Bioethics最新文献

{"title":"Another “turn” in bioethics? A plea for methodological continuity","authors":"Michiel De Proost,&nbsp;Veerle Provoost","doi":"10.1111/bioe.13324","DOIUrl":"10.1111/bioe.13324","url":null,"abstract":"<p>A growing trend in bioethics highlights the importance of using big data science methods to advance normative insight. This has been called the “digital turn” in bioethics by Salloch and Ursin. Automated data processing can, for example, detect significant patterns of correlation that have escaped the attention of human scholars. Although we agree that such technological innovations could bolster existing methods in empirical bioethics (EB), we argue that it should not be conceptualized as a new turn but rather as a revivification, and possibly an amplification of entrenched debates in EB. We begin by highlighting some convergences between EB and digital bioethics that Salloch and Ursin seem to categorize as fundamental differences and end up with elaborating on some risks related to the integration of empirical findings with normative (philosophical) analysis in the digitalization trend.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 8","pages":"728-732"},"PeriodicalIF":1.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321969","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":"Euthanasia in detention and the ethics of caring solidarity: A case study of the ‘Tarragona Gunman’","authors":"Luis Espericueta","doi":"10.1111/bioe.13325","DOIUrl":"10.1111/bioe.13325","url":null,"abstract":"<p>Almost a year after the enactment of the law regulating euthanasia in Spain, public opinion was shocked to learn that a defendant in criminal proceedings obtained medical assistance in dying following injuries sustained in an exchange of gunfire with the police after having committed a series of severe crimes. Although there are very few cases in the world where prisoners have received euthanasia, the one we will discuss in this article is the only known case where both the public prosecutor's office and the private prosecutors judicially opposed the defendant's euthanasia. This article aims to offer a new perspective on the ethical legitimacy of detainees' access to euthanasia: the ethics of caring solidarity. To do this, we will first place the case in its legal context. Subsequently, we will address the two main arguments proposed in the literature to justify euthanasia in detention: respect for the autonomy of the detainee and the principle of equivalence of care. Finally, after having identified serious shortcomings in both arguments, we will argue that the perspective of caring solidarity offers a better ethical basis for people in detention's access to euthanasia.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 8","pages":"713-721"},"PeriodicalIF":1.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321970","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":"Age-related hearing loss and “hearables”: An agenda for moral considerations","authors":"Michiel De Proost,&nbsp;Seppe Segers,&nbsp;Heidi Mertes","doi":"10.1111/bioe.13327","DOIUrl":"10.1111/bioe.13327","url":null,"abstract":"<p>Rapid advances in digital hearing technologies, also known as hearables, are expected to disrupt the direct-to-consumer health market. For older adults with higher incidence of hearing loss, such disruption could reduce hearing problems, increase accessibility to hearing aids, and mitigate related stigmas. This paper delves into the intersection of disruptive innovation and hearables within the realm of biomedical ethics. Through a comprehensive exploration, we shed light on the ethical implications surrounding hearables. By critically evaluating the key ethical advantages and drawbacks, we find that no single concern presents an insurmountable a priori objection to hearables. We conclude with some ideas to maximize the benefits of hearables and further promote opportunities for equitable hearing health.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 9","pages":"778-786"},"PeriodicalIF":1.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321968","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":"Christian anthropology-based contributions to the ethics of socially assistive robots in care for older adults","authors":"Chris Gastmans,&nbsp;Edoardo Sinibaldi,&nbsp;Richard Lerner,&nbsp;Miguel Yáñez,&nbsp;László Kovács,&nbsp;Laura Palazzani,&nbsp;Renzo Pegoraro,&nbsp;Tijs Vandemeulebroucke","doi":"10.1111/bioe.13322","DOIUrl":"10.1111/bioe.13322","url":null,"abstract":"<p>Our society, in general, and health care, in particular, faces notable challenges due to the emergence of innovative digital technologies. The use of socially assistive robots in aged care is a particular digital application that provokes ethical reflection. The answers we give to the ethical questions associated with socially assistive robots are framed by ontological and anthropological considerations of what constitutes human beings and how the meaning of being human relates to how these robots are conceived. Religious beliefs and secular worldviews, each of which may participate fully in pluralist societies, have an important responsibility in this foundational debate, as anthropological theories can be inspired by religious and secular viewpoints. This article identifies seven anthropological considerations grounded in the synthesis of biblical scriptures, Roman Catholic documents, and recent research literature. We highlight the inspirational quality of these anthropological considerations when dealing with ethical issues regarding the development and use of socially assistive robots in aged care. With this contribution, we aim to foster a global and inclusive dialogue on digitalization in aged care that deeply challenges our basic understanding of what constitutes a human being and how this notion relates to machine artefacts.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 9","pages":"787-795"},"PeriodicalIF":1.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302144","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":"Good principles, badly applied: Logical and ethical inconsistencies in selecting Qatar as a venue for the WCB","authors":"David Shaw,&nbsp;Gabriela Arguedas-Ramírez","doi":"10.1111/bioe.13321","DOIUrl":"10.1111/bioe.13321","url":null,"abstract":"","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 7","pages":"659-661"},"PeriodicalIF":1.7,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263585","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":"The ethics of mHealth as a global phenomenon","authors":"Verina Wild,&nbsp;Tereza Hendl,&nbsp;Bianca Jansky","doi":"10.1111/bioe.13311","DOIUrl":"10.1111/bioe.13311","url":null,"abstract":"&lt;p&gt;Over the last years, mHealth technologies in combination with internet-driven data exchange are being widely implemented in many countries.1 These involve a diverse range of apps, wearables, implants and other digital devices that purport to improve health. With the increasing use of smartphones worldwide, a growing percentage of the global population has access to powerful handheld tools that are in almost continuous use and interaction with other devices and users, enabling, among other things, the real time sharing of health data and resulting in a near ubiquitous network of health data technologies. mHealth thus has the potential to widely impact on individual health, on health care provision, health care systems and public health throughout the world, and independently from the physical territory where the user is placed.&lt;/p&gt;&lt;p&gt;This development is endorsed by political and industrial stakeholders, also on a global scale. The World Health Organization (WHO), for example, published a report in 2018 on mHealth claiming that “The spread of digital technologies and global interconnectedness has a significant potential to accelerate Member States' progress towards achieving universal health coverage, including ensuring access to quality health services.”2&lt;/p&gt;&lt;p&gt;This special issue is part of our broader research within the project “META - mHealth: Ethical, Legal, Social aspects in the technological age3”. In this editorial we want to emphasize that the global and globalized scope of mHealth is essential to this technology, but is too often neglected in the ethical and social discussions. Increasingly, providers, developers and marketing companies are organized as international companies, with some of them carrying massive market interest and power, and apps can be downloaded across the globe. The generated data are globally collected and processed. Users are connected via global digital networks too. mHealth also facilitates new forms of patient activism, dissolving geographical boundaries through their global connectivity, but potentially creating new barriers and inequalities.4 Various mHealth technologies are utilized to tackle urgent issues in global health,5 while the mass generation of (health) data as a global phenomenon and the many related opportunities and challenges are debated among scholars and policy makers.6&lt;/p&gt;&lt;p&gt;The rapid developments in the mHealth field are particularly significant for influencing user self-diagnosis, self-monitoring, health prevention, and remote management of chronic and acute conditions. Such far-reaching developments that impact health in all its bio-psycho-social dimensions have ethical implications on an individual, societal and global scale. However, most ethical discussions are Western-centric, despite the significance of the ethical implications that arise from a global, globalized and international perspective,7 for example: Whose understanding of health and particular cultural norms does mHealth tec","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 6","pages":"479-480"},"PeriodicalIF":2.2,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263586","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":"Surrogacy and the significance of gestation: Implications for law and policy","authors":"Andrea Mulligan","doi":"10.1111/bioe.13302","DOIUrl":"10.1111/bioe.13302","url":null,"abstract":"<p>Gestational surrogacy is ethically complex, generating very different responses in law and policy worldwide. This paper argues that contemporary surrogacy law and policy, across many jurisdictions, fail to give sufficient attention to the significance of the relationship between the child and the gestational surrogate. This failure risks repeating the mistakes of historical, discredited approaches to adoption and donor-assisted conception. This paper argues that proper recognition of the significance of gestation must be an organising principle in surrogacy law and policy. The paper begins by pointing to examples of surrogacy law and practice where the role of the gestator is unacceptably minimised, most notably the framing of the surrogate as a mere ‘carrier’. It goes on to examine the nature of gestation, including consideration of contemporary scholarship on the metaphysics of pregnancy and emerging work in epigenetics, and argues that current evidence supports the view that the gestational relationship must be taken more seriously than it currently is. The paper then draws analogies with parenthood in donor-assisted conception and adoption to argue that approaches to parental status in novel family formations that fail to promote transparency and seek to deny the truth of familial relationships are doomed to fail. The paper concludes by suggesting some implications for law and policy that flow from placing sufficient emphasis on the gestational role. The overarching thesis of this paper is that gestational surrogacy is ethically permissible when these fundamental requirements are adhered to, and that surrogacy law should proceed on this basis.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 8","pages":"674-683"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185574","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":"NIPT for adult-onset conditions: Australian NIPT users' views","authors":"India R. Marks,&nbsp;Katrien Devolder,&nbsp;Hilary Bowman-Smart,&nbsp;Molly Johnston,&nbsp;Catherine Mills","doi":"10.1111/bioe.13310","DOIUrl":"10.1111/bioe.13310","url":null,"abstract":"<p>Noninvasive prenatal testing (NIPT) has become widely available in recent years. While initially used to screen for trisomies 21, 18, and 13, the test has expanded to include a range of other conditions and will likely expand further. This paper addresses the ethical issues that arise from one particularly controversial potential use of NIPT: screening for adult-onset conditions (AOCs). We report data from our quantitative survey of Australian NIPT users' views on the ethical issues raised by NIPT for AOCs. The survey ascertained support for NIPT for several traits and conditions including AOCs. Participants were then asked about their level of concern around implications of screening for AOCs for the future child and parent(s). Descriptive and comparative data analyses were conducted. In total, 109 respondents were included in data analysis. The majority of respondents expressed support for NIPT screening for preventable (70.9%) and nonpreventable AOCs (80.8%). Most respondents indicated concern around potential harmful impacts associated with NIPT for AOCs, including the psychological impact on the future child and on the parent(s). Despite this, the majority of participants thought that continuation of a pregnancy known to be predisposed to an AOC is ethically acceptable. The implications of these data are critically discussed and used to inform the normative claim that prospective parents should be given access to NIPT for AOCs. The study contributes to a body of research debating the ethical acceptability and regulation of various applications of NIPT as screening panels expand.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 6","pages":"566-575"},"PeriodicalIF":2.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086068","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":"Four shades of paternalism in doctor–patient communication and their ethical implications","authors":"Anniken Fleisje","doi":"10.1111/bioe.13307","DOIUrl":"10.1111/bioe.13307","url":null,"abstract":"<p>The present study aims to explore the forms paternalistic communication can take in doctor–patient interactions and how they should be considered from a normative perspective. In contemporary philosophical debate, the problem with paternalism is often perceived as either undermining autonomy (the autonomy problem) or the paternalist viewing their judgment as superior (the superiority problem). In either case, paternalism is problematized mainly in a general, theoretical sense. In contrast, this paper investigates specific doctor–patient encounters, revealing distinct types of paternalistic communication. For this study, I reviewed videorecorded encounters from a Norwegian hospital to detect paternalism—specifically, doctors overriding patients' expressed preferences, presumably to benefit or protect the patients. I identified variations in paternalistic communication styles—termed <i>paternalist modes</i>—which I categorized into four types: <i>the fighter, the advocate, the sympathizer</i>, and <i>the fisher</i>. Drawing on these findings, I aim to nuance the debate on paternalism. Specifically, I argue that each paternalist mode carries its own normative implications and that the autonomy and the superiority problems manifest differently across the modes. Furthermore, by illustrating paternalism in communication through real-life cases, I aim to reach a more comprehensive understanding of what we mean by <i>paternalistic doctors</i>.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"38 6","pages":"539-548"},"PeriodicalIF":2.2,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bioe.13307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077113","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":"‘Displaced in the name of Religion’: Girl child abuse and community healthcare workers' response to women crying for help in IDP camps in North Central, Nigeria","authors":"Favour Chukwuemeka Uroko,&nbsp;Mary Jerome Obiorah","doi":"10.1111/bioe.13305","DOIUrl":"10.1111/bioe.13305","url":null,"abstract":"<p>This study examines girl child abuse in an internally displaced people's camp in north-central Nigeria and the response of community health workers. The conflict in Benue State is caused by religious differences between the natives (Tiv people) and the invading Fulani herdsmen. During these conflicts, women and girls were displaced, and they were kept in internally displaced persons (IDPs) located in different parts of the state. Literature has been extensively written on internal displacement in Nigeria, but none has been able to elucidate the health needs of girls and the various abuses girls and women are suffering in IDP camps. In this study, literature was extended (1) to explore the environment of the girl child in IDP camps, (2) to identify reasons for the abuse of the girl child in IDP camps, (3) to investigate the impacts of the abuse on the girl child in IDP camps and (4) to investigate how healthcare workers could be used to alleviate the plight of girl children in IDP camps. This is a qualitative case study, with data obtained from relevant academic literature and personal observation. The data were analysed using content analysis. Findings reveal that the girl child is suffering from psychological, economic and health challenges due to the various forms of abuse they are going through. Following the devastation in Benue State, healthcare workers from the community relocated to neighbouring states. There is a need to recall those healthcare workers and provide them with the necessary materials to assist girls in IDP camps. Recommendations are discussed.</p>","PeriodicalId":55379,"journal":{"name":"Bioethics","volume":"39 1","pages":"41-48"},"PeriodicalIF":1.7,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077112","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}