Bioethics最新文献

{"title":"Missing references and citations at Google Scholar.","authors":"Joona Räsänen","doi":"10.1111/bioe.13403","DOIUrl":"https://doi.org/10.1111/bioe.13403","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectogenesis and gender inequality: Two pathways converge.","authors":"Jolie Zhou","doi":"10.1111/bioe.13406","DOIUrl":"https://doi.org/10.1111/bioe.13406","url":null,"abstract":"<p><p>Debate on whether ectogenesis is a morally desirable solution to gender inequality often starts by analyzing whether gender inequality has been caused by (i) reproductive differences between the sexes or (ii) social structures. I term these two sides the biological model and the social model. Without taking either side, this article contends that both models provide a fragile foundation for assessing the moral desirability of ectogenesis. I draw on Ronald Dworkin's luck egalitarian theory and Ron Amundson's perspective to demonstrate that both models are inherently interactionist and share the view that society's inadequate response to female reproductive traits is crucial in gender oppression. Actions on either biological or social factors are prima facie valid. Meanwhile, neither model can conclusively determine whether ectogenesis is morally desirable.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryo selection, gene editing, and the person-affecting principle.","authors":"Xueshi Wang","doi":"10.1111/bioe.13407","DOIUrl":"https://doi.org/10.1111/bioe.13407","url":null,"abstract":"<p><p>This article examines the ethical implications of embryo selection (ES) and gene editing (GE) in reproductive medicine through the lens of Pummer's Person-Affecting View (PAV). I argue that even if the edited embryo is not numerically identical to the unedited one, GE may still be ethically preferable to ES in certain scenarios. PAV assesses the moral permissibility of an action based on the balance of requiring reasons against and permitting reasons for it, from the perspective of particular individuals. I apply PAV to ES/GE decisions, considering the expected happiness and suffering of potential future children. The permissibility of ES or GE depends on the nature of the genetic disorder and the balance of expected happiness and suffering in each case.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confucian reflections on the new reproductive model of ROPA.","authors":"Yonghui Ma, Hua Chen, Kathryn Muyskens","doi":"10.1111/bioe.13402","DOIUrl":"https://doi.org/10.1111/bioe.13402","url":null,"abstract":"<p><p>Some countries are legalizing same-sex marriage and assisted reproductive technologies (ART) for homosexual couples. One unique form of ART, ROPA (Reception of Oocytes from Partner), recently stirred up controversy in China, when a custody dispute between a female same-sex couple who used ROPA brought this reproductive model into the public eye. Some Western scholars have argued for the legitimacy of ROPA from the perspective of autonomy and reproductive rights. Yet, these arguments do not easily translate into all cultural contexts, as this case will show. There is a need to articulate the ethical considerations of such technologies in light of local philosophical traditions. To that end, this paper will explore the permissibility of ROPA from a Confucian lens, exploring Confucian perspectives on naturalness, filial piety, family and social harmony. Accordingly, we hope to further the discussion of cross-cultural bioethics.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care and the ethical implications of treatment spaces","authors":"Ruth Chadwick","doi":"10.1111/bioe.13401","DOIUrl":"https://doi.org/10.1111/bioe.13401","url":null,"abstract":"<p>The recent advertisement in the United Kingdom for nurses to give corridor care1 has revived discussion of the ethical issues associated with the spaces in which health care is delivered. While we are sadly used to seeing, on television screens at least, treatment given in situations of war and disasters—in conditions of extreme deprivation—there are concerns about the normalisation of less than optimal situations for delivery of care in relatively rich countries in peace time. Rachelle Barina has written of the distinction between places and spaces:</p><p>‘By <i>place</i>, I mean the material qualities, setting and location of health care delivery. The various <i>places</i> in which health care is delivered are also distinct <i>spaces</i>. By <i>space</i>, I mean not only physical and geographical qualities, but also the ideas, activities and symbols that form, result from, and function within places’.2</p><p>The distinction between the implications of old-style Nightingale ward arrangements and more intimate settings is a familiar one, but Barina also writes about the properties of Intensive Care Units, which are not just particular spaces but ones which have symbolic meaning around the use of the ventilator for example. Indeed, this was very evident during the COVID-19 pandemic.</p><p>‘Corridor care’ or care in spaces that have been referred to as ‘temporary escalation spaces’3 clearly has implications not only for patients but also for health care providers and for society more generally. As regards patients, concerns raised have included those related to privacy and dignity (although it has to be acknowledged that in a standard ward the use of a curtain may give visual but not verbal privacy). There are also issues about access to necessary equipment. The term ‘corridor’ symbolises a passing through, a way past rooms which one might want to enter. It is in those rooms that it might be imagined that desired resources might be found—but not accessible.</p><p>For health care providers, having one's role designated as a ‘corridor carer’ may give rise to diminished job satisfaction and frustration, through recognising that one does not have the wherewithal to give the care to the standard one would want. Sheather and Phillips, reviewing a guide to the ethics of corridor care published by NHS England,4 have argued that ‘[S]afe and good quality care cannot co-exist with treatment in corridors’.5</p><p>A key issue here is normalisation. When do ‘temporary escalation spaces’ become a permanent feature? This is an issue for consideration by managers, policy-makers and society more widely Arguably the very exercise of drafting principles for care in these circumstances only makes that outcome more likely.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"231"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral dilemmas and slow codes.","authors":"Parker Crutchfield","doi":"10.1111/bioe.13399","DOIUrl":"https://doi.org/10.1111/bioe.13399","url":null,"abstract":"<p><p>Slow codes-insincere attempts at resuscitation-are widely regarded in medicine and medical ethics as morally impermissible. My goal here is to enrich this special issue on the slow code with an argument for the permissibility of slow codes that is rooted in moral psychology. Specifically, if we take seriously the results from moral psychology, the slow code is not only permissible, it is often the best option. The context of the decision about whether to perform a slow code is analogous to thoroughly investigated moral dilemmas such as the trolley problem. In particular, when the trolley problem is framed as a trilemma, it becomes clear that the decisional context of the slow code is analogous to the famous moral dilemma. Since in the trolley problem the choice analogous to the slow code is the best choice, the slow code may be the best choice when facing patient or family requests for futile CPR. In establishing this claim, I address a range of objections to the slow code. I conclude with an empirically supported explanation of the conventional wisdom. Resistance to the slow code doesn't sprout from the act's moral properties, but from moral judgments influenced by other factors, such as emotion, physical distance, and personal force.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is more data always better? On alternative policies to mitigate bias in Artificial Intelligence health systems.","authors":"Guillermo Lazcoz, Iñigo de Miguel","doi":"10.1111/bioe.13398","DOIUrl":"https://doi.org/10.1111/bioe.13398","url":null,"abstract":"<p><p>The development and implementation of Artificial Intelligence (AI) health systems represent a great power that comes with great responsibility. Their capacity to improve and transform healthcare involves inevitable risks. A major risk in this regard is the propagation of bias throughout the life cycle of the AI system, leading to harmful or discriminatory outcomes. This paper argues that the European medical device regulations may prove inadequate to address this-not only technical but also social challenge. With the advent of new regulatory remedies, it seems that the European policymakers also want to reinforce the current medical device legal framework. In this paper, we analyse different policies to mitigate bias in AI health systems included in the Artificial Intelligence Act and in the proposed European Health Data Space. As we shall see, the different remedies based on processing sensitive data for such purpose devised by the European policymakers may have very different effects both on privacy and on protection against discrimination. We find the focus on mitigation during the pre-commercialisation stages rather weak, and believe that bias control once the system has been implemented in the real world would have merited greater ambition.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sufficiency and healthcare emissions.","authors":"Joshua Parker","doi":"10.1111/bioe.13400","DOIUrl":"https://doi.org/10.1111/bioe.13400","url":null,"abstract":"<p><p>In this paper, I am concerned with how healthcare systems ought to transition away from the greenhouse gas emissions that they have historically relied on to provide care. I address two questions in relation to this issue. The first is what emissions target should healthcare systems adopt? Second, is how should the burdens of mitigation be shared fairly in light of that target? I argue that sufficientarianism offers an attractive way to answer both of these questions because it is better situated to strike the right balance between healthcare benefits and the costs of mitigation than rivals. Sufficiency describes the view that what is important from the perspective of distributive justice is that individuals have enough. I argue that this ideal can be used to set a threshold of enough health from which an emissions threshold can be set. Once an emissions threshold is in place, this can be used to demarcate permissible from impermissible emissions in healthcare. In turn, the emissions threshold provides guidance on which emissions are liable to mitigation and when it would be fair for healthcare to shoulder the associated burdens. Permissible emissions, on the other hand, are necessary to secure sufficiency and so healthcare's mitigation responsibilities should be altered in light of this. I also discuss various alternative methods of setting an emissions target like net zero, zero emissions, emissions grandfathering and emissions egalitarianism. I point to several issues with these approaches.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow Codes are symptomatic of ethically and legally inappropriate CPR policies.","authors":"Stuart McLennan, Marieke Bak, Kathrin Knochel","doi":"10.1111/bioe.13396","DOIUrl":"https://doi.org/10.1111/bioe.13396","url":null,"abstract":"<p><p>Although cardiopulmonary resuscitation (CPR) was initially used very selectively at the discretion of clinicians, the use of CPR rapidly expanded to the point that it was required to be performed on all patients having in-hospital cardiac arrests, regardless of the underlying condition. This created problems with CPR being clearly inadvisable for many patients. Do Not Resuscitate (DNR) orders emerged as a means of providing a transparent process for making decisions in advance regarding resuscitation, initially by patients and later also by clinicians. Under hospital policies in many countries, however, CPR remains the default position for all patients having cardiac arrest in the hospital if there is no DNR order in place, regardless of whether CPR is medically indicated or in the patient's best interests. \"Slow Codes\" are the delayed or token efforts to provide CPR when clinicians feel CPR is futile or inappropriate. After giving a historical overview of the development and the changing use of CPR, we argue that more attention needs to be given to the cause of slow codes, namely, policies requiring CPR to be performed as the default action while simultaneously lacking implementing interventions such as advance care planning as a routine policy. This is ethically and legally inappropriate, and hospital policies should be modified to allow clinicians to consider whether CPR is appropriate at the time of arrest. Such a change requires a stronger emphasis on early recognition of patients for whom CPR is not in their best interests and to improve hospital emergency planning.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xenotransplantation as a business solution to the organ shortage.","authors":"Christopher Bobier, Richard B Gibson, Anthony Merlocco, Daniel Rodger, Daniel J Hurst","doi":"10.1111/bioe.13397","DOIUrl":"https://doi.org/10.1111/bioe.13397","url":null,"abstract":"<p><p>Xenotransplantation has the potential to alter the U.S. transplant system in profound ways. However, this emerging \"spare parts\" solution spearheaded by biotechnology companies raises concerns about its impact on the organ shortage, healthcare systems, population health, and health inequalities. We contend that xenotransplantation may have limited benefits in improving health, could prove prohibitively expensive for many, and may divert resources away from proven public health measures. Additionally, it carries the risk of perpetuating stigma. Xenotransplantation may thereby exacerbate existing healthcare inequities across racial, ethnic, socio-economic, and geographic lines. To mitigate these risks, we contend that public health expert input is integral for xenotransplant policy development and outreach and that this underscores the importance of federal government investment in transplant infrastructure.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}