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Theoretical medicine and bioethics最新文献

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Reaffirming the irrationality of human confidence that an ageless existence would be better: A reply to García-Barranquero and Llorca Albareda. 重申人类认为不老的存在会更好的非理性自信：答复加西亚-巴兰奎罗和洛尔卡-阿尔巴雷达。
Theoretical medicine and bioethics Pub Date : 2024-11-19 DOI: 10.1007/s11017-024-09688-w
Susan B Levin
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引用次数: 0
The ethical inadequacy of uninformed surrogate consent: advancing respect for persons in clinical research. 不知情代理同意的伦理缺陷：促进临床研究中对人的尊重。
Theoretical medicine and bioethics Pub Date : 2024-11-10 DOI: 10.1007/s11017-024-09693-z
Robert R Harrison
{"title":"The ethical inadequacy of uninformed surrogate consent: advancing respect for persons in clinical research.","authors":"Robert R Harrison","doi":"10.1007/s11017-024-09693-z","DOIUrl":"https://doi.org/10.1007/s11017-024-09693-z","url":null,"abstract":"<p><p>In clinical research, decision-making capacity is often equated with unspecified conceptions of autonomy, and autonomy is often equated with personhood. On this view, the loss of decision-making capacity is seen as a loss of autonomy, and the loss of autonomy subsumes a loss of personhood. An ethical concern arises at the intersection of those philosophical considerations with the legal considerations in informed consent. Because persons with inadequate decision-making capacity cannot provide legally effective consent, enrollment in research can occur only if a surrogate gives permission on the person's behalf. Federal regulations and resulting institutional policies allow permission from surrogates empowered under state law to consent to medical treatment procedures, typically in a hierarchy of legislatively prioritized relationships lacking regard for what the surrogate actually knows about the current research-related values and preferences of the potential subject. As a result, the research enterprise often countenances reliance on surrogates who have no relational or informational basis for an enrollment decision that aligns with the values and preferences of the subject. Arguing from the perspective that losing decision-making capacity does not alter the moral status of persons, and that respect for persons rather than respect for autonomy is the central ethical obligation, I assess the ethical implications of allowing persons with no knowledge of the values and preferences of the potential subject to make enrollment decisions, concluding that reliance on uninformed surrogates is not an ethically defensible approach to enrolling subjects in clinical research.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: On instrumentality and second-order effects: revisiting anti-natalism and animal farming. 更正：关于工具性和二阶效应：重新审视反出生论和动物养殖。
Theoretical medicine and bioethics Pub Date : 2024-11-09 DOI: 10.1007/s11017-024-09692-0
Niñoval F Pacaol, Kielle Vincent J Delima, Jhon Russel B Ventura, Julius Lawrence J Curbilla, Rohn Fredrick P Casas, Bernel G Moquia, Samantha Mae N Mendoza, Mark Francis E Habagat, Ai Mei Niña G Cabillan, Frenz Alrie P Terio
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引用次数: 0
Correction: Flourishing at the end of life. 更正：生命终结时的繁荣。
Theoretical medicine and bioethics Pub Date : 2024-10-19 DOI: 10.1007/s11017-024-09691-1
Xavier Symons, John Rhee, Anthony Tanous, Tracy Balboni, Tyler J VanderWeele
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引用次数: 0
On instrumentality and second-order effects: revisiting anti-natalism and animal farming. 论工具性和二阶效应：重新审视反出生论和动物养殖。
Theoretical medicine and bioethics Pub Date : 2024-10-10 DOI: 10.1007/s11017-024-09690-2
Niñoval F Pacaol, Kielle Vincent J Delima, Jhon Russel B Ventura, Julius Lawrence J Curbilla, Rohn Fredrick P Casas, Bernel G Moquia, Samantha Mae N Mendoza, Mark Francis E Habagat, Ai Mei Niña G Cabillan, Frenz Alrie P Terio
{"title":"On instrumentality and second-order effects: revisiting anti-natalism and animal farming.","authors":"Niñoval F Pacaol, Kielle Vincent J Delima, Jhon Russel B Ventura, Julius Lawrence J Curbilla, Rohn Fredrick P Casas, Bernel G Moquia, Samantha Mae N Mendoza, Mark Francis E Habagat, Ai Mei Niña G Cabillan, Frenz Alrie P Terio","doi":"10.1007/s11017-024-09690-2","DOIUrl":"10.1007/s11017-024-09690-2","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defending a choice-based system for the determination of death. 为基于选择的死亡判定系统辩护。
Theoretical medicine and bioethics Pub Date : 2024-10-07 DOI: 10.1007/s11017-024-09689-9
William Choi
{"title":"Defending a choice-based system for the determination of death.","authors":"William Choi","doi":"10.1007/s11017-024-09689-9","DOIUrl":"https://doi.org/10.1007/s11017-024-09689-9","url":null,"abstract":"","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Baruch Brody and the principle of justifiable homicide. 巴鲁克-布罗迪与正当杀人原则。
Theoretical medicine and bioethics Pub Date : 2024-10-01 Epub Date: 2024-08-17 DOI: 10.1007/s11017-024-09678-y
Timothy Furlan
{"title":"Baruch Brody and the principle of justifiable homicide.","authors":"Timothy Furlan","doi":"10.1007/s11017-024-09678-y","DOIUrl":"10.1007/s11017-024-09678-y","url":null,"abstract":"<p><p>In a series of papers in the early 1970s and in his important book Abortion and the Sanctity of Human Life (1975), Baruch Brody offered what remains to this day one of the most philosophically rigorous contributions to the debate concerning the morality of abortion and the ethics of homicide more generally. In this paper I would like to critically examine Brody's argument that abortion is sometimes justifiable in some cases even when (1) one cannot claim self-defense, or (2) diminished responsibility, and (3) the abortion is a 'killing' rather than a 'not saving.' This justification, I argue, is limited to certain cases in which the life of the mother is at stake. The cautious principle which he finally formulates merits serious attention and consideration. While I find a great deal of value in Brody's discussion, I will argue that there are several difficulties with the principle of justifiable homicide he constructs. Accordingly, I will further amend and supplement his final version by offering my own alternative principle.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"329-361"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The self-fulfilling prophecy in medicine. 医学中的自我实现预言。
Theoretical medicine and bioethics Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI: 10.1007/s11017-024-09677-z
Mayli Mertens
{"title":"The self-fulfilling prophecy in medicine.","authors":"Mayli Mertens","doi":"10.1007/s11017-024-09677-z","DOIUrl":"10.1007/s11017-024-09677-z","url":null,"abstract":"<p><p>This article first describes the mechanism of any self-fulfilling prophecy through discussion of its four conditions: credibility, employment, employment sensitivity, and realization. Each condition is illustrated with examples specific to the medical context. The descriptive account ends with the definition of self-fulfilling prophecy and an expansion on collective self-fulfilling prophecies. Second, the normative account then discusses the moral relevance of self-fulfilling prophecies in medicine. A self-fulfilling prophecy is typically considered problematic when the prediction itself changes the predicted outcome to match the prediction (transformative self-fulfillment). I argue that also self-fulfilling prophecies that do not change the outcome but change the ways in which the outcome was realized (operative self-fulfillment), have significant ethical and epistemic ramifications. Because it is difficult to distinguish, retrospectively, between a transformative and an operative self-fulfilling prophecy, and thus between a false or true positive, it becomes equally difficult to catch mistakes. Moreover, since the prediction necessarily turns out true, there is never an error signal warning that a mistake might have been made. On the contrary, accuracy is seen as the standard for quality assurance. As such, self-fulfilling prophecies inhibit our ability to learn, inviting repetition and exacerbation of mistakes. With the rise of automated diagnostic and prognostic procedures and the increased use of machine learning and artificial intelligence for the development of predictive algorithms, attention to self-fulfilling feedback loops is especially warranted. This account of self-fulfilling prophecies is practically relevant for medical research and clinical practice. With it, researchers and practitioners can detect and analyze potential self-fulfilling mechanisms in any medical case and take responsibility for their ethical and epistemic implications.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"363-385"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Take five? A coherentist argument why medical AI does not require a new ethical principle. 五选一？连贯主义论证为什么医学人工智能不需要新的伦理原则。
Theoretical medicine and bioethics Pub Date : 2024-10-01 Epub Date: 2024-06-08 DOI: 10.1007/s11017-024-09676-0
Seppe Segers, Michiel De Proost
{"title":"Take five? A coherentist argument why medical AI does not require a new ethical principle.","authors":"Seppe Segers, Michiel De Proost","doi":"10.1007/s11017-024-09676-0","DOIUrl":"10.1007/s11017-024-09676-0","url":null,"abstract":"<p><p>With the growing application of machine learning models in medicine, principlist bioethics has been put forward as needing revision. This paper reflects on the dominant trope in AI ethics to include a new 'principle of explicability' alongside the traditional four principles of bioethics that make up the theory of principlism. It specifically suggests that these four principles are sufficient and challenges the relevance of explicability as a separate ethical principle by emphasizing the coherentist affinity of principlism. We argue that, through specification, the properties of explicability are already covered by the four bioethical principles. The paper finishes by anticipating an objection that coherent principles could not facilitate technology induced change and are not well-suited to tackle moral differences.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"387-400"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Flourishing at the end of life. 在生命的尽头绽放光彩
Theoretical medicine and bioethics Pub Date : 2024-10-01 Epub Date: 2024-08-20 DOI: 10.1007/s11017-024-09679-x
Xavier Symons, John Rhee, Anthony Tanous, Tracy Balboni, Tyler J VanderWeele
{"title":"Flourishing at the end of life.","authors":"Xavier Symons, John Rhee, Anthony Tanous, Tracy Balboni, Tyler J VanderWeele","doi":"10.1007/s11017-024-09679-x","DOIUrl":"10.1007/s11017-024-09679-x","url":null,"abstract":"<p><p>Flourishing is an increasingly common construct employed in the study of human wellbeing. But its appropriateness as a framework of wellbeing at certain stages of life is contested. In this paper, we consider to what extent it is possible for someone to flourish at the end of life. People with terminal illness often experience significant and protracted pain and suffering especially when they opt for treatments that prolong life. Certain aspects of human goods, however, that are plausibly constitutive of flourishing-such as meaning and purpose, deep personal relationships, and character and virtue-can be uniquely realised when life is ending. We argue that there is a qualified sense in which one can flourish at the end of life but that one must make important modifications to the criteria implicit in conventional conceptions of flourishing. We close with a discussion of the empirical assessment of wellbeing at the end of life and explore the possibility of introducing a flourishing measure in palliative care practice.</p>","PeriodicalId":94251,"journal":{"name":"Theoretical medicine and bioethics","volume":" ","pages":"401-425"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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