Bioethics最新文献_第4页

Argument for Consensual Paternalism in Shared Decision-Making: Rediscovering Autonomy in Western Bioethics. 共同决策中的共识式家长制之论证：重新发现西方生命伦理学中的自主性。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.70003

Sarosh Saleem

{"title":"Argument for Consensual Paternalism in Shared Decision-Making: Rediscovering Autonomy in Western Bioethics.","authors":"Sarosh Saleem","doi":"10.1111/bioe.70003","DOIUrl":"https://doi.org/10.1111/bioe.70003","url":null,"abstract":"Western bioethics has evolved from discussions centered around paternalism and individual autonomy to the concept of Shared Decision-Making (SDM). This approach to decision-making aims to uphold patients' autonomy while prioritizing open communication and collaboration. When it comes to making decisions for infants or children, both parents and pediatricians share the responsibility. Parents' personal experiences, values, and beliefs play a central role in the concept of SDM. However, there is still ongoing debate regarding whether physicians should convey their own values, preferences, and recommendations. In Pakistan, clinical decision-making is predominantly the domain of physicians. Physicians are regarded as figures of respect and authority, and seeking a physician's opinion is common. In a patrilineal and family-oriented society, medical paternalism is accepted and valued by patients and their families. Autonomy is viewed through a different lens in this cultural setting. This paper presents a narrative analysis of the contrasting approaches to clinical decision-making in these two cultural contexts. It raises thought-provoking questions about how clinicians navigate decision-making dynamics, particularly when faced with different expectations from patients and families. The juxtaposition of these approaches prompts reflection on the potential impact of cultural and societal norms on ethical considerations in healthcare. The paper criticizes the moral hegemony of autonomy and argues for rethinking the separation of autonomy and paternalism in Western bioethics, offering Consensual Paternalism, which represents shared yet unconventional decision-making.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499450","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

Existentialism and My 'Postwolf' Dachshund: Authenticity in the Age of Genetic Engineering. 存在主义和我的“后狼”腊肠犬：基因工程时代的真实性。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.13428

Donrich Thaldar

{"title":"Existentialism and My 'Postwolf' Dachshund: Authenticity in the Age of Genetic Engineering.","authors":"Donrich Thaldar","doi":"10.1111/bioe.13428","DOIUrl":"https://doi.org/10.1111/bioe.13428","url":null,"abstract":"Human genetic engineering has the potential to profoundly alter the traits of future generations, raising critical ethical questions about authenticity and identity. Essentialist perspectives reject genetic engineering, claiming it inherently compromises authenticity by deviating from a species-typical genome. In contrast, this article advocates for an existentialist interpretation of authenticity, drawing on the philosophies of Heidegger and Sartre. Here, authenticity is understood as a dynamic and relational process rooted in individual choice, responsibility, and engagement with existential conditions. Unlike essentialism, existentialism evaluates genetic interventions not as inherently wrong but based on their alignment with values such as autonomy and authenticity, offering a more flexible and ethically robust framework. Existentialism's emphasis on individual freedom, self-determination, and the creation of meaning in life makes it ethically more compelling than essentialist frameworks, which impose deterministic constraints. Moreover, essentialist critiques falter when they concede the permissibility of therapeutic genetic engineering, undermining the notion of an inherently valuable species-typical human genome. In contrast, existentialism affirms the transformative potential of genetic engineering, recognising it as a means to expand autonomy, self-expression, and opportunities for flourishing when applied responsibly. The article advocates for a balanced ethical approach by integrating the Principle of Procreative Beneficence, which promotes enhancements to optimise flourishing, with the Principle of Procreative Non-Maleficence, which safeguards autonomy by preventing deterministic constraints. This complementary framework, grounded in an existentialist perspective, reframes authenticity as an evolving concept aligned with the transformative possibilities of genetic engineering, enriching the discourse on bioethics and identity in a rapidly changing era.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499451","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

Exploring the Hypothetical Impact of Genetic Engineering on Ethnicity: An Analysis of a Large-Scale Data Set Retrieved From a Museal Setting. 探索基因工程对种族的假设影响：对从博物馆环境中检索到的大规模数据集的分析。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.70005

Niklas A Döbler, Alexander Pastukhov, Claus-Christian Carbon

{"title":"Exploring the Hypothetical Impact of Genetic Engineering on Ethnicity: An Analysis of a Large-Scale Data Set Retrieved From a Museal Setting.","authors":"Niklas A Döbler, Alexander Pastukhov, Claus-Christian Carbon","doi":"10.1111/bioe.70005","DOIUrl":"https://doi.org/10.1111/bioe.70005","url":null,"abstract":"Critics of human genetic engineering warn that if ever put into practice, this will diminish human diversity, especially regarding skin color. Nonetheless, given the solid and shameful causal link between skin color and discrimination, the provocative question is whether to manipulate this feature and create children whose stereotype-aligning features reduce the risk of evoking hostility in the social environment. To address this possibility, we analyzed data from an interactive exhibit in a German museum that partly addresses these questions. Visitors could manipulate randomized features of a virtual child-for example, appearance and intelligence-to align them with their notion of a \"perfect child.\" Analysis of N = 13,641 virtual children showed an apparent effect on aligning skin color with a Caucasian type. This was true for extreme light and dark, randomly assigned initial skin colors, but stronger for the latter. This preference could reflect the attempt to align the hypothetical child's skin color with the creating visitors. We also analyzed the chosen skin-color-dependent distribution of designed intelligence based on previous findings showing that high intelligence is less desirable for Black than White persons. We revealed that virtual children with a chosen darker skin color were designed with relatively lower intelligence and a larger proportion of maximized and minimized values. Although most effects were small, they might indicate racial prejudices and/or the attempt to design virtual children with high alignment with normative stereotypes. Our findings provide an important starting point to empirically inform the critical and timely debate about human genetic engineering.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499454","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

Time to expand a paradigm: Healthcare sustainability and eco-ethical assessment 是时候扩展一个范例了：医疗保健可持续性和生态伦理评估。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.70008

Luca Valera

{"title":"Time to expand a paradigm: Healthcare sustainability and eco-ethical assessment","authors":"Luca Valera","doi":"10.1111/bioe.70008","DOIUrl":"10.1111/bioe.70008","url":null,"abstract":"This paper aims to rethink healthcare sustainability from an eco-ethical approach, mainly referring to van Rensselaer Potter's global bioethics and Arne Naess's ecosophy. In this sense, it seeks to address the ethical problem of allocating resources from a non-individualist and essentially bio-medical perspective, which interprets health (or disease) as a mere feature of the individual. On the contrary, starting from a planetary health approach (Potter) and an “ecosophical” view of human beings (Næss), individual health gains meaning in a broader context. At the ethical level, this implies: 1. a focus on the patient's wellbeing, more than his/her diagnosis and cure; 2. a conception of shared responsibility and agency of all stakeholders; 3. the pursuit of ecologically sound decisions that go beyond the individual; 4. promoting environmental stewardship, which may overcome the dichotomy between anthropocentrism and biocentrism; and 5. pursuing epistemic humility. All these pragmatic considerations may inspire the construction of environmentally sustainable health systems. In this regard, the paradigm proposed in this paper is principally directed to healthcare organizations, and not to the particular doctor-patient relationship, where the classical principles of bio-medical ethics might still be appropriate. This non-exclusionary approach allows the integration of the two facets of bioethics: Georgetown bio-medical ethics (Kennedy Institute) and Wisconsin global bioethics (Potter).","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 6","pages":"530-537"},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499456","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

Against Public-Facing Religious Bio-Restrictionism 反对面向公众的宗教生物限制主义。

IF 2.1 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.70013

Muralidharan Anantharaman

引用次数: 0

Mental Health Is Psychological Well-Being 心理健康就是心理健康。

IF 2.1 2区哲学

Bioethics Pub Date : 2025-06-25 DOI: 10.1111/bioe.70010

John T. Maier

引用次数: 0

International Humanitarian Law and the Immunity of Hospitals in Gaza. 国际人道主义法与加沙医院的豁免权。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-15 DOI: 10.1111/bioe.13433

Zohar Lederman

{"title":"International Humanitarian Law and the Immunity of Hospitals in Gaza.","authors":"Zohar Lederman","doi":"10.1111/bioe.13433","DOIUrl":"https://doi.org/10.1111/bioe.13433","url":null,"abstract":"International Humanitarian Law (IHL), specifically Article 18 of the IV Geneva Convention, affords special protection to civilian hospitals. This special protection is waived, however, under certain circumstances specified in Article 19. Such conditions to waive the special protection of hospitals are now being used by Israel to justify the attack on civilian hospitals and healthcare institutions in Gaza. This paper critically evaluates Article 19 and the conditions for the removal of the immunity of hospitals in general and in the specific case of Gaza. The substance and language of Article 19 are found to be flawed in this case. The paper thus argues that Article 19 should be revised to better reflect the special protection hospitals generally and in Gaza specifically should have. This paper is primarily geared at fellow bioethicists who wish to contribute to and lament the injustices occurring in Gaza and elsewhere but are unsure as to how ethical arguments may do so. This paper also addresses international law scholars, inviting further commentary on a novel and ambitious ethical argument to revise long-standing international law. Additionally, the paper is a call to the wider, global public and healthcare providers to actively condemn unjust attacks on healthcare in Gaza and elsewhere in the world. Lastly, the paper is written in a meager attempt at standing in solidarity with the People in Gaza and elsewhere whose healthcare systems are being targeted by unjust governments.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303689","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 Effectiveness of Nudging and Its Ethical Implications 轻推的有效性及其伦理意义。

IF 2.1 2区哲学

Bioethics Pub Date : 2025-06-15 DOI: 10.1111/bioe.70000

Leonard Dung

引用次数: 0

Bioethical Issues as Triggers of Religious Transformation in Orthodox Christianity. 生命伦理问题是东正教宗教转型的导火索。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-15 DOI: 10.1111/bioe.70006

Tarabrin Roman

{"title":"Bioethical Issues as Triggers of Religious Transformation in Orthodox Christianity.","authors":"Tarabrin Roman","doi":"10.1111/bioe.70006","DOIUrl":"https://doi.org/10.1111/bioe.70006","url":null,"abstract":"The advent of new biomedical technologies has given rise to an emerging area of sociocultural discourse. The sociocultural perception of these technologies is contingent upon a number of factors, including the prevailing attitudes within dominant religious traditions. Religious bioethics is fundamentally distinct from secular bioethics. The former is grounded in unchanging sacred scriptures and traditions, which inform its normative provisions. Consequently, a shift in the perception of technology must be accompanied by a corresponding shift in how religious institutions interpret scripture and tradition. This article employs the Russian Orthodox Church (ROC) as a case study to investigate how religious institutions can adapt to changing societal and cultural demands, and whether religious moral decrees can evolve in response to shifting sociocultural discourse. A discourse analysis of the ROC's interactions with the medical community and the general public reveals the following: To maintain influence with its followers, a religious institution should not categorically reject new advances in biomedicine. Rather, it should engage in a comprehensive bioethical analysis of the challenges posed by each emerging technology. In this process, it is valuable to define boundaries based on religious doctrine-limits that a believer must not exceed to maintain communion with the deity-while allowing for the use of new biomedical solutions.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303688","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

Striking a Balance in Reproductive Genetic Counseling: Directiveness for Testing, Non-Directiveness About Selection. 生殖遗传咨询的平衡：测试的指导性，选择的非指导性。

IF 1.7 2区哲学

Bioethics Pub Date : 2025-06-15 DOI: 10.1111/bioe.70007

Marie Kerguelen Feldblyum Le Blevennec

引用次数: 0