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Sentience. Not Necessarily a Problem? 感觉。不一定是个问题？
IF 2.3
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2025-10-01 DOI: 10.1017/S0963180126100139
Karim Akerma
{"title":"Sentience. Not Necessarily a Problem?","authors":"Karim Akerma","doi":"10.1017/S0963180126100139","DOIUrl":"10.1017/S0963180126100139","url":null,"abstract":"<p><p>Pain is often portrayed as the guardian of life. Unpleasant sensations are undisputedly in the service of the self-preservation of living beings. However, it is questionable whether the first sensations in evolution must have been those of pain. The emergence of a new property cannot be derived from the function that the property has once it is there. In evolution, new properties are not produced by needs (this would be teleological thinking), but by mutations and selection. Accordingly, rather than pain, the first sensation of an early creature may just as well have been a neutral (or pleasant) sensation. Furthermore, it is conceivable that the self-preservation of early organisms and evolutionarily old and successful species (such as bacteria or jellyfish) is achieved by biochemical processes without the involvement of consciousness. The individuals of evolutionarily very old extant species may still have a kind of luxury primitive consciousness (restricted to neutral or pleasant sensations) hovering above organismal needs. This has ramifications as regards argumentative standards of antinatalist moral theory, for example.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"547-562"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147871329","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
Sentience and Why It Matters. 感知及其重要性。
IF 2.3
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2025-10-01 DOI: 10.1017/S0963180126100085
David Benatar
{"title":"Sentience and Why It Matters.","authors":"David Benatar","doi":"10.1017/S0963180126100085","DOIUrl":"10.1017/S0963180126100085","url":null,"abstract":"<p><p>In this article, it is argued that in the actual world, even if not in all possible worlds, sentience is both a necessary and sufficient condition for having moral standing. In arguing for this conclusion, the concepts of sentience and moral standing are explained. Five kinds of interest are then differentiated-functional, biotic, sentient, sapient, and self-conscious. It is argued that having <i>sentient</i> interests, rather than merely any interests, is what grounds moral standing. However, determining who has moral standing is only a beginning. Once we know whose interests we need to consider, we still need to know <i>what</i> interests need to be considered. We also need to know what considering those interests implies. Those questions are engaged in the remainder of this article.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"563-571"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794987","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
Neural Organoids: How Should We Handle the Possibility of Sentience? 神经类器官：我们应该如何处理感知的可能性？
IF 2.3
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2025-10-01 DOI: 10.1017/S0963180126100140
Søren Holm, Jonathan Lewis
{"title":"Neural Organoids: How Should We Handle the Possibility of Sentience?","authors":"Søren Holm, Jonathan Lewis","doi":"10.1017/S0963180126100140","DOIUrl":"10.1017/S0963180126100140","url":null,"abstract":"<p><p>Neural organoids derived from pluripotent stem cells have sparked ethical debate because, it is claimed, they could be sentient, or could develop sentience. We critically assess three routes for defending such a possibility: analogy with known sentient organisms, inference from neural function using leading theories of consciousness, and foundational philosophical commitments. Current cortical organoids lack nociceptors, sensory integration, and behavioral repertoires necessary for analogical arguments; they also fall short of the structural differentiation presupposed by most empirically grounded consciousness theories, rendering existing neural metrics unreliable. Even if constitutive panpsychism were accepted, the moral relevance of any putative micro experiences would remain undetermined. Precautionary appeals, therefore, hinge on how the term \"possible\" is interpreted. We argue that regulatory or experimental restrictions are warranted only once there is a non-trivial empirical likelihood that a given organoid type can generate valenced experience. Given present technological limits on size, complexity, and vascularization, that threshold has not been reached, nor is it likely to be met in the near to medium term. This claim is contingent on the current state of research, but we believe it to be justified. Our analysis clarifies conceptual ambiguities surrounding organoid sentience and offers a principled framework for proportionate precaution.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"586-596"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795048","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
The End of Sentience. 感知的终结。
IF 2.3
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2025-10-01 DOI: 10.1017/S0963180126100127
Amanda Sukenick
{"title":"The End of Sentience.","authors":"Amanda Sukenick","doi":"10.1017/S0963180126100127","DOIUrl":"10.1017/S0963180126100127","url":null,"abstract":"<p><p>While David Benatar's 2006 book <i>Better Never to Have Been: The Harm of Coming into Existence</i> remains the most influential formulation of contemporary academic antinatalism, numerous other iterations, both academic and nonacademic, have emerged since its publication. These newer forms reflect differing styles, motivations, and normative commitments across a range of issues, none more contentious than the question of what duties human antinatalists may hold toward nonhuman animals or life more broadly. This debate has produced a significant division within antinatalisms. Anthropocentric forms endorse the voluntary extinction of humanity while allowing other life to continue. Sentiocentric forms recommend the eventual extinction of all sentient life. While humans could voluntarily choose to cease reproducing, sentiocentric antinatalism implies, sometimes explicitly requires, active human intervention to end the reproduction of other sentient beings, potentially involving coercion or violence. This paper builds upon Patricia MacCormack's critique of Benatarian antinatalism and efilism in her 2020 book <i>The Ahuman Manifesto: Activism for the End of the Anthropocene.</i> By widening the scope of inquiry to include multiple antinatalist traditions, the analysis maps how and why some formulations of antinatalism come to endorse forceful or promortalist positions aimed at achieving the extinction of certain, even all, species.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"646-662"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794976","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
Human Antinatalism and the Limits of Bipolar Pessimism. 人类反出生主义和两极悲观主义的极限。
IF 2.3
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2025-10-01 DOI: 10.1017/S0963180126100061
Matti Häyry
{"title":"Human Antinatalism and the Limits of Bipolar Pessimism.","authors":"Matti Häyry","doi":"10.1017/S0963180126100061","DOIUrl":"10.1017/S0963180126100061","url":null,"abstract":"<p><p>David Benatar's Better Never to Have Been (2006) presents a view that came to be known as antinatalism: the claim that it is always wrong to have children, because life is bad, death is bad, and the only way to avoid both is never to be brought into existence. Benatar argues that his two-barreled-or \"bipolar\"-pessimism is not limited to humans but applies equally to all sentient beings. This extension, however, is prone to producing theoretical confusion. The anti-reproductive view laid out in the book is coherent as a form of human antinatalism, but Benatar's own caveats prevent it from developing into the radical sentiocentrism it seems to promise.</p>","PeriodicalId":520577,"journal":{"name":"Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees","volume":" ","pages":"671-685"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794966","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
Biomarkers in Psychiatric Disorders. 精神疾病的生物标志物。
IF 1.8
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2022-10-01 DOI: 10.1017/S0963180122000056
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
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2022-10-01 DOI: 10.1017/S0963180122000111
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
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2022-10-01 DOI: 10.1017/S0963180122000081
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
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2022-10-01 DOI: 10.1017/S096318012200041X
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
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees Pub Date : 2022-10-01 DOI: 10.1017/S0963180122000391
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
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