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Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting. 基于个人责任的歧视：Luck Egalitarianism and Healthcare Priority Setting.
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-08-30 DOI: 10.1017/S0963180123000415
Andreas Albertsen
{"title":"Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting.","authors":"Andreas Albertsen","doi":"10.1017/S0963180123000415","DOIUrl":"10.1017/S0963180123000415","url":null,"abstract":"<p><p>Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"23-34"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precision Medicine and Rough Justice: Wicked Problems. 精准医疗与粗暴司法：邪恶的问题。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-06-16 DOI: 10.1017/S0963180123000312
Leonard M Fleck
{"title":"Precision Medicine and Rough Justice: Wicked Problems.","authors":"Leonard M Fleck","doi":"10.1017/S0963180123000312","DOIUrl":"10.1017/S0963180123000312","url":null,"abstract":"<p><p>What exactly is a \"wicked problem\"? It is a social or economic problem that is so complex and so interconnected with other issues that it is extraordinarily difficult or impossible to resolve. This is because all proposed resolutions generate equally complex, equally wicked problems. In this essay, I argue that precision medicine, especially in the context of the U.S. healthcare system, generates numerous wicked problems related to distributive justice. Further, I argue that there are no easy solutions to these wicked problems. The need for trade-offs is inescapable. Rough justice is the best outcome we can hope for, and that outcome requires a commitment to processes of public reason that are fair and inclusive.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9631289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Synthesizing Methuselah: The Question of Artificial Agelessness. 合成玛土撒拉：人工衰老的问题。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-09-22 DOI: 10.1017/S0963180123000488
Richard B Gibson
{"title":"Synthesizing Methuselah: The Question of Artificial Agelessness.","authors":"Richard B Gibson","doi":"10.1017/S0963180123000488","DOIUrl":"10.1017/S0963180123000488","url":null,"abstract":"<p><p>As biological organisms, we age and, eventually, die. However, age's deteriorating effects may not be universal. Some theoretical entities, due to their synthetic composition, could exist independently from aging-artificial general intelligence (AGI). With adequate resource access, an AGI could theoretically be ageless and would be, in some sense, immortal. Yet, this need not be inevitable. Designers could imbue AGIs with artificial mortality via an internal shut-off point. The question, though, is, should they? Should researchers curtail an AGI's potentially endless lifespan by deliberately making it mortal? It is this question that this article explores. First, it considers what type of AGI is under discussion before outlining how such beings could be ageless. Then, after clarifying the type of immortality under discussion and arguing that imbuing an AGI with synthetic aging would be person-affecting, the article explores four core conundrums: (i) deliberately causing a morally significant being's death; (ii) immortality's associated harms; (iii) concerns about immortality's unequal assignment; and (iv) the danger of immortal AGI overlords. The article concludes that while prudence requires we create an aging AGI, in the face of the material harm such an action would constitute, this is an insufficient reason to justify doing so.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"60-75"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Federalism for Bioethics? 生物伦理学的联邦制？
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-09-22 DOI: 10.1017/S0963180123000476
Leslie Francis, John Francis
{"title":"Federalism for Bioethics?","authors":"Leslie Francis, John Francis","doi":"10.1017/S0963180123000476","DOIUrl":"10.1017/S0963180123000476","url":null,"abstract":"<p><p>In the wake of the <i>Dobbs</i> decision withdrawing federal constitutional protection for reproductive rights, the United States is in the throes of federalist conflicts. Some states are enacting draconian prohibitions of abortion or gender-affirming care, whereas other states are attempting to shield providers and their patients seeking care. This article explores standard arguments supporting federalism, including that it allows for cultural differences to remain along with a structure that provides for the advantages of common security and commerce, that it provides a laboratory for confined experiments, that it is government closer to the people and thus more informed about local needs and preferences, and that it creates layers of government that can constrain one another and thus doubly protect rights. We contend that these arguments do not justify significant differences among states with respect to the recognition of important aspects of well-being; significant injustices among subnational units cannot be justified by federalism. However, as nonideal theorists, we also observe that federalism presents the possibility of some states protecting rights that others do not. Assuming that movement among subnational units is protected, those who are fortunate enough to be able to travel will be able to access rights they cannot access at home. Nonetheless, movement may not be readily available to minors, people without documentation, people with disabilities, people who lack economic resources, or people who have responsibilities that preclude travel. Only rights protection at the federal level will suffice in such cases.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"112-120"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When Is Something an Alternative? A General Account Applied to Animal-Free Alternatives to Animal Research. 什么时候是替代品？适用于动物研究的无动物替代品的一般说明。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-06-08 DOI: 10.1017/S0963180123000300
Koen Kramer
{"title":"When Is Something an Alternative? A General Account Applied to Animal-Free Alternatives to Animal Research.","authors":"Koen Kramer","doi":"10.1017/S0963180123000300","DOIUrl":"10.1017/S0963180123000300","url":null,"abstract":"<p><p>The first \"R\" from animal research ethics prescribes the replacement of animal experiments with animal-free alternatives. However, the question of when an animal-free method qualifies as an alternative to animal experiments remains unresolved.Drawing lessons from another debate in which the word \"alternative\" is central, the ethical debate on alternatives to germline genome editing, this paper develops a general account of when something qualifies as an alternative to something. It proposes three ethically significant conditions that technique, method, or approach X must meet to qualify as an alternative to Y: (1) X must address the same problem as Y, under an appropriate description of that problem; (2) X must have a reasonable chance of success, compared to Y, in solving the problem; and (3) X must not be ethically unacceptable as a solution. If X meets all these conditions, its relative advantages and disadvantages determine whether it is preferable, indifferent, or dispreferable as an alternative to Y.This account is then applied to the question of whether animal-free research methods qualify as alternatives to animal research. Doing so breaks down the debate around this question into more focused (ethical and other) issues and illustrates the potential of the account.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"89-101"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9948250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Call to Revise the Declaration of Helsinki's Placebo Guidelines. 呼吁修订《赫尔辛基宣言》的安慰剂指南。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-07-28 DOI: 10.1017/S0963180123000397
Dien Ho
{"title":"A Call to Revise <i>the Declaration of Helsinki's</i> Placebo Guidelines.","authors":"Dien Ho","doi":"10.1017/S0963180123000397","DOIUrl":"10.1017/S0963180123000397","url":null,"abstract":"<p><p>Since its introduction in 1964, the World Medical Association's <i>Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects</i> has enshrined the importance of safeguarding the well-being of human subjects in clinical research. <i>The Declaration</i> has undergone seven revisions, often in response to requests for clarification. I want to argue that <i>the Declaration</i> is in need of another revision in light of recent discoveries in placebo research.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"141-142"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9874218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial Intelligence and Human Enhancement: Can AI Technologies Make Us More (Artificially) Intelligent? 人工智能与人类增强：人工智能技术能否让我们更加（人工）智能？
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-08-30 DOI: 10.1017/S0963180123000464
Sven Nyholm
{"title":"Artificial Intelligence and Human Enhancement: Can AI Technologies Make Us More (Artificially) Intelligent?","authors":"Sven Nyholm","doi":"10.1017/S0963180123000464","DOIUrl":"10.1017/S0963180123000464","url":null,"abstract":"<p><p>This paper discusses two opposing views about the relation between artificial intelligence (AI) and human intelligence: on the one hand, a worry that heavy reliance on AI technologies might make people less intelligent and, on the other, a hope that AI technologies might serve as a form of cognitive enhancement. The worry relates to the notion that if we hand over too many intelligence-requiring tasks to AI technologies, we might end up with fewer opportunities to train our own intelligence. Concerning AI as a potential form of cognitive enhancement, the paper explores two possibilities: (1) AI as extending-and thereby enhancing-people's minds, and (2) AI as enabling people to behave in artificially intelligent ways. That is, using AI technologies might enable people to behave as if they have been cognitively enhanced. The paper considers such enhancements both on the level of individuals and on the level of groups.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"76-88"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10468291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
If You Must Give Them a Gift, Then Give Them the Gift of Nonexistence. 如果你必须给他们一份礼物，那就给他们一份 "不存在 "的礼物。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2022-12-13 DOI: 10.1017/S0963180122000317
Matti Häyry
{"title":"If You Must Give Them a Gift, Then Give Them the Gift of Nonexistence.","authors":"Matti Häyry","doi":"10.1017/S0963180122000317","DOIUrl":"10.1017/S0963180122000317","url":null,"abstract":"<p><p>I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children's life quality in a world threatened by environmental degradation, climate change, and the like. The main elements of the defense are an understanding of antinatalism's historical nature and contemporary varieties, a positional theory of value based on Epicurean hedonism and Schopenhauerian pessimism, and a sensitive guide for reproductive decision-making in the light of different views on life's value and risk-taking. My conclusion, main message, to the concerned would-be parents is threefold. If they believe that life's ordinary frustrations can make it not worth living, they should not have children. If they believe that a noticeably low life quality makes it not worth living and that such life quality can be reasonably expected, they should not have children, either. If they believe that a noticeably low life quality is not reasonably to be expected or that the risk is worth taking, they can, in the light of their own values and beliefs, have children. The conclusion is supported by a combination of the extant arguments for reproductive abstinence, namely the arguments from consent, moral asymmetry, life quality, and risk.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"48-59"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10682866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Daring to Taste: A Review of Living as a Bird by Vinciane Despret. 敢于品尝：Vinciane Despret 的《像鸟儿一样生活》评论。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-04-03 DOI: 10.1017/S0963180123000129
Jason D Keune
{"title":"Daring to Taste: A Review of <i>Living as a Bird</i> by Vinciane Despret.","authors":"Jason D Keune","doi":"10.1017/S0963180123000129","DOIUrl":"10.1017/S0963180123000129","url":null,"abstract":"<p><p>There is a certain sigh of relief-a sense of coming home-when encountering a concept that deeply reinforces a scholarly path that you have been on for over a decade, especially when that concept is better articulated than anything you have ever produced yourself. It was that home that I found in Vinciane Despret's <i>Living as a Bird.</i> My mind perked up when I read, \"if we are to sound like economists, there is also a price to be paid,\"<sup>1</sup> and then really connected with a sentence where she explains that in addition to being particularly punishing to read, studies of bird territories and territorialization, which are rooted in a clean, quantitative economics approach, have certain things that fail to be said, due to an \"element of negligence.\"<sup>2</sup> Finally, she turns to a quotation by Bruno Latour that rang wonderfully true with a sense of where I have lived over the last several years.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"143-147"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9240452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics. 通过诠释主义实现社会生物伦理学：医疗保健伦理框架》。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-01-01 Epub Date: 2023-08-25 DOI: 10.1017/S0963180123000452
Ryan J Dougherty, Joseph J Fins
{"title":"Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics.","authors":"Ryan J Dougherty, Joseph J Fins","doi":"10.1017/S0963180123000452","DOIUrl":"10.1017/S0963180123000452","url":null,"abstract":"<p><p>Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term \"social bioethics.\" Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"6-16"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10058571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","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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