Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees最新文献

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Biomarkers in Psychiatric Disorders. 精神疾病的生物标志物。
IF 1.8
Walter Glannon
{"title":"Biomarkers in Psychiatric Disorders.","authors":"Walter Glannon","doi":"10.1017/S0963180122000056","DOIUrl":"https://doi.org/10.1017/S0963180122000056","url":null,"abstract":"<p><p>Central and peripheral biomarkers can be used to diagnose, treat, and potentially prevent major psychiatric disorders. But there is uncertainty about the role of these biological signatures in neural pathophysiology, and their clinical significance has yet to be firmly established. Psychomotor, cognitive, affective, and volitional impairment in these disorders results from the interaction between neural, immune, endocrine, and enteric systems, which in turn are influenced by a person's interaction with the environment. Biomarkers may be a critical component of this process. The identification and interpretation of biomarkers also raise ethical and social questions. This article analyzes and discusses these aspects of biomarkers and how advances in biomarker research could contribute to personalized psychiatry that could prevent or mitigate the effects of these disorders.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"444-452"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Complexity, Not Severity: Reinterpreting the Sliding Scale of Capacity. 复杂性,而非严重性:重新解释能力的滑动规模。
IF 1.8
George Mellgard, Nada Gligorov
{"title":"Complexity, Not Severity: Reinterpreting the Sliding Scale of Capacity.","authors":"George Mellgard,&nbsp;Nada Gligorov","doi":"10.1017/S0963180122000111","DOIUrl":"https://doi.org/10.1017/S0963180122000111","url":null,"abstract":"<p><p>In this article, we focus on the definition and application of the sliding scale of capacity. We show that the current interpretations of the sliding scale confound distinct features of the medical decision, such as its urgency, its severity, or its complexity, that do not always covary. We propose that the threshold for assessing capacity should be adjusted based solely on the cognitive complexity of the decision at hand. We further suggest that the complexity of a decision should be identified based on a patient's particular cognitive deficits. We utilize the current research on the types of deficits that characterize amnestic dementias and examine which types of medical decisions might be most complex for patients with that type of dementia. We conclude that applying the sliding scale based on individualized judgments of cognitive complexity will improve accuracy of assessment of capacity and enable capable patients to participate in medical decision making.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"506-517"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Skip the Trip? Five Arguments on the Use of Nonhallucinogenic Psychedelics in Psychiatry. 不去旅行?精神病学中使用非致幻致幻剂的五个论点。
IF 1.8
Andrew Peterson, Dominic Sisti
{"title":"Skip the Trip? Five Arguments on the Use of Nonhallucinogenic Psychedelics in Psychiatry.","authors":"Andrew Peterson,&nbsp;Dominic Sisti","doi":"10.1017/S0963180122000081","DOIUrl":"https://doi.org/10.1017/S0963180122000081","url":null,"abstract":"Andrew Peterson* and Dominic Sisti Institute for Philosophy and Public Policy and Department of Philosophy, George Mason University, Fairfax, Virginia 22030, USA Penn Program on Precision Medicine for the Brain, University of Pennsylvania Memory Center, Philadelphia, Pennsylvania 19104, USA Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA *Corresponding author. Email: apeter31@gmu.edu","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"472-476"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40484346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Toward Informed User Decisions About Pharmacological Cognitive Enhancement. 关于药理认知增强的知情用户决策。
IF 1.8
Polaris Koi
{"title":"Toward Informed User Decisions About Pharmacological Cognitive Enhancement.","authors":"Polaris Koi","doi":"10.1017/S096318012200041X","DOIUrl":"https://doi.org/10.1017/S096318012200041X","url":null,"abstract":"Abstract Pharmacological cognitive enhancement (PCE) refers to the use of pharmaceuticals to improve cognitive function when that use is not intended to prevent or treat disease. Those who favour a liberal approach to PCE trust users to make informed decisions about whether enhancing is in their best interest. The author argues that making informed decisions about PCE requires a nuanced risk-benefit analysis that is not accessible to many users. Presently, the PCE use of prescription medications such as methylphenidate and modafinil is widespread but most commonly happens without medical supervision. Direct and indirect barriers generate a situation where the risks and benefits of PCE are inequitably distributed; as a result, PCE is sometimes not in the user’s best interest. This is likely to also be the case for future pharmaceuticals. As a result, even if PCE pharmaceuticals were equitably distributed, its associated risks and benefits would not be. The article concludes with a discussion of the prospects of the clinical consultation on one hand, and e-health solutions on the other, in ameliorating the situation, arguing for cautious optimism.","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"545-556"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities: An Ethical Analysis. 安老院舍护理员使用抗精神病药物自我防卫:伦理分析。
IF 1.8
Hojjat Soofi
{"title":"Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities: An Ethical Analysis.","authors":"Hojjat Soofi","doi":"10.1017/S0963180122000391","DOIUrl":"https://doi.org/10.1017/S0963180122000391","url":null,"abstract":"<p><p>People with dementia at times exhibit threatening and physically aggressive behavior toward care staff in residential aged care facilities (RACFs). Current clinical guidelines recommend judicious use of antipsychotic (AP) medications when there is an immediate risk of harm to care staff in RACFs and non-pharmacological interventions have failed to avert the threats. This article examines an account of how this recommendation can be ethically defensible: caregivers in RACFs may have a <i>prima facie</i> ethical justification, in certain cases, to use APs as an act of self-defense. The author examines whether such uses of APs meet the three commonly invoked conditions of ethically permissible acts of self-defense-namely, the conditions of liability, proportionality, and necessity-and argues that such conditions obtain only in a restricted range of cases. The liability constraint can be satisfied if residents are the only ones who are causally responsible for the threats they pose. Further, the condition of proportionality obtains if there is sufficient objective ground to demonstrate that the harm of using the medications does not outweigh the good to be secured. Lastly, the necessity condition obtains when the medications are used at their lowest effective dosage and caregivers in RACFs can reasonably assume that, for the purpose of averting threats posed by residents, the use of APs is the only available course of action. Not meeting any of these fairly stringent conditions renders uses of APs as acts of self-defense in RACFs morally impermissible actions.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"487-495"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40484348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Can We Justify Military Enhancements? Some Yes, Most No. 我们能证明加强军事力量是正当的吗?有些是,大多数不是。
IF 1.8
Blake Hereth, Nicholas Evans
{"title":"Can We Justify Military Enhancements? Some Yes, Most No.","authors":"Blake Hereth,&nbsp;Nicholas Evans","doi":"10.1017/S0963180122000421","DOIUrl":"https://doi.org/10.1017/S0963180122000421","url":null,"abstract":"<p><p>The United States Department of Defense has, for at least 20 years, held the stated intention to enhance active military personnel (\"warfighters\"). This intention has become more acute in the face of dropping recruitment, an aging fighting force, and emerging strategic challenges. However, developing and testing enhancements is clouded by the ethically contested status of enhancements, the long history of abuse by military medical researchers, and new legislation in the guise of \"health security\" that has enabled the Department of Defense to apply medical interventions without appropriate oversight. This paper aims to reconcile existing legal and regulatory frameworks on military biomedical research with ethical concerns about military enhancements. In what follows, we first outline one justification for military enhancements. The authors then briefly address existing definitional issues over what constitutes enhancement before addressing existing research ethics regulations governing military biomedical research. Next, they argue that two common justifications for rapid military innovation in science and technology, including enhancement, fail. These justifications are (a) to satisfy a compelling military need and (b) strategic dominance. The authors then turn to an objection that turns on the idea that we need not have these justifications if warfighters are willing to adopt enhancement, and argue that laissez-faire approaches to enhancement fail in the context of the military due to pressing and historically significant concerns about coercion and exploitation. The paper concludes with what is referred to as the \"least-worst\" justification: Given the rise of untested enhancements in civilian and military life, we have good reason to validate potential enhancements even if they do not satisfy reasons (a) or (b) above.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"557-569"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Incidental Findings from Deep Phenotyping Research in Psychiatry: Legal and Ethical Considerations. 精神病学深层表现型研究的偶然发现:法律和伦理考虑。
IF 1.8
Amanda Kim, Michael Hsu, Amanda Koire, Matthew L Baum
{"title":"Incidental Findings from Deep Phenotyping Research in Psychiatry: Legal and Ethical Considerations.","authors":"Amanda Kim,&nbsp;Michael Hsu,&nbsp;Amanda Koire,&nbsp;Matthew L Baum","doi":"10.1017/S0963180122000135","DOIUrl":"https://doi.org/10.1017/S0963180122000135","url":null,"abstract":"<p><p>Substantial advancement in the diagnosis and treatment of psychiatric disorders may come from assembling diverse data streams from clinical notes, neuroimaging, genetics, and real-time digital footprints from smartphones and wearable devices. This is called \"deep phenotyping\" and often involves machine learning. We argue that incidental findings arising in deep phenotyping research have certain special, morally and legally salient features: They are specific, actionable, numerous, and probabilistic. We consider ethical and legal implications of these features and propose a practical ethics strategy for managing them.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"482-486"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40484344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Evidence for the Pharmaceutical Strengthening of Attachment: What, Precisely, Would Love Drugs Enhance? 药物增强依恋的证据:爱情药物究竟会增强什么?
IF 1.8
Peter N Herissone-Kelly
{"title":"The Evidence for the Pharmaceutical Strengthening of Attachment: What, <i>Precisely</i>, Would Love Drugs Enhance?","authors":"Peter N Herissone-Kelly","doi":"10.1017/S0963180122000196","DOIUrl":"https://doi.org/10.1017/S0963180122000196","url":null,"abstract":"<p><p>In recent decades, scientists have begun to identify the brain processes and neurochemicals associated with the different stages of love, including the all-important stage of attachment. Experimental findings-readily seized upon by those bioethicists who want to urge that we sometimes have good reason pharmaceutically to enhance flagging relationships-are presented as demonstrating that attachment is regulated and strengthened by the neuropeptides oxytocin and vasopressin. I shall argue, however, that often what the experimental data in fact show is only that exogenous administration of such chemicals can control and intensify the trappings of attachment, not attachment itself. That this is sometimes overlooked by both scientists and ethicists, is due to attachment being miscategorised as a set of feelings or a drive, rather than as a disposition to think about, feel toward, and behave toward its object in certain distinctive ways.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"536-544"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40484347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Psychedelics as Standard of Care? Many Questions Remain. 迷幻药作为治疗标准?许多问题仍然存在。
IF 1.8
Kurt Rasmussen, David E Olson
{"title":"Psychedelics as Standard of Care? Many Questions Remain.","authors":"Kurt Rasmussen,&nbsp;David E Olson","doi":"10.1017/S096318012200010X","DOIUrl":"https://doi.org/10.1017/S096318012200010X","url":null,"abstract":"the of of a","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"477-481"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40484345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurolaw-A Call to Action. 神经法——行动的号召。
IF 1.8
David R Lawrence
{"title":"Neurolaw-A Call to Action.","authors":"David R Lawrence","doi":"10.1017/S0963180122000123","DOIUrl":"https://doi.org/10.1017/S0963180122000123","url":null,"abstract":"relevant to sentencing; predicting recidivism; distinguishing pain from malingering; verifying intent; and manipulating memories.","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"415-417"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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