Bioethics最新文献_第10页

Accounting for future populations in health research 在健康研究中考虑未来人口

IF 2.2 2区哲学

Bioethics Pub Date : 2024-04-11 DOI: 10.1111/bioe.13284

Leah Pierson

引用次数: 0

The selective deployment of AI in healthcare 在医疗保健领域有选择地部署人工智能：算法的道德算法。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-30 DOI: 10.1111/bioe.13281

Robert Vandersluis, Julian Savulescu

{"title":"The selective deployment of AI in healthcare","authors":"Robert Vandersluis, Julian Savulescu","doi":"10.1111/bioe.13281","DOIUrl":"10.1111/bioe.13281","url":null,"abstract":"Machine-learning algorithms have the potential to revolutionise diagnostic and prognostic tasks in health care, yet algorithmic performance levels can be materially worse for subgroups that have been underrepresented in algorithmic training data. Given this epistemic deficit, the inclusion of underrepresented groups in algorithmic processes can result in harm. Yet delaying the deployment of algorithmic systems until more equitable results can be achieved would avoidably and foreseeably lead to a significant number of unnecessary deaths in well-represented populations. Faced with this dilemma between equity and utility, we draw on two case studies involving breast cancer and melanoma to argue for the selective deployment of diagnostic and prognostic tools for some well-represented groups, even if this results in the temporary exclusion of underrepresented patients from algorithmic approaches. We argue that this approach is justifiable when the inclusion of underrepresented patients would cause them to be harmed. While the context of historic injustice poses a considerable challenge for the ethical acceptability of selective algorithmic deployment strategies, we argue that, at least for the case studies addressed in this article, the issue of historic injustice is better addressed through nonalgorithmic measures, including being transparent with patients about the nature of the current epistemic deficits, providing additional services to algorithmically excluded populations, and through urgent commitments to gather additional algorithmic training data from excluded populations, paving the way for universal algorithmic deployment that is accurate for all patient groups. These commitments should be supported by regulation and, where necessary, government funding to ensure that any delays for excluded groups are kept to the minimum. We offer an ethical algorithm for algorithms—showing when to ethically delay, expedite, or selectively deploy algorithmic systems in healthcare settings.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 5","pages":"391-400"},"PeriodicalIF":2.2,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330339","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}

引用次数: 0

A paradigm shift?—On the ethics of medical large language models 范式转变？--论医学大型语言模型的伦理问题。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-25 DOI: 10.1111/bioe.13283

Thomas Grote, Philipp Berens

引用次数: 0

Conscientious refusal or conscientious provision: We can't have both 出于良心拒绝还是出于良心提供？两者不可兼得。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-22 DOI: 10.1111/bioe.13285

Ryan Kulesa, Alberto Giubilini

{"title":"Conscientious refusal or conscientious provision: We can't have both","authors":"Ryan Kulesa, Alberto Giubilini","doi":"10.1111/bioe.13285","DOIUrl":"10.1111/bioe.13285","url":null,"abstract":"Some authors argue that it is permissible for clinicians to conscientiously provide abortion services because clinicians are already allowed to conscientiously refuse to provide certain services. Call this the symmetry thesis. We argue that on either of the two main understandings of the aim of the medical profession—what we will call “pathocentric” and “interest-centric” views—conscientious refusal and conscientious provision are mutually exclusive. On pathocentric views, refusing to provide a service that takes away from a patient's health is professionally justified because there are compelling reasons, based on professional standards, to refuse to provide that service (e.g., it does not heal, and it is contrary to the goals of medicine). However, providing that same service is not professionally justified when providing that service would be contrary to the goals of medicine. Likewise, the thesis turns out false on interest-centric views. Refusing to provide a service is not professionally justified when that service helps the patient fulfill her autonomous preferences because there are compelling reasons, based on professional standards, to provide that service (e.g., it helps her achieve her autonomous preferences, and it would be contrary to the goals of medicine to deny her that service). However, refusing to provide that same service is not professionally justified when refusing to provide that service would be contrary to the goals of medicine. As a result, on either of the two most plausible views on the goals of medicine, the symmetry thesis turns out false.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 5","pages":"445-451"},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190441","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}

引用次数: 0

Navigating conflicts of reproductive rights: Unbundling parenthood and balancing competing interests 在生殖权利的冲突中航行：解除为人父母的束缚，平衡相互竞争的利益。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-22 DOI: 10.1111/bioe.13282

Dorian Accoe, Guido Pennings

{"title":"Navigating conflicts of reproductive rights: Unbundling parenthood and balancing competing interests","authors":"Dorian Accoe, Guido Pennings","doi":"10.1111/bioe.13282","DOIUrl":"10.1111/bioe.13282","url":null,"abstract":"Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. Since terminating or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 5","pages":"425-430"},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190442","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}

引用次数: 0

Arguments for a ban on pediatric intersex surgery: A dis/analogy with Jehovah witness blood transfusion 禁止小儿阴阳人手术的论据：与耶和华见证人输血的异同。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-12 DOI: 10.1111/bioe.13280

Catherine Clune-Taylor

{"title":"Arguments for a ban on pediatric intersex surgery: A dis/analogy with Jehovah witness blood transfusion","authors":"Catherine Clune-Taylor","doi":"10.1111/bioe.13280","DOIUrl":"10.1111/bioe.13280","url":null,"abstract":"This article argues for a ban on the performance of medically unnecessary genital normalizing surgeries as part of assigning a binary sex/gender to infants with intersex conditions on the basis of autonomy, regardless of etiology. It does this via a dis/analogy with the classic case in bioethics of Jehovah Witness (JW) parents' inability to refuse life-saving blood transfusions for their minor children. Both cases address ethical medical practice in situations where parents are making irreversible medical decisions on the basis of values strongly held, identity, and relationship-shaping values—such as religious beliefs or beliefs regarding the inherent value of binary sex/gender—amidst ethical pluralism. Furthermore, it takes seriously—as we must in the intersex case—that the restriction of parents' right to choose will likely result in serious harms to potentially large percentage of patients, their families, and their larger communities. I address the objection that parents' capacity to choose is restricted in the JW case on the basis of the harm principle or a duty to nonmaleficence, given that the result of parent choice would be death. I provide evidence that this is mistaken from how we treat epistemic uncertainty in the JW case and from cases in which clinicians are ethically obligated to restrict the autonomy of nonminor patients. I conclude that we restrict the parents' right to choose in the JW case—and should in the case of pediatric intersex surgery—to secure patient's future autonomy.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 5","pages":"460-468"},"PeriodicalIF":2.2,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102912","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}

引用次数: 0

Why restrict medical effective altruism? 为什么要限制医学上的有效利他主义？

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-11 DOI: 10.1111/bioe.13279

Travis Quigley

{"title":"Why restrict medical effective altruism?","authors":"Travis Quigley","doi":"10.1111/bioe.13279","DOIUrl":"10.1111/bioe.13279","url":null,"abstract":"In a challenge trial, research subjects are purposefully exposed to some pathogen in a controlled setting, in order to test the efficacy of a vaccine or other experimental treatment. This is an example of medical effective altruism (MEA), where individuals volunteer to risk harms for the public good. Many bioethicists rejected challenge trials in the context of Covid-19 vaccine research on ethical grounds. After considering various grounds of this objection, I conclude that the crucial question is how much harm research subjects can permissibly risk. But we lack a satisfying way of making this judgment that does not appeal simply to the intuitions of doctors or bioethicists. I consider one recent and structurally plausible approach to critically evaluating the harm question. Alex London defends a social consistency test for research risks: we should compare the risks undertaken by research subjects to relevantly similar risks which are accepted in other spheres of society. I argue there is no good reason not to consider volunteer military service as a relevant social comparison. This implies there is essentially no cap on acceptable risks on the social consistency rationale. In short, if soldiers can be heroes, why can't research volunteers?","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 5","pages":"452-459"},"PeriodicalIF":2.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095131","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}

引用次数: 0

Corrigendum to: Attitudes, intentions and procreative responsibility in current and future assisted reproduction 更正：当前和未来辅助生殖的态度、意图和生育责任。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-08 DOI: 10.1111/bioe.13278

{"title":"Corrigendum to: Attitudes, intentions and procreative responsibility in current and future assisted reproduction","authors":"","doi":"10.1111/bioe.13278","DOIUrl":"10.1111/bioe.13278","url":null,"abstract":"Battisti, D. (2023). Attitudes, intentions and procreative responsibility in current and future assisted reproduction. Bioethics, 37(5), 449–461. https://doi.org/10.1111/bioe.13150.The name ‘McDougall’ is incorrectly spelled as ‘McDougal’ on pages 453 and 454.The phrase ‘focus-agent focus’ on page 454 is incorrect and should read ‘future-agent focus’.The part of the sentence \"implies the prospective parents\" should be replaced with \"commits\", and the word \"have\" in the same sentence should be replaced with \"having\". This sentence should read: \"Considering this, we can recognize that the parent-child relationship argument commits procreators to having attitudes and intentions that are not in contrast with the desires and hopes that their children's lives go well and that they are safe from suffering\" paragraph 4, page 456.The word ‘having’ should be replaced with ‘parenting’ in the final paragraph of page 455. This sentence should read: ‘On the one hand, the distinction between creating and parenting a child enables us to justify the fact that the beginning of a parent–child relationship is also morally relevant in the procreative context’.The word ‘having’ should be replaced with ‘creating’ on the first line of page 456. This sentence should read: ‘To explain the moral relevance of the distinction between creating and parenting a child let us consider again the example of the couple that, through PGD plus IVF, deliberately select a child with a disability D’.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 4","pages":"377"},"PeriodicalIF":2.2,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066278","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}

引用次数: 0

Nature-versus-nurture considered harmful: Actionability as an alternative tool for understanding the exposome from an ethical perspective 自然对自然有害：可操作性作为从伦理角度理解暴露体的另一种工具。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-03-05 DOI: 10.1111/bioe.13276

Caspar W. Safarlou, Annelien L. Bredenoord, Roel Vermeulen, Karin R. Jongsma

{"title":"Nature-versus-nurture considered harmful: Actionability as an alternative tool for understanding the exposome from an ethical perspective","authors":"Caspar W. Safarlou, Annelien L. Bredenoord, Roel Vermeulen, Karin R. Jongsma","doi":"10.1111/bioe.13276","DOIUrl":"10.1111/bioe.13276","url":null,"abstract":"Exposome research is put forward as a major tool for solving the nature-versus-nurture debate because the exposome is said to represent “the nature of nurture.” Against this influential idea, we argue that the adoption of the nature-versus-nurture debate into the exposome research program is a mistake that needs to be undone to allow for a proper bioethical assessment of exposome research. We first argue that this adoption is originally based on an equivocation between the traditional nature-versus-nurture debate and a debate about disease prediction/etiology. Second, due to this mistake, exposome research is pushed to adopt a limited conception of agential control that is harmful to one's thinking about the good that exposome research can do for human health and wellbeing. To fully excise the nature-versus-nurture debate from exposome research, we argue that exposome researchers and bioethicists need to think about the exposome afresh from the perspective of actionability. We define the concept of actionability and related concepts and show how these can be used to analyze the ethical aspects of the exposome. In particular, we focus on refuting the popular “gun analogy” in exposome research, returning results to study participants and risk-taking in the context of a well-lived life.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 4","pages":"356-366"},"PeriodicalIF":2.2,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029633","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}

引用次数: 0

Cryonics: Traps and transformations 冷冻技术：陷阱与转变。

IF 2.2 2区哲学

Bioethics Pub Date : 2024-02-29 DOI: 10.1111/bioe.13277

Daniel Story

引用次数: 0