Bioethics最新文献_第2页

Slow Codes are symptomatic of ethically and legally inappropriate CPR policies.

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-31 DOI: 10.1111/bioe.13396

Stuart McLennan, Marieke Bak, Kathrin Knochel

{"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":"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.","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}

引用次数: 0

Xenotransplantation as a business solution to the organ shortage.

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-29 DOI: 10.1111/bioe.13397

Christopher Bobier, Richard B Gibson, Anthony Merlocco, Daniel Rodger, Daniel J Hurst

引用次数: 0

Environmental sustainability and the limits of healthcare resource allocation.

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-27 DOI: 10.1111/bioe.13395

James Hart, Sapfo Lignou, Mark Sheehan

{"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":"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.","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}

引用次数: 0

Is Hume's Law a valid argument against empirical bioethics?

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-25 DOI: 10.1111/bioe.13393

Paolo Corsico

{"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":"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.","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}

引用次数: 0

The virtues of limits and environmental sustainability in healthcare. 医疗保健中的限制和环境可持续性的优点。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-22 DOI: 10.1111/bioe.13382

Xavier Symons

引用次数: 0

Is germline genome-editing person-affecting or identity-affecting, and does it matter? 生殖系基因组编辑对人有影响还是对身份有影响，这有关系吗？

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-17 DOI: 10.1111/bioe.13385

Andrew McGee, Sinead Prince

引用次数: 0

Arguments against a "general and permanent" ban on pediatric intersex surgery: A response to Clune-Taylor. 反对“全面和永久”禁止儿科双性人手术的争论：对克伦-泰勒的回应。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-13 DOI: 10.1111/bioe.13392

Suzаnа Ignjаtоvić

引用次数: 0

The Impairment Argument's Coup de Grâce. 减值论的意外之喜。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-10 DOI: 10.1111/bioe.13394

Braylen Samuel

引用次数: 0

Bioethical challenges in postwar development aid: The Rwandan case study. 战后发展援助中的生物伦理挑战：卢旺达案例研究。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-01-01 Epub Date: 2024-05-17 DOI: 10.1111/bioe.13304

Łukasz Wiktor, Maria Damps, Grace Kansayisa, Szymon Pietrzak, Bartłomiej Osadnik

{"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":"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.","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}

引用次数: 0

A defense of ectogenic abortion. 为人工流产辩护。

IF 1.7 2区哲学

Bioethics Pub Date : 2024-12-25 DOI: 10.1111/bioe.13389

Shane Ward

引用次数: 0