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Why Pediatric Ethics Needs a Theory of Goodness 为什么儿科伦理学需要一个善良的理论。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70053
Tyler Tate, Jenny Clark Schiff, Karolina Grekov, Akilah Burford
{"title":"Why Pediatric Ethics Needs a Theory of Goodness","authors":"Tyler Tate,&nbsp;Jenny Clark Schiff,&nbsp;Karolina Grekov,&nbsp;Akilah Burford","doi":"10.1002/hast.70053","DOIUrl":"10.1002/hast.70053","url":null,"abstract":"<p><i>We begin this commentary with a brief analysis of “Making Medical Decisions for Children with Profound Cognitive Disabilities: Pluralism and the Best Interest Standard,” by Pierce Randall, and “A Life Worth Sustaining? Bestowed Worth and Pediatric Care,” by Daniel T. Kim and Xiang Yu, in the same issue of the</i> Hastings Center Report. <i>These two articles examine decision-making for children with profound cognitive disabilities and critique the relational potential standard found in pediatric ethics. We agree with the authors that the relational potential standard risks using children as a means to other people's ends. We also raise two additional concerns: the standard is incongruent with parents’ self-descriptions, and it neglects the concept of</i> goodness, <i>which we take to be the fundamental concern of pediatric ethical analysis. We close with a brief discussion of goodness and consider how goodness might serve as the lodestar of pediatric ethics</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"43-45"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469882","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
A Parental Request for an Unproven Treatment for a Rare Pediatric Cancer: Sound Reasons for Not Going Off-Label 一名家长要求对一种罕见的儿童癌症进行未经证实的治疗：不脱离标签的合理理由。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.5025
Margot Hedlin, Louis Voigt
{"title":"A Parental Request for an Unproven Treatment for a Rare Pediatric Cancer: Sound Reasons for Not Going Off-Label","authors":"Margot Hedlin,&nbsp;Louis Voigt","doi":"10.1002/hast.5025","DOIUrl":"10.1002/hast.5025","url":null,"abstract":"<p><i>We present the case of a three-year-old in remission from ependymoma whose parents requested off-label metformin in the hope that it could reduce her chance of recurrence. A prominent specialist who was developing a clinical trial studying metformin as an adjunctive treatment for children with relapsed ependymoma had recommended metformin for the patient based on theoretical chance of benefit. The child's primary neuro-oncologist sought an ethics consult, as he did not believe that prescribing metformin off-label to this patient was ethical. We argue that he should not prescribe the medication. Current data do not support its use, and it carries nontrivial risks. Moreover, prescribing unproven treatments outside of a trial risks giving families false hope, undermining clinical research, and creating pressure on physicians to offer unproven interventions. Social media amplifies these requests, shaping parental decision-making and potentially spreading unvalidated practices. Physicians may respond compassionately while declining to provide interventions outside standard care. This case highlights the ethical boundaries of off-label prescribing in pediatric oncology</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"13-15"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470335","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
Contributors 贡献者
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70054
{"title":"Contributors","authors":"","doi":"10.1002/hast.70054","DOIUrl":"https://doi.org/10.1002/hast.70054","url":null,"abstract":"","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147566120","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 Case for Prescribing Metformin Off-Label for a Child in Remission from Ependymoma 对一名室管膜瘤缓解期儿童开说明书外二甲双胍的案例。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70044
Emily S. Hahn, Margot Hedlin
{"title":"The Case for Prescribing Metformin Off-Label for a Child in Remission from Ependymoma","authors":"Emily S. Hahn,&nbsp;Margot Hedlin","doi":"10.1002/hast.70044","DOIUrl":"10.1002/hast.70044","url":null,"abstract":"<p><i>Pediatrics often faces ethical challenges when families request unproven therapies. We respond to a clinical case described in “A Parental Request for an Unproven Treatment for a Rare Pediatric Cancer: Sound Reasons for Not Going Off-Label,” by Margot Hedlin and Louis Voigt, in the same issue of this journal. The case concerns Natalie, a three-year-old in remission from ependymoma, whose parents requested metformin to prevent recurrence. Although Natalie's neuro-oncologist opposed the use of the drug, its favorable safety profile, pediatric Food and Drug Administration approval for other indications, emerging evidence in cancer research, and endorsement by a specialist support careful consideration. Off-label prescribing is common in pediatric oncology due to issues presented by rare diseases and due to the limitations of clinical trials. With informed consent, monitoring, and interdisciplinary input about the patient's care, prescribing metformin may be ethically justifiable despite uncertain efficacy. This case illustrates the balance between evidence-based practice, patient- and family-centered care, and the realities of pediatric cancer treatment</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"16-18"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470314","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
Public Engagement as a Form of Moral Leadership 公众参与是道德领导的一种形式。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70050
Rebecca W. Brendel, Mildred Z. Solomon
{"title":"Public Engagement as a Form of Moral Leadership","authors":"Rebecca W. Brendel,&nbsp;Mildred Z. Solomon","doi":"10.1002/hast.70050","DOIUrl":"10.1002/hast.70050","url":null,"abstract":"<p><i>Government leaders and social influencers are using “informed consent,” “choice,” and other bioethical terms related to autonomy to justify dramatically weakening U.S. vaccination policy. In response, we call on bioethicists to help the public understand that the mere availability of choice does not ensure that a moral choice is made. Bioethicists have the skills, and, we hope, the willingness, to help the public understand that there are equally important values, such as care and concern for the well-being of others, a recognition of human interdependence, and a shared sense of responsibility to build a society that can benefit all of us. Moving some hearts and minds to see why personal autonomy is not the only moral consideration would be an important advance in the national conversation and an important form of moral leadership</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470325","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
Should Parents of the Deceased Have Standing to Initiate Posthumous Sperm Retrieval? Analyzing Developments in Israel 死者的父母是否有资格在死后取回精子？分析以色列的事态发展。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.4984
Roee Amir, Vardit Ravitsky
{"title":"Should Parents of the Deceased Have Standing to Initiate Posthumous Sperm Retrieval? Analyzing Developments in Israel","authors":"Roee Amir,&nbsp;Vardit Ravitsky","doi":"10.1002/hast.4984","DOIUrl":"10.1002/hast.4984","url":null,"abstract":"<p><i>Posthumous sperm retrieval is a complex and contentious issue that raises various ethical, legal, and social concerns. Policies regulating this practice vary globally, reflecting diverse normative approaches and cultural values. Israel, which had a permissive stance on the matter even before the October 7 attack, has seen a significant shift in policy since the attack and subsequent war, now allowing sperm retrieval based on parental request. This development, partly driven by a desire to honor fallen soldiers, adds new complexity to the ethical discourse. This paper uses Israel's policy shift as a starting point to explore whether parents of the deceased should be granted a right to initiate the procedure, particularly in the context of war and national loss. The discussion navigates a web of competing interests and narratives that require careful untangling, including the deceased's autonomy and bodily integrity, the relatives’ desire for genetic continuity, the potential for conflict between relatives with opposing wishes, the welfare of potential offspring, and broader societal implications with special attention to the tension between honoring sacrifice and respecting individual reproductive choices</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"6-13"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470375","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
Why Should People with Lived Experience Be Included in the DSM Revision Process? 为什么要把有生活经验的人纳入DSM修订过程？
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70051
Anne-Marie Gagné-Julien, Phoebe Friesen
{"title":"Why Should People with Lived Experience Be Included in the DSM Revision Process?","authors":"Anne-Marie Gagné-Julien,&nbsp;Phoebe Friesen","doi":"10.1002/hast.70051","DOIUrl":"10.1002/hast.70051","url":null,"abstract":"<p><i>Increasingly, scholars and advocates are recognizing the importance of including individuals with lived experience of mental health issues in the development of psychiatric research and policy. Here, we hope to contribute to discussions regarding the specific context of the</i> Diagnostic and Statistical Manual of Mental Disorders (DSM) <i>revision process. We argue that this process is not inclusive enough, but also that those who have advocated for better inclusivity have not been responsive enough to the risks reported from other inclusive mental health contexts (in research, practice, and policy). In particular, tokenism and lack of uptake of input from people with lived experience are likely to loom large in relation to</i> DSM <i>efforts at inclusivity as well. In light of this, we suggest that disentangling the reasons for inclusion can help to overcome these problems, and we offer practical recommendations for a more inclusive</i> DSM <i>revision process</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"46-56"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470096","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
Making Medical Decisions for Children with Profound Cognitive Disabilities: Pluralism and the Best Interest Standard 为患有严重认知障碍的儿童做出医疗决定：多元化和最佳利益标准。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70011
Pierce Randall
{"title":"Making Medical Decisions for Children with Profound Cognitive Disabilities: Pluralism and the Best Interest Standard","authors":"Pierce Randall","doi":"10.1002/hast.70011","DOIUrl":"10.1002/hast.70011","url":null,"abstract":"<p><i>Requests by parents or other caregivers for treatment to prolong the lives of minors with profound cognitive disabilities can be ethically challenging. Some patients have very limited capacity for conscious experience, and so it becomes difficult to say that a longer life is truly good for them. For such cases, some commentators have proposed the relational potential standard as an alternative to the best interest standard. Yet, if the relational potential standard holds that requests for care ought to be honored because they respect patients’ familial relationships even though they provide no benefit to patients themselves, then the proposal is objectionable. We have good ethical reasons to accept at least one element of the best interest standard: the exclusionary criteria that no one's interests but the patient's should count when making medical decisions on their behalf. This paper defends a pluralistic conception of what can be in a severely cognitively disabled minor patient's interests. This approach can yield the same result that proponents of the relational potential standard want (honoring requests for care even when providers doubt that these requests are in the patient's best interest) while avoiding committing clinicians to honoring unreasonable requests that discount the patient's other interests</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"19-29"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470352","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
Issue Information and About the Cover Art 发行信息和关于封面艺术
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-03-16 DOI: 10.1002/hast.70055
{"title":"Issue Information and About the Cover Art","authors":"","doi":"10.1002/hast.70055","DOIUrl":"https://doi.org/10.1002/hast.70055","url":null,"abstract":"<p><b>On the cover:</b> <i>Future of Memory</i>, by Arun Prem, oil on canvas, 24 × 30 inches.</p><p>Courtesy of the artist. Instagram: arun.prem_art</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 2","pages":"1-4"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hast.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147566121","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
Implications for All Animal Research 对所有动物研究的启示。
IF 2.3 3区 哲学
Hastings Center Report Pub Date : 2026-02-04 DOI: 10.1002/hast.70039
Christopher Bobier, Daniel J. Hurst
{"title":"Implications for All Animal Research","authors":"Christopher Bobier,&nbsp;Daniel J. Hurst","doi":"10.1002/hast.70039","DOIUrl":"10.1002/hast.70039","url":null,"abstract":"<p>This letter responds to the article “Xenotransplantation: Injustice, Harm, and Alternatives for Addressing the Organ Crisis,” by Jasmine Gunkel and Franklin G. Miller in the September-October 2025 issue of the <i>Hastings Center Report</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":"56 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121205","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
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