BioethicsPub Date : 2024-02-17DOI: 10.1111/bioe.13275
Parker Crutchfield, Scott Scheall
{"title":"Abolishing morality in biomedical ethics","authors":"Parker Crutchfield, Scott Scheall","doi":"10.1111/bioe.13275","DOIUrl":"10.1111/bioe.13275","url":null,"abstract":"<p>In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as “S should do X.” The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails to truly capture the person's actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision-making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non-obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898348","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}
BioethicsPub Date : 2024-02-17DOI: 10.1111/bioe.13270
Hans-Jörg Ehni, Urban Wiesing
{"title":"The Declaration of Helsinki in bioethics literature since the last revision in 2013","authors":"Hans-Jörg Ehni, Urban Wiesing","doi":"10.1111/bioe.13270","DOIUrl":"10.1111/bioe.13270","url":null,"abstract":"<p>The World Medical Association has announced that a new revision process of the Declaration of Helsinki has been started. This article will identify the criticisms that have been made in the bioethics literature, particularly since the last revision. In addition, criticisms are discussed that were made in the literature even before the last revision and have not fallen silent. The plausibility of the recommendation for a change in the Declaration of Helsinki is examined.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898349","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}
BioethicsPub Date : 2024-02-16DOI: 10.1111/bioe.13272
Zhaochen Wang, Yuzhi Fan, Wenchen Shao
{"title":"Social egg freezing and reproductive rights justification: A perspective from China","authors":"Zhaochen Wang, Yuzhi Fan, Wenchen Shao","doi":"10.1111/bioe.13272","DOIUrl":"10.1111/bioe.13272","url":null,"abstract":"<p>Divergences and controversies are inevitable in the discussion of freedoms and rights, especially in the matter of reproduction. The Chinese first social egg freezing lawsuit raises the question: is the freedom to freeze eggs for social reasons justified because it is an instance of reproductive rights? This paper accepts social egg freezing as desirable reproductive freedom, but following Harel's approach and considering two theories of rights, the choice and interest theories of rights, we argue that social egg freezing is not a reproductive right because one cannot justify a right or an instance of rights via merely describing the function of those instances that have been justified as right, that is, the choice theory lacks justifying normativity. Since reserving fertility and a suspension from reproduction do not serve reproductive ends <i>per se</i>, the sufficient reason for demanding social egg freezing as a right should be found in other ends rather than in right-to-reproduce, that is, the interest theory denies the demand as a right-to-reproduce. Permitting it on any grounds without guaranteeing adequate and accessible resources, especially in light of cross-border reproductive care, raises serious questions about reproductive equality and violates the idea of reproductive rights. Therefore, any ground for social egg freezing should be weighed against whether more pressing reproductive needs, specifically those that are justified as rights, have been met. It would be social progress to shoulder these burdens for the vulnerable and then allow social egg freezing—if right-to-reproduce were not the only privilege of the few.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747856","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}
BioethicsPub Date : 2024-02-15DOI: 10.1111/bioe.13269
Jordan A. Parsons, Pamela Cairns, Jonathan Ives
{"title":"Translational bioethics","authors":"Jordan A. Parsons, Pamela Cairns, Jonathan Ives","doi":"10.1111/bioe.13269","DOIUrl":"10.1111/bioe.13269","url":null,"abstract":"<p>Bioethics as a field has sometimes struggled to have, and demonstrate, “real-world” impact. Notwithstanding the fact that bioethics lies at the practical/applied end of the ethics spectrum, and for some can only really be understood as a field concerned with ‘practical ought questions’,1 it is hopefully not too controversial to say that bioethics has tended to adopt a relatively passive ‘if we build it, they will come’ attitude to impact. That is, impact being achieved ad hoc through, for example, committee work, rather than systematically as a planned output of research.2 The problem with this kind of approach is that clinicians and policymakers at all levels will be largely unaware of much of the bioethics literature, and bioethicists may not always have a full understanding of evolving clinical realities. As such, bioethicists may not be producing work that resonates sufficiently with decision makers, even if they happened to come across it at an apposite time. An obvious recent example was the response of the bioethics community to the COVID-19 pandemic. Countless publications explored various challenges, but there is an open question as to how much impact resulted.</p><p>Efforts to overcome accusations of ivory tower ethics have included the so-called ‘empirical turn’ in bioethics.3 That is, combining normative and empirical inquiry with the aim of grounding ethical theorising in context.4 Whilst not universally adopted, there has certainly been a strong uptake of empirical bioethics methods and methodologies, as scholars look to orient their works towards practice and impact. Complementing this empirical turn, and possibly even prior to it, a literature has been developing that consider impact in different ways—focussing on the idea of translational bioethics. The first use of this term is often attributed to Cribb, who argued in 2010 that just as scientific research paradigms have ‘bench to bedside’ process, so might bioethics, explicitly introducing the idea that translational work might be undertaken to develop impact from bioethics research.5 Bærøe later explicitly developed this idea of translational bioethics.6 More recently, Sisk and colleagues have argued for the incorporation of implementation science into bioethics, to ensure that impact is achieved.7</p><p>Whether positioned as parallel to, or part of, empirical bioethics, this developing literature is distinct, as it is concerned with the role of bioethics research in policy and practice, and how this relationship can be characterised—in terms of process, scope, and direction. Important questions in translational bioethics discourse include: How should translational bioethics be defined? What is the purpose of translational bioethics? Is there a need for translational bioethics? What does good translational bioethics look like? How can/should translational bioethics be evaluated?</p><p>These questions formed the basis of a workshop hosted at the University of Bristol in Septe","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736835","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}
BioethicsPub Date : 2024-01-13DOI: 10.1111/bioe.13268
Udo Schuklenk
{"title":"Ethics of a pandemic of deliberate health misinformation: From abortion care to vaccines","authors":"Udo Schuklenk","doi":"10.1111/bioe.13268","DOIUrl":"https://doi.org/10.1111/bioe.13268","url":null,"abstract":"<p>Much has been written about the decline of legacy publishing models like newspapers. Much has also been written about the parallel rise of misinformation disseminated on internet platforms like X, TikTok, Instagram, and others. For someone belonging to an older generation, it is stunning to see that a convicted child abuser like Ruby Franke, who gave child education advice to parents on her popular YouTube channel, managed to attract 2.5 million followers. She pleaded guilty to torturing her kids.1 Clearly, many internet netizens of the postnewspaper era are not the most discerning of audience members. And don't get me started on the massive amount of antivaccine misinformation disseminated successfully during the COVID-19 pandemic.2</p><p>What is oftentimes overlooked is that efforts at manipulating vulnerable populations into acting in particular ways that may not be in their best interest, has a history going back much longer. Arguably the internet turbocharged some of these efforts, but this has been happening for a long time.</p><p>A case in point is brick-and-mortar “pregnancy crisis centers.” They exist in many countries, including, for instance the United States and Canada, today. The American College of Obstetrics and Gynecology, in a fact sheet, notes that they typically target marginalized and vulnerable populations, in particular “people of color, young people, and under-resourced people who are struggling to afford an abortion.”3 Their objective, invariably, to manipulate a pregnant woman considering having an abortion into not having one. Laypeople with no relevant professional expertise masquerade, oftentimes for good measure in white coats, as counselors when really their agenda is manipulation. A litany of misinformation is typically provided to the information-seeking pregnant women. In jurisdictions where there are time limits on abortion, efforts are made to ensure pregnant women miss the window during which they can legally access an abortion, and the list of misconduct goes on.</p><p>Sometimes healthcare professionals serve on the boards of directors of such establishments, but usually—there are exceptions—they themselves do not directly engage in the spreading of misinformation. Instead pregnant women seeking unbiased information will be seen by “trained advocates,” as the Chequamegon Pregnancy Center in Wisconsin puts it so deceptively. The Pregnancy Center in Sanford's Florida meanwhile provides on its website misleading information on the morning-after pill, despite the known safety profile of the pill having led to its availability as over-the-counter medication across the European Union member-states.4 Images of medical equipment and machinery feature prominently on the photos of many of these centers. Anyone can buy them, after all.</p><p>What is interesting is that arguments invoking the ethical and fiduciary obligations of professionals, vis-a-vis their patients do not apply here, precisely because these establis","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436242","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}
BioethicsPub Date : 2024-01-12DOI: 10.1111/bioe.13267
Zohar Lederman
{"title":"Dying a lonely death: A conceptual and normative analysis","authors":"Zohar Lederman","doi":"10.1111/bioe.13267","DOIUrl":"10.1111/bioe.13267","url":null,"abstract":"<p>This paper argues that a lonely death is, by definition, a bad death and that society as a whole, as well as individuals in society are obligated to assure a certain degree of well-being, flourishing, or care among and for fellow individuals. Individuals can then be said to have a right against dying a lonely death. Such a right has corresponding duties. The paper further specifies what such duties may entail based on what individuals may need on their deathbed, specifically focusing on the need for human touch. Assuming that human touch might indeed be needed by some individuals in order to avoid a lonely death, the paper explores potential implications from a public health perspective, particularly during infectious disease outbreaks such as COVID.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433119","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}
BioethicsPub Date : 2024-01-09DOI: 10.1111/bioe.13266
Tereza Hendl, Ayush Shukla
{"title":"Can digital health democratize health care?","authors":"Tereza Hendl, Ayush Shukla","doi":"10.1111/bioe.13266","DOIUrl":"10.1111/bioe.13266","url":null,"abstract":"<p>Much has been said about the potential of digital health technologies for democratizing health care. But how exactly is democratization with digital health technologies conceptualized and what does it involve? We investigate debates on the democratization of health care with digital health and identify that democratization is being envisioned as a matter of access to health information, health care, and patient empowerment. However, taking a closer look at the growing pool of empirical data on digital health, we argue that these technologies come short of materializing these goals, given the unequal health outcomes they facilitate. Building on this evidence, we argue that not only debates on democratization need to be connected to concerns of social determinants of health but also debates on the impact of digital health need to go far beyond democratization and engage with concerns of health justice.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405402","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}
BioethicsPub Date : 2024-01-09DOI: 10.1111/bioe.13264
Ji-Young Lee
{"title":"The social epistemology of eating disorders: How our gaps in understanding challenge patient care","authors":"Ji-Young Lee","doi":"10.1111/bioe.13264","DOIUrl":"10.1111/bioe.13264","url":null,"abstract":"<p>In this article, I argue that various epistemic challenges associated with eating disorders (EDs) can negatively affect the care of already marginalized patient groups with various EDs. I will first outline deficiencies in our understanding of EDs—in research, healthcare settings, and beyond. I will then illustrate with examples cases where discriminatory misconceptions about <i>what</i> EDs are, the presentation and treatment of EDs, and <i>who</i> gets EDs, instantiate obstacles for the treatment of various ED patient groups.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405403","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}
BioethicsPub Date : 2024-01-06DOI: 10.1111/bioe.13260
Susan Kennedy
{"title":"Ectogenesis and the value of gestational ties","authors":"Susan Kennedy","doi":"10.1111/bioe.13260","DOIUrl":"10.1111/bioe.13260","url":null,"abstract":"<p>Ectogenesis technology would make it possible to support the complete gestational development of a human being outside the female body. Proponents argue that this technology offers a welcome opportunity to expand reproductive options for those unable or unwilling to gestate. However, by completely bypassing pregnancy, the use of ectogenesis prevents the formation of gestational family ties. Consequently, it has faced criticism for perpetuating a patriarchal view of the family that undermines the moral significance of gestation. The concern is that the introduction of this technology might result in the loss of reproductive autonomy for those who desire to experience pregnancy, as they face pressures to opt for ectogenesis instead. Existing accounts of family values define parents' rights to rear a child, but they fail to establish a right to gestate that can protect an individual's interest in bearing a child. To provide a more comprehensive account of family values, I argue that pregnancy involves a unique quality of intimacy and can make distinct contributions to one's flourishing. Based on this premise, I defend a fundamental moral right to gestate that can help safeguard the option of pregnancy for those who desire it. In conclusion, I consider how a prospective gestator need not provide optimal conditions for fetal development in the way that ectogenesis promises in order for their choice of pregnancy to be justified.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111365","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}
BioethicsPub Date : 2024-01-06DOI: 10.1111/bioe.13262
Christopher Bobier, Daniel J. Hurst, Daniel Rodger, Adam Omelianchuk
{"title":"Xenograft recipients and the right to withdraw from a clinical trial","authors":"Christopher Bobier, Daniel J. Hurst, Daniel Rodger, Adam Omelianchuk","doi":"10.1111/bioe.13262","DOIUrl":"10.1111/bioe.13262","url":null,"abstract":"<p>Preclinical xenotransplantation research using genetically engineered pigs has begun to show some promising results and could one day offer a scalable means of addressing organ shortage. While it is a fundamental tenet of ethical human subject research that participants have a right to withdraw from research once enrolled, several scholars have argued that the right to withdraw from xenotransplant research should be suspended because of the public health risks posed by xenozoonotic transmission. Here, we present a comprehensive critical evaluation of the claim that xenotransplant recipients should be required to waive their right to withdraw from lifelong biosurveillance. We conclude that <i>if</i> xenotransplantation requires participants to waive their right to withdraw, then clinical trials may not be justifiable, given the ethical and legal obstacles involved with doing so. Consequently, <i>if</i> clinical trials are permitted with a right to withdraw, then they may pose a significant public health risk.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111367","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}