Bioethics最新文献_第6页

Should Moral Repair Be Offered to Morally Injured Laboratory Animal Technicians? 道德创伤的实验动物技术人员是否应该得到道德修复？

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-12 Epub Date: 2026-05-20 DOI: 10.1111/bioe.70128

John Goris, Jane Johnson

{"title":"Should Moral Repair Be Offered to Morally Injured Laboratory Animal Technicians?","authors":"John Goris, Jane Johnson","doi":"10.1111/bioe.70128","DOIUrl":"10.1111/bioe.70128","url":null,"abstract":"Lab-technicians are at risk of sustaining moral injuries when complicit in unethical experiments. Prima facie, it would be puzzling to offer the perpetrator of an unethical experiment psychological support in the form of moral repair. However, we argue that lab technicians are owed moral repair as a special case of our proposed duty of special concern. The duty of special concern states that special consideration must be given to the welfare of those who undertake substantial risks for the benefit of others in a cooperative scheme. We make sense of the substantial risk of moral concern lab technicians face by drawing on Rawls' notion of imperfect procedures of justice. Imperfect procedures of justice are those that aim for just outcomes, but procedures do not guarantee those outcomes. Animal experimentation belongs to this category, as it aims for only ethical experiments to be conducted, yet that result is not guaranteed by its procedures. The risk of moral injury falls heavily on lab technicians as they will be the ones to implement the unethical experiment. Hence, we make sense of the puzzling intuition that lab technicians have conducted an unethical experiment yet are owed psychological support.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"40 8","pages":"893-899"},"PeriodicalIF":2.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977287","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

P4s Are Either Unhelpful or Unnecessary. Proposing a Better AI-Powered Solution to Predict Patients' Preferences P4s要么没有帮助，要么没有必要。提出一个更好的人工智能解决方案来预测患者的偏好。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-12 Epub Date: 2026-05-07 DOI: 10.1111/bioe.70114

Beatrice Marchegiani

{"title":"P4s Are Either Unhelpful or Unnecessary. Proposing a Better AI-Powered Solution to Predict Patients' Preferences","authors":"Beatrice Marchegiani","doi":"10.1111/bioe.70114","DOIUrl":"10.1111/bioe.70114","url":null,"abstract":"The Personalized Patient Preference Predictor (P4) has been proposed as an AI tool to aid surrogate decision-making when incapacitated patients lack advance directives. Unlike population-level Patient Preference Predictors (PPPs), which infer preferences from demographic correlations, P4s fine-tune large language models (LLMs) on a patient's digital footprint to simulate their likely treatment preferences. The goal is to preserve autonomy by grounding predictions in individualized data rather than broad statistical trends. This paper argues that P4s face a fundamental dilemma: they are either unnecessary or unhelpful. When relevant, individualized evidence of preferences exists in a patient's digital footprint, the P4 is unnecessary and suboptimal, since the original data can be examined directly, with richer context than a generative model can preserve. When no such evidence exists, the P4 is unhelpful or misleading, producing plausible-sounding outputs that in the best case rely on population-level correlations rather than the patient's own values. To address these limitations, I propose a better AI-powered alternative: the Patient Preference Retriever (PPR). Rather than generating new text, the PPR uses vector search techniques to retrieve relevant statements from a patient's digital footprint, presenting them verbatim alongside metadata such as date, context, and source. This approach offers greater transparency, respects autonomy more reliably, and supports surrogate decision-makers in weighing authentic evidence. I conclude that while advance directives remain the gold standard, retrieval-based approaches like the PPR provide a more reliable and ethically defensible use of AI in surrogate decision-making than generative approaches like P4s.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"40 8","pages":"854-864"},"PeriodicalIF":2.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846667","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

Enhancement, Autonomy, and the Limits of Beneficence 增强、自治和善行的限制。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-12 Epub Date: 2026-05-04 DOI: 10.1111/bioe.70113

K. Lindsey Chambers

引用次数: 0

Protecting Patient Information in Healthcare. 在医疗保健中保护患者信息。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-09 DOI: 10.1111/bioe.70188

Marta Szabat

{"title":"Protecting Patient Information in Healthcare.","authors":"Marta Szabat","doi":"10.1111/bioe.70188","DOIUrl":"https://doi.org/10.1111/bioe.70188","url":null,"abstract":"This paper considers the connection between fairness and unfairness from a theoretical standpoint, highlighting the importance of critically evaluating the potential impact of artificial intelligence (AI) tools on patients' perception of healthcare justice. The arguments and analysis are framed within the context of Hannah Arendt's concept of the 'banality of evil' and Miranda Fricker's concept of 'epistemic injustice'. The article suggests that the greatest threat to fairness and transparency when it comes to AI may not be people deliberately trying to cause harm, but rather a widespread culture of apathy and complacency that prevents people from taking action. The paper concludes that renewing patients' commitment to critical thinking and encouraging them to take greater personal responsibility are key. More active and engaged citizenship is also required. By cultivating critical reflection, prioritising data privacy, promoting collective support, building emotional resilience, and advocating for ethical AI, individuals can transform their healthcare into a formidable bulwark against those who seek to curtail their autonomy and stifle their voices. This comprehensive healthcare strategy is about more than just the individual's welfare. It is also about creating a fair, self-governing society in which the potential of each person as a smart, active participant is recognised and protected.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914481","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

VSED Should Not Be a Pathway to MAiD (Though Both Are Ethically Permissible). VSED不应该成为通往MAiD的途径（尽管两者都是伦理允许的）。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-08 DOI: 10.1111/bioe.70144

D B Davison

引用次数: 0

Post-Trial Responsibilities for Participants Implanted With Neurosurgical Devices: A Qualitative Study. 植入神经外科装置的受试者的试验后责任：一项定性研究。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-07 DOI: 10.1111/bioe.70186

Nathan Higgins, Adrian Carter, John Gardner

{"title":"Post-Trial Responsibilities for Participants Implanted With Neurosurgical Devices: A Qualitative Study.","authors":"Nathan Higgins, Adrian Carter, John Gardner","doi":"10.1111/bioe.70186","DOIUrl":"https://doi.org/10.1111/bioe.70186","url":null,"abstract":"The issue of post-trial responsibility is about what is owed to research participants after a clinical trial ends, who is responsible, and how long this responsibility must endure. Despite two decades of international guidance on this issue, research involving novel high-risk interventions-such as implantable neurotechnologies-raises underexplored ethical tensions. Trials of implantable devices carry surgical risks and require access to multidisciplinary teams and specialised clinical infrastructures. These factors can foster participant dependence on investigator teams and trial institutions for post-trial care and support. With research and development in this area accelerating, actionable ethical guidance on the post-trial responsibilities of trial stakeholders is urgently needed. Recent normative commentaries have examined the post-trial responsibilities of clinical trial investigators, who play a central role in study design, trial coordination, and follow-up. A persistent challenge is demarcating investigator responsibilities of research integrity from those of therapeutic care when developing ethical guidance on post-trial responsibilities. Recognising the value of empirical engagement for informing further ethical reflection, we conducted qualitative semi-structured interviews with n = 21 investigators involved in neurosurgical device trials. We contend that investigators frequently experience institutional and regulatory pressures that shape how they interpret and enact responsibilities for participants' post-trial wellbeing, often in ways that extend beyond standard expectations of clinical research practice.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908018","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 Evidential and Ethical Weight of Opt-Out Consent: An Empirical Bioethical Examination. 选择退出同意的证据和伦理权重：一个经验的生物伦理检验。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-09-03 DOI: 10.1111/bioe.70185

Shang Long Yeo

{"title":"The Evidential and Ethical Weight of Opt-Out Consent: An Empirical Bioethical Examination.","authors":"Shang Long Yeo","doi":"10.1111/bioe.70185","DOIUrl":"10.1111/bioe.70185","url":null,"abstract":"Opt-out consent for posthumous organ donation has been criticized for its lower evidential weight: a person's not opting out of donation is poorer evidence of their preferences than their opting in to it, because their not opting out could be due to unawareness, inertia, or lack of preference. Do people also perceive opt-out consent to have lower evidential weight, and how does this affect their downstream ethical judgments about the validity of consent and the appropriateness of families overriding it? Could the evidential weight of opt-out consent be augmented, and if so, how? In this paper, I use two survey experiments to address these questions. First, I find that when a potential donor has merely not opted out of donation (rather than opted in to it), participants are less likely to judge that this person has given valid, informed consent; are more likely to judge that hospitals should uphold a familial challenge to their consent; and are more likely to judge that this person prefers the family to override their decision. Secondly, I evaluate three augmentation measures that aim to increase this evidential weight; I find substantial public alignment with the theoretical claim that the consent process should involve a \"selective occasion\". I then draw some ethical implications about the deficiencies of opt-out consent and how we might improve it.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882505","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

ABCDE of Deception: A Relational Research Ethics Proposal. ABCDE的欺骗：一个相关的研究伦理建议。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-08-29 DOI: 10.1111/bioe.70178

Kamiel Verbeke, Dieter Baeyens, Jan Piasecki, Tomasz Krawczyk, Pascal Borry

{"title":"ABCDE of Deception: A Relational Research Ethics Proposal.","authors":"Kamiel Verbeke, Dieter Baeyens, Jan Piasecki, Tomasz Krawczyk, Pascal Borry","doi":"10.1111/bioe.70178","DOIUrl":"https://doi.org/10.1111/bioe.70178","url":null,"abstract":"Various research ethics frameworks and guidelines assist researchers and research ethics committees (RECs) with ensuring ethically justified deception of participants. However, there remain challenges with balancing context-sensitivity and consistency: when applying ethics requirements during REC review; when handling ethics issues that only surface during the study; and when distributing the responsibility for these two tasks between researcher and REC. To support rigorous contextualization and responsibility allocation, we propose a relational research ethics framework, the \"ABCDE of deception.\" By modifying prevalent ethics requirements and proposing corresponding implementation strategies, grounded in a social model of the researcher-participant interaction, it aligns REC review at study level with ethical decision-making during researcher-participant interactions. Specifically, the ABCDE of deception covers five modified requirements and corresponding implementation strategies: Attune, a situated and interpersonal researcher-participant analogue of ethics deliberation; Be as truthful as possible, which integrates truthfulness and deception in light of informational and methodological needs; Cap harms and wrongs, to identify risks and allocate the responsibility for their handling; Diligent safeguarding, to tackle identified risks; and Ensure equality, a practicable approach to identify and address (potential) social inequalities in deceptive studies. With the ABCDE of deception, we propose a tool for RECs and researchers engaging with deceptive studies, along with several avenues for the framework's future elaboration.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857870","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

Response to 'Safeguards Are Not Suspicion: A Clinical Palliative Care Perspective on Autonomy in Medical Assistance in Dying'. 回应“保障不是怀疑：临床姑息治疗的角度对自主性的医疗援助在死亡”。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-08-27 DOI: 10.1111/bioe.70182

Janet Delgado, Iris Parra Jounou, Mar Vallès-Poch, Ramón Ortega-Lozano, María Victoria Martínez-López, Luis Espericueta, Maria Isabel Tamayo-Velázquez, David Rodríguez-Arias, Rosana Triviño-Caballer

引用次数: 0

Responding Ethically to Violence From Patients and Families in the Hospital Emergency Department: A Symbiotic Empirical Ethics Study. 医院急诊科对患者和家庭暴力的伦理反应：一项共生的实证伦理学研究。

IF 2.3 2区哲学

Bioethics Pub Date : 2026-08-21 DOI: 10.1111/bioe.70176

Rosalind McDougall, Meaghan Storey, Katheryn Hall, Sharon Feldman, Michael Geluk, Will Halpin, Jess Simionato, Jerry Luo, Danielle Ko

{"title":"Responding Ethically to Violence From Patients and Families in the Hospital Emergency Department: A Symbiotic Empirical Ethics Study.","authors":"Rosalind McDougall, Meaghan Storey, Katheryn Hall, Sharon Feldman, Michael Geluk, Will Halpin, Jess Simionato, Jerry Luo, Danielle Ko","doi":"10.1111/bioe.70176","DOIUrl":"https://doi.org/10.1111/bioe.70176","url":null,"abstract":"Violent behaviour by patients and families is a significant issue facing healthcare providers, with a particularly high prevalence in hospital emergency departments. Occupational violence and aggression (OVA) puts both staff and patients at risk of physical and psychological harm and can affect the delivery of timely patient care. To help address this issue, many healthcare settings have adopted zero-tolerance language in relation to OVA. Drawing on interviews with 25 emergency department staff in one Australian hospital, we argue that a more nuanced ethical approach is needed and develop a framework of values for responding ethically to OVA incidents in the emergency department. Staff are ethically and legally entitled to a safe working environment, and their safety should be protected. Yet some patients acting aggressively, including patients without capacity, need emergency medical or psychiatric healthcare and ways must be found to deliver such care. For some other patients and visitors however, removal from the hospital is ethically appropriate. The unique uncertainty and urgency of emergency department work means that six values are important in ethical responses to OVA: staff safety, the health needs of the patient acting aggressively, the patient's decision-making capacity, community safety, fair resource allocation, and compassion. We argue for an approach which prioritizes staff safety while also considering the other values, in order to generate nuanced ethical decisions which are sensitive to the range of OVA situations that arise in emergency departments.","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802152","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