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A Path Forward—and Outward: Repositioning Bioethics to Face Future Challenges 向前和向外的道路:重新定位生命伦理学以面对未来的挑战
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1510
Vardit Ravitsky
{"title":"A Path Forward—and Outward: Repositioning Bioethics to Face Future Challenges","authors":"Vardit Ravitsky","doi":"10.1002/hast.1510","DOIUrl":"10.1002/hast.1510","url":null,"abstract":"<p><i>This essay explores what the future may hold for bioethics if it continues its evolution toward a field that embraces systemic, collective-level challenges; has a global scale and focus; emphasizes human flourishing; and seeks to have increased societal impact. As The Hastings Center considers strategic priorities for its research, public engagement, and impact, this essay reflects on where we have been and where we are going. It offers an expansive and inclusive vision for the future of bioethics, in order to invite an open and wide-ranging conversation about the future of our field and the role that The Hastings Center can and should play within it</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 5","pages":"7-10"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592857","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}
引用次数: 0
Trust in Health Care and Science: Toward Common Ground on Key Concepts 对医疗保健和科学的信任:在关键概念上达成共识
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1517
Lauren A. Taylor, Mildred Z. Solomon, Gregory E. Kaebnick
{"title":"Trust in Health Care and Science: Toward Common Ground on Key Concepts","authors":"Lauren A. Taylor,&nbsp;Mildred Z. Solomon,&nbsp;Gregory E. Kaebnick","doi":"10.1002/hast.1517","DOIUrl":"10.1002/hast.1517","url":null,"abstract":"<p><i>This essay summarizes key insights across the essays in the</i> Hastings Center Report's <i>special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility of seeking to win trust without being trustworthy, building and borrowing trust as distinct strategies, and challenges to trustworthiness posed by the contingent nature of science. Together, these insights stand to advance an area of research that we believe has been historically stymied by conceptual confusion and a long-standing insistence on treating trust as a purely instrumental good</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"S2-S8"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592874","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}
引用次数: 0
About the Special Report 关于特别报告
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1516
{"title":"About the Special Report","authors":"","doi":"10.1002/hast.1516","DOIUrl":"https://doi.org/10.1002/hast.1516","url":null,"abstract":"","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"inside_front_cover"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109169147","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}
引用次数: 0
Hope and Exploitation in Commercial Provision of Assisted Reproductive Technologies 辅助生殖技术商业化的希望与开发
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1513
Anthony Wrigley, Gabriel Watts, Wendy Lipworth, Ainsley J. Newson
{"title":"Hope and Exploitation in Commercial Provision of Assisted Reproductive Technologies","authors":"Anthony Wrigley,&nbsp;Gabriel Watts,&nbsp;Wendy Lipworth,&nbsp;Ainsley J. Newson","doi":"10.1002/hast.1513","DOIUrl":"10.1002/hast.1513","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add-on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever-increasing array of add-ons are marketed to ART patients, even when evidence to support them is equivocal. A defining feature of ART is hope—hope that a cycle will lead to a baby or that another test or intervention will make a difference. Yet such hope also leaves ART patients vulnerable in a variety of ways. This article argues that previous attempts to safeguard ART patients have neglected how the use of add-ons in commercial ART can exploit patients’ hopes. Commercial providers of ART should provide add-ons only free of charge, under a suitable research protocol</i>.</p>\u0000 </div>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 5","pages":"30-41"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hast.1513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592860","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}
引用次数: 0
Physician Perspectives on Building Trust with Patients 医生对与病人建立信任的看法
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1528
Jessica Greene, Daniel Wolfson
{"title":"Physician Perspectives on Building Trust with Patients","authors":"Jessica Greene,&nbsp;Daniel Wolfson","doi":"10.1002/hast.1528","DOIUrl":"10.1002/hast.1528","url":null,"abstract":"<p><i>Prior research has documented how important it is to patients to be able to trust their physicians. In this essay, we introduce physician perspectives on the importance of earning patients’ trust. We conducted twelve semistructured interviews in late 2022, eleven with physicians and one with a patient-experience expert. Physicians described earning patients’ trust as crucial for working effectively with patients, with several saying that it was as important as having medical knowledge. Physicians also expressed that feeling a patient trusting them is professionally rewarding and fulfilling. To build trust with patients, physicians reported, they make the medical interaction all about the patient, express their belief in their patients, share their personal experiences, and use other strategies identified in previous literature: communicating effectively, being compassionate, and demonstrating competence. Physicians also reported experiencing challenges in building trust with patients, most often because of patients’ lack of trust in other levels of the health care system and because of having inadequate time to spend with patients. Additionally, Black and Brown physicians described how patients’ bias often blocks trust</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"S86-S90"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592868","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}
引用次数: 0
When Mistakes Multiply: How Inadequate Responses to Medical Mishaps Erode Trust in American Medicine 当错误成倍增加:对医疗事故的不充分反应如何侵蚀对美国医学的信任
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1520
Mark Schlesinger, Rachel Grob
{"title":"When Mistakes Multiply: How Inadequate Responses to Medical Mishaps Erode Trust in American Medicine","authors":"Mark Schlesinger,&nbsp;Rachel Grob","doi":"10.1002/hast.1520","DOIUrl":"10.1002/hast.1520","url":null,"abstract":"<p><i>In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient-safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long-lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public. Yet no one seems to notice that patient safety is a root cause, because no one is counting. In addition to identifying the origins of this purblindness, we offer an alternative policy approach. This would call for government to transparently track safety threats through the systematic collection and reporting of patients’ experiences. This alternative strategy offers real promise for stemming the erosion of trust that currently accompanies patient-safety shortfalls while staying consistent with Americans’ preferences for a constrained government role with respect to medical care</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"S22-S32"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592877","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}
引用次数: 0
The Pitfalls of Genomic Data Diversity 基因组数据多样性的陷阱
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1511
Anna Jabloner, Alexis Walker
{"title":"The Pitfalls of Genomic Data Diversity","authors":"Anna Jabloner,&nbsp;Alexis Walker","doi":"10.1002/hast.1511","DOIUrl":"10.1002/hast.1511","url":null,"abstract":"<p><i>Biomedical research recruitment today focuses on including participants representative of global genetic variation—rightfully so. But ethnographic attention to practices of inclusion highlights how this agenda often transforms into “predatory inclusion,” simplistic pushes to get Black and brown people into genomic databases. As anthropologists of medicine, we argue that the question of how to get from diverse data to concrete benefit for people who are marginalized cannot be presumed to work itself out as a byproduct of diverse datasets. To actualize the equitable translation of genomics, practitioners need to place the impacts of ancestral genetic difference in the scope of much more impactful social determinants. For this to happen, multidisciplinary expertise needs to be leveraged, and current, structurally unequal health care systems ultimately need to transform. As modest steps toward this goal, new models for benefit-sharing must be developed and implemented to mitigate existing inequality between data donors and the entities profiting from that data</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 5","pages":"10-13"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592862","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}
引用次数: 0
Regaining Trust in Public Health and Biomedical Science following Covid: The Role of Scientists 2019冠状病毒病后重新获得对公共卫生和生物医学科学的信任:科学家的作用
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1531
Arthur L. Caplan
{"title":"Regaining Trust in Public Health and Biomedical Science following Covid: The Role of Scientists","authors":"Arthur L. Caplan","doi":"10.1002/hast.1531","DOIUrl":"10.1002/hast.1531","url":null,"abstract":"<p><i>Biomedical science suffered a loss of trust during the Covid-19 pandemic. Why? One reason is a crisis fueled by confusion over the epistemology of science. Attacks on biomedical expertise rest on a mistaken view of what the justification is for crediting scientific information. The ideas that science is characterized by universal agreement and that any evolution or change of beliefs about facts and theories undermines trustworthiness in science are simply false. Biomedical science is trustworthy precisely because it is fallible, admits error, adjusts to new information, and, most importantly, is practical. Successful diagnosis and cure demarcate the boundaries of warranted knowledge. The other reason is sociological. As the pandemic made all too clear, the loss of faith in scientific experts was due to the failure of most of them to engage in regular public dialogue, reflecting a failure to recognize the obligation that science has to bolster trust in its work and findings by concerted public engagement</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"S105-S109"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592869","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}
引用次数: 0
Trust in Crises and Crises of Trust 危机中的信任和信任危机
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1518
Jonathan H. Marks
{"title":"Trust in Crises and Crises of Trust","authors":"Jonathan H. Marks","doi":"10.1002/hast.1518","DOIUrl":"10.1002/hast.1518","url":null,"abstract":"<p><i>During times of crisis, institutions tend to focus on maintaining or restoring public trust, as well as on measures to insulate themselves (and their leadership) from potential legal liability. This is because institutions reflexively turn to lawyers, risk managers, crisis consultants, and public relations firms that focus on what they euphemistically call the “optics.” In this essay, I highlight the vital importance of addressing underlying reasons for an institution's loss of public trust—in particular, the loss (or erosion) of its integrity and trustworthiness. Loss of public trust generates one kind of crisis—which I term</i> “opsis.” <i>But there is another kind of institutional crisis that so often remains unrecognized. Just as medical sepsis in the human body is a critical condition that endangers life, the loss of an institution's integrity and trustworthiness constitutes a type of</i> sepsis—<i>ethical sepsis—that poses an existential threat to the institution if unaddressed</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 S2","pages":"S9-S15"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592873","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}
引用次数: 0
Dependence 依赖
IF 3.3 3区 哲学
Hastings Center Report Pub Date : 2023-11-14 DOI: 10.1002/hast.1508
Gregory E. Kaebnick
{"title":"Dependence","authors":"Gregory E. Kaebnick","doi":"10.1002/hast.1508","DOIUrl":"https://doi.org/10.1002/hast.1508","url":null,"abstract":"<div>\u0000 \u0000 <p><i>The</i> Hastings Center Report's <i>September-October 2023 issue is about relying on others—on loved ones, clinicians, scientists, and institutions. The lead article explores how loving relationships support and reshape the agency of people who have dementia. Authors Eran Klein and Sara Goering argue that the understanding of agency as a shared, relational capacity has implications for the development of treatments for dementia, the role of caregivers, and the structuring of patients’ environments. In the second article, Anthony Wrigley and colleagues examine whether providers of assisted reproductive technologies market “add-on” interventions by inappropriately exploiting their patients’ profound hope for a baby. Published with this issue of</i> HCR <i>is a special report, guest edited by health policy scholar Lauren A. Taylor and colleagues, on the need to rebuild public trust in science and health care</i>.</p>\u0000 </div>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"53 5","pages":"inside_front_cover"},"PeriodicalIF":3.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hast.1508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109169301","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}
引用次数: 0
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