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Cambridge Quarterly of Healthcare Ethics最新文献

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Making Sense of John Harris and The Value of Life: An Enigma, Wrapped in Mysterious Contradictions, inside an Absence of Theoretical Commitments? 理解约翰·哈里斯和生命的价值：一个谜，包裹在神秘的矛盾中，在理论承诺的缺失中？
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-04-01 DOI: 10.1017/S0963180124000586
John Coggon
{"title":"Making Sense of John Harris and <i>The Value of Life</i>: An Enigma, Wrapped in Mysterious Contradictions, inside an Absence of Theoretical Commitments?","authors":"John Coggon","doi":"10.1017/S0963180124000586","DOIUrl":"10.1017/S0963180124000586","url":null,"abstract":"<p><p>This paper critically engages with the work of John Harris. Its central focus is his 1985 book, <i>The Value of Life</i>: a foundational text in philosophical bioethics, whose relevance and resonance continue firmly to endure. My aim is to examine what it says-and omits to say-about political authority. Through analysis of apparent and substantive contradictions, and of John's core focus on moral reasons rather than a basic moral theory, I argue that John says too little about the founding of political obligation. This is so even while he sees political obligation as morally required. I argue that the framings he gives in favor of moral requirements to accept political obligations are particularly significant because they indicate problems in the fundamentality and import of the idea of respect for persons as it features in <i>The Value of Life.</i></p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"156-165"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016772","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
Collective Reflective Equilibrium, Algorithmic Bioethics and Complex Ethics. 集体反思平衡，算法生命伦理学和复杂伦理学。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-04-01 DOI: 10.1017/S0963180124000719
Julian Savulescu
{"title":"Collective Reflective Equilibrium, Algorithmic Bioethics and Complex Ethics.","authors":"Julian Savulescu","doi":"10.1017/S0963180124000719","DOIUrl":"10.1017/S0963180124000719","url":null,"abstract":"<p><p>John Harris has made many seminal contributions to bioethics. Two of these are in the ethics of resource allocation. Firstly, he proposed the \"fair innings argument\" which was the first sufficientarian approach to distributive justice. Resources should be provided to ensure people have a fair innings-when Harris first wrote this, around 70 years of life, but perhaps now 80. Secondly, Harris famously advanced the egalitarian position in response to utilitarian approaches to allocation (such as maximizing Quality Adjusted Life Years [QALYs]) that what people want is the greatest chance of the longest, best quality life for themselves, and justice requires treating these claims equally. Harris thus proposed both sufficientarian and egalitarian approaches. This chapter compares these approaches with utilitarian and contractualist approaches and provides a methodology for deciding among these (Collective Reflective Equilibrium). This methodology is applied to the allocation of ventilators in the pandemic (as an example) and an ethical algorithm for their deployment created. This paper describes the concept of algorithmic bioethics as a way of addressing pluralism of values and context specificity of moral judgment and policy, and addressing complex ethics.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"204-219"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why we Must Change the Bioethical Terminology around So-Called "Lives Not Worth Living," and "Worthwhile" and "Unworthwhile" Lives. 为什么我们必须改变所谓“不值得活下去”、“值得”和“不值得”生命的生物伦理术语？
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-04-01 DOI: 10.1017/S0963180124000562
Rebecca Bennett
{"title":"Why we Must Change the Bioethical Terminology around So-Called \"Lives Not Worth Living,\" and \"Worthwhile\" and \"Unworthwhile\" Lives.","authors":"Rebecca Bennett","doi":"10.1017/S0963180124000562","DOIUrl":"10.1017/S0963180124000562","url":null,"abstract":"<p><p>The terminology of \"lives not worth living,\" \"worthwhile lives,\" and \"unworthwhile lives,\" used by John Harris and many others, has become an accepted linguistic convention in bioethical discussions. These terms are used to distinguish lives of overwhelming negative experience from lives that are or are expected to be of overall positive value. As such, this terminology seems helpful in discussions around resource allocation, end-of-life decision making and questions of when it might be acceptable (and unacceptable) to reproduce. This paper argues that there is, however, a problematic ambiguity inherent in these general terms that is particularly evident when it comes to discussing reproductive choices. It is suggested that in this context, this ambiguity can conceal authoritarian eugenic motivations that are difficult to justify and that many using these terms would not adhere to. As a result, it is argued that we should replace these terms with the terms \"intrinsically valuable\" and \"intrinsically harmful.\" This would make it more explicit what exactly is meant and would allow these matters to be debated with greater clarity.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"173-183"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383962","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
Rethinking Animal Consciousness Research to Prioritize Well-Being. 重新思考动物意识研究，将福祉放在首位。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-04-01 DOI: 10.1017/S0963180124000501
Liv Baker, Barbara J King, William S Lynn
{"title":"Rethinking Animal Consciousness Research to Prioritize Well-Being.","authors":"Liv Baker, Barbara J King, William S Lynn","doi":"10.1017/S0963180124000501","DOIUrl":"10.1017/S0963180124000501","url":null,"abstract":"<p><p>The authors critique the NY Declaration on Animal Consciousness, which does not denounce continued captivity and invasive research in the pursuit of animal consciousness markers. They argue that such research often increases animal suffering by accepting harmful practices. Instead, they propose a nonanthropocentric, ethical framework aligned with the Belmont Report's principle of beneficence, advocating for noninvasive methods in natural habitats. This approach prioritizes animal well-being, recognizing and safeguarding the intrinsic value of all conscious beings.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"280-284"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513379","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
Suffering and Intellectual (Dis)Ability - ERRATUM. 痛苦和智力（疾病）能力-勘误。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-03-19 DOI: 10.1017/S0963180125000131
Ryan H Nelson
{"title":"Suffering and Intellectual (Dis)Ability - ERRATUM.","authors":"Ryan H Nelson","doi":"10.1017/S0963180125000131","DOIUrl":"https://doi.org/10.1017/S0963180125000131","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659861","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
Suffering at the Margins: Non-Experiential Suffering and Disorders of Consciousness. 边缘的痛苦：非经验的痛苦和意识的紊乱。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-03-18 DOI: 10.1017/S0963180125000052
Jennifer Blumenthal-Barby
{"title":"Suffering at the Margins: Non-Experiential Suffering and Disorders of Consciousness.","authors":"Jennifer Blumenthal-Barby","doi":"10.1017/S0963180125000052","DOIUrl":"https://doi.org/10.1017/S0963180125000052","url":null,"abstract":"<p><p>Research suggests that caregivers of patients with disorders of consciousness such as minimally conscious states (MCS) believe they suffer in some way. How so, if they cannot experience sensations or feelings? What is the nature of their suffering? This paper explores non-experiential suffering (NES). It argues that concerns about NES are really concerns about harms (e.g., dignity-based harms), but still face problems. Second, it addresses the moral importance of bearing witness to suffering. It explores several possible accounts: epistemic (bearing witness generates important knowledge), consequentialist (witnesses' interests also matter), and deontological (there is a duty to bear witness). It argues that witnessing suffering creates epistemic advantages and disadvantages for determining a patient's interests; that clinicians' interests to not bear witness may have considerable moral weight; and that the obligation to bear witness to NES is unclear.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651895","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
Suffering and Intellectual (Dis)Ability. 痛苦和智力（疾病）能力。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-03-10 DOI: 10.1017/S0963180125000088
Ryan H Nelson
{"title":"Suffering and Intellectual (Dis)Ability.","authors":"Ryan H Nelson","doi":"10.1017/S0963180125000088","DOIUrl":"https://doi.org/10.1017/S0963180125000088","url":null,"abstract":"<p><p>This essay argues that what distinguishes a negatively valenced phenomenal experience from suffering is an ability to make meaning of the experience. In this sense, intellectual ability influences the extent and nature of suffering. But this connection is not a straightforward one, since intellectual ability cuts both ways. On the one hand, those with higher levels of intellectual functioning are better able to make meaning of negative experiences, thereby reducing their suffering. On the other, intellectual ability can influence the depth and breadth of one's negative experiences, thereby increasing suffering. This means that we cannot make any assumptions about a person's susceptibility to suffering based on their level of intellectual functioning alone.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588001","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
How do Persons With Dementia Suffer? 痴呆症患者是如何遭受痛苦的？
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-02-20 DOI: 10.1017/S096318012500012X
Jason Karlawish
{"title":"How do Persons With Dementia Suffer?","authors":"Jason Karlawish","doi":"10.1017/S096318012500012X","DOIUrl":"https://doi.org/10.1017/S096318012500012X","url":null,"abstract":"<p><p>This essay argues that suffering in persons with dementia is more than a matter of personal experience. It is knowable by others and does not need to rely on the reports of the patient to affirm it. It is even possible for a person to claim not to be suffering-\"I'm doing fine\"-but for others to conclude to the contrary-\"You are suffering.\" A key property of this objective account is the caregiver observes the suffering. This observation is a product of the work of caregiving and this work relies on perceiving and supporting the mind of the person living with dementia. When that work of mind support is successful, it creates a feeling of being at home. When it is not, suffering ensues.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460878","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
Miracle. 奇迹。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-02-10 DOI: 10.1017/S0963180124000665
Robert A Burton
{"title":"Miracle.","authors":"Robert A Burton","doi":"10.1017/S0963180124000665","DOIUrl":"https://doi.org/10.1017/S0963180124000665","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383924","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
The Moral Significance of Biofixtures: A Response to Nathan Goldstein, Bridget Tracy, and Rosamond Rhodes "But I have a pacer…there is no point in engaging in hypothetical scenarios": A Non-imminently Dying Patient's Request for Pacemaker Deactivation. 生物装置的道德意义：对Nathan Goldstein， Bridget Tracy和Rosamond Rhodes的回应“但是我有一个起搏器……参与假设的场景没有意义”：一个非迫在眉睫的垂死病人要求起搏器停用。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-02-10 DOI: 10.1017/S0963180125000039
Kelsey Gipe
{"title":"The Moral Significance of Biofixtures: A Response to Nathan Goldstein, Bridget Tracy, and Rosamond Rhodes \"But I have a pacer…there is no point in engaging in hypothetical scenarios\": A Non-imminently Dying Patient's Request for Pacemaker Deactivation.","authors":"Kelsey Gipe","doi":"10.1017/S0963180125000039","DOIUrl":"https://doi.org/10.1017/S0963180125000039","url":null,"abstract":"<p><p>Based on the case report of Nathan Goldstein et al., \"But I have a pacer…there is no point in engaging in hypothetical scenarios\": A Non-imminently Dying Patient's Request for Pacemaker Deactivation, it is reasonable to conclude that it was, all-things-considered, ethically appropriate to grant the patient's request to deactivate her pacemaker. Philosophically, and as a clinical ethicist, I support the team's decision to honor the patient's request for pacemaker deactivation. However, it is worth exploring a bit further whether the distress on the part of the outside hospital's ethics committee and providers-who declined to honor the patient's request for pacemaker deactivation-may actually track something of moral significance. In this commentary, I argue that there are reasonable grounds for holding that deactivation of a 'biofixture' such as a pacemaker may be more analogous in moral terms to medical aid in dying than it is to standard cases of withdrawal of life support at the end of a patient's life.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383960","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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