Developing World Bioethics最新文献

{"title":"Ration health resources to save more statistical lives from cervical cancer death in Africa: Why are we allowing them to die?","authors":"Adolf Kofi Awua","doi":"10.1111/dewb.12434","DOIUrl":"https://doi.org/10.1111/dewb.12434","url":null,"abstract":"<p><p>Public health interventions, particularly in low- and middle-income countries (LMICs), are implemented with the never-ending challenge of limited resources and the ever-present challenge of choosing between interventions. While necessary, the application of ethical analysis is absent in most of such decision-making, resulting in fewer favourable consequences. In applying ethical principles to the saving of women from the burden of cervical cancer, I argue in favour of saving statistical lives (investing in prevention) in LMICs, by mapping the principles of justice in resource allocation to the prevailing circumstance. The key facts in this circumstance are that providing treatment (which is saving identified lives), involves mostly providing palliative treatment, which is associated with a high likelihood of death among the identified lives while undergoing treatment or shortly thereafter. I focus on the dilemma of having a national cancer prevention program versus the expansion of cancer treatment facilities.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650415","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}

{"title":"Bioethics and witnessing","authors":"Debora Diniz","doi":"10.1111/dewb.12432","DOIUrl":"10.1111/dewb.12432","url":null,"abstract":"<p>Bioethics is about abstract reasoning and philosophical thinking.1 It is also about listening and telling stories; it is about ethical care and political imagination. In my way of doing bioethics, I need ethnography—the process of listening, feeling, and sharing lives—to understand how and why bioethical issues, such as life and death, care and abandonment, power and need, are lived concretely by people. It is a constant tension between the abstract concepts and the lived lives of people.</p><p>I know that it is not a shared definition, but doing bioethics means being an accompaniment-witness with the duty to speak the truth.2 It is not just the academic truth of methods and reasonable arguments; it is a truth that respects people's lives and actively seeking to challenge the oppressive powers. There is always a risk in doing bioethics as an accompaniment-witness—the risk of not properly listening to people and failing to fully respect their stories. I write academic papers, I make documentary films, I photograph fragments of survival and care, yet I struggle with not knowing how to best share my findings with people that matters the most: those at the center of the needs. To listen to them is to receive fragments of life and intimacy: my writings and images are formats for sharing back what they offer; and they are always precarious.</p><p>The ethical compromise to, first, share with them the academic work and to be challenged by them is one of the reasons that led me to make films and take pictures—as these are artistic ways of expressing my understandings in formats that are not just the jargon of academic papers; films and photos are languages that cross our multiple communities of expression. I always share my academic outcomes with women before moving from the role of listener to the public writer. Usually what happens is that they watch the film and recommend edits; they select the pictures they prefer. Not rarely, they ask me for new shots or new poses. They tell new fragments of life, and I am invited to be a listener again. We redo the work together.</p><p>I can imagine some readers arguing that this community engagement might contaminate my work or even introduce a pervasive bias into my writings. I have no counterarguments to this position, as I do not seek neutrality in my work, but rather I want to be reliable to the communities of practice in which I engage. And the academic community is just one of them. The gesture of sharing my writing or films with the communities is not the same as accepting their narratives or perspectives on the ethical issues: I am the author of my work, and the responsibility of how I frame their narratives is mine. It is more a movement of having them as my first interlocutors for whatever I want to say about their lives. As I do with my academic colleagues, I will open a conversation about my work, and in case of deep disagreements, we will find solutions to deal with them. As in academic dialogues, i","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488434","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}

{"title":"Family-based consent and motivation for familial organ donation in Bangladesh: An empirical exploration.","authors":"Md Sanwar Siraj","doi":"10.1111/dewb.12431","DOIUrl":"https://doi.org/10.1111/dewb.12431","url":null,"abstract":"<p><p>The government of Bangladesh approved the human organ transplantation law in 1999 and updated it in 2018. This legislation approved both living-related donor and posthumous organ transplantation. The law only allows family members to legally donate organs to their relatives. The main focus of this study was to explore how Bangladeshis make donation decisions on familial organs for transplantation. My ethnographic fieldwork with forty participants (physicians and nurses, a healthcare administrator, organ donors, recipients, and their relatives) disclosed that the organ donation decision was family-based. An assessment of the relationship between religion, culture, and biomedicine leads to the conclusion that deciding on donating organs to relatives is primarily family-based and is perceived to be steeped in Islamic ethical principles and religious cultural tradition. The family-based consent and motivation for donor-recipient pair organ transplantation strengthen an altruistic environment for the family and act as the moral and legal authority that ensures ethical healthcare outcomes for Bangladeshis.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684492","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}

{"title":"Euthanasia in Colombia: Experience in a palliative care program and bioethical reflections.","authors":"Marcela Erazo-Munoz,&nbsp;Diana Borda-Restrepo,&nbsp;Johana Benavides-Cruz","doi":"10.1111/dewb.12430","DOIUrl":"https://doi.org/10.1111/dewb.12430","url":null,"abstract":"<p><p>The increased prevalence of advanced-stage chronic diseases has augmented the need for palliative care teams. In Colombia, although the legislation promotes palliative care development, people still die without receiving management from a palliative care team. In addition, judiciary regulations regarding euthanasia have generated public confusion and ethical conflicts among members of the palliative care teams. Therefore, this study aimed to perform a bioethical reflection on the relationship between palliative care and euthanasia supported by data on euthanasia requests in a palliative care program. This reflection is based on retrospective and descriptive observational data, collected in two highly complex hospitals in Bogotá, Colombia. A total of 50 euthanasia requests were identified, of which 62% met the defined criteria, 16% did not, and 22% were not considered by the interdisciplinary committee for the right to die with dignity due to early death. All patients were treated and followed up by a palliative care team until their death. This study considered that palliative care could be a complement management for patients requesting euthanasia based on their experience by supporting the decision-making, alleviating suffering, and providing emotional support in the last days of life.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240587","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}

{"title":"Proportionality and Mexico's pandemic management during the COVID-19 crisis.","authors":"Felicitas Holzer,&nbsp;Ivette M Ortiz Alcántara,&nbsp;Tobias Eichinger,&nbsp;Julian W März","doi":"10.1111/dewb.12429","DOIUrl":"https://doi.org/10.1111/dewb.12429","url":null,"abstract":"<p><p>Mexico's pandemic management and the absence of measures have been harshly criticized as being disproportionate. This paper examines whether the proportionality principle was properly applied to Mexico's COVID-19 response and outlines three reasons against such an endeavor, namely (i) the content of \"proportionate measures\" remained insufficiently well defined, (ii) there were yet fundamental rights conflicts to resolve, and (iii) the situation was moreover characterized by epistemic uncertainty.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240588","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}

{"title":"Global health impact, priority and time","authors":"Anders Herlitz","doi":"10.1111/dewb.12428","DOIUrl":"10.1111/dewb.12428","url":null,"abstract":"<p>This paper addresses normative issues that arise in relation to indicators and measures of health impact. With inspiration from Nicole Hassoun's recent proposal, the paper argues and illustrates that those interested in measuring global health impact face questions about how to prioritize among those with ill-health, how to weigh benefits to those who cannot lead minimally good lives against benefits to the better off, and how to think about whether someone is badly off.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219235","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}

{"title":"Examining the adequacy of preoperative informed consent in a developing country: Challenges in the era of surgical specialisation.","authors":"Osita Ede,&nbsp;Oke R Obadaseraye,&nbsp;Ifeanyi Anichi,&nbsp;Chisom Mbaeze,&nbsp;Chukwuka O Udemezue,&nbsp;Chinonso Basil-Nwachuku,&nbsp;Kenechi A Madu,&nbsp;Emmanuel C Iyidobi,&nbsp;Udo E Anyaehie,&nbsp;Cajetan U Nwadinigwe,&nbsp;Chidinma Ngwangwa,&nbsp;Uto Essien Adetula","doi":"10.1111/dewb.12427","DOIUrl":"https://doi.org/10.1111/dewb.12427","url":null,"abstract":"<p><p>Preoperative informed consent is a legal and ethical requirement that ensures patients understand a procedure, its associated risks and benefits, alternative treatment options, and potential complications to make an informed decision about their care. This cross-sectional study evaluated the informed consent process for major orthopaedic surgeries at a tertiary hospital in Nigeria. A self-administered questionnaire was used to collect data from 120 adult participants. Results showed that many patients do not read the consent form before signing it, and surgeons do not adequately explain the alternatives to surgery, potential risks, and available anaesthetic options. Higher-educated patients are more likely to read the consent form. Surgeons performed well in explaining the nature of the condition and prognosis, the procedure's potential benefits, and answering patients' questions. The study emphasises the need to improve the informed consent process to ensure patients understand and can make rational decisions about their healthcare.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150864","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}

{"title":"Are Turkish doctors in deep water? The role of professional ethics and factors affecting the medical brain drain: A qualitative study from Turkey.","authors":"F Gülsüm Önal,&nbsp;Fatih Erkan Akay","doi":"10.1111/dewb.12426","DOIUrl":"https://doi.org/10.1111/dewb.12426","url":null,"abstract":"<p><p>With the increased rate of the Turkish medical brain drain (MDB) in recent years, there is a need for more comprehensive studies to elucidate its vague migratory factors. The aim of this paper is to try to narrow that gap by analyzing present impacts of the MDB in Turkey and to evaluate if these aspects were driven by professional ethical values, and if so, what ethical principles they were based on. In-depth interviews were conducted with 19 doctors from various backgrounds, followed by a thematic analysis. The MDB in Turkey demonstrated a multifactorial structure, with prominent push factors that are intertwined at macro-meso-micro levels. The effort to maintain the principles of beneficence, non-maleficence, and protecting professional autonomy were the most important in the context of professional ethics. Only deep-rooted regulations might ensure the prevention of the MDB in Turkey and the prospect of doctors returning in the future. Conclusively, the recent criticisms the MDB has been garnering may inspire improvements in deteriorating human and health rights in Turkey.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168681","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}

{"title":"Editors' statement on the responsible use of generative artificial intelligence technologies in scholarly journal publishing","authors":"Gregory E. Kaebnick,&nbsp;David Christopher Magnus,&nbsp;Audiey Kao,&nbsp;Mohammad Hosseini,&nbsp;David Resnik,&nbsp;Veljko Dubljević,&nbsp;Christy Rentmeester,&nbsp;Bert Gordijn","doi":"10.1111/dewb.12424","DOIUrl":"10.1111/dewb.12424","url":null,"abstract":"<p>The new generative artificial intelligence (AI) tools, and especially the large language models (LLMs) of which ChatGPT is the most prominent example, have the potential to transform many aspects of scholarly publishing. How the transformations will play out remains to be seen, both because the different parties involved in the production and publication of scholarly work are still learning about these tools and because the tools themselves are still in development, but the tools have a vast range of potential uses. Authors are likely to use generative AI to conduct research, frame their thoughts, produce data, search for ways of articulating their thoughts, develop drafts, generate text, revise their writing, and create visuals. Peer reviewers might use AI to help them produce their reviews. Editors might use AI in the initial editorial screening of manuscripts, to locate reviewers, or for copyediting.</p><p>We are editors of bioethics and humanities journals who have been contemplating the implications of this ongoing transformation. We believe that generative AI may pose a threat to the goals that animate our work but could also be valuable for achieving those goals. We do not pretend to have resolved the many social questions that we think generative AI raises for scholarly publishing, but in the interest of fostering a wider conversation about these questions, we have developed a preliminary set of recommendations about generative AI in scholarly publishing. We hope that the recommendations and rationales set out here will help the scholarly community navigate toward a deeper understanding of the strengths, limits, and challenges of AI for responsible scholarly work.</p><p>The stance set out here is consistent with those taken by the Committee on Publishing Ethics and many journal publishers, including those that publish or provide publishing services to the journals we edit. Previous position statements have addressed concerns about the use of AI for peer review and the importance of reviewers revealing to authors if they used AI in their review.5 However, to our knowledge, none have addressed the importance of using human reviewers to review manuscripts and editors retaining final decisions over what reviewers to select. Our stance differs from the position of <i>Science</i> magazine, which holds not only that a generative AI tool cannot be an author but also that “text generated by ChatGPT (or any other AI tools) cannot be used in the work, nor can figures, images, or graphics be the products of such tools.”6 Such a proscription is too broad and may be impossible to enforce, in our view. Yet we recognize that the ethical issues raised by generative AI are complex, and we have struggled to decide how editors should promote responsible use of these technologies. Over time, we hope, the community of scholars will develop professional norms about the appropriate ways of using these new tools. Reviewers and readers, not just editors, will h","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156134","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}

{"title":"A Sino-African perspective and the morality of procreation.","authors":"Luís Cordeiro-Rodrigues,&nbsp;Qingjuan Sun,&nbsp;Aribiah David Attoe,&nbsp;Cornelius Ewuoso","doi":"10.1111/dewb.12425","DOIUrl":"https://doi.org/10.1111/dewb.12425","url":null,"abstract":"Current studies of anti/-natalism have been carried out mainly in the context of western philosophy. In this article, we offer a pro-natalist view based on Confucian and Afro-communitarian philosophy (Sino-African ethics). Grounded in this Sino-African perspective, we uphold that there is, at least, one reason to believe that not only is it morally permissible to procreate, but also that on some occasions, procreating is what morality prescribes. Specifically, we contend that, from a Sino-African perspective, procreating sometimes is the best way to fulfil duties of reciprocity and care towards our parents.","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180414","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}