Bioethics最新文献

{"title":"Environmental sustainability and the limits of healthcare resource allocation.","authors":"James Hart, Sapfo Lignou, Mark Sheehan","doi":"10.1111/bioe.13395","DOIUrl":"https://doi.org/10.1111/bioe.13395","url":null,"abstract":"<p><p>Recent literature has drawn attention to the complex relationship between health care and the environmental crisis. Healthcare systems are significant contributors to climate change and environmental degradation, and the environmental crisis is making our health worse and thus putting more pressure on healthcare systems; our health and the environment are intricately linked. In light of this relationship, we might think that there are no trade-offs between health and the environment; that healthcare decision-makers have special responsibilities to the environment; and that environmental values should be included in healthcare resource-allocation decisions. However, we argue that these claims are mistaken. The environmental crisis involves a wider range of considerations than just health. There is a plurality of reasons to act on the environment; we might do so to protect the natural world, to prevent catastrophes in other parts of the world, or to avert climate war and displacement. Trading-off between health care and environmental sustainability is thus unavoidable and requires sensitivity to all these reasons. Healthcare decision-makers are not well placed to be sensitive to these reasons, nor do they have the democratic authority to make such value judgements. Therefore, decisions about environmental sustainability interventions should be made at a 'higher level' of resource allocation. Importantly, hospitals have environmental duties but not environmental responsibilities; their job is to provide the best healthcare possible within the constraints given to them, not to choose between health care and other goods.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048858","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 Hume's Law a valid argument against empirical bioethics?","authors":"Paolo Corsico","doi":"10.1111/bioe.13393","DOIUrl":"https://doi.org/10.1111/bioe.13393","url":null,"abstract":"<p><p>If \"no ought from is,\" how can bioethics be empirical? Despite the widespread recognition that we can integrate empirical and normative, Hume's Law is still often claimed to pose logical limitations to empirical bioethics. Is Hume's Law a valid argument against empirical bioethics? I argue that we have reasons to answer no. First, I outline and reject two unverified assumptions: that Hume' s Law, the fact-value distinction, and the naturalistic fallacy are roughly the same thing, and that Hume's Law is an undisputed meta-ethical principle which dictates how to formulate normative statements. I then show how the interpretation of Hume's Law as establishing a logical gulf between facts and morality-rather than as clarifying the logical rules of normative argumentation-is dependent upon a non-cognitivist interpretation of the Is-Ought problem. I argue that the version of Hume's Law that stems from ethical non-cognitivism is what is problematic for empirical bioethics. However, other interpretations are possible. We have two reasons to reject the thesis that Hume's Law is an argument against empirical bioethics. First, conflating meta-ethics and applied ethics is problematic. Second, a non-cognitivist interpretation of Hume's Law is likely to constitute an argument not only against empirical bioethics, but against all bioethics that claims to be situated within ethical cognitivism, be it empirical or philosophical. Lastly, I present two meta-ethical postulates shared by empirical and philosophical bioethics. I call them: (1) the \"bridge\" postulate and (2) the \"ethical cognitivism\" postulate.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048859","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":"The virtues of limits and environmental sustainability in healthcare.","authors":"Xavier Symons","doi":"10.1111/bioe.13382","DOIUrl":"https://doi.org/10.1111/bioe.13382","url":null,"abstract":"<p><p>The spectre of human-induced climate change has drawn attention to the need to discover new, environmentally sustainable approaches to healthcare. This article draws upon David McPherson's The Virtues of Limits (2021) to develop a virtue ethics for sustainability in healthcare. I explore how a virtuous appreciation of the value of healthcare resources can lead us to exercise stewardship in our use of those resources, whereas a failure to appreciate the value of resources can lead to irresponsible and unsustainable patterns of use. I close with some recommendations of how health systems might go about facilitating the cultivation of the virtues of sustainable health practice.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016939","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":"‘Bioethics: What? and why?’ : Revisited","authors":"Udo Schuklenk","doi":"10.1111/bioe.13391","DOIUrl":"10.1111/bioe.13391","url":null,"abstract":"&lt;p&gt;Ruth Chadwick and I have been editors-in-chief of the journal for the last 25 years. We have tried to steward it to the best of our ability, and we have aimed to keep it true to its founders’ mission. That means, first and foremost, &lt;i&gt;Bioethics&lt;/i&gt; is a journal that publishes primarily philosophical bioethics content. This scope limitation has—over the years—given rise to criticism from various quarters that didn't see themselves represented in the pages of the journal. &lt;i&gt;Bioethics&lt;/i&gt; never claimed to represent every activity that goes under the label ‘bioethics’.&lt;/p&gt;&lt;p&gt;I want to take the opportunity this Editorial affords me to address some of these criticisms.&lt;/p&gt;&lt;p&gt;Some members of the bioethics community have criticized this—as well as other—journal(s) for being ‘too quiet’ when it comes to shocking human rights abuses, as is currently the case in the Gaza war, Yemen, Ukraine, etc. And it is true, we have not issued editorials condemning the activities of the Israel army in Gaza, or Russia's attacks on civilian infrastructure in the Ukraine. Like you, I have strong personal views on these conflicts, but these views are not significantly informed by my bioethics expertise. There are specific bioethics issues within the context of these conflicts that are worth addressing, such as the professional obligations of healthcare professionals to enemy combatants, terrorists with and without inverted commas, military attacks on healthcare facilities suspected of being used as shields by a group in the conflict, to name but a few. However, who the guilty party is in terms of what caused the Gaza conflict is not a bioethics issue. Accordingly, it is not a topic that will be litigated in the journal. This doesn't mean that we don't have views on these issues—like you, we are not intransigent to human suffering and injustice—but we don't have views on these issues in our role as editors of this journal. There are other academic journals that have a specialist focus on the ethical issues raised by these sorts of conflicts. Colleagues wishing to publish content on these topics should consider submitting their content to these kinds of publications, where their articles will be reviewed by academic peers with the relevant subject expertise. My good intentions and strong personal convictions do not make me an expert on war.&lt;/p&gt;&lt;p&gt;Every now and then colleagues who are—rightly—concerned about our abuse of non-human animals, as well as our destruction of the environment, ask us to increase the scope of the journal to include such matters, too. As you will note from my own positioning, I concur with these colleagues that these issues are both extremely important, and also that they are—like the war and human rights issue—legitimate subjects of ethical inquiry. However, as far as human bioethics is concerned, they are clearly not within the scope of the journal that Kuhse and Singer envisaged. As it happens, and much like in the case of the topic I discussed ","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 2","pages":"161-162"},"PeriodicalIF":1.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025536","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":"Is germline genome-editing person-affecting or identity-affecting, and does it matter?","authors":"Andrew McGee,&nbsp;Sinead Prince","doi":"10.1111/bioe.13385","DOIUrl":"10.1111/bioe.13385","url":null,"abstract":"<p>Writers have debated whether germline genome-editing is person-affecting or identity-affecting. The difference is thought to be ethically relevant to whether we should choose genome-editing or choose preimplantation genetic diagnosis and embryo selection, when seeking to prevent or produce bad conditions (e.g., cystic fibrosis, or deafness) in the individuals who will grow from the embryo edited or selected. We consider the very recent views of three prominent bioethicists and philosophers who have grappled with this issue. We claim that both sides are right, but that the sense in which genome-editing is person-affecting is less important, morally, when the aim is to have healthy children. Since this is the predominant objective of engaging in embryo selection and genome-editing, and since there are certain risks, at least for now, with genome-editing, it remains better, morally, to engage in embryo selection than genome-editing.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"250-258"},"PeriodicalIF":1.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016938","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":"Arguments against a “general and permanent” ban on pediatric intersex surgery: A response to Clune-Taylor","authors":"Suzаnа Ignjаtоvić","doi":"10.1111/bioe.13392","DOIUrl":"10.1111/bioe.13392","url":null,"abstract":"<p>The paper offers a critical response to the proposed “dis/analogy” between the restriction of Jehovah's Witness parental right to refuse life-saving blood transfusions for their minor children and a “general” and “permanent” ban on “unnecessary” pediatric intersex surgery. The main argument of the analogy is “securing the patient's future autonomy.” Feinberg's theory of rights is used to demonstrate that the proposed analogy is untenable. A new category of developmental rights-in-trust is introduced to address specific needs of gender development in DSD situations. Both premises are disputed. First, it is shown that the case of overriding Jehovah's Witness parental rights is not based on securing the patient's future autonomy, but a simple dependency right in Feinberg's theory. Second, it is demonstrated that pediatric intersex surgery is not in the same situation in all morally relevant respects as the Jehovah's Witness case because it represents a special type of developmental right-in-trust. In conclusion, the arguments based on the proposed analogy do not justify a “general and permanent” on pediatric intersex surgery.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"296-301"},"PeriodicalIF":1.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973409","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":"The Impairment Argument's Coup de Grâce.","authors":"Braylen Samuel","doi":"10.1111/bioe.13394","DOIUrl":"https://doi.org/10.1111/bioe.13394","url":null,"abstract":"<p><p>According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here, I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn't harmed by an abortion. But if the fetus is numerically identical to the person it will become, it is harmed by the deprivation of a future of value. However, taking this route ultimately undermines the novelty of the impairment argument.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959283","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":"Bioethical challenges in postwar development aid: The Rwandan case study.","authors":"Łukasz Wiktor, Maria Damps, Grace Kansayisa, Szymon Pietrzak, Bartłomiej Osadnik","doi":"10.1111/bioe.13304","DOIUrl":"10.1111/bioe.13304","url":null,"abstract":"<p><p>This article considers aspects of a development aid that provides medical support to strengthen pediatric orthopedics in Rwanda. We present part of the Afriquia foundation work, a nonprofit foundation from Poland involved in supporting the medical sector in Rwanda as a sign of global solidarity and the human right to health. The main foundation's activity is the treatment of orthopedic problems among Rwandan citizens. We present a case study of two children under the care of the Afiquia foundation. 11-year-old Seraphine treated due to the consequences of right tibia osteomyelitis and 11-year-old Lavi suffering from osteogenesis imperfecta. Both children were treated surgically in Poland due to Rwanda's lack of treatment possibilities. After the applied treatment, Seraphine walks correctly without crutches and can attend school and thrive among her peers. Lavi has not sustained any fragility fracture since the surgery in Poland. He is healthy and constantly ongoing his rehabilitation including gait training. The described cases initiated development aid in Rwanda, supplying hospitals with orthopedic implants and training medical staff. The growing number of humanitarian crises across the globe and the people affected requires increasing organizations involved in providing relief. The emphasis should be on global education, aiming to make the recipients reflect and prepare them to face humanitarian crises.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":"90-97"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961065","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":"A defense of ectogenic abortion.","authors":"Shane Ward","doi":"10.1111/bioe.13389","DOIUrl":"https://doi.org/10.1111/bioe.13389","url":null,"abstract":"<p><p>A popular argument for a right to ectogenic abortions appeals to a right to avoid the obligations associated with parenthood. A common objection to this argument questions whether there are any sufficiently great harms associated with parenthood to ground such a right. I propose a novel formulation of this argument that avoids these objections. I then defend it against important objections.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886513","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":"Medical test and employee's autonomy. Confidentiality of data and non-discrimination.","authors":"Javier Fernández-Costales Muñiz","doi":"10.1111/bioe.13384","DOIUrl":"https://doi.org/10.1111/bioe.13384","url":null,"abstract":"<p><p>Monitoring health is one of the basic principles of Occupational Health and Safety. The main objective of this monitoring will be the detection of possible damage to health arising from work. They try to discover the effects that the inherent risks with the work may cause the worker, which will show, given the case, through an alteration of health or the state of organic and functional state, both physically and mentally. Regarding the monitoring of health, there are many and varied issues to be raised concerning the right to personal privacy. Thus, notably, whether there was effective consensus, and whether, in particular, the object and the purpose of the medical examination meant a disregard of the statutory scheme, an excess or even a failure to comply with the terms of the Spanish Constitution. The limits imposed by the law makers to the productive unit will play a key role in identifying the content of the company obligation to monitor health, being in many cases guarantees of constitutional rights. Therefore, the methods of health monitoring and control of workers will always be carried out respecting the privacy and dignity of the worker as well as the confidentiality of all information related to their health.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873439","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}