment data. In this study, we survey the minimal available Pennsylvania data and then contextualize our results within state laws and norms by (1) framing involuntary commitment data within the state's gun control agenda, (2) implementing the language of undone science, agnotology, and visibility, and (3) discussing the rights and social obligations surrounding privacy, confidentiality, and dangerousness. We find that sensitive administrative data is collected at several points during the involuntary commitment process but is rarely available in a useful, de-identified form. Improved access to useful data about the commitment population would close a major gap in state and national healthcare delivery, policy, and accountability.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"328-338"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845513","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
Ethical and Legal Dilemmas in Prolonged Physiologic Support after Brain Death in Previable Pregnancy. 妊娠前脑死亡后延长生理支持的伦理和法律困境。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2026.10260
April R Dworetz, Allison M Whelan, Ashley Waddell Tingstad, Kara B Markham, DonnaMaria E Cortezzo
{"title":"Ethical and Legal Dilemmas in Prolonged Physiologic Support after Brain Death in Previable Pregnancy.","authors":"April R Dworetz, Allison M Whelan, Ashley Waddell Tingstad, Kara B Markham, DonnaMaria E Cortezzo","doi":"10.1017/jme.2026.10260","DOIUrl":"10.1017/jme.2026.10260","url":null,"abstract":"<p><p>Providing physiologic support to a brain-dead pregnant decedent poses complex ethical, legal, and clinical challenges. Understanding these considerations is necessary to navigate complex discussion and provide appropriate medical care. We use a theoretical case to examine these considerations and outline a path forward.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"290-300"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693284","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
Centering Lived and Living Experience: The Key to Effective and Equitable Medicaid Section 1115 Reentry Waivers. 以生活和生活经验为中心:有效和公平的医疗补助条款1115再入豁免的关键。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 Epub Date: 2026-04-16 DOI: 10.1017/jme.2026.10226
Anna Steiner, Emma Kaeser, Susan M Fleurant, Dorel Clayton, Shira Shavit
{"title":"Centering Lived and Living Experience: The Key to Effective and Equitable Medicaid Section 1115 Reentry Waivers.","authors":"Anna Steiner, Emma Kaeser, Susan M Fleurant, Dorel Clayton, Shira Shavit","doi":"10.1017/jme.2026.10226","DOIUrl":"10.1017/jme.2026.10226","url":null,"abstract":"<p><p>When returning to their communities after incarceration, individuals face elevated rates of mortality and other poor health outcomes. The reentry period provides a critical opportunity for interventions to improve health, but, historically, a prohibition on federal Medicaid coverage during incarceration has created barriers to care after release. To address these barriers, many states have applied for Medicaid section 1115 reentry waivers to expand access to Medicaid coverage for certain pre- and post-release services. These waivers present an important opportunity to improve care access during reentry, but, if driven by carceral entities, they run the risk of replicating carceral systems that harm health. This article advocates for an alternative approach: centering the perspectives of people with lived experience of incarceration in all aspects of waiver design, implementation, and evaluation. Drawing on personal and professional experience, the authors explore the value of centering lived experience in health policy and identify successes, challenges, and lessons learned from California's waiver. This article also explores the importance of centering lived experience in information sharing and privacy practices in waiver implementation. Across these areas, waivers driven by lived experience can promote dignity, autonomy, and wellbeing, dismantling carceral approaches that reinforce stigma, erode trust, and perpetuate inequities.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 S1","pages":"26-31"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693299","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
Disaggregating Public Health Data by Race and Ethnicity to Improve Public Health. 按种族和民族分类公共卫生数据以改善公共卫生。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 Epub Date: 2026-04-16 DOI: 10.1017/jme.2026.10232
Leslie Zellers, Amy Vertal, Lloyd Feng, Mar Velez
{"title":"Disaggregating Public Health Data by Race and Ethnicity to Improve Public Health.","authors":"Leslie Zellers, Amy Vertal, Lloyd Feng, Mar Velez","doi":"10.1017/jme.2026.10232","DOIUrl":"10.1017/jme.2026.10232","url":null,"abstract":"<p><p>Disaggregation of public health data by race and ethnicity is critical to understanding health disparities and driving progress toward health equity. While the federal government updated the minimum set of categories federal agencies must use when collecting race and ethnicity data, implementation of these standards remains uncertain. Additionally, federal standards set a floor; states can adopt laws requiring additional data collection specific to their population. As of May 2025, 13 states have passed laws to require disaggregation of race and ethnicity. One state - New York - is implementing the Asian and Native Hawaiian/Pacific Islander (NHPI) Data Disaggregation Law. Challenges include finding effective pressure points for the state agencies that are required to update data and helping agencies access funding for necessary changes. In California, the 2024 Latine and Indigenous Health Disparities Act builds on previous data disaggregation legislation for the Asian and NHPI community in California. Challenges with the bill's adoption included pressure to narrow the agencies affected by the law and creating an appropriate implementation timeline. Key considerations in the adoption of a state data disaggregation law or policy include educating policymakers about the importance of data disaggregation, determining the scope of the policy, and preparing for implementation.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 S1","pages":"70-78"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693378","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
From Decision Supporter to Informed Surrogate: An Improved Approach to Enrolling Cognitively Impaired Subjects in Clinical Research. 从决策支持者到知情代理人:在临床研究中招募认知障碍受试者的改进方法。
IF 1.3 4区 哲学
Journal of Law Medicine & Ethics Pub Date : 2026-01-01 DOI: 10.1017/jme.2025.10197
Robert Randolph Harrison, Alannah Trombetta
{"title":"From Decision Supporter to Informed Surrogate: An Improved Approach to Enrolling Cognitively Impaired Subjects in Clinical Research.","authors":"Robert Randolph Harrison, Alannah Trombetta","doi":"10.1017/jme.2025.10197","DOIUrl":"10.1017/jme.2025.10197","url":null,"abstract":"<p><p>While supported decision-making for persons with dynamic cognitive impairment has been considered in the context of medical treatment, there has been little attention to its application in the context of enrolling cognitively impaired subjects in clinical research. The Common Rule allows enrollment permission from a Legally Authorized Representative, one empowered under institutional policy to provide consent for subjects lacking decision-making capacity, but many Legally Authorized Representatives lack knowledge of the person's values and preferences adequate to an ethically valid judgement about research enrollment. Supported decision-making and surrogate decision-making can be complementary as subjects transition between impairment stages, providing an opportunity to address ethical problems with the current practice of reliance on uninformed surrogates. Through designation of a supporter who is willing to serve through the progression of impairment, dementia patients choose their supporter and ultimate surrogate, engage with them on the issues that later give rise to requests to enroll the subject in research, and ensure that the surrogate will have knowledge of the values and preferences of the subject necessary to an ethically defensible substituted judgement. Legal frameworks can be adapted to provide recognition of research enrollment as an area of valid decision by supporters on behalf of beneficiaries.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"67-73"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534268","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
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