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Cambridge Quarterly of Healthcare Ethics最新文献

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Naming and Describing Disability in Law and Medicine. 在法律和医学中命名和描述残疾。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-07-01 Epub Date: 2024-01-02 DOI: 10.1017/S0963180123000609
Heloise Robinson, Jonathan Herring
{"title":"Naming and Describing Disability in Law and Medicine.","authors":"Heloise Robinson, Jonathan Herring","doi":"10.1017/S0963180123000609","DOIUrl":"10.1017/S0963180123000609","url":null,"abstract":"<p><p>This article explores the effects of naming and describing disability in law and medicine. Instead of focusing on substantive issues like medical treatment or legal rights, it will address questions which arise in relation to the use of language itself. When a label which is attached to a disability is associated with a negative meaning, this can have a profound effect on the individual concerned and can create stigma. Overly negative descriptions of disabilities can be misleading, not only for the individual, but also more broadly in society, if there are inaccurate perceptions about disability in the social context. This article will examine some relevant examples of terminology, where these issues arise. It will also suggest that the role of medicine and the law in naming and describing disability is particularly important because in these areas there is, perhaps more than anywhere else, a recognized source of authority for the choice of terminology. Labels and descriptions used in the medical and legal contexts can not only perpetuate existing stigmatization of disabled people, but can also contribute to creating stigma at its source, given that the words used in these contexts can constitute an exercise of power.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"401-412"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075937","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
Sam's Story: Reflections on Suicide and the Doctor/Patient Relationship. 山姆的故事：关于自杀和医患关系的思考》。
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-07-01 Epub Date: 2024-01-02 DOI: 10.1017/S0963180123000610
William Andereck
{"title":"Sam's Story: Reflections on Suicide and the Doctor/Patient Relationship.","authors":"William Andereck","doi":"10.1017/S0963180123000610","DOIUrl":"10.1017/S0963180123000610","url":null,"abstract":"","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"440-442"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075938","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
Hard Choices: How Does Injustice Affect the Ethics of Medical Aid in Dying? 艰难抉择：不公正如何影响临终医疗救助的伦理？
IF 1.5 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-07-01 Epub Date: 2023-10-16 DOI: 10.1017/S0963180123000531
Brent M Kious
{"title":"Hard Choices: How Does Injustice Affect the Ethics of Medical Aid in Dying?","authors":"Brent M Kious","doi":"10.1017/S0963180123000531","DOIUrl":"10.1017/S0963180123000531","url":null,"abstract":"<p><p>Critics of medical aid in dying (MAID) often argue that it is impermissible because background social conditions are insufficiently good for some persons who would utilize it. I provide a critical evaluation of this view. I suggest that receiving MAID is a sort of \"hard choice,\" in that death is <i>prima facie</i> bad for the individual and only promotes that person's interests in special circumstances. Those raising this objection to MAID are, I argue, concerned primarily about the effects of injustice on hard choices. I show, however, that MAID and other hard choices are not always invalidated by injustice and that what matters is whether the injustice can be remediated given certain constraints. Injustice invalidates a hard choice when it can, reasonably, be remedied in a way that makes a person's life go better. I consider the implications of this view for law and policy regarding MAID.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"413-424"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241038","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
Gray Rainbows. 灰色彩虹
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-05-23 DOI: 10.1017/S0963180124000276
Robert Burton
{"title":"Gray Rainbows.","authors":"Robert Burton","doi":"10.1017/S0963180124000276","DOIUrl":"https://doi.org/10.1017/S0963180124000276","url":null,"abstract":"<p><p>\"You fooled me. I never dreamt,\" George said to the pasty gray face in the mirror. As a child, he had worked out complicated schemes of how the world must be constructed. This led to that, and that led to this. When this and that no longer fit together, he began to squint, and limit his view to the essential. At any moment, the sky might break open and rain body parts and end times. He never imagined that it would be colors that would give way.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-2"},"PeriodicalIF":1.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082852","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
Operationalizing the Intolerable Suffering Criterion in Advance Requests for Medical Assistance in Dying for People Living with Dementia in Canada. 加拿大痴呆症患者死亡医疗协助预先申请中难以忍受的痛苦标准的操作化。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-05-22 DOI: 10.1017/S0963180124000264
Hayden P Nix
{"title":"Operationalizing the Intolerable Suffering Criterion in Advance Requests for Medical Assistance in Dying for People Living with Dementia in Canada.","authors":"Hayden P Nix","doi":"10.1017/S0963180124000264","DOIUrl":"https://doi.org/10.1017/S0963180124000264","url":null,"abstract":"<p><p>In Canada, there is interest in expanding medical assistance in dying (MAID) to include advance requests (AR) for people living with dementia (PLWD). However, operationalizing the intolerable suffering criterion for MAID in ARs for PLWD is complicated by the Canadian legal context-in which MAID is understood as a medical intervention and suffering is conceptualized as subjective-and the degenerative nature of dementia. ARs that express a wish to receive MAID when the PLWD develops pre-specified impairments are problematic because people are unlikely to accurately predict the conditions that will cause intolerable suffering. ARs that express a wish to receive MAID when the PLWD exhibits pre-specified behaviors that likely represent suffering are problematic because they are inconsistent with the subjective conceptualization of suffering. Further research is required to determine whether adopting an objective conceptualization of suffering is justified in these cases and, if so, how to reliably identify intolerable suffering in PLWD.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076998","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 Suicide is not a Self-Killing: Advance Decisions and Psychological Discontinuity-Part II. 当自杀不是自尽时：预先决定和心理中断--第二部分。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-05-09 DOI: 10.1017/S0963180124000239
Suzanne E Dowie
{"title":"When Suicide is not a <i>Self</i>-Killing: Advance Decisions and Psychological Discontinuity-Part II.","authors":"Suzanne E Dowie","doi":"10.1017/S0963180124000239","DOIUrl":"https://doi.org/10.1017/S0963180124000239","url":null,"abstract":"<p><p>Derek Parfit's view of personal identity raises questions about whether advance decisions refusing life-saving treatment should be honored in cases where a patient loses psychological continuity; it implies that these advance decisions would not be <i>self</i>-determining at all. However, rather than accepting that an unknown metaphysical 'further fact' underpins agential unity, one can accept Parfit's view but offer a different account of what it implies morally. Part II of this article argues that contractual obligations provide a moral basis for honoring advance decisions refusing life-saving and/or life-sustaining medical treatment; advance decisions have similarities to contracts, such as life insurance policies and will-contracts, that come into effect when the psychological discontinuity is through death.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892909","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 "Life" of the Mind: Persons and Survival. 心灵的 "生命"：人与生存。
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-05-08 DOI: 10.1017/S0963180124000082
John Harris
{"title":"The \"Life\" of the Mind: Persons and Survival.","authors":"John Harris","doi":"10.1017/S0963180124000082","DOIUrl":"https://doi.org/10.1017/S0963180124000082","url":null,"abstract":"<p><p>A life of the mind can be lived only by creatures who know that they have minds. We call these creatures \"persons,\" and currently, all such persons THAT we know OF are \"alive\" in the biological sense. But are there, or could there be, either in the future or elsewhere in the universe, creatures with \"a life of the mind\" that are not \"alive\" in the sense that we humans usually understand this term today?</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":" ","pages":"1-26"},"PeriodicalIF":1.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877967","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
Identifying Relevant Topics for Inclusion in an Ethics Curriculum for Anesthesiology Trainees: A Survey of Practitioners in the Field 确定麻醉学受训人员伦理课程的相关主题：对该领域从业人员的调查
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-04-29 DOI: 10.1017/s0963180124000240
Madeline J. Pence, Raymond A. Pla, Eric Heinz, Rundell Douglas, Eduard Shaykhinurov, Breanne Jacobs
{"title":"Identifying Relevant Topics for Inclusion in an Ethics Curriculum for Anesthesiology Trainees: A Survey of Practitioners in the Field","authors":"Madeline J. Pence, Raymond A. Pla, Eric Heinz, Rundell Douglas, Eduard Shaykhinurov, Breanne Jacobs","doi":"10.1017/s0963180124000240","DOIUrl":"https://doi.org/10.1017/s0963180124000240","url":null,"abstract":"<p>Anesthesiology training programs are tasked with equipping trainees with the skills to become medically and ethically competent in the practice of anesthesia and to be prepared to obtain board certification, yet there is currently no standardized ethics curriculum within anesthesia training programs in the United States. To bridge this gap, and to provide a validated ethics curriculum to meet the aforementioned needs, in July 2021, a survey was sent to anesthesia scholars in the field of biomedical ethics to identify key areas that should be included in such an ethics curriculum. The responses were rated on a Likert scale and ranked. This paper identifies the top ten topics identified as high priority for inclusion in an anesthesiology training program and consequently deemed most relevant to meet the educational needs of graduates of an anesthesiology residency: (1) capacity to consent; (2) capacity to refuse elective versus lifesaving treatment; (3) application of surrogate decisionmaking; (4) approach to do not resuscitate (DNR) status in the operating room; (5) patient autonomy and advance directives; (6) navigating patient beliefs that may impair care; (7) “futility” in end-of-life care: when to withdraw life support; (8) disclosure of medical errors; (9) clinical criteria for “brain death” and consequences of this definition; and (10) the impaired anesthesiologist.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":"4 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140808729","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
AI-Inclusivity in Healthcare: Motivating an Institutional Epistemic Trust Perspective 医疗保健领域的人工智能包容性：从机构认识论信任的视角出发
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-04-29 DOI: 10.1017/s0963180124000215
Kritika Maheshwari, Christoph Jedan, Imke Christiaans, Mariëlle van Gijn, Els Maeckelberghe, Mirjam Plantinga
{"title":"AI-Inclusivity in Healthcare: Motivating an Institutional Epistemic Trust Perspective","authors":"Kritika Maheshwari, Christoph Jedan, Imke Christiaans, Mariëlle van Gijn, Els Maeckelberghe, Mirjam Plantinga","doi":"10.1017/s0963180124000215","DOIUrl":"https://doi.org/10.1017/s0963180124000215","url":null,"abstract":"<p>This paper motivates institutional epistemic trust as an important ethical consideration informing the responsible development and implementation of artificial intelligence (AI) technologies (or AI-inclusivity) in healthcare. Drawing on recent literature on epistemic trust and public trust in science, we start by examining the conditions under which we can have institutional epistemic trust in AI-inclusive healthcare systems and their members as providers of medical information and advice. In particular, we discuss that institutional epistemic trust in AI-inclusive healthcare depends, in part, on the reliability of AI-inclusive medical practices and programs, its knowledge and understanding among different stakeholders involved, its effect on epistemic and communicative duties and burdens on medical professionals and, finally, its interaction and alignment with the public’s ethical values and interests as well as background sociopolitical conditions against which AI-inclusive healthcare systems are embedded. To assess the applicability of these conditions, we explore a recent proposal for AI-inclusivity within the Dutch Newborn Screening Program. In doing so, we illustrate the importance, scope, and potential challenges of fostering and maintaining institutional epistemic trust in a context where generating, assessing, and providing reliable and timely screening results for genetic risk is of high priority. Finally, to motivate the general relevance of our discussion and case study, we end with suggestions for strategies, interventions, and measures for AI-inclusivity in healthcare more widely.</p>","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":"4 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140808958","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 Suicide is not a Self-Killing: Advance Decisions and Psychological Discontinuity—Part I 当自杀不是自尽时：预先决定和心理中断--第一部分
IF 1.8 4区 医学
Cambridge Quarterly of Healthcare Ethics Pub Date : 2024-04-24 DOI: 10.1017/s0963180124000227
Suzanne E. Dowie
{"title":"When Suicide is not a Self-Killing: Advance Decisions and Psychological Discontinuity—Part I","authors":"Suzanne E. Dowie","doi":"10.1017/s0963180124000227","DOIUrl":"https://doi.org/10.1017/s0963180124000227","url":null,"abstract":"Derek Parfit’s view of ‘personal identity’ raises questions about whether advance decisions refusing life-saving treatment should be honored in cases where a patient loses psychological continuity; it implies that these advance decisions would not be self-determining at all. Part I of this paper argues that this assessment of personal identity undermines the distinction between suicide and homicide. However, rather than accept that an unknown metaphysical ‘further fact’ underpins agential unity, one can accept Parfit’s view but offer a different account of what it implies morally: that the social and legal bases for ascribing a persisting ‘personal identity’ maintain the distinction between homicide and suicide.","PeriodicalId":55300,"journal":{"name":"Cambridge Quarterly of Healthcare Ethics","volume":"129 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140806447","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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