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The problem of value change: Should advance directives hold moral authority for persons living with dementia? 价值改变的问题：预先指示是否对痴呆症患者具有道德权威？
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-12-15 DOI: 10.1111/bioe.13386
Anand Sergeant
{"title":"The problem of value change: Should advance directives hold moral authority for persons living with dementia?","authors":"Anand Sergeant","doi":"10.1111/bioe.13386","DOIUrl":"https://doi.org/10.1111/bioe.13386","url":null,"abstract":"<p><p>As the prevalence of dementia rises, it is increasingly important to determine how to best respect incapable individuals' autonomy during end-of-life decisions. Many philosophers advocate for the use of advance directives in these situations to allow capable individuals to outline preferences for their future incapable selves. In this paper, however, I consider whether advance directives lack moral authority in instances of dementia. First, I introduce several scholars who have argued that changes in peoplewith dementia's values throughout disease progression reduce the validity of their advanced wishes. I then outline Karin Jongsma's rejection of this claim, which she calls the \"losing and choosing\" distinction. Jongsma argues that changes in people with dementia's values should not be respected, because they are unchosen and dictated by the disease. I critique her claim that the process of value change is morally relevant when determining which values we respect. I argue that if individuals with dementia are capable of valuing, their contemporary values should be respected, even when they conflict with past preferences outlined in an advance directive. As such, situations of value change diminish the moral authority of advance directives for individuals with dementia.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830845","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
Ethical considerations for biobanks serving underrepresented populations 为代表性不足的人群服务的生物银行的伦理考虑。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-12-10 DOI: 10.1111/bioe.13381
Yoon Seo Lee, Nelson Luis Badia Garrido, George Lord, Zane Allan Maggio, Bohdan B. Khomtchouk
{"title":"Ethical considerations for biobanks serving underrepresented populations","authors":"Yoon Seo Lee,&nbsp;Nelson Luis Badia Garrido,&nbsp;George Lord,&nbsp;Zane Allan Maggio,&nbsp;Bohdan B. Khomtchouk","doi":"10.1111/bioe.13381","DOIUrl":"10.1111/bioe.13381","url":null,"abstract":"<p>Biobanks are essential biological database resources for the scientific community, enabling research on the molecular, cellular, and genetic basis of human disease. They are crucial for computational, data-driven biomedical research, which advances precision medicine and the development of targeted therapies. However, biobanks often lack racial and ethnic diversity, with many data sets predominantly comprising individuals of white, primarily northern European, ancestry. Establishing or enhancing biobanks for the inclusion of historically underrepresented populations requires meticulous ethical and social planning beyond logistical, legal, and economic considerations. This guide provides a roadmap for building and sustaining diverse biobanks, emphasizing ethical guidelines and cultural sensitivity. We highlight the importance of obtaining informed consent from donors, respecting their bodily autonomy, and the economic and research benefits of diverse biobanks to enable precision medicine, drug discovery, and industry-academic partnerships. Prioritizing key ethical and social considerations allows biobanks to advance scientific knowledge while upholding the rights and autonomy of underrepresented populations. Diversity in biobank sample collection enhances research outcomes by ensuring findings are representative and applicable to various human population groups, fostering trust, promoting inclusivity, and addressing health disparities while informing health policy. This is vital to ensuring biobanking efforts contribute meaningfully to the advancement of health equity.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"240-249"},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808359","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
Moral enhancement and cheapened achievement: Psychedelics, virtual reality and AI 道德的提升与成就的贬低：迷幻剂、虚拟现实和人工智能。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-20 DOI: 10.1111/bioe.13374
Emma C. Gordon, Katherine Cheung, Julian Savulescu, Brian D. Earp
{"title":"Moral enhancement and cheapened achievement: Psychedelics, virtual reality and AI","authors":"Emma C. Gordon,&nbsp;Katherine Cheung,&nbsp;Julian Savulescu,&nbsp;Brian D. Earp","doi":"10.1111/bioe.13374","DOIUrl":"10.1111/bioe.13374","url":null,"abstract":"<p>A prominent critique of cognitive or athletic enhancement claims that certain performance-improving drugs or technologies may ‘cheapen’ resulting achievements. Considerably less attention has been paid to the impact of enhancement on the value of <i>moral</i> achievements. Would the use of moral enhancement (bio)technologies, rather than (solely) ‘traditional’ means of moral development like schooling and socialization, cheapen the ‘achievement’ of morally improving oneself? We argue that, to the extent that the ‘cheapened achievement’ objection succeeds in the domains of cognitive or athletic enhancement, it could plausibly also succeed in the domain of moral enhancement—but only regarding certain forms. Specifically, although the value of moral self-improvement may be diminished by some of the more <i>speculative</i> and <i>impractical</i> forms of moral enhancement proposed in the literature, this worry has less force when applied to more plausibly viable forms of moral enhancement: forms in which drugs or technologies play an <i>adjunctive</i> or <i>facilitative</i>, rather than a <i>determinative</i>, role in moral improvement. We illustrate this idea with three examples from recent literature: the possible use of psychedelic drugs in certain moral-learning contexts, ‘Socratic Al’ (a proposed Al-driven moral enhancer) and empathy enhancement through virtual reality (VR). We argue that if one assumes that these technologies work roughly as advertised (which is an open empirical question), the ‘cheapened achievement’ objection loses much of its bite. The takeaway lesson is that moral enhancement in its most promising and practical forms ultimately evades a leading critique of cognitive and athletic enhancement. We end by reflecting on the potential upshot of our analysis for enhancement debates more widely.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"276-287"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677834","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
Cracking the code of the slow code: A taxonomy of slow code practices and their clinical and ethical implications. 破解慢代码的密码：慢代码实践分类法及其对临床和伦理的影响。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-20 DOI: 10.1111/bioe.13378
Erica Andrist, Jacqueline Meadow, Nurah Lawal, Naomi T Laventhal
{"title":"Cracking the code of the slow code: A taxonomy of slow code practices and their clinical and ethical implications.","authors":"Erica Andrist, Jacqueline Meadow, Nurah Lawal, Naomi T Laventhal","doi":"10.1111/bioe.13378","DOIUrl":"https://doi.org/10.1111/bioe.13378","url":null,"abstract":"<p><p>The ethical permissibility of the \"slow code\" sparks vigorous debate. However, definitions of the \"slow code\" that exist in the literature often leave room for interpretation. Thus, those assessing the ethical permissibility of the slow code may not be operating with shared definitions, and definitions may not align with clinicians' understanding and use of the term in clinical practice. To add clarity and nuance to discussions of the \"slow code,\" this manuscript highlights the salient medical and moral components that distinguish resuscitative practices, resulting in a taxonomy that includes nine distinct entries: the Fake Code, Casual Code, Time-Limited Code, Family Code, Contained Code, a la Carte Code, Preventive Code, Passive Code, and Accepted Code. We argue that cogent analyses of the ethical implications of the \"slow code\" must begin with clear, shared understandings of the practices under debate.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677833","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
Misaligned hope and conviction in health care 医疗保健中希望与信念的错位。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-16 DOI: 10.1111/bioe.13370
Steve Clarke, Justin Oakley, Jonathan Pugh, Dominic Wilkinson
{"title":"Misaligned hope and conviction in health care","authors":"Steve Clarke,&nbsp;Justin Oakley,&nbsp;Jonathan Pugh,&nbsp;Dominic Wilkinson","doi":"10.1111/bioe.13370","DOIUrl":"10.1111/bioe.13370","url":null,"abstract":"<p>It is often said that it is important for patients to possess hope that their treatment will be successful. We agree, but a widely appealed to type of hope—hope based on conviction (religious or otherwise), renders this assertion problematic. If conviction-based hope influences patient decisions to undergo medical procedures, then questions are raised about the scope of patient autonomy. Libertarians permit patients to make decisions to undergo medical procedures on the basis of any considerations, including conviction-based hopes, on grounds of respect for freedom of choice. Rational interventionists want to restrict choices made on the basis of conviction-based hope on the grounds that choices based on hope incorporate irrationality of a sort incompatible with autonomous decision-making. In this article, we navigate a middle path between these extremes, arguing that patient decision-making based on conviction-based hope ought to be acceptable and permitted in health care when it conforms to norms of practical rationality. These norms allow patients some room to make decisions to consent to undergo medical procedures informed by conviction-based hope.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"232-239"},"PeriodicalIF":1.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645253","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
Contraceptive digital pills and sexual and reproductive healthcare of women with mental disabilities: Problem or solution? 数字避孕药与智障妇女的性保健和生殖保健：问题还是解决方案？
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-14 DOI: 10.1111/bioe.13372
Rosana Triviño, María Victoria Martínez-López
{"title":"Contraceptive digital pills and sexual and reproductive healthcare of women with mental disabilities: Problem or solution?","authors":"Rosana Triviño, María Victoria Martínez-López","doi":"10.1111/bioe.13372","DOIUrl":"10.1111/bioe.13372","url":null,"abstract":"<p><p>For years, the sexual and reproductive health of women with intellectual and developmental disability or disabilities has been insufficiently addressed by institutions and family members due to a lack of information, training, and, sometimes, religious issues. In this context, contraceptive digital pills can enhance the sexual and reproductive control of this population group. Digital pills could help to improve adherence to treatments aimed to prevent unwanted pregnancies, as well as allowing women and their caregivers to exert better drug intake control. However, there are some ethical risks to consider that may outweigh these benefits. This study sets out to explore the ethical considerations that should be taken into account in the case of a potential roll-out of contraceptive digital pills as a way of improving the sexual and reproductive health of these women.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632977","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
Ethical considerations for non-procreative uterus transplantation 非生殖性子宫移植的伦理考虑。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-14 DOI: 10.1111/bioe.13379
J. Y. Lee
{"title":"Ethical considerations for non-procreative uterus transplantation","authors":"J. Y. Lee","doi":"10.1111/bioe.13379","DOIUrl":"10.1111/bioe.13379","url":null,"abstract":"<p>The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the <i>function</i> of UTx (and what constitutes its ‘success’), as well as the recipient <i>eligibility</i> for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this—the treatment of uterine infertility—explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which both cis- and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non-procreative motivations for uterus acquisition ought to be taken seriously as a matter of non-discrimination and consistency.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 3","pages":"267-275"},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632981","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
Loneliness as lack of solidarity: The case of Palestinians standing alone 孤独是缺乏团结：孤独的巴勒斯坦人
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-14 DOI: 10.1111/bioe.13368
Zohar Lederman, Tamara Kayali Browne, Liyana Kayali, Shumel Lederman, Zvika Orr
{"title":"Loneliness as lack of solidarity: The case of Palestinians standing alone","authors":"Zohar Lederman,&nbsp;Tamara Kayali Browne,&nbsp;Liyana Kayali,&nbsp;Shumel Lederman,&nbsp;Zvika Orr","doi":"10.1111/bioe.13368","DOIUrl":"10.1111/bioe.13368","url":null,"abstract":"<p>This paper explores the notion of loneliness as lack of solidarity in relations to Palestinians living in the Occupied Palestinian Territory, Israel, and the diaspora. Loneliness as lack of solidarity is defined as lacking someone to identify with and/or lacking someone who is willing to assist while carrying a burden. We describe the mechanism of lack of identification using the concept of epistemic injustice. The paper suggests that art may serve as a way to mitigate this kind of loneliness, and focus on the Freedom Theater, which was operating in Jenin Refugee Camp until recently.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 1","pages":"76-89"},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633036","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
To never exist is always best. A critique of the metaphysics of pronatalism in contemporary bioethics 永远不存在永远是最好的。对当代生命伦理学中的代孕形而上学的批判。
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-13 DOI: 10.1111/bioe.13376
Konrad Szocik
{"title":"To never exist is always best. A critique of the metaphysics of pronatalism in contemporary bioethics","authors":"Konrad Szocik","doi":"10.1111/bioe.13376","DOIUrl":"10.1111/bioe.13376","url":null,"abstract":"<p>The subject of this paper is a critique of the pronatalist metaphysics that underlies bioethics and shapes the thinking and discourse on reproductive rights. The point of reference is the philosophy of antinatalism presented by Marcus T. L. Teo. Seemingly arguing in favor of antinatalism, Teo mixes antinatalist concepts with pronatalist intuitions. The consequence of combining the impossible is the restoration of negative eugenics on the one hand, and a series of contradictions on the other. The article shows that philosophical antinatalism is a universal position that indicates that procreation always, everywhere and for everyone is wrong. The paper simultaneously exposes and criticizes the metaphysics of pronatalism underlying bioethical discourse. Weakening pronatalism in bioethics and turning more attention to antinatalism could bring good results for women, the environment, and bioethics itself in terms of its thematic preferences.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 1","pages":"145-150"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633038","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
Biology of kindness: Six daily choices for health, well-being, and longevity By Immaculata De Vivo and Daniel Lumera, Cambridge, MA: The MIT Press. 2024. pp. 264. $24.95 (Paperback); $24.99 (eBook). ISBN: 9780262547659
IF 1.7 2区 哲学
Bioethics Pub Date : 2024-11-12 DOI: 10.1111/bioe.13377
Raymond D. Villareal, Gustavo Carlo
{"title":"Biology of kindness: Six daily choices for health, well-being, and longevity By \u0000 Immaculata De Vivo and \u0000 Daniel Lumera, Cambridge, MA: The MIT Press. 2024. pp. 264. $24.95 (Paperback); $24.99 (eBook). ISBN: 9780262547659","authors":"Raymond D. Villareal,&nbsp;Gustavo Carlo","doi":"10.1111/bioe.13377","DOIUrl":"https://doi.org/10.1111/bioe.13377","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 2","pages":"221-222"},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143110555","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
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