1,703 results match your criteria Bioethics[Journal]


The health sphere beyond borders: Coverage portability and justice in a global space.

Authors:
Adam K Webb

Bioethics 2020 Jul 11. Epub 2020 Jul 11.

Johns Hopkins University School of Advanced International Studies - Hopkins-Nanjing Centre, Nanjing, Jiangsu, China.

Medical coverage often stops at borders, for both travellers and long-term migrants. Such patchiness imposes a de facto limit on free movement. This article considers this phenomenon not as a mere policy choice or technical matter, but as a form of territorial discrimination that is incoherent and even unjust. Read More

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http://dx.doi.org/10.1111/bioe.12775DOI Listing

Deliberately infecting healthy volunteers with malaria parasites: Perceptions and experiences of participants and other stakeholders in a Kenyan-based malaria infection study.

Bioethics 2020 Jul 9. Epub 2020 Jul 9.

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Controlled human malaria infection (CHMI) studies involve the deliberate infection of healthy volunteers with malaria parasites under controlled conditions to study immune responses and/or test drug or vaccine efficacy. An empirical ethics study was embedded in a CHMI study at a Kenyan research programme to explore stakeholders' perceptions and experiences of deliberate infection and moral implications of these. Data for this qualitative study were collected through focus group discussions, in-depth interviews and non-participant observation. Read More

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http://dx.doi.org/10.1111/bioe.12781DOI Listing

What really is the nature of suffering? Three problems with Eric Cassell's concept of distress.

Authors:
Charlotte Duffee

Bioethics 2020 Jul 6. Epub 2020 Jul 6.

Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, Ontario, Canada.

Eric Cassell famously defined suffering as a person's severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell's theory turns on distress but does not define it, which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell's account does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that, in medical contexts, 'distress' just means 'suffering' or some cognate concept not yet distinguished from it, rendering Cassell's theory circular. Read More

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http://dx.doi.org/10.1111/bioe.12748DOI Listing

Rethinking counselling in prenatal screening: An ethical analysis of informed consent in the context of non-invasive prenatal testing (NIPT).

Bioethics 2020 Jul 4. Epub 2020 Jul 4.

Department of Medical Ethics and Philosophy of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease-it only requires a blood draw and reaches high levels of reliability-might hinder women's understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to informed choice, and for a focus on value-consistent choices and personalized informational preferences. Read More

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http://dx.doi.org/10.1111/bioe.12760DOI Listing

Compensation and reparations for victims and bystanders of the U.S. Public Health Service research studies in Tuskegee and Guatemala: Who do we owe what?

Authors:
Susan M Reverby

Bioethics 2020 Jun 30. Epub 2020 Jun 30.

Women's and Gender Studies Department, Wellesley College, Wellesley, Massachusetts.

Using the infamous research studies in Tuskegee and Guatemala, the article examines the difference between victims and bystanders. The victims can include families, sexual partners, and children not just the participants. There are also the bystanders in the populations who are affected, even vaguely, decades after the initial studies took place. Read More

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http://dx.doi.org/10.1111/bioe.12784DOI Listing

Responsibility amid the social determinants of health.

Authors:
Ben Schwan

Bioethics 2020 Jun 25. Epub 2020 Jun 25.

It is natural to think that there is a tight connection between whether someone is responsible for some outcome and whether it is appropriate to hold her accountable for that outcome. And this natural thought naturally extends to health: if someone is responsible for her health, then, all else being equal, she is accountable for it. Given this, some have thought that responsibility for health has an important role to play in distributing the benefits and burdens of healthcare. Read More

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http://dx.doi.org/10.1111/bioe.12782DOI Listing

Decision analysis approach to risk/benefit evaluation in the ethical review of controlled human infection studies.

Bioethics 2020 Jun 26. Epub 2020 Jun 26.

Biomedical Ethics Unit/Social Studies of Medicine, McGill University, Montreal, Canada.

Risks and benefit evaluation for controlled human infection studies, where healthy volunteers are deliberately exposed to infectious agents to evaluate vaccine efficacy, should be explicit, systematic, thorough, and non-arbitrary. Decision analysis promotes these qualities using four steps: (1) determining explicit criteria and measures for evaluation, (2) identifying alternatives to the study, (3) defining the models used to estimate the measures for each alternative, and (4) running the models to produce the estimates and compare the alternatives. In this paper, we describe how decision analysis might be applied by funders and regulators, as well as by others contemplating the use of novel controlled human infection studies for vaccine development and evaluation. Read More

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http://dx.doi.org/10.1111/bioe.12773DOI Listing

The differentiation argument: If newborns outrank animals, so do fetuses.

Authors:
Kyle Blanchette

Bioethics 2020 Jun 24. Epub 2020 Jun 24.

The Department of Social Science, Alabama A&M University, Huntsville, Alabama.

Common-sense morality seems to dictate that newborn babies strictly outrank non-human animals on an ordered list of subjects of moral consideration. This is best described as the view that newborn babies have a higher moral status than any non-human animal. In this article, I will argue that this common-sense claim about the special moral status of newborn babies makes it hard to avoid the conclusion that fetuses, including pre-conscious fetuses, also have a higher moral status than any non-human animal-indeed, as high as newborn babies. Read More

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http://dx.doi.org/10.1111/bioe.12776DOI Listing

Who's afraid of perfectionist moral enhancement? A reply to Sparrow.

Authors:
Pei-Hua Huang

Bioethics 2020 Jun 22. Epub 2020 Jun 22.

Department of Philosophy, Monash University, Clayton, Victoria, Australia.

Robert Sparrow recently argued that state-driven moral bioenhancement is morally problematic because it inevitably invites moral perfectionism. While sharing Sparrow's worry about state-driven moral bioenhancement, I argue that his anti-perfectionism argument is too strong to offer useful normative guidance. That is, if we reject state-driven moral bioenhancement because it cannot remain neutral between different conceptions of the good, we might have to conclude that all forms of moral enhancement programs ought not be made compulsory, including the least controversial and most popular state-driven program: compulsory (moral) education. Read More

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http://dx.doi.org/10.1111/bioe.12751DOI Listing

Conceptions of dignity in the Charlie Gard, Alfie Evans and Isaiah Haastrup cases.

Bioethics 2020 Jun 19. Epub 2020 Jun 19.

Victorian Pediatric Palliative Care Programme, Melbourne, Australia.

In 2017 and 2018, the English courts were asked to decide whether continued life-sustaining treatment was in the best interests of three infants: Charlie Gard, Alfie Evans and Isaiah Haastrup. Each infant had sustained catastrophic, irrecoverable brain damage. Dignity played an important role in the best interests assessments reached by the Family division of the High Court in each case. Read More

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http://dx.doi.org/10.1111/bioe.12749DOI Listing

Critical analysis of communication strategies in public health promotion: An empirical-ethical study on organ donation in Germany.

Bioethics 2020 Jun 18. Epub 2020 Jun 18.

Department of Medical Ethics and the History of Medicine, University Medical Centre, Göttingen, Germany.

Given the need for organs, public organizations use social marketing strategies to increase the number of donors. Their campaigns employ a variety of moral appeals. However, their effects on audiences are unclear. Read More

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http://dx.doi.org/10.1111/bioe.12774DOI Listing

Does the heterogeneity of autism undermine the neurodiversity paradigm?

Bioethics 2020 Jun 15. Epub 2020 Jun 15.

School of Law, Keele University, Keele, Staffordshire, United Kingdom of Great Britain and Northern Ireland.

The neurodiversity paradigm is presented by its proponents as providing a philosophical foundation for the activism of the neurodiversity movement. Its central claims are that autism and other neurodivergent conditions are not disorders because they are not intrinsically harmful, and that they are valuable, natural and/or normal parts of human neurocognitive variation. This paper: (a) identifies the non-disorder claim as the most central of these, based on its prominence in the literature and connections with the practical policy claims that the paradigm is supposed to support; (b) describes the heterogeneity of autism at the behavioural and causal levels, and argues that at the behavioural level this encompasses ways of being autistic that are harmful in ways that cannot be not wholly attributed to discrimination or unjust social arrangements, challenging the claim that autism is not a disorder; (c) considers and rejects responses to this challenge based on separation of high- and low-functioning autism, separation of autism from co-occurring conditions, and viewing autism as part of an individual's identity. Read More

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http://dx.doi.org/10.1111/bioe.12780DOI Listing

Selecting participants fairly for controlled human infection studies.

Bioethics 2020 Jun 15. Epub 2020 Jun 15.

University of North Carolina, Dept. of Public Policy, Chapel Hill, North Carolina, USA.

Controlled human infection (CHI) studies involve the deliberate exposure of healthy research participants to infectious agents to study early disease processes and evaluate interventions under controlled conditions with high efficiency. Although CHI studies expose participants to the risk of infection, they are designed to offer investigators unique advantages for studying the pathogenesis of infectious diseases and testing potential vaccines or treatments in humans. One of the central challenges facing investigators involves the fair selection of research subjects to participate in CHI studies. Read More

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http://dx.doi.org/10.1111/bioe.12778DOI Listing

Special Issue: IAB 14th World Congress.

Bioethics 2020 Jul;34(6):560-561

George Mason University, Fairfax, Virginia, USA.

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http://dx.doi.org/10.1111/bioe.12761DOI Listing

Rethinking parenthood within assisted reproductive technology: The need for regulation in Nigeria.

Bioethics 2020 Jul;34(6):578-584

University of Ibadan, Ibadan, Nigeria.

In Nigeria, reproduction is highly valued, with many people desiring to produce a child 'in their own image and likeness'. Previously, aspiring parents often resorted to adoption. Today, the availability of assisted reproductive technologies (ARTs) has provided options other than adoption for those desiring to procreate. Read More

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http://dx.doi.org/10.1111/bioe.12759DOI Listing

'Aching to be a boy': A preliminary analysis of gender assignment of intersex persons in India in a culture of son preference.

Authors:
Arpita Das

Bioethics 2020 Jul 3;34(6):585-592. Epub 2020 Jun 3.

Department of Gender and Cultural Studies, University of Sydney.

Intersexuality, particularly in the global South, remains an under-researched field of study. In my in-progress doctoral research project, I explore the cultural, social, and medical discourses that influence how key stakeholders such as healthcare providers make decisions about the sex and gender assignment of the intersex child in India. In this paper I interrogate some of these ideas around gender assignment of intersex people in India, paying particular attention to the context of son preference. Read More

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http://dx.doi.org/10.1111/bioe.12750DOI Listing

Reconstructing feminist perspectives of women's bodies using a globalized view: The changing surrogacy market in Japan.

Bioethics 2020 Jul 3;34(6):570-577. Epub 2020 Jun 3.

School of Science and Engineering, Tokyo Denki University - Hatoyama Campus, Hiki-gun, Saitama-ken, Japan.

This paper aims to evoke an alternative viewpoint on surrogacy, moving beyond popular Western feminist beliefs on the practice, by introducing the history and current context of East Asian surrogacy. To elaborate a different cultural perspective on surrogacy, this paper first introduces the East Asian history of contract pregnancy systems, prior to the emergence of the American invention of 'modern' surrogacy practice. Then, it examines Japanese mass media portrayals of cross-border surrogacy in which white women have become 'convenient' entities. Read More

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http://dx.doi.org/10.1111/bioe.12758DOI Listing

The death of dignity is greatly exaggerated: Reflections 15 years after the declaration of dignity as a useless concept.

Authors:
Bjørn Hofmann

Bioethics 2020 Jul 1;34(6):602-611. Epub 2020 Jun 1.

Department of Health Sciences, the Norwegian University for Science and Technology, Gjøvik, Norway.

Fifteen years ago, Ruth Macklin shook the medical community with her claim in the BMJ that dignity is a useless concept. Her essay provoked a storm of reactions. What have we learned from the debate? In this article I analyse the responses to her essay and the following debate to investigate whether she was right that "[d]ignity is a useless concept in medical ethics and can be eliminated without any loss of content. Read More

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http://dx.doi.org/10.1111/bioe.12752DOI Listing

Weiqu, structural injustice and caring for sick older people in rural Chinese families: An empirical ethical study.

Bioethics 2020 Jul 29;34(6):593-601. Epub 2020 May 29.

School of Social Sciences, University of Otago, Dunedin, New Zealand.

This paper examines caregiving for sick older family members in the context of socio-economic transformations in rural China, combining empirical investigation with normative inquiry. The empirical part of this paper is based on a case study, taken from fieldwork in a rural Chinese hospital, of a son who took care of his hospitalized mother. This empirical study highlighted family members' weiqu (sense of unfairness)-a mental status from experiencing mistreatment and oppression in family care, yet with constrained power to explicitly protest or make care-related choices. Read More

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http://dx.doi.org/10.1111/bioe.12753DOI Listing

Rethinking race in medical decision making.

Bioethics 2020 Jun;34(5):447-449

Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts.

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http://dx.doi.org/10.1111/bioe.12755DOI Listing

Utilitarianism and the pandemic.

Bioethics 2020 07;34(6):620-632

Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland.

There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. Read More

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http://dx.doi.org/10.1111/bioe.12771DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276855PMC

Queries on the COVID-19 quick publishing ethics.

Bioethics 2020 07 1;34(6):633-634. Epub 2020 Jun 1.

College of Pharmacy and Health Care, Tajen University, Yanpu, Pingtung, 907, Taiwan.

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http://dx.doi.org/10.1111/bioe.12772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276831PMC

Navigating conflicts of justice in the use of race and ethnicity in precision medicine.

Bioethics 2020 May 19. Epub 2020 May 19.

Nanyang Technological University, School of Social Sciences, Lee Kong Chian School of Medicine and School of Biological Sciences, Singapore.

Given the sordid history of injustices linking genetics to race and ethnicity, considerations of justice are central to ensuring the responsible development of precision medicine programmes around the world. While considerations of justice may be in tension with other areas of concern, such as scientific value or privacy, there are also tensions between different aspects of justice. This paper focuses on three particular aspects of justice relevant to this precision medicine: social justice, distributive justice and human rights. Read More

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http://dx.doi.org/10.1111/bioe.12757DOI Listing

The ethics of ectogenesis.

Bioethics 2020 May;34(4):328-330

Department of Philosophy, Classics, History of Art and Ideas, University of Oslo, Oslo, Norway.

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http://dx.doi.org/10.1111/bioe.12745DOI Listing

Rethinking patient involvement in healthcare priority setting.

Bioethics 2020 May;34(4):403-411

Department of Philosophy, Stockholm University, Sweden.

With healthcare systems under pressure from scarcity of resources and ever-increasing demand for services, difficult priority setting choices need to be made. At the same time, increased attention to patient involvement in a wide range of settings has given rise to the idea that those who are eventually affected by priority setting decisions should have a say in those decisions. In this paper, we investigate arguments for the inclusion of patient representatives in priority setting bodies at the policy level. Read More

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http://dx.doi.org/10.1111/bioe.12730DOI Listing

Corrigendum.

Authors:

Bioethics 2020 May;34(4):444

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http://dx.doi.org/10.1111/bioe.12735DOI Listing

Using, risking, and consent: Why risking harm to bystanders is morally different from risking harm to research subjects.

Authors:
Alec Walen

Bioethics 2020 Apr 7. Epub 2020 Apr 7.

Rutgers University School of Law, Camden, NJ, 08102-1519, USA.

Subjects in studies on humans are used as a means of conducting the research and achieving whatever good would justify putting them at risk. Accordingly, consent must normally be obtained before subjects are exposed to any substantial risks to their welfare. Bystanders are also often put at risk, but they are not used as a means. Read More

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http://dx.doi.org/10.1111/bioe.12743DOI Listing

Neonatal incubator or artificial womb? Distinguishing ectogestation and ectogenesis using the metaphysics of pregnancy.

Bioethics 2020 May 5;34(4):354-363. Epub 2020 Apr 5.

Faculty of Humanities, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland.

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation-or metaphysics of pregnancy-(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth as a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. Read More

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http://dx.doi.org/10.1111/bioe.12717DOI Listing

Environmental migrants, structural injustice, and moral responsibility.

Authors:
James Dwyer

Bioethics 2020 Jul 5;34(6):562-569. Epub 2020 Mar 5.

Center for Bioethics and Humanities, Upstate Medical University, Syracuse, United States.

Climate change and environmental problems will force or induce millions of people to migrate. In this article, I describe environmental migration and articulate some of the ethical issues. To begin, I give an account of these migrants that overcomes misleading dichotomies. Read More

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http://dx.doi.org/10.1111/bioe.12738DOI Listing

Medicine's collision with false hope: The False Hope Harms (FHH) argument.

Authors:
Marleen Eijkholt

Bioethics 2020 Mar 5. Epub 2020 Mar 5.

Leiden University Medical Center - Medical Ethics and Health Law, University of Leiden, Netherlands.

The goal of this paper is to introduce the false hope harms (FHH) argument, as a new concept in healthcare. The FHH argument embodies a conglomerate of specific harms that have not convinced providers to stop endorsing false hope. In this paper, it is submitted that the healthcare profession has an obligation to avoid collaborating or participating in, propagating or augmenting false hope in medicine. Read More

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http://dx.doi.org/10.1111/bioe.12731DOI Listing

Empirical research in clinical ethics: The 'committed researcher' approach.

Bioethics 2020 Mar 3. Epub 2020 Mar 3.

Clinical Ethics Centre, (AP-HP), Paris, France.

After the 'empirical turn' in bioethics, few specific approaches have been developed for doing clinical ethics research in close connection with clinical decision-making on a daily basis. In this paper we describe the 'committed researcher' approach to research in clinical ethics that we have developed over the years. After comparing it to two similar research methodological approaches, the 'embedded researcher' and 'deliberative engagement', we highlight its main features: it is patient-oriented, it is implemented by collegial and multidisciplinary teams, it uses an ethical grid to build the interview guide, and it is geared towards bringing the results to bear on the public debate surrounding the issue at stake. Read More

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http://dx.doi.org/10.1111/bioe.12742DOI Listing

Frozen embryos and the obligation to adopt.

Bioethics 2020 Mar 3. Epub 2020 Mar 3.

Department of Philosophy, Baylor University, USA.

Rob Lovering has developed an interesting new critique of views that regard embryos as equally valuable as other human beings: the moral argument for frozen human embryo adoption. The argument is aimed at those who believe that the death of a frozen embryo is a very bad thing, and Lovering concludes that some who hold this view ought to prevent one of these deaths by adopting and gestating a frozen embryo. Contra Lovering, we show that there are far more effective strategies for preserving the lives of frozen embryos than adoption. Read More

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http://dx.doi.org/10.1111/bioe.12733DOI Listing

Burying our mistakes: Dealing with prognostic uncertainty after severe brain injury.

Authors:
Mackenzie Graham

Bioethics 2020 Jul 2;34(6):612-619. Epub 2020 Mar 2.

Uehiro Centre for Practical Ethics, Oxford University, UK and Wellcome Centre for Ethics and Humanities, Oxford University, UK.

Prognosis after severe brain injury is highly uncertain, and decisions to withhold or withdraw life-sustaining treatment are often made prematurely. These decisions are often driven by a desire to avoid a situation where the patient becomes 'trapped' in a condition they would find unacceptable. However, this means that a proportion of patients who would have gone on to make a good recovery, are allowed to die. Read More

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http://dx.doi.org/10.1111/bioe.12737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318633PMC

Slipping on slippery slope arguments.

Bioethics 2020 May 2;34(4):412-419. Epub 2020 Mar 2.

Department of Political Economy, King's College London, London, UK.

Slippery slope arguments (SSAs) are used in a wide range of philosophical debates, but are often dismissed as empirically ill-founded and logically fallacious. In particular, leading authors put forward a meta-SSA which points to instances of empirically ill-founded and logically fallacious SSAs and to the alleged existence of a slippery slope leading to such SSAs to demonstrate that people should avoid using SSAs altogether. In this paper, I examine these prominent calls against using SSAs and argue that such calls do not withstand scrutiny. Read More

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http://dx.doi.org/10.1111/bioe.12727DOI Listing

What risks should be permissible in controlled human infection model studies?

Authors:
Ariella Binik

Bioethics 2020 May 1;34(4):420-430. Epub 2020 Mar 1.

Department of Philosophy, McMaster University, Ontario, Canada.

Controlled human infection model (CHIM) studies involve the intentional exposure of healthy research volunteers to infectious agents. These studies contribute to knowledge about the cause or development of disease and to the advancement of vaccine research. But they also raise ethical questions about the kinds of risks that should be permissible and whether limits should be imposed on research risks in CHIM studies. Read More

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http://dx.doi.org/10.1111/bioe.12736DOI Listing

View on donated life: Construction of philosophical ethics on human organ donation.

Bioethics 2020 03;34(3):318-321

Zhejiang Chinese Medical University, China.

With the emergence of organ donation and donation technology, the previous indivisibility of the human body becomes divisible, and different human organs form a new life subject. With reference to specific case studies in China, a new life, consisting of donated organs from different bodies by donation, can be called "donated life." Donated life is a win-win action between altruism and egoism, that is, to save the lives of others and to regenerate the organs of donors or their relatives. Read More

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http://dx.doi.org/10.1111/bioe.12732DOI Listing

Direct to consumer testing, drugs and gifts.

Authors:
Ruth Chadwick

Bioethics 2020 03;34(3):222

Universities of Cardiff and Leeds.

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http://dx.doi.org/10.1111/bioe.12734DOI Listing

Family refusal of emergency medical treatment in China: An investigation from legal, empirical and ethical perspectives.

Bioethics 2020 03;34(3):306-317

School of Humanities and Social Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

This paper is an analysis of the limits of family authority to refuse life saving treatment for a family member (in the Chinese medical context). Family consent has long been praised and practiced in many non-Western cultural settings such as China and Japan. In contrast, the controversy of family refusal remains less examined despite its prevalence in low-income and middle-income countries. Read More

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http://dx.doi.org/10.1111/bioe.12728DOI Listing

Minimal or reasonable? Considering the ethical threshold for research risks to nonconsenting bystanders and implications for nonconsenting participants.

Bioethics 2020 Feb 24. Epub 2020 Feb 24.

Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania.

When research poses risks to non-participant bystanders, it is not always practicable to obtain their consent. One approach to assessing how much research risk may be imposed on nonconsenting bystanders is to examine analogous circumstances, including risk thresholds deemed acceptable for nonconsenting research participants and for nonconsensual risks imposed outside the research setting. For nonconsenting participants, US research regulations typically limit risks to those deemed to be "minimal. Read More

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http://dx.doi.org/10.1111/bioe.12725DOI Listing
February 2020

The ethics of risk displacement in research and public policy.

Bioethics 2020 Feb 23. Epub 2020 Feb 23.

Harvard University, Graduate School of Education, Cambridge, Massachusetts, USA.

We identify three distinct ethical problems that can arise with risk displacement. Risk displacement is the shifting of extant risk from one or more individuals to other individual(s) such that the reduction of risk to the first group is causally implicated in increasing risk to the second group. These problems are: concentration of risk in inequitable ways; transfer of risk to already vulnerable or disadvantaged populations; and exercise of undue influence over potential research participants. Read More

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http://dx.doi.org/10.1111/bioe.12726DOI Listing
February 2020

What is the best age to circumcise? A medical and ethical analysis.

Bioethics 2020 Feb 18. Epub 2020 Feb 18.

Yale-Hastings Program in Ethics and Health Policy, Yale University, New Haven, Connecticut.

Circumcision is often claimed to be simpler, safer and more cost-effective when performed in the neonatal period as opposed to later in life, with a greater benefit-to-risk ratio. In the first part of this paper, we critically examine the evidence base for these claims, and find that it is not as robust as is commonly assumed. In the second part, we demonstrate that, even if one simply grants these claims for the sake of argument, it still does not follow that neonatal circumcision is ethically permissible absent urgent medical necessity. Read More

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http://dx.doi.org/10.1111/bioe.12714DOI Listing
February 2020

Not the doctor's business: Privacy, personal responsibility and data rights in medical settings.

Authors:
Carissa Véliz

Bioethics 2020 Feb 14. Epub 2020 Feb 14.

University of Oxford, Uehiro Centre for Practical Ethics, Wellcome Centre for Ethics and Humanities, Faculty of Philosophy, United Kingdom of Great Britain and Northern Ireland.

This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients' sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. Read More

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http://dx.doi.org/10.1111/bioe.12711DOI Listing
February 2020

Metaphysics to the rescue?: Four-dimensionalism and the twinning argument against conceptionism.

Authors:
Chunghyoung Lee

Bioethics 2020 Jun 14;34(5):542-548. Epub 2020 Feb 14.

Division of Humanities and Social Sciences, Pohang University of Science and Technology, Republic of Korea.

The view that human beings begin to exist at fertilization (namely conceptionism) faces a serious challenge from the twinning argument, that identical twins coming from the same zygote must be numerically distinct from the zygote and so did not exist at fertilization. Recently, some philosophers have claimed that the twinning argument rests on a particular metaphysical theory of persistence, namely endurantism, on which a human being, for example, is wholly present at every moment of her existence. And we can easily refute the argument, they claim, by employing perdurantism or exdurantism, according to which a human being is a temporally extended entity with temporal parts or a momentarily existing stage who has other momentarily existing stages as counterparts. Read More

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http://dx.doi.org/10.1111/bioe.12712DOI Listing

Equitable access to ectogenesis for sexual and gender minorities.

Bioethics 2020 May 12;34(4):338-345. Epub 2020 Feb 12.

Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York.

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive alternative to gestation within a human womb under certain circumstances. Read More

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http://dx.doi.org/10.1111/bioe.12723DOI Listing

Cryonics for all?

Authors:
Tena Thau

Bioethics 2020 Feb 9. Epub 2020 Feb 9.

Department of Philosophy, University of Oxford, United Kingdom.

In fascinating recent work, some philosophers have argued that it would be morally permissible and prudentially rational to sign up for cryonics-if you can afford the price tag of the procedure. In this paper I ask: why not share the elixir of extended life with everyone? Should governments financially support, positively encourage, or even require people to undergo cryonics? From a general principle of beneficence, I construct a formal argument for cryonics promotion policies. I consider the objection that a subset of these policies would violate autonomy, but I argue that-to the contrary-considerations of autonomy weigh in their favour. Read More

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http://dx.doi.org/10.1111/bioe.12710DOI Listing
February 2020

Engendering moral post-persons: A novel self-help strategy.

Bioethics 2020 Feb 9. Epub 2020 Feb 9.

Program in Medical Ethics, Humanities, and Law, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan.

Humans are morally deficient in a variety of ways. Some of these deficiencies threaten the continued existence of our species. For example, we appear to be incapable of responding to climate change in ways that are likely to prevent the consequent suffering. Read More

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http://dx.doi.org/10.1111/bioe.12722DOI Listing
February 2020

The ethics of ectogenesis-aided foetal treatment.

Bioethics 2020 May 9;34(4):364-370. Epub 2020 Feb 9.

Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent, Belgium.

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. Read More

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http://dx.doi.org/10.1111/bioe.12715DOI Listing

Is ugliness a pathology? An ethical critique of the therapeuticalization of cosmetic surgery.

Bioethics 2020 May 9;34(4):431-441. Epub 2020 Feb 9.

Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia.

Pathologizing ugliness refers to the framing of unattractive features as a type of disease or deformity. By framing ugliness as pathology, cosmetic procedures are reframed as therapy rather than enhancement, thereby potentially avoiding ethical critiques regularly levelled against cosmetic surgery. As such, the practice of pathologizing ugliness and the ensuing therapeuticalization of cosmetic procedures require an ethical analysis that goes beyond that offered by current enhancement critiques. Read More

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http://dx.doi.org/10.1111/bioe.12721DOI Listing

A lost cause? Fundamental problems for causal theories of parenthood.

Authors:
Teresa Baron

Bioethics 2020 Feb 5. Epub 2020 Feb 5.

Faculty of Arts and Humanities, University of Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland.

In this paper, I offer a critique of (actual and possible) causal theories of parenthood. I do not offer a competing account of who incurs parental obligations and why; rather, I aim to show that there are fundamental problems for any account of who acquires parental obligations and why by appeal to causal responsibility for a child's existence. I outline and justify three criteria that any plausible causal account of parental obligation must meet, and demonstrate that attempting to fulfil all three criteria simultaneously will give rise to one or both of two potentially insurmountable dilemmas. Read More

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http://dx.doi.org/10.1111/bioe.12719DOI Listing
February 2020