BioethicsPub Date : 2025-06-11DOI: 10.1111/bioe.13436
Caitríona Cox, Zoë Fritz
{"title":"In Defence of Causing Patients to Worry: Ethical Issues in the Communication of Diagnostic Uncertainty","authors":"Caitríona Cox, Zoë Fritz","doi":"10.1111/bioe.13436","DOIUrl":"10.1111/bioe.13436","url":null,"abstract":"<p>Doctors are often motivated by a desire to avoid causing their patients worry. In this paper, we provide a defence of disclosing diagnostic uncertainty information to patients, even if such disclosures are worrying. We first consider whether making a patient worry harms them, arguing that worry can be harmful in some—but not all—situations. Although worry is an aversive emotion, sometimes, worry can be beneficial (e.g., if the worry drives adaptive behaviours that are ultimately good for the patient's well-being). In contrast, worry that is excessive, or is related to events outside the patient's control, can be considered harmful. Even if worry <i>is</i> harmful, communicating worrying information can still sometimes be justified—for example, by applying a consequentialist harm–benefit analysis to consider whether the other benefits of the disclosure (broadly defined) might outweigh the harm created by the worry. We summarise the growing empirical evidence that suggests that patients often prefer their doctors to communicate transparently throughout the diagnostic process, even if the acknowledgement of serious but uncertain diagnoses induces some worry. We do, however, note the difficulty in predicting how an individual patient will respond to the disclosure of potentially worrying information (as the preference for greater communication of diagnostic uncertainty may not be universal). We conclude that a holistic consideration of the expected consequences of communication—including self-assessment by the doctor to avoid unwitting bias or unwarranted projection of their own values—often supports the communication of diagnostic uncertainty information, <i>even</i> if it worries the patient.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"700-708"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276778","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}
BioethicsPub Date : 2025-06-11DOI: 10.1111/bioe.13439
Federico Germán Abal
{"title":"Euthanasia, Anti-Egalitarian Bias, and Breach of the Duty of Medical Care: A Reply to Rivera López","authors":"Federico Germán Abal","doi":"10.1111/bioe.13439","DOIUrl":"10.1111/bioe.13439","url":null,"abstract":"<div>\u0000 \u0000 <p>Rivera López offers a coherent defense of three norms: the right to active euthanasia, the right to refuse or withdraw medical treatments, and the prohibition of consensual homicide. These norms appear to come to tension if an autonomy-based justification for euthanasia is adopted. To resolve this tension, Rivera López appeals to a paternalistic argument and to the distinction between the right to autonomy and the right to bodily integrity. In this paper, I argue that the paternalistic argument implies an anti-egalitarian bias about the value of certain lives and that the distinction between the right to autonomy and the right to bodily integrity leads to consequences that are incompatible with the special duty of medical care.</p>\u0000 </div>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"716-722"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276776","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}
BioethicsPub Date : 2025-06-11DOI: 10.1111/bioe.13438
George Rugare Chingarande
{"title":"The Ethics of Informed Consent for Data Registries: Moving Beyond Moral Minimalism to the High Ground","authors":"George Rugare Chingarande","doi":"10.1111/bioe.13438","DOIUrl":"10.1111/bioe.13438","url":null,"abstract":"<p>There is a rapid increase in disease registries all over the world, propelled by innovations in electronic health records and computer technologies. Unlike the developed world, where many registries are well established, many disease registries in the developing world are still in their incipient stage. Establishment of disease registries is blighted by many ethical concerns. These include but are not limited to data capture and data transfer happening without explicit patient consent; data sharing with third parties for various purposes including research, policy making and advocacy; and retrospective consent waiver. This is compounded by the lack of ethical guidelines and international best practices. This paper presents an ethical analysis of the ethics of informed consent for data registries.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"709-715"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276779","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}
BioethicsPub Date : 2025-06-11DOI: 10.1111/bioe.13432
Marcus T. L. Teo
{"title":"From Abstinence to Assistance: Antinatalism's Unexpected Endorsement of the Principle of Procreative Beneficence","authors":"Marcus T. L. Teo","doi":"10.1111/bioe.13432","DOIUrl":"10.1111/bioe.13432","url":null,"abstract":"<p>This essay begins from the point that developments in antinatalism, or the view that it is wrong to bear children, place legitimate pressures on prospective parents to seriously consider the harms of bringing their prospective children into existence. This essay does not defend antinatalism but instead considers an upshot of bioethical import if one takes these antinatalist pressures seriously. Attending to the debate on the normative legitimacy of Savulescu's Principle of Procreative Beneficence (PPB), I argue that antinatalist pressures give rise to reasons that count in favor of the PPB. I show how an antinatalist-corollary version of the PPB might be derived and how we might respond to the PPB's main criticisms and conceptual difficulties.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"693-699"},"PeriodicalIF":2.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276777","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}
BioethicsPub Date : 2025-06-08DOI: 10.1111/bioe.70002
David G. Kirchhoffer, Bridget Pratt
{"title":"In hospital resource allocation conflicts between health goods and environmental goods, a relational, co-benefits frame, rather than a dualistic, competing goods frame, is key","authors":"David G. Kirchhoffer, Bridget Pratt","doi":"10.1111/bioe.70002","DOIUrl":"10.1111/bioe.70002","url":null,"abstract":"<p>Health systems contribute to the environmental crisis. Yet, addressing this problem seems to generate a resource allocation dilemma for hospitals: investing in healthcare delivery seems to mean sacrificing environmental goods, and vice versa. We question this zero-sum thinking. After presenting the benefits of investing in the two seemingly competing goods—environmental goods and health goods—we propose that the apparent dilemma arises due to a tendency to think in dualisms. Consequently, health and environmental goods seem, respectively, to correspond to opposing sides of four dualisms: human/nature, local/global, present/future and therapy/prevention. We argue, instead, that a relational frame that considers the human person in their relational context should be used to approach the problem. A relational understanding of the human person as a meaning-making subject in relationship to all that is shows us that choosing between either health goods <i>or</i> environmental goods is frequently a false dichotomy: both can serve the well-being of human beings adequately understood. Such an approach, then, widens our conception of health and healthcare to include environmental goods. This wider conception of health and healthcare means that hospitals should (1) look for co-benefits in the first instance when allocating resources, thereby often resolving zero-sum thinking that gives rise to the competing goods dilemma, and (2) in the remaining cases where co-benefits are not achievable, use classic resource allocation principles, such as proportionality of benefits and burdens, to reach allocation decisions about a now wider range of goods (i.e., health and environmental, rather than merely health goods).</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 6","pages":"565-575"},"PeriodicalIF":1.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250993","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}
BioethicsPub Date : 2025-06-08DOI: 10.1111/bioe.13434
Marco Annoni
{"title":"Toward a Global Bioethics: Principlism and the Problem of Political Legitimacy.","authors":"Marco Annoni","doi":"10.1111/bioe.13434","DOIUrl":"https://doi.org/10.1111/bioe.13434","url":null,"abstract":"<p><p>Tom Beauchamp and James Childress's Principles of Biomedical Ethics introduced principlism-or the \"four principles approach\"-which has since become one of the most influential frameworks in contemporary bioethics. However, its potential to serve as a foundation for shared transcultural bioethical norms has elicited both substantial support and considerable critique. In this article, I analyze two notable attempts that utilize, or appear to be modeled after, principlism as a basis for global bioethics: Beauchamp and Childress's original formulation and the recently revised International Code of Medical Ethics by the World Medical Association. I argue that each model fails, but for different reasons. Beauchamp and Childress's account is rooted in particular moralities, making it suitable for guiding action in specific clinical contexts but ill-equipped to handle global ethical pluralism. Conversely, the WMA's approach is deficient due to its undefined moral foundation and lack of political legitimacy. To address these shortcomings, I outline a third approach designed to make explicit the connection between principlism, global bioethics, and the problem of political legitimacy.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250994","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}
BioethicsPub Date : 2025-05-26DOI: 10.1111/bioe.13431
Funda Gülay Kadioglu
{"title":"A Bioethical Assessment of the Environmental Impacts of War.","authors":"Funda Gülay Kadioglu","doi":"10.1111/bioe.13431","DOIUrl":"https://doi.org/10.1111/bioe.13431","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144403","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}
BioethicsPub Date : 2025-05-11DOI: 10.1111/bioe.13435
Akshay Pendyal
{"title":"Biobank Diversity and the Perils of Race Essentialism","authors":"Akshay Pendyal","doi":"10.1111/bioe.13435","DOIUrl":"10.1111/bioe.13435","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"727-729"},"PeriodicalIF":2.1,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013846","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}
BioethicsPub Date : 2025-05-07DOI: 10.1111/bioe.13429
Carlos M. Adila
{"title":"Autonomous Neurosurgical Robots: Ethical Concerns in Informed Consent and Global Health Equity","authors":"Carlos M. Adila","doi":"10.1111/bioe.13429","DOIUrl":"10.1111/bioe.13429","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"723-724"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053398","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}
BioethicsPub Date : 2025-05-07DOI: 10.1111/bioe.13430
Frank G. Lee, Christopher H. Kim, Tayyab S. Diwan
{"title":"Artificial Intelligence: The New Transplant Selection Committee Member","authors":"Frank G. Lee, Christopher H. Kim, Tayyab S. Diwan","doi":"10.1111/bioe.13430","DOIUrl":"10.1111/bioe.13430","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 7","pages":"725-726"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058125","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}