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Cambridge Quarterly of Healthcare Ethics最新文献

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Best Interests and Decisions to Withdraw Life-Sustaining Treatment from a Conscious, Incapacitated Patient. 对有意识、丧失行为能力的病人撤销维持生命治疗的最佳利益和决定。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-16 DOI: 10.1017/S0963180124000793
L Syd M Johnson, Kathy L Cerminara
{"title":"Best Interests and Decisions to Withdraw Life-Sustaining Treatment from a Conscious, Incapacitated Patient.","authors":"L Syd M Johnson, Kathy L Cerminara","doi":"10.1017/S0963180124000793","DOIUrl":"https://doi.org/10.1017/S0963180124000793","url":null,"abstract":"<p><p>Conscious but incapacitated patients need protection from both undertreatment and overtreatment, for they are exceptionally vulnerable, and dependent on others to act in their interests. In the United States, the law prioritizes autonomy over best interests in decision making. Yet U.S. courts, using both substituted judgment and best interests decision making standards, frequently prohibit the withdrawal of life-sustaining treatment from conscious but incapacitated patients, such as those in the minimally conscious state, even when ostensibly seeking to determine what patients would have wanted. In the United Kingdom, under the Mental Capacity Act of 2005, courts decide on the best interests of incapacitated patients by, in part, taking into account the past wishes and values of the patient. This paper examines and compares those ethicolegal approaches to decision making on behalf of conscious but incapacitated patients. We argue for a limited interpretation of best interests such that the standard is properly used only when the preferences of a conscious, but incapacitated patient are unknown and unknowable. When patient preferences and values are known or can be reasonably inferred, using a holistic, all-things-considered substituted judgment standard respects patient autonomy.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-17"},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016767","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
Sentience and Beyond-A Representative Interview With Peter Singer AI. 感知与超越——彼得·辛格AI代表访谈
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-13 DOI: 10.1017/S0963180124000781
Sankalpa Ghose, Matti Häyry, Peter Singer
{"title":"Sentience and Beyond-A Representative Interview With Peter Singer AI.","authors":"Sankalpa Ghose, Matti Häyry, Peter Singer","doi":"10.1017/S0963180124000781","DOIUrl":"https://doi.org/10.1017/S0963180124000781","url":null,"abstract":"<p><p>This interview with Peter Singer AI serves a dual purpose. It is an exploration of certain-utilitarian and related-views on sentience and its ethical implications. It is also an exercise in the emerging interaction between natural and artificial intelligence, presented not as just ethics of AI but perhaps more importantly, as ethics with AI. The one asking the questions-Matti Häyry-is a person, in the contemporary sense of the word, sentient and self-aware, whereas Peter Singer AI is an artificial intelligence persona, created by Sankalpa Ghose, a person, through dialogue with Peter Singer, a person, to programmatically model and incorporate the latter's writings, presentations, recipes, and character qualities as a renowned philosopher. The interview indicates some subtle differences between natural perspectives and artificial representation, suggesting directions for further development. PSai, as the project is also known, is available to anyone to chat with, anywhere in the world, on almost any topic, in almost any language, at www.petersinger.ai.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973407","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
Both Sides, Now: A Personal Stroke Recovery Journey. 双方，现在：个人中风康复之旅。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-06 DOI: 10.1017/S0963180124000641
Grant Gillett
{"title":"Both Sides, Now: A Personal Stroke Recovery Journey.","authors":"Grant Gillett","doi":"10.1017/S0963180124000641","DOIUrl":"https://doi.org/10.1017/S0963180124000641","url":null,"abstract":"<p><p>This is a personal narrative of my stroke and recovery experience, and the medical, psychological, and social circumstances surrounding it.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933349","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
Ethical Considerations and Implications of Multi-Cancer Early Detection Screening: Reliability, Access and Cost to Test and Treat. 多种癌症早期检测筛查的伦理考虑和意义：可靠性、可及性和检测和治疗的成本。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-03 DOI: 10.1017/S0963180124000744
Lorenzo F Sempere
{"title":"Ethical Considerations and Implications of Multi-Cancer Early Detection Screening: Reliability, Access and Cost to Test and Treat.","authors":"Lorenzo F Sempere","doi":"10.1017/S0963180124000744","DOIUrl":"10.1017/S0963180124000744","url":null,"abstract":"<p><p>This essay focuses on the ethical considerations and implications of providing a universal multi-cancer screening test as the best approach to reduce societal cancer burden in a society with limited funds, resources, and infrastructure. With 1.9 million cancer diagnoses each year in the United States, with 86% of all cancers diagnosed in individuals over the age of 50, and with screening tools approved for only four cancer types (breast, cervical, colorectal, and lung cancer), it seems that a multi-cancer screening test to detect most cancer early that is easy to administer, and is accurate and cost-effective, would be worth considering. Whole-body magnetic resonance imaging and a multi-marker blood test are the two main technologies that we will discuss as a universal screening test. However, to understand and appreciate the societal and clinical breakthrough of such a screening test, we must first consider the accessibility and efficacy of current screening methods. We conclude with a closer examination of the ethical implications of implementing the Galleri test as a multi-cancer detection screening tool as adamantly advocated by the company that developed this blood-based test.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923879","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
Neural Voices of Patients with Severe Brain Injury? 重型颅脑损伤患者的神经声音？
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-03 DOI: 10.1017/S0963180124000446
Matthew Owen, Darren Hight, Anthony G Hudetz
{"title":"Neural Voices of Patients with Severe Brain Injury?","authors":"Matthew Owen, Darren Hight, Anthony G Hudetz","doi":"10.1017/S0963180124000446","DOIUrl":"https://doi.org/10.1017/S0963180124000446","url":null,"abstract":"<p><p>Studies have shown that some covertly conscious brain-injured patients, who are behaviorally unresponsive, can reply to simple questions via neuronal responses. Given the possibility of such neuronal responses, Andrew Peterson et al. have argued that there is warrant for some covertly conscious patients being included in low-stakes medical decisions using neuronal responses, which could protect and enhance their autonomy. The justification for giving credence to alleged neuronal responses must be analyzed from various perspectives, including neurology, bioethics, law, and as we suggest, philosophy of mind. In this article, we analyze the warrant for giving credence to neuronal responses from two different views in philosophy of mind. We consider how nonreductive physicalism's causal exclusion problem elicits doubt about interpreting neural activity as indicating a conscious response. By contrast, such an interpretation is supported by the mind-body powers model of neural correlates of consciousness inspired by hylomorphism.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-22"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923882","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
Against the Phrase "Aggressive Care". 反对“侵略性护理”一词。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-03 DOI: 10.1017/S096318012400077X
Trevor M Bibler
{"title":"Against the Phrase \"Aggressive Care\".","authors":"Trevor M Bibler","doi":"10.1017/S096318012400077X","DOIUrl":"https://doi.org/10.1017/S096318012400077X","url":null,"abstract":"<p><p>Language is the primary technology clinical ethicists use as they offer guidance about norms. Like any other piece of technology, to use the technology well requires attention, intention, skill, and knowledge. Word choice becomes a matter of professional practice. The Brief Report offers clinical ethicists several reasons for rejecting the phrase \"aggressive care.\" Instead, ethicists should consider replacing \"aggressive care\" with the adjacent concept of a \"recovery-focused path.\" The virtues of this neologism include: the opportunity to set aside the emotion of \"aggression,\" the phrase's accuracy when capturing the intention of the patient or their representative, and an unappreciated rhetorical force-and transparent logic-that arises when the patient's recovery is unlikely.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-3"},"PeriodicalIF":1.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923864","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
Setting Limits for the Principle of Equal Entitlement to Continued Life. 为延续生命的平等权利原则设限。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2025-01-02 DOI: 10.1017/S0963180124000768
Juan D Moreno-Ternero, Lars Peter Østerdal
{"title":"Setting Limits for the Principle of Equal Entitlement to Continued Life.","authors":"Juan D Moreno-Ternero, Lars Peter Østerdal","doi":"10.1017/S0963180124000768","DOIUrl":"https://doi.org/10.1017/S0963180124000768","url":null,"abstract":"<p><p>The normative principle that every individual is equally entitled to continued life is a subject of debate in ethics, health economics and policy. We reconsider this principle in the context of setting priorities for healthcare interventions. When applied without restriction, the principle overlooks quality of life concerns entirely. However, we contend that it remains ethically relevant in certain situations, particularly when patients suffer from conditions unrelated to the therapeutic areas and treatments under consideration. Thus, we defend the principle while also emphasizing the need for its application within tight limits.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916497","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
Multicancer Early Detection Screening Tools: Not Economically Efficient, Not Ethically Equitable, Marginally Medically Effective. 多癌早期检测筛查工具：经济效益不高，伦理不公平，医学上收效甚微。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-12-11 DOI: 10.1017/S0963180124000756
Leonard M Fleck
{"title":"Multicancer Early Detection Screening Tools: Not Economically Efficient, Not Ethically Equitable, Marginally Medically Effective.","authors":"Leonard M Fleck","doi":"10.1017/S0963180124000756","DOIUrl":"https://doi.org/10.1017/S0963180124000756","url":null,"abstract":"<p><p>A screening test for more than 50 cancers at earlier stages would strike many as a godsend. Such a test would promise, prima facie, to save 160,000 lives annually from a premature death from cancer, reduce the intensity of medical treatment, and reduce social costs. In brief, this is what is promised by the Galleri test. We will delineate those claims in greater detail and critically assess them from medical, economic, and ethical perspectives. We conclude, with many others, that this test lacks clinical validity and clinical utility. In addition, annual public funding of $100 billion for this test would be socially unaffordable; the opportunity costs would be unacceptable for both ethical and economic reasons. Further, the least well off with respect to cancer care would be made worse off if this test were publicly funded for everyone over the age of fifty.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808738","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
That Is My Mind. 这就是我的思想。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-12-11 DOI: 10.1017/S0963180124000690
Robert Burton
{"title":"That Is My Mind.","authors":"Robert Burton","doi":"10.1017/S0963180124000690","DOIUrl":"https://doi.org/10.1017/S0963180124000690","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807168","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
Ghost in the Machine. 机器里的幽灵。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-12-10 DOI: 10.1017/S0963180124000677
Robert A Burton
{"title":"Ghost in the Machine.","authors":"Robert A Burton","doi":"10.1017/S0963180124000677","DOIUrl":"https://doi.org/10.1017/S0963180124000677","url":null,"abstract":"<p><p>Delisted in the building directory, my name stripped from my cramped quarters just off the corpus callosum, I am impossible to find. In petitioning for official reinstatement, I have agreed to the humiliating lab investigations required for documentation. I have waved, howled, screamed, pleaded, and moaned into the latest scanners, and generally made a fool of myself. But researchers, after extensive soul-searching, and being unable to capture me as pixels and waveforms, have moved on to greener pastures. So be it. I accept official non-existence.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803426","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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