Bioethics最新文献

{"title":"The emergence and use of expanded carrier screening in gamete donation: A new form of repro-genetic selection.","authors":"Nicky Hudson, Cathy Herbrand, Lorraine Culley","doi":"10.1111/bioe.13349","DOIUrl":"https://doi.org/10.1111/bioe.13349","url":null,"abstract":"<p><p>With the continued expansion and commercialisation of fertility treatments, the selection and matching of donors have become more sophisticated and technologised. As part of this landscape, new form of genetic screening: 'expanded carrier screening' (ECS) is being offered as a technique to avoid the risk of donors passing on genetic conditions to future offspring. Allowing donors to be tested for hundreds of genetic conditions simultaneously, ECS marks a considerable departure from traditional 'family history' models of screening, which rely on an individual's knowledge of family health. There is growing evidence of a drive towards the use of ECS within the fertility sector, and a growing number of clinics are offering it for a fee, as part of an egg or sperm donation cycle or as an add-on to IVF treatment. In this article, we use methods of critical reflection to synthesise data from two studies to explore how ECS is being used to avoid genetic risk in IVF treatment using donor gametes. We suggest that ECS is a new form of repro-genetic selection-a selective reproductive technology-with specific and important implications for donors, recipients and clinicians and with the potential to reconfigure the scope and application of gamete donation. We examine these implications and conclude that the existing policy blind spot relating to this development in fertility treatment practice needs to be urgently addressed.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115007","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":"Trading one problem for two: The case against tobacco bans.","authors":"Mathieu Doucet","doi":"10.1111/bioe.13348","DOIUrl":"https://doi.org/10.1111/bioe.13348","url":null,"abstract":"<p><p>The past two decades have seen growing calls for the \"tobacco endgame.\" Its advocates are united by their commitment to two ideas. First, tobacco-related harms represent a catastrophic health emergency, and second, current tobacco-control approaches are an inadequate response to the scale of that emergency. To endgame advocates, tobacco policy should have more ambitious goals than merely \"controlling\" tobacco. Instead, it should aim to bring about a smoke-free world. While a range of different policies are included under the umbrella of the \"tobacco endgame,\" the most radical proposal is for a complete ban on tobacco. Its advocates argue that in addition to improving global public health, an effective ban on tobacco would also promote overall autonomy and would have important egalitarian benefits. This article critically examines these arguments for a tobacco ban. I argue that they rely on idealizing assumptions about the likely effects of a ban. Because an effective ban would require robust enforcement to control the illegal market in tobacco, it would be more likely to undermine autonomy and equality than it would be to promote them. By relying on idealizing assumptions and ignoring the likely consequences of a tobacco ban, advocates of a ban obscure, rather than clarify, both the policy debate and the ethical stakes. I conclude by considering the ways that idealizing assumptions should-and should not-play a role in debates about ethical issues in public policy.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115008","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":"Athletic enhancement and human nature.","authors":"Shlomit Wygoda Cohen","doi":"10.1111/bioe.13346","DOIUrl":"https://doi.org/10.1111/bioe.13346","url":null,"abstract":"<p><p>There is a well-established asymmetry in our judgments of performance enhancing drugs (PEDs) in sports and in other competitive activities. When an athlete is found using such drugs, it is a scandal that prompts public outrage, fan disappointment, and even loss of title. It seems that we judge enhanced results cannot be genuinely attributed to athletes. There is no similar reaction to use of PEDs in art, science, music, literature, business, and other human endeavors. The question I tackle in this paper is whether this disanalogy is justified: Is there some underlying difference in virtue of which PEDs should be thus stigmatized in sports but not elsewhere? I survey a couple of potential justifications that I find lacking. I then consider the difference in our judgments of the participation of superman-like characters in sports (which we censure) and in other activities (which we endorse). I argue that the fact that the athlete is human is relevant to the value of sports-and by extension, the status of the effort involved-while this fact plays no significant role with regard to the value of other activities and that this difference in the value of activities ultimately justifies our differing judgments here. I then return to my initial question and examine whether similar appeal to what is human can justify the varying judgments of the use of PEDs. I argue that it can but only under certain assumptions. I conclude by discussing wider implication of my suggestion.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074611","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":"Are companies ethically justified in offering nonmedical egg freezing as an employee benefit?","authors":"Alejandro Espinosa-Herrera, Maria-Jose Pietrini-Sanchez","doi":"10.1111/bioe.13347","DOIUrl":"https://doi.org/10.1111/bioe.13347","url":null,"abstract":"<p><p>All over the world, many companies are including oocyte cryopreservation for nonmedical reasons, also popularly known as nonmedical egg freezing (NMEF), within their employee benefits packages. However, it is important to ask whether companies are ethically justified in offering NMEF as a benefit for their employees. The inclusion of NMEF within companies' employee benefits packages could be ethically justified in two ways. On the one hand, company-sponsored NMEF can serve as a strategy to mitigate or eliminate gender inequalities in the workplace, such as female underrepresentation in positions of authority and leadership and the so-called work/motherhood conflict. On the other hand, company-sponsored NMEF can be a means to expand women's reproductive autonomy by making egg freezing accessible to those women who are not able to afford it otherwise. This article calls into question these ethical justifications. We argue that by offering NMEF as an employee benefit, companies maintain current workplace inequalities and impose an option for women with multiple risks and externalities. Therefore, companies' offering of NMEF benefits cannot be ethically justified. Furthermore, we argue that companies that offer NMEF benefits incur fiduciary responsibilities related to the physiological, emotional, psychological, and financial costs of the use of company-sponsored NMEF.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047583","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":"Should Doctor Robot possess moral empathy?","authors":"Elisabetta Sirgiovanni","doi":"10.1111/bioe.13345","DOIUrl":"https://doi.org/10.1111/bioe.13345","url":null,"abstract":"<p><p>Critics of clinical artificial intelligence (AI) suggest that the technology is ethically harmful because it may lead to the dehumanization of the doctor-patient relationship (DPR) by eliminating moral empathy, which is viewed as a distinctively human trait. The benefits of clinical empathy-that is, moral empathy applied in the clinical context-are widely praised, but this praise is often unquestioning and lacks context. In this article, I will argue that criticisms of clinical AI based on appeals to empathy are misplaced. As psychological and philosophical research has shown, empathy leads to certain types of biased reasoning and choices. These biases of empathy consistently impact the DPR. Empathy may lead to partial judgments and asymmetric DPRs, as well as disparities in the treatment of patients, undermining respect for patient autonomy and equality. Engineers should consider the flaws of empathy when designing affective artificial systems in the future. The nature of sympathy and compassion (i.e., displaying emotional concern while maintaining some balanced distance) has been defended by some ethicists as more beneficial than perspective-taking in the clinical context. However, these claims do not seem to have impacted the AI debate. Thus, this article will also argue that if machines are programmed for affective behavior, they should also be given some ethical scaffolding.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047584","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":"Protecting controversial thought: Editing Bioethics in the age of social media facilitated outrage","authors":"Udo Schuklenk","doi":"10.1111/bioe.13343","DOIUrl":"10.1111/bioe.13343","url":null,"abstract":"&lt;p&gt;Much has been said about the harmful role played by algorithms that are deployed by social media platforms to ensure engagement. Less has arguably been said about the impact this had on editorial practices of academic journals that publish content that is vulnerable to the machinations of said algorithms. We have seen a few of these events over the years in our field, bioethics. Interested readers of the journal will recall the global outcry a paper by Alberto Giubilini and Francesca Minerva. It was caused by what they called provocatively ‘after-birth abortion’.1 In academic terms, the paper has been a runaway success, netting our colleagues over at the &lt;i&gt;Journal of medical ethics&lt;/i&gt; a bit more than a million article downloads. Career development wise there were negative consequences suffered by both authors. Given that the Editor of the journal was under tremendous pressure to resign or be fired, I did publish a supportive Editorial in this journal at the time.2 Do you recall Rebecca Tuvel's article about transracialism in &lt;i&gt;Hypathia&lt;/i&gt; some years back?3 The Editor of the journal, and the—at the time—junior, tenure-track academic, who published the paper, were subjected to endless ad hominem attacks on various social media platforms. Particularly disturbing was the participation of senior tenured academics in what constituted a concerted effort of the academic outrage machine to effectively end the academic career of a junior female philosopher without job security. Much of this pressure, as in the other examples I'm about to mention, was facilitated by social media platforms. Academics seemingly take to signing petitions aimed at boycotting, demanding resignations, retractions, and worse, in case they find published peer reviewed content disagreeable. Virtue signalling at its finest. Perhaps a response in the pages of the journal that published the offending paper is seen as too old fashioned by this sort of academic activism.&lt;/p&gt;&lt;p&gt;I have always thought that these types of reactions display a deeply troubling understanding of academic freedom. They are celebrating and defending the academic freedom of agreeable content, while failing to defend academic freedom when it matters most, namely when the content is disagreeable. There will be all sorts of verbiage thrown around from ‘epistemic injustice’ to varieties of ‘privilege’, but typically, the apparently so obviously flawed substance of what one disagrees with isn't confronted. However, precisely that is what ought to happen if one cared enough to ensure that diversity of thought is maintained in a field of inquiry such as bioethics. That doesn't mean that one has to concede a methodological free-for-all. I have gone on the record stating that public reason-based arguments are a &lt;i&gt;conditio sine qua non&lt;/i&gt; of bioethical analyses that aim to have a universal appeal. Somewhat reassuringly the outrage machine tends to direct its vitriol at particular conclusions rather than the bioethic","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005986","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":"Opt-out vaccination in school and daycare: Reconciling parental authority and obligations","authors":"Didde Boisen Andersen,&nbsp;Viki Møller Lyngby Pedersen","doi":"10.1111/bioe.13344","DOIUrl":"10.1111/bioe.13344","url":null,"abstract":"<p>An increasing vaccine hesitancy among parents, which has resulted in insufficient rates of immunization, provides reason to reconsider childhood vaccination practices. Studies suggest that parents' decision-making process concerning whether to vaccinate their child is highly influenced by cognitive biases. These biases can be utilized to increase vaccination uptake via changes in the choice context. This article considers childhood vaccination programmes, which involve children being vaccinated in school or daycare unless their parents actively ‘opt out’. We suggest that such programmes reconcile parents' decisional authority and vaccination duties. First, opt-out childhood vaccination based in schools or daycare centres are not disrespectful of parental authority. Second, the programme aligns the default setting with a moral obligation to vaccinate one's child that most parents have.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001418","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":"War on All Fronts: A Theory of Health Security Justice By  Nicholas G. Evans, Cambridge, MA: MIT Press. 2023. pp. 258. $45.00 paperback. ISBN: 9780262545433","authors":"Ben Davies","doi":"10.1111/bioe.13342","DOIUrl":"10.1111/bioe.13342","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180013","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":"Will older adults be represented in patient-reported data? Opportunities and realities","authors":"Nina Roxburgh","doi":"10.1111/bioe.13341","DOIUrl":"10.1111/bioe.13341","url":null,"abstract":"<p>Policy makers and health professionals are grappling with the high costs of and demand for health care, questions of sustainability and value, and changing population demographics—in particular, ageing populations. Digital solutions, including the adoption of patient-reported measures, are considered critical in achieving person-centred and value-based health care. However, the utility of patient-reported measures and the data they produce may be subject to ageist beliefs, prejudices and attitudes, rendering these data ineffective at promoting improved patient experiences and outcomes for older adults. This article explores the ethical considerations raised in relation to patient-reported measures and the digital agency of older patients.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894974","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":"The pregnancy rescue case versus typical abortion","authors":"Alex R Gillham","doi":"10.1111/bioe.13328","DOIUrl":"10.1111/bioe.13328","url":null,"abstract":"<p>Hendricks' pregnancy rescue case (PRC) tries to show that abortion is typically morally wrong. I argue here that there are at least two morally relevant differences between the abortion in PRC and the typical abortion so that the latter isn't morally wrong even if the former is morally wrong. I develop five modifications to PRC to show that these two differences are morally important. First, in PRC we don't know whether the person gives informed consent to the abortion, nor does the medical professional who will perform the abortion, and so the abortion can't be performed because the patient gives informed consent to it. Second, not preventing the death of the fetus in PRC brings about the death of an additional fetus gestating in a separate pregnant person, whereas most abortions don't entail the termination of another's pregnancy.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879902","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}