American Journal of Bioethics最新文献

{"title":"Genital Modifications in Prepubescent Minors: When May Clinicians Ethically Proceed?","authors":"","doi":"10.1080/15265161.2024.2353823","DOIUrl":"10.1080/15265161.2024.2353823","url":null,"abstract":"<p><p>When is it ethically permissible for clinicians to surgically intervene into the genitals of a legal minor? We distinguish between <i>voluntary</i> and <i>nonvoluntary</i> procedures and focus on <i>nonvoluntary</i> procedures, specifically in prepubescent minors (\"children\"). We do not address procedures in adolescence or adulthood. With respect to children categorized as female at birth who have no apparent differences of sex development (i.e., non-intersex or \"endosex\" females) there is a near-universal ethical consensus in the Global North. This consensus holds that clinicians may not perform <i>any</i> nonvoluntary genital cutting or surgery, from \"cosmetic\" labiaplasty to medicalized ritual \"pricking\" of the vulva, insofar as the procedure is not strictly necessary to protect the child's physical health. All other motivations, including possible psychosocial, cultural, subjective-aesthetic, or prophylactic benefits as judged by doctors or parents, are seen as categorically inappropriate grounds for a clinician to proceed with a <i>nonvoluntary</i> genital procedure in this population. We argue that the main ethical reasons capable of supporting this consensus turn not on empirically contestable benefit-risk calculations, but on a fundamental concern to respect the child's privacy, bodily integrity, developing sexual boundaries, and (future) genital autonomy. We show that these ethical reasons are sound. However, as we argue, they do not only apply to endosex female children, but rather to all children regardless of sex characteristics, including those with intersex traits and endosex males. We conclude, therefore, that as a matter of justice, inclusivity, and gender equality in medical-ethical policy (we do not take a position as to criminal law), clinicians should not be permitted to perform any nonvoluntary genital cutting or surgery in prepubescent minors, irrespective of the latter's sex traits or gender assignment, unless urgently necessary to protect their physical health. By contrast, we suggest that <i>voluntary</i> surgeries in older individuals might, under certain conditions, permissibly be performed for a wider range of reasons, including reasons of self-identity or psychosocial well-being, in keeping with the circumstances, values, and explicit needs and preferences of the persons so concerned. Note: Because our position is tied to clinicians' widely accepted role-specific duties as medical practitioners within regulated healthcare systems, we do not consider genital procedures performed outside of a healthcare context (e.g., for religious reasons) or by persons other than licensed healthcare providers working in their professional capacity.</p>","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":" ","pages":"53-102"},"PeriodicalIF":17.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informed Consent Under Ignorance.","authors":"Daniel Villiger","doi":"10.1080/15265161.2023.2296429","DOIUrl":"10.1080/15265161.2023.2296429","url":null,"abstract":"<p><p>In recent years, an old challenge to informed consent has been rediscovered: the challenge of ignorance. Several authors argue that due to the presence of irreducible ignorance in certain treatments, giving informed consent to these treatments is not possible. The present paper examines in what ways ignorance is believed to prevent informed consent and which treatments are affected by that. At this, it becomes clear that if the challenge of ignorance truly holds, it poses a major problem to informed consent. The paper argues, however, that from both an empirical and a theoretical point of view, it is not convincing that ignorance prevents informed consent. Still, it seems important that the presence of irreducible ignorance is openly discussed during the informed consent process.</p>","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":" ","pages":"126-138"},"PeriodicalIF":17.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Technocracy to Democracy: The Need for Another Translational Justice.","authors":"Keiichiro Yamamoto, Tomohide Ibuki, Eisuke Nakazawa","doi":"10.1080/15265161.2025.2497999","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497999","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"48-50"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Equity Frameworks in Bioethical Perspective: Systemic Interventions and Innovative Justice.","authors":"Junxi Liu, Mocun Yang, Boda Zhou","doi":"10.1080/15265161.2025.2497976","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497976","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"111-112"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned from Reproductive Justice: Communication with the Public to Earn and Maintain Trust of New and Existing Innovations.","authors":"Cambray Smith, Elizabeth Pleasants, Kavita Shah Arora","doi":"10.1080/15265161.2025.2498845","DOIUrl":"https://doi.org/10.1080/15265161.2025.2498845","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"40-42"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking at Gender Affirming Care Through the Lens of Justice.","authors":"Jilles Smids","doi":"10.1080/15265161.2025.2497997","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497997","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"84-87"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening ARIE: Integrating Complexity and Ethics for Equitable Health Outcomes.","authors":"Y Tony Yang","doi":"10.1080/15265161.2025.2497977","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497977","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"113-114"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Translation: Applicational Justice in Biomedical Innovation and Healthcare Delivery.","authors":"Drew L Cheng","doi":"10.1080/15265161.2025.2497978","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497978","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"37-39"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enriching Translational Justice with Value-Oriented Expertise.","authors":"Andrea Lavazza, Mirko Farina","doi":"10.1080/15265161.2025.2498000","DOIUrl":"https://doi.org/10.1080/15265161.2025.2498000","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"51-53"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients and Clinical Guidelines Deserve High-Quality Evidence, Not Politics.","authors":"Patrick Hunter, Kathleen A Goonan","doi":"10.1080/15265161.2025.2497998","DOIUrl":"https://doi.org/10.1080/15265161.2025.2497998","url":null,"abstract":"","PeriodicalId":50962,"journal":{"name":"American Journal of Bioethics","volume":"25 6","pages":"81-84"},"PeriodicalIF":17.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}