Developing World Bioethics最新文献

{"title":"A market for diagnostic devices for extreme point-of-care testing: Are we ASSURED of an ethical outcome?","authors":"Mark Howard","doi":"10.1111/dewb.12389","DOIUrl":"10.1111/dewb.12389","url":null,"abstract":"<p>The World Health Organisation (WHO) is leading a global effort to deliver improved diagnostic testing to people living in low-resource settings. A reliance on the healthcare technologies marketplace and industry, shapes many aspects of the WHO project, and in this situation normative guidance comes by way of the ASSURED criteria — Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free, and Delivered. While generally improving access to diagnostics, I argue that the ASSURED approach to distributive justice — efficiency — and assessment of worth — productivity — may constrain efforts to deliver timely and accurate diagnosis in the developing world equitably by holding back new and innovative diagnostics and indirectly encouraging program and device design that may unfairly discriminate against certain groups. Even as we try to overcome the problem of global healthcare injustice, we may be entrenching disadvantage. I present my critique of ASSURED by 1) referencing Boltanski and Thévenot's theory of orders of worth to highlight the industrial and market foundations of the ASSURED guidelines; 2) comparing ASSURED with other normative guides that elevate the importance of civic responsibility in evaluations of distributive justice; 3) presenting a case study of the failed promise of microfluidic diagnostic devices. I conclude that a new approach to normative guidance is required to assess the value of developing world diagnostics, preferably, one that does not force global public goods into the marketplace.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553532","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":"Population, abortion, contraception, and the relation between biopolitics, bioethics, and biolaw in Iran","authors":"Kiarash Aramesh","doi":"10.1111/dewb.12386","DOIUrl":"10.1111/dewb.12386","url":null,"abstract":"<p>The Islamic government of Iran recently passed and announced a new law titled “Rejuvenation of the Population and Protection of the Family.” This legislation is a noteworthy example of biopolitics-influenced biolaw. In terms of abortion, contraception, prenatal screening, and population control, this law clearly contrasts with women's fundamental rights and freedoms and has significant health-related consequences for different sectors of the population. A historical review of the population policies of the Islamic Republic of Iran shows the occurrence of multiple abrupt and radical changes in such policies over the past four decades. This new law, promoted by religious biopolitics, is the most recent example, and places stringent limits on abortion. According to it, all decisions concerning abortion must be made in courts rather than in health clinics. Such courts are typically presided over by male religious scholars. This law also limits prenatal screening to the degree that will increase the rate of genetic defects, especially in the population's lower socioeconomic strata. By strictly limiting access to contraception, this law will increase the rate of unwanted pregnancies and sexually transmitted diseases. This paper argues that such an influence of biopolitics on biolaw contrasts with the principles of bioethics. Still, Iran's current institution of bioethics cannot address it effectively. Therefore, a new model of interaction between bioethics, biopolitics, and biolaw is needed to prevent the detrimental consequences of such pieces of legislation. Such a paradigm shift is demanded by the current “Woman, Life, Freedom” movement of the Iranian people.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9105373","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":"Power and respect in global health research collaboration: Perspectives from research partners in the United States and the Dominican Republic","authors":"Corrinne Green,&nbsp;Jodi Scharf,&nbsp;Ana Jiménez-Bautista,&nbsp;Mina Halpern","doi":"10.1111/dewb.12384","DOIUrl":"10.1111/dewb.12384","url":null,"abstract":"<p>Research partnerships between institutions in the Global North and institutions in the Global South have many potential benefits, including sharing of knowledge and resources. However, such partnerships are traditionally exploitative to varying degrees. In order to promote equity in South-North research partnerships, it is necessary to learn from the experiences of researchers collaborating internationally. This study analyzed transcripts from eleven semi-structured qualitative interviews with researchers working at Clínica de Familia La Romana, an institution in the Dominican Republic with decades of experience with research and research partnerships with institutions from the Global North. The findings of this study suggest that respect for resources invested in research, as well as for the researchers and institutions themselves, are vital components to a successful global health research partnership. These findings have implications for individual research partnerships, as well as the policies of journals and institutions providing funding that affect these partnerships.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520734","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":"THANK YOU TO DEVELOPING WORLD BIOETHICS REVIEWERS","authors":"","doi":"10.1111/dewb.12379","DOIUrl":"10.1111/dewb.12379","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42296014","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":"Counting the costs of the global north's COVID-19 policies: Lives vs life years","authors":"Udo Schuklenk","doi":"10.1111/dewb.12380","DOIUrl":"10.1111/dewb.12380","url":null,"abstract":"<p>Countries of the global north responded to the spread of COVID-19 typically with mitigation strategies aimed at flattening the curve. The laudable objectives were intended to reduce the number of people requiring care at any given time, as well as to prevent the health care system from collapsing under a tidal wave of sick people requiring intensive care in hospitals. Different countries have employed different mitigation strategies. Most had in common a shutting down of their borders for tourists and business travelers, or at least a dramatic reduction in international travel. Some countries even went so far as to imprison people in their own homes over extended periods of time, China being the paradigmatic examples of this.</p><p>The impacts of COVID-19 in the global north were significant. Economies contracted, health care for non-COVID-19 patients was delayed (for some patients irreversibly so), global supply chains were interrupted, schools switched to very suboptimal on-line learning, and so on. Currently reviews of such mitigation efforts both by academics as well as by various kinds of commissions of inquiries are ongoing, effectively comparing the number of COVID-19 deaths a given mitigation strategy has prevented, versus the number of prevented COVID-19 deaths in countries that deployed different mitigation strategies.</p><p>The question is, of course, why deaths should be <i>the</i> relevant measure of success or failure, when in pretty much every other health policy instance one would focus on the loss of quality adjusted life years, or of disability adjusted life years. The reason why this issue matters is that these mitigation strategies all had their own costs. No doubt, unless a significant number of lives were directly lost as a result of a given COVID-19 mitigation strategy, a lower number of COVID-19 deaths than alternative mitigation strategies would have to be considered a success, and this is what happens today in review articles looking at these different responses.</p><p>Taking an alternative measure, say quality adjusted or disability adjusted life years, could quite conceivably change the outcomes of these reviews quite substantially. So, unsurprisingly, the measure one chooses often determines whether a particular policy response will be considered a success or a failure. Choosing deaths-prevented as the measure to be used is a normative choice that is far from self-evident, unless we decide that people's quality of life can be fully discounted. We would have to disregard then, for instance, the loss of quality learning environments that children encountered, the highest price being invariably paid by children of resource poor families. Equity campaigners who were busy arguing for particular equity considerations when it came to priority groups in the early days of the vaccine roll-outs had little to say about the harms affecting these children quite inequitably, with the greatest burdens being carried by the poorest","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877681/pdf/DEWB-22-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9196141","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":"Evolving capacity of children and their best interests in the context of health research in South Africa: An ethico-legal position","authors":"Melodie Labuschaigne,&nbsp;Safia Mahomed,&nbsp;Ames Dhai","doi":"10.1111/dewb.12383","DOIUrl":"10.1111/dewb.12383","url":null,"abstract":"<p>The existing ethico-legal regulation of adolescent children's participation in health research in South Africa is currently unclear. The article interrogates the existing framework governing children's consent to research participation, with specific emphasis on discrepancies in consent norms in law and ethical guidelines. Against the backdrop of the constitutional directive that requires that a child's best interests are of paramount importance in every matter concerning the child, the article assesses whether sufficient consideration is given to children's evolving maturity and capacities when consent to their participation in health research is sought. The article provides specific recommendations and proposes a legislative change to consent provisions in the National Health Act 61 of 2003 in order to address the existing lacunae and to align the framework with constitutional imperatives and international fundamental rights considerations.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12383","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40701140","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":"Tropical storm in the Philippines and in Vietnam: A critical need for gender-based violence prevention","authors":"Saverio Bellizzi,&nbsp;Katherina Molek,&nbsp;Alessandra Nivoli","doi":"10.1111/dewb.12382","DOIUrl":"10.1111/dewb.12382","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632397","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":"A proposal for an international Code of Conduct for data sharing in genomics","authors":"Amal Matar,&nbsp;Mats Hansson,&nbsp;Santa Slokenberga,&nbsp;Adam Panagiotopoulos,&nbsp;Gauthier Chassang,&nbsp;Olga Tzortzatou,&nbsp;Kärt Pormeister,&nbsp;Elias Uhlin,&nbsp;Antonella Cardone,&nbsp;Michael Beauvais","doi":"10.1111/dewb.12381","DOIUrl":"10.1111/dewb.12381","url":null,"abstract":"<p>As genomic research becomes commonplace across the world, there is an increased need to coordinate practices among researchers, especially with regard to data sharing. One such way is an international code of conduct. In September 2020, an expert panel consisting of representatives from various fields convened to discuss a draft proposal formed via a synthesis of existing professional codes and other recommendations. This article presents an overview and analysis of the main issues related to international genomic research that were discussed by the expert panel, and the results of the discussion and follow up responses by the experts. As a result, the article presents as an annex a proposal for an international code of conduct for data sharing in genomics that is meant to establish best practices.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40661370","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":"Addressing exploitation and inequities in open science: A relational perspective","authors":"Cornelius Ewuoso,&nbsp;Luís Cordeiro-Rodrigues,&nbsp;Ambroise Wonkam,&nbsp;Jantina de Vries","doi":"10.1111/dewb.12378","DOIUrl":"10.1111/dewb.12378","url":null,"abstract":"<p>There are concerns that participation in open science will lead to various forms of exploitation – of researchers and scholars in low-income countries and under-resourced institutions. This article defends a contrary thesis and demonstrates the exact ways the underexplored notions of communal relationships, human dignity and social justice – and the normative principles to which they give rise – grounded in African philosophy can usefully address critical concerns regarding exploitation in the sharing of research resources to facilitate open partnership/collaboration and reuse. Further research is required to study the specific roles different institutions can play in facilitating open practice and contribute towards establishing effective structures that can enhance equity and balance unfavourable power asymmetries.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40339458","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":"Primary care and abortion legislation in Chile: A failed point of entry","authors":"Lidia Casas,&nbsp;Lieta Vivaldi,&nbsp;Adela Montero,&nbsp;Natalia Bozo,&nbsp;Juan José Álvarez,&nbsp;Jorge Babul","doi":"10.1111/dewb.12377","DOIUrl":"10.1111/dewb.12377","url":null,"abstract":"<p>While Chile's partial decriminalization of abortion in 2017 was a long overdue recognition of women's sexual and reproductive rights, nearly four years later the caseload remains well below expectations. This pattern is the product of standing barriers in access to abortion-related health services, especially at the primary care point of entry. This study seeks to identify and describe these barriers. The findings presented here were obtained through a qualitative, exploratory study based on 19 semi-structured interviews with relevant actors identified through non-random sampling and snowballing techniques. Coding was inductive and complemented by semantic content analysis. The authors find that the key barriers in primary care to accessing legal abortion are unfamiliarity with the law, insufficient practitioner training, intersectoral discrimination, and the stigma surrounding abortion. They conclude that the government needs to exercise its constitutional mandate as guarantor of public health and act promptly to safeguard and guarantee the abortion rights of Chilean women.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10051357","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}