1,544 results match your criteria Bioethics[Journal]


How to reject Benatar's asymmetry argument.

Authors:
Erik Magnusson

Bioethics 2019 Apr 23. Epub 2019 Apr 23.

Centre for Professional & Applied Ethics, University of Manitoba, Winnipeg, Canada.

In this article I reconsider David Benatar's primary argument for anti-natalism-the asymmetry argument-and outline a three-step process for rejecting it. I begin in Part 2 by reconstructing the asymmetry argument into three main premises. I then turn in Parts 3-5 to explain how each of these premises is in fact false. Read More

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http://dx.doi.org/10.1111/bioe.12582DOI Listing

Moral dilemmas in (not) treating patients who feel they are a burden.

Bioethics 2019 Apr 23. Epub 2019 Apr 23.

Department of Medical Humanities, VU University Medical Center, Medical Humanities, Amsterdam, The Netherlands.

Working as clinical ethicists in an academic hospital, we find that practitioners tend to take a principle-based approach to moral dilemmas when it comes to (not) treating patients who feel like a burden, in which respect for autonomy tends to trump other principles. We argue that this approach insufficiently deals with the moral doubts of professionals with regard to feeling that you are a burden as a motive to decline or withdraw from treatment. Neither does it take into adequately account the specific needs of the patient that might underlie their feeling of being a burden to others. Read More

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http://dx.doi.org/10.1111/bioe.12579DOI Listing

Supporting families involved in court cases about life-sustaining treatment: Working as academics, advocates and activists.

Bioethics 2019 Apr 15. Epub 2019 Apr 15.

School of Journalism, Media and Culture, Cardiff University, Cardiff, Wales, UK.

This article explores the links between our roles as academics, advocates, and activists, focusing on our research on treatment decisions for patients in vegetative and minimally conscious states. We describe how our work evolved from personal experience through traditional social science research to public engagement activities and then to advocacy and activism. We reflect on the challenges we faced in navigating the relationship between our research, advocacy, and activism, and the implications of these challenges for our research ethics and methodology-giving practical examples of how we worked with research participants, wrote up case studies and developed interventions into legal debates. Read More

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http://dx.doi.org/10.1111/bioe.12583DOI Listing

Covert moral bioenhancement, public health, and autonomy.

Bioethics 2019 Apr 15. Epub 2019 Apr 15.

Coe College, 1220 1st Ave NEIA, 52402-5008, Cedar Rapids, Iowa, United States.

In a recent article in this journal, Parker Crutchfield argues that if moral bioenhancement ought to be compulsory, as some authors claim, then it ought to be covert, i.e., performed without the knowledge of the population that is being morally enhanced. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12567
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http://dx.doi.org/10.1111/bioe.12567DOI Listing
April 2019
1 Read

Patient and public involvement: Two sides of the same coin or different coins altogether?

Bioethics 2019 Apr 8. Epub 2019 Apr 8.

The Ethox Centre, Medical Sciences Division, University of Oxford, Oxford, UK.

Patient and public involvement (PPI) has gained widespread support in health research and health policy circles, but there is little consensus on the precise meaning or justifications of PPI. We argue that an important step towards clarifying the meaning and justification for PPI is to split apart the familiar acronym and draw a distinction between patient and public involvement. Specifically, we argue that patient involvement should refer to the practice of involving individuals in health research or policy on the basis of their experience with a particular condition, while public involvement should refer to the practice of involving individuals in health policy or research based on their status as members of a relevant population. Read More

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http://dx.doi.org/10.1111/bioe.12584DOI Listing

Feeling like a burden to others and the wish to hasten death in patients with advanced illness: A systematic review.

Bioethics 2019 Apr 8. Epub 2019 Apr 8.

Department of Nursing, Universitat Internacional de Catalunya, Barcelona, Spain.

Studies that have explored the wish to hasten death (WTHD) in patients with advanced illness have found that the feeling of being a burden may trigger WTHD. Research suggests that both the feeling and the wish are indicators of multidimensional suffering whose meaning may depend on the patient's biographical background. Therefore, we carried out a systematic review and meta-ethnography. Read More

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http://dx.doi.org/10.1111/bioe.12562DOI Listing
April 2019
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Relationships and burden: An empirical-ethical investigation of lived experience in home nursing arrangements.

Bioethics 2019 Apr 8. Epub 2019 Apr 8.

Institute of Ethics and History of Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany.

Quantitative research has called attention to the burden associated with informal caregiving in home nursing arrangements. Less emphasis has been placed, however, on care recipients' subjective feelings of being a burden and on caregivers' willingness to carry the burden in home care. This article uses empirical material from semi-structured interviews conducted with older people affected by multiple chronic conditions and in need of long-term home care, and with informal and professional caregivers, as two groups of relevant others. Read More

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http://dx.doi.org/10.1111/bioe.12586DOI Listing

What do we owe the newly dead? An ethical analysis of findings from Japan's corpse hotels workers.

Bioethics 2019 Apr 4. Epub 2019 Apr 4.

Department of Biomedical Ethics, University of Tokyo Graduate School of Medicine, Tokyo, Japan.

While people are still alive, we owe them respect. Yet what, if anything, do we owe the newly dead? This question is an urgent practical concern for aged societies, because older people die at higher rates than any other age group. One novel way in which Japan, the frontrunner of aged societies, meets its need to accommodate high numbers of newly dead is itai hoteru or corpse hotels. Read More

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http://dx.doi.org/10.1111/bioe.12578DOI Listing
April 2019
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The impairment argument for the immorality of abortion: A reply.

Bioethics 2019 Apr 3. Epub 2019 Apr 3.

Department of Philosophy, University of Birmingham, Birmingham, UK.

In his recent article Perry Hendricks presents what he calls the impairment argument to show that abortion is immoral. To do so, he argues that to give a fetus fetal alcohol syndrome is immoral. Because killing the fetus impairs it more than giving it fetal alcohol syndrome, Hendricks concludes that killing the fetus must also be immoral. Read More

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http://dx.doi.org/10.1111/bioe.12576DOI Listing

Great minds think different: Preserving cognitive diversity in an age of gene editing.

Bioethics 2019 Apr 2. Epub 2019 Apr 2.

Oxford Uehiro Centre for Practical Ethics, University of Oxford, UK.

It is likely that gene editing technologies will become viable in the current century. As scientists uncover the genetic contribution to personality traits and cognitive styles, parents will face hard choices. Some of these choices will involve trade-offs from the standpoint of the individual's welfare, while others will involve trade-offs between what is best for each and what is good for all. Read More

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http://dx.doi.org/10.1111/bioe.12585DOI Listing
April 2019
5 Reads

Conflicting demands on a modern healthcare service: Can Rawlsian justice provide a guiding philosophy for the NHS and other socialized health services?

Bioethics 2019 Mar 18. Epub 2019 Mar 18.

School of Clinical Medicine, Cambridge University, Cambridge, U.K.

We explore whether a Rawlsian approach might provide a guiding philosophy for the development of a healthcare system, in particular with regard to resolving tensions between different groups within it. We argue that an approach developed from some of Rawls' principles - using his 'veil of ignorance' and both the 'difference' and 'just savings' principles which it generates - provides a compelling basis for policy making around certain areas of conflict. We ask what policies might be made if those making them did not know if one was patient, doctor, nurse or manager - in this generation or the next. Read More

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http://dx.doi.org/10.1111/bioe.12568DOI Listing

The point of no return: Up to what point should we be allowed to withdraw consent to the storage and use of embryos and gametes?

Bioethics 2019 Mar 18. Epub 2019 Mar 18.

Department of Social Work, University of Huddersfield, Yorkshire, Huddersfield, UK.

This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that is, the 'point of no return'. In this article, we will consider other points of no return and argue that having a single point of no return, a one size fits all form of consent can, in some cases, lead to restrictions on individuals' autonomy and cause particular types of harm. Read More

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http://dx.doi.org/10.1111/bioe.12572DOI Listing

Research versus practice: The dilemmas of research ethics in the era of learning health-care systems.

Bioethics 2019 Mar 18. Epub 2019 Mar 18.

Department of Philosophy and Bioethics, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.

In this article we attempt to answer the question of how the ethical and conceptual framework (ECF) for a learning health-care system (LHS) affects some of the main controversies in research ethics by addressing five key problems of research ethics: (a) What is the difference between practice and research? (b) What is the relationship between research ethics and clinical ethics? (c) What is the ethical relevance of the principle of clinical equipoise? (d) Does participation in research require a higher standard of informed consent than the practice of medicine? and (e) What ethical principle should take precedence in medicine? These questions allow us to construct two opposite idealized positions on the distinction between research and practice: the integration model and the segregation model of research and practice. We then compare the ECF for an LHS with these two idealized positions. We argue that the ECF for a LHS does not, in fact, solve these problems, but that it is a third, separate position in the relationship between research ethics and clinical ethics. Read More

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http://dx.doi.org/10.1111/bioe.12571DOI Listing

Balancing competing interests and obligations in mental health-care practice and policy.

Authors:
Jeffrey Kirby

Bioethics 2019 Mar 18. Epub 2019 Mar 18.

Department of Bioethics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

It is often challenging for mental health-care providers and health organizations to perform their various roles and to meet their varied obligations. In complex mental health-care circumstances the concurrent application of relevant ethical principles and values often leads to the emergence of completing obligations that need to be carefully weighed and balanced in the making of care-related decisions. Although some clinical circumstances, such as those potentially triggering the duty to warn, are adequately guided by existing rules based on legal precedents, there is a gap in decision-making support in other mental health-care domains. Read More

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http://dx.doi.org/10.1111/bioe.12575DOI Listing

Research ethics guidelines and moral obligations to developing countries: Capacity-building and benefits.

Bioethics 2019 Mar;33(3):389-395

St George's University, Grenada, Windward Islands Research and Education Foundation, Grenada.

This article outlines challenges to benefitting developing countries that are hosts of international research. In the context of existing guidance and frameworks for benefit-sharing, it aims to provoke dialog about socioeconomic factors and other background conditions that influence what constitute benefits in a given host setting, and about the proportionality between benefits to hosts and benefits to sponsors and researchers. It argues that capacity-building for critical thinking and negotiation in many developing country governments, institutions, and communities is a benefit because it can help to overcome background conditions that impinge on equitable international research negotiations, partnerships, and benefits. Read More

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http://dx.doi.org/10.1111/bioe.12577DOI Listing

Health-related Research Ethics and Social Value: Antibiotic Resistance Intervention Research and Pragmatic Risks.

Bioethics 2019 Mar;33(3):335-342

Institute for Biomedicine, Department of Infectious Diseases, and the Centre for Antibiotic Resistance Research, University of Gothenburg, Gothenburg, Sweden.

We consider the implications for the ethical evaluation of research programs of two fundamental changes in the revised research ethical guideline of the Council for International Organizations of Medical Sciences. The first is the extension of scope that follows from exchanging "biomedical" for "health-related" research, and the second is the new evaluative basis of "social value," which implies new ethical requirements of research. We use the example of antibiotic resistance interventions to explore the need to consider the instances of what we term the pragmatic risks of such interventions to evaluate the social value of certain kinds of health-related research. Read More

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http://dx.doi.org/10.1111/bioe.12580DOI Listing
March 2019
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Research ethics revised: The new CIOMS guidelines and the World Medical Association Declaration of Helsinki in context.

Bioethics 2019 Mar;33(3):310-311

Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Sweden.

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http://dx.doi.org/10.1111/bioe.12581DOI Listing

Public reason in justifications of conscientious objection in health care.

Bioethics 2019 Mar 13. Epub 2019 Mar 13.

State University of New York at Oswego, New York, USA.

Current mainstream approaches to conscientious objection either uphold the standards of public health care by preventing objections or protect the consciences of health-care professionals by accommodating objections. Public justification approaches are a compromise position that accommodate conscientious objections only when objectors can publicly justify the grounds of their objections. Public justification approaches require objectors and assessors to speak a common normative language and to this end it has been suggested that objectors should be required to cast their objection in terms of public reason. Read More

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http://dx.doi.org/10.1111/bioe.12573DOI Listing

The injustice of fat stigma.

Authors:
Rekha Nath

Bioethics 2019 Feb 13. Epub 2019 Feb 13.

Philosophy, University of Alabama, Tuscaloosa, Alabama, United States.

Fatness stigma is pervasive. Being fat is widely regarded a bad thing, and fat persons suffer numerous social and material disadvantages in virtue of their weight being regarded that way. Despite the seriousness of this problem, it has received relatively little attention from analytic philosophers. Read More

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http://dx.doi.org/10.1111/bioe.12560DOI Listing
February 2019

Bioethics and activism: A natural fit?

Authors:
Wendy Rogers

Bioethics 2019 Feb 8. Epub 2019 Feb 8.

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

Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. Read More

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http://dx.doi.org/10.1111/bioe.12558DOI Listing
February 2019

Can conscientious objection lead to eugenic practices against LGBT individuals?

Bioethics 2019 Feb 8. Epub 2019 Feb 8.

Allied Health Sciences, School of Health and Social Care, London South Bank University, London, UK.

In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact with his opponents' views; equivocates on the meaning of 'natural'; fails to show that the practice he opposes is eugenic in any non-trivial sense; and fails to justify and explicate the relevance of the naturalism he proposes. Read More

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http://dx.doi.org/10.1111/bioe.12557DOI Listing
February 2019

The aims of expanded universal carrier screening: Autonomy, prevention, and responsible parenthood.

Bioethics 2019 Feb 7. Epub 2019 Feb 7.

CAPHRI School for Public Health and Primary Care, Maastricht University, Netherlands.

Expanded universal carrier screening (EUCS) entails a population-wide screening offer for multiple disease-causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry-based carrier screening has traditionally been understood: reducing the disease burden in the population. Read More

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http://dx.doi.org/10.1111/bioe.12555DOI Listing
February 2019
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Ethical classification of ME/CFS in the United Kingdom.

Authors:
Diane O'Leary

Bioethics 2019 Feb 8. Epub 2019 Feb 8.

Rotman Institute of Philosophy, Western University, London, Ontario, Canada.

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U. Read More

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http://dx.doi.org/10.1111/bioe.12559DOI Listing
February 2019

The positive value of moral distress.

Authors:
Daniel W Tigard

Bioethics 2019 Feb 7. Epub 2019 Feb 7.

RWTH Aachen University - Human Technology Center, Aachen, Germany.

Moral distress in healthcare has been an increasingly prevalent topic of discussion. Most authors characterize it as a negative phenomenon, while few have considered its potentially positive value. In this essay, I argue that moral distress can reveal and affirm some of our most important concerns as moral agents. Read More

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http://dx.doi.org/10.1111/bioe.12564DOI Listing
February 2019

An ethical pathway for gene editing.

Bioethics 2019 Feb;33(2):221-222

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http://doi.wiley.com/10.1111/bioe.12570
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http://dx.doi.org/10.1111/bioe.12570DOI Listing
February 2019
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Unlocking data: Where is the key?

Bioethics 2019 Jan 25. Epub 2019 Jan 25.

Institute of Health Carlos III, Madrid, Spain.

Health-related data uses and data sharing have been in the spotlight for a while. Since the beginning of the big data era, massive data mining and its inherent possibilities have only increased the debate about what the limits are. Data governance is a relevant aspect addressed in ethics guidelines. Read More

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http://dx.doi.org/10.1111/bioe.12565DOI Listing
January 2019
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Stages of life: A new metaphysics of conceptionism.

Bioethics 2019 Jan 25. Epub 2019 Jan 25.

Departments of Philosophy and Health Sciences at the University of York, York, UK.

When a human being comes into existence is crucial in bioethics. Conceptionism is the view that a human being comes into existence at conception. The twinning argument is an influential objection to this view. Read More

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http://dx.doi.org/10.1111/bioe.12556DOI Listing
January 2019
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Respect for autonomy in systems of postmortem organ procurement: A comment.

Bioethics 2019 Jan 25. Epub 2019 Jan 25.

Department of Philosophy, University of Amsterdam, Haarlem, Netherlands.

In 2015 Robert Veatch published the second edition of his Transplantation ethics, this time together with Lainie Ross. The chapters on postmortem organ procurement distinguish between 'giving' and 'taking' systems, and argue that 'taking' systems may promise a greater yield of organs for transplantation, but inevitably violate a requirement of respect for the deceased's autonomy. That argument has been very influential, and is also representative of a way of thinking that is widespread in the literature and in public debate. Read More

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http://dx.doi.org/10.1111/bioe.12553DOI Listing
January 2019

A failure in solidarity: Ethical challenges in the development and implementation of new tuberculosis technologies.

Bioethics 2019 Jan 25. Epub 2019 Jan 25.

Faculty of Health Sciences, Simon Fraser Universtiy, Burnaby, British Columbia, Canada.

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB community to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. Read More

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http://dx.doi.org/10.1111/bioe.12554DOI Listing
January 2019
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The ethics of biobanking: Assessing the right to control problem for broad consent.

Authors:
Neil C Manson

Bioethics 2019 Jan 22. Epub 2019 Jan 22.

Dept of Politics, Philosophy and Religion, Lancaster University, Lancaster, United Kingdom.

The biobank consent debate is one with deeply held convictions on both the 'broad' and 'specific' side with little sign of resolution. Recently, Thomas Ploug and Soren Holm have developed an alternative to both specific and broad consent: a meta-consent framework. The aim here is to consider whether meta-consent provides a 'solution' to the biobank consent debate. Read More

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http://doi.wiley.com/10.1111/bioe.12550
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http://dx.doi.org/10.1111/bioe.12550DOI Listing
January 2019
8 Reads

Adjusting the focus: A public health ethics approach to data research.

Bioethics 2019 Mar 22;33(3):357-366. Epub 2019 Jan 22.

University of Otago Wellington, Wellington, New Zealand.

This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population-level research and big data because it results in a primary focus on consent (meta-, broad, dynamic and/or specific consent). Two recent guidelines - the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health-related research involving humans - both focus on the growing reliance on health data for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Read More

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http://dx.doi.org/10.1111/bioe.12551DOI Listing

No conscientious objection without normative justification: a reply.

Bioethics 2019 Jan 18. Epub 2019 Jan 18.

Department of Philosophy, University of Birmingham, Birmingham, UK.

Benjamin Zolf, in his recent paper 'No conscientious objection without normative justification: Against conscientious objection in medicine', attempts to establish that in order to rule out arbitrary conscientious objections, a reasonability constraint is necessary. This, he contends, requires normative justification, and the subjective beliefs that ground conscientious objections cannot easily be judged by normative criteria. Zolf shows that the alternative of using extrinsic criteria, such as requiring that unjustified harm must not be caused, are likewise grounded on normative criteria. Read More

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http://dx.doi.org/10.1111/bioe.12552DOI Listing
January 2019

Qualitative and quantitative interpretations of the least restrictive means.

Authors:
Morten F Byskov

Bioethics 2019 Jan 18. Epub 2019 Jan 18.

Wageningen Universiteit en Researchcentrum, Wageningen, Netherlands.

Within healthcare ethics and public health ethics, it has been the custom that medical and public health interventions should adhere to the principle of the least restrictive means. This principle holds that public health measures should interfere with the autonomous freedom of individuals to the least possible or necessary extent. This paper contributes to the discussion on how best to conceptualize what counts as the least restrictive means. Read More

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http://dx.doi.org/10.1111/bioe.12548DOI Listing
January 2019

The role of data custodians in establishing and maintaining social licence for health research.

Bioethics 2019 Jan 18. Epub 2019 Jan 18.

Research Infrastructure Centres, The University of Western Australia, Perth, Western Australia, Australia.

In this article we explore the role of data custodians in establishing and maintaining social licence for the use of personal information in health research. Personal information from population-level data collections can be used to make significant contributions to health and medical research, but this use is dependent on community acceptance or a social licence. We conducted semi-structured interviews with data custodians across Australia to better understand data custodians' views on their roles and responsibilities. Read More

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http://dx.doi.org/10.1111/bioe.12549DOI Listing
January 2019
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Circumcising human subjects: An evaluation of experimental foreskin amputation using the Declaration of Helsinki.

Authors:
Michael Drash

Bioethics 2019 Mar 9;33(3):383-388. Epub 2019 Jan 9.

Independent Scholar.

This paper explores ethical considerations for active studies of circumcision, i.e., the amputation of the foreskin, in the form of a case study of three major trials performed in African countries in the early 2000s. Read More

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http://dx.doi.org/10.1111/bioe.12566DOI Listing

Gene editing: An ethical disruptor?

Authors:
Ruth Chadwick

Bioethics 2019 Jan;33(1)

Inter-Disciplinary Ethics Applied Centre (IDEA), University of Leeds.

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http://dx.doi.org/10.1111/bioe.12563DOI Listing
January 2019

Withholding and withdrawing treatment for cost-effectiveness reasons: Are they ethically on par?

Bioethics 2019 Feb 7;33(2):278-286. Epub 2018 Dec 7.

Linkopings universitet, Linkoping, Sweden.

In healthcare priority settings, early access to treatment before reimbursement decisions gives rise to problems of whether negative decisions for cost-effectiveness reasons should result in withdrawing treatment, already accessed by patients. Among professionals there seems to be a strong attitude to distinguish between withdrawing and withholding treatment, viewing the former as ethically worse. In this article the distinction between withdrawing and withholding treatment for reasons of cost effectiveness is explored by analysing the doing/allowing distinction, different theories of justice, consequentialist and virtue perspectives. Read More

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http://dx.doi.org/10.1111/bioe.12545DOI Listing
February 2019
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Non-therapeutic male genital cutting and harm: Law, policy and evidence from U.K. hospitals.

Bioethics 2018 Dec 4. Epub 2018 Dec 4.

Law, University of Leeds, Leeds, Yorkshire, United Kingdom of Great Britain and Northern Ireland.

Female genital cutting (FGC) is generally understood as a gendered harm, abusive cultural practice and human rights violation. By contrast, male genital cutting (MGC) is held to be minimally invasive, an expression of religious identity and a legitimate parental choice. Yet scholars increasingly problematize this dichotomy, arguing that male and female genital cutting can occasion comparable levels of harm. Read More

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http://doi.wiley.com/10.1111/bioe.12542
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http://dx.doi.org/10.1111/bioe.12542DOI Listing
December 2018
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Addressing the challenge for expedient ethical review of research in disasters and disease outbreaks.

Authors:
Derrick Aarons

Bioethics 2019 Mar 4;33(3):343-346. Epub 2018 Dec 4.

The Caribbean Public Health Agency (CARPHA) - Ethics Unit, Port of Spain, Trinidad and Tobago.

Guideline 20 of the updated International Ethics Guidelines for Health-related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre-screen study protocols to expedite ethical reviews in a situation of crisis, that pre-arrangements be made regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster. This paper critiques these recommendations against the background of the findings of a survey of public health officials and chairs of research ethics committees in the Caribbean during 2016, which sought to determine the best template for the expeditious ethical review of research proposals in emergency and epidemic situations in the Caribbean, and whose findings can serve as a model for other low- and middle-income countries. Read More

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http://dx.doi.org/10.1111/bioe.12543DOI Listing
March 2019
1 Read

Causal parenthood and the ethics of gamete donation.

Authors:
Jason Hanna

Bioethics 2019 Feb 27;33(2):267-273. Epub 2018 Nov 27.

Philosophy, Northern Illinois University, DeKalb, IL, USA.

According to the causal theory of parenthood, people incur parental obligations by causing children to exist. Proponents of the causal theory often argue that gamete donors have special obligations to their genetic offspring. In response, many defenders of current gamete donation practices would reject the causal theory. Read More

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http://doi.wiley.com/10.1111/bioe.12537
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http://dx.doi.org/10.1111/bioe.12537DOI Listing
February 2019
10 Reads

The Identity Objection to the future-like-ours argument.

Authors:
Skott Brill

Bioethics 2019 Feb 27;33(2):287-293. Epub 2018 Nov 27.

Department of Philosophy, Frostburg State University, Frostburg, MD, United States.

Some critics of Don Marquis's 'future-like-ours' anti-abortion argument launch what has been called the Identity Objection. The upshot of this objection is that under a psychological theory of personal identity, a non-sentient fetus lacks precisely what Marquis believes gives it a right to life - a future like ours. However, Eric Vogelstein, in a recent article, has argued that under this theory of personal identity a non-sentient fetus, in fact, has a future like ours, which he believes dissolves the Identity Objection. Read More

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http://dx.doi.org/10.1111/bioe.12546DOI Listing
February 2019
1 Read

The role of trust in global health research collaborations.

Bioethics 2018 Nov 27. Epub 2018 Nov 27.

The Ethox Centre, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland.

Collaborations in global health research are on the rise because they enhance productivity, facilitate capacity building, accelerate output and make tackling big, multifactorial research questions possible. In this paper, I examine the concepts of trust and reliance in scientific collaborations in general, but also in the particular context of collaborations in global health research between high-income countries and low-and-middle income countries (LMIC). I propose and defend the argument that given the particular characteristics of collaborations and demands of trust relationships, reliance is a better relational mode for successful collaborations. Read More

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http://dx.doi.org/10.1111/bioe.12536DOI Listing
November 2018

Even if the fetus is not a person, abortion is immoral: The impairment argument.

Authors:
Perry Hendricks

Bioethics 2019 Feb 27;33(2):245-253. Epub 2018 Nov 27.

Purdue University Department of Philosophy, West Lafayette, IN, USA.

Much of the debate about the ethics of abortion has centered on whether the fetus is a person. In an attempt to sidestep this complex issue, I argue that, even if the fetus is not a person, abortion is immoral. To arrive at this conclusion, I argue that giving a fetus fetal alcohol syndrome is immoral, and that if this is so, then killing the fetus is immoral. Read More

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http://dx.doi.org/10.1111/bioe.12533DOI Listing
February 2019
1 Read

Patients with multiple needs for healthcare and priority to the worse off.

Authors:
Erik Gustavsson

Bioethics 2019 Feb 27;33(2):261-266. Epub 2018 Nov 27.

Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping university, Linköping, Sweden.

There is a growing body of literature which suggests that decisions about healthcare priority setting should take into account the extent to which patients are worse off. However, such decisions are often based on how badly off patients are with respect to the condition targeted by the treatment whose priority is under consideration (condition-specific severity). In this paper I argue that giving priority to the worse off in terms of condition-specific severity does not reflect the morally relevant sense of being worse off. Read More

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http://doi.wiley.com/10.1111/bioe.12535
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http://dx.doi.org/10.1111/bioe.12535DOI Listing
February 2019
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Refining the ethics of preimplantation genetic diagnosis: A plea for contextualized proportionality.

Bioethics 2019 Feb 26;33(2):294-301. Epub 2018 Nov 26.

Health, Ethics and Society, Maastricht University, Maastricht, Netherlands; GROW School for Oncology & Developmental Biology; CAPHRI School for Public Health & Primary Care, Maastricht University, Maastricht, Netherlands.

Many European countries uphold a 'high risk of a serious condition' requirement for limiting the scope of preimplantation genetic diagnosis (PGD). This 'front door' rule should be loosened to account for forms of PGD with a divergent proportionality. This applies to both 'added PGD' (aPGD), as an add-on to in vitro fertilization (IVF), and 'combination PGD' (cPGD), for a secondary disorder in addition to the one for which the applicants have an accepted PGD indication. Read More

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http://dx.doi.org/10.1111/bioe.12534DOI Listing
February 2019
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Insight and the no-self in deep brain stimulation.

Bioethics 2018 Nov 26. Epub 2018 Nov 26.

College of Charleston School of Humanities and Social Sciences, Charleston, SC, USA.

Ethical analyses of the effects of neural interventions commonly focus on changes to personality and behavior, interpreting these changes in terms of authenticity and identity. These phenomena have led to debate among ethicists about the meaning of these terms for ethical analysis of such interventions. While these theoretical approaches have different criteria for ethical significance, they agree that patients' reports are concerning because a sense of self is valuable. Read More

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http://dx.doi.org/10.1111/bioe.12539DOI Listing
November 2018

Erosion of informed consent in U.S. research.

Bioethics 2019 Jan 26;33(1):4-12. Epub 2018 Nov 26.

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.

This paper evaluates four recent randomized clinical trials in which the informed consent of participants was either not sought at all, or else was conducted with critical information missing from the consent documents. As these studies have been taking place, various proposals to conduct randomized clinical trials without consent have been appearing in the medical literature. Some of the explanations offered for why it is appropriate to bypass consent or disclosure requirements appear to represent a fundamental misunderstanding of applicable government regulations and even the research enterprise. Read More

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http://doi.wiley.com/10.1111/bioe.12532
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http://dx.doi.org/10.1111/bioe.12532DOI Listing
January 2019
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The common rule's 'reasonable person' standard for informed consent.

Bioethics 2019 Feb 26;33(2):274-277. Epub 2018 Nov 26.

Gulf Coast State College, Panama City, Florida, United States.

Laura Odwazny and Benjamin Berkman have raised several challenges regarding the new reasonable person standard in the revised Common Rule, which states that informed consent requires potential research subjects be provided with information a reasonable person would want to know to make an informed decision on whether to participate in a study. Our aim is to offer a response to the challenges Odwazny and Berkman raise, which include the need for a reasonable person standard that can be applied consistently across institutional review boards and that does not stigmatize marginal groups. In response, we argue that the standard ought to be based in an ordinary rather than ideal person conception of reasonable person and that the standard ought to employ what we call a liberal constraint: the reasonability standard must be malleable enough such that a wide variety of individuals with different, unique value systems would endorse it. Read More

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http://dx.doi.org/10.1111/bioe.12544DOI Listing
February 2019
6 Reads