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A physician’s identity can never be reconfigured to put climate protection on par with an individual patient’s best interests J. Med. Eth. (IF 4.1) Pub Date : 2024-03-05 Narcyz Ghinea
In their article, van Gils Schmidt and Salloch defend the claim that physicians have a duty to protect the climate. The logic of the argument in broad terms is that (i) there is a relationship between climate change and the burden of disease, (ii) the healthcare sector is a significant emitter of global greenhouse gasses, thereby enhancing the burden of disease and (iii) since doctors are advocates
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Words matter: ‘enduring intolerable suffering’ and the provider-side peril of Medical Assistance in Dying in Canada J. Med. Eth. (IF 4.1) Pub Date : 2024-03-05 Christopher Lyon
Enduring intolerable suffering, an essential eligibility criterion in Medical Assistance in Dying (MAiD) in Canada and elsewhere, is a contradiction in terms, in that suffering must be tolerable to be endured. Cases of people who were approved for MAiD but who elected to die naturally, thus tolerating their suffering, bear out the unreliability of this central safeguard. The clinical assessment of
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Medical ethics, equity and social justice J. Med. Eth. (IF 4.1) Pub Date : 2024-03-05 Lucy Frith
As John McMillan notes in January’s editorial,1 many countries are reflecting on how they responded to the COVID-19 pandemic, what went wrong and how responses to such system shocks can be better managed in the future. However, while it is tempting to think that the COVID-19 pandemic is over and that what is now needed is a reflection on how countries could have responded better, some of the underlying
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Towards an environmentally sensitive healthcare ethics: ten tasks and one model J. Med. Eth. (IF 4.1) Pub Date : 2024-03-05 Kristine Bærøe, Anand Singh Bhopal, TOrbjørn Gundersen
In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage
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Stem cell-derived embryo models: moral advance or moral obfuscation? J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Christopher Gyngell, Fiona Lynch, Tsutomu Sawai, Julian Savulescu
Stem cell-derived embryo models (SCEMs) are model embryos used in scientific research to gain a better understanding of early embryonic development. The way humans develop from a single-cell zygote to a complex multicellular organism remains poorly understood. However, research looking at embryo development is difficult because of restrictions on the use of human embryos in research. Stem cell embryo
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Keeping it in the family: reproduction beyond genetic parenthood J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Daniela Cutas, Anna Smajdor
Recent decades have seen the facilitation of unconventional or even extraordinary reproductive endeavours. Sperm has been harvested from dying or deceased men at the request of their wives; reproductive tissue has been surgically removed from children at the request of their parents; deceased adults’ frozen embryos have been claimed by their parents, in order to create grandchildren; wombs have been
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Ethical preparedness in genomic medicine: how NHS clinical scientists navigate ethical issues J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Kate Sahan, Kate Lyle, Helena Carley, Nina Hallowell, Michael J Parker, Anneke M Lucassen
Much has been published about the ethical issues encountered by clinicians in genetics/genomics, but those experienced by clinical laboratory scientists are less well described. Clinical laboratory scientists now frequently face navigating ethical problems in their work, but how they should be best supported to do this is underexplored. This lack of attention is also reflected in the ethics tools available
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What does it mean for a clinical AI to be just: conflicts between local fairness and being fit-for-purpose? J. Med. Eth. (IF 4.1) Pub Date : 2024-02-29 Michal Pruski
There have been repeated calls to ensure that clinical artificial intelligence (AI) is not discriminatory, that is, it provides its intended benefit to all members of society irrespective of the status of any protected characteristics of individuals in whose healthcare the AI might participate. There have also been repeated calls to ensure that any clinical AI is tailored to the local population in
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Is the UN receiving ethical approval for its research with human participants? J. Med. Eth. (IF 4.1) Pub Date : 2024-02-27 Robert James Torrance, Maru Mormina, Sadath Sayeed, Anthony Kessel, Chang Ho Yoon, Beniamino Cislaghi
This paper examines the institutional mechanisms supporting the ethical oversight of human participant research conducted by the United Nations (UN). The UN has served an instrumental role in shaping international standards on research ethics, which invariably require ethical oversight of all research studies with human participants. The authors’ experiences of conducting research collaboratively with
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Tsunami-tendenko follows the antiextinction principle, not utilitarianism J. Med. Eth. (IF 4.1) Pub Date : 2024-02-27 Susumu Cato, Ken Oshitani
This paper examines the concept of ‘tsunami-tendenko,’ a guideline suggesting that individuals prioritise their own safety over aiding others during large-scale disasters. Kodama defends tsunami-tendenko against accusations of egoism by arguing that the principle can be justified ethically on consequentialist (or more precisely, utilitarian) grounds. Kodama asserts that attempting to assist others
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Ladders and stairs: how the intervention ladder focuses blame on individuals and obscures systemic failings and interventions J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Tyler Paetkau
Introduced in 2007 by the Nuffield Council on Bioethics, the intervention ladder has become an influential tool in bioethics and public health policy for weighing the justification for interventions and for weighing considerations of intrusiveness and proportionality. However, while such considerations are critical, in its focus on these factors, the ladder overemphasises the role of personal responsibility
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Leveraging artificial intelligence to detect ethical concerns in medical research: a case study J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Kannan Sridharan, Gowri Sivaramakrishnan
Background Institutional review boards (IRBs) have been criticised for delays in approvals for research proposals due to inadequate or inexperienced IRB staff. Artificial intelligence (AI), particularly large language models (LLMs), has significant potential to assist IRB members in a prompt and efficient reviewing process. Methods Four LLMs were evaluated on whether they could identify potential ethical
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‘Empathy counterbalancing’ to mitigate the ‘identified victim effect’? Ethical reflections on cognitive debiasing strategies to increase support for healthcare priority setting J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Jilles Smids, Charlotte H C Bomhof, Eline Maria Bunnik
Priority setting is inevitable to control expenditure on expensive medicines, but citizen support is often hampered by the workings of the ‘identified victim effect’, that is, the greater willingness to spend resources helping identified victims than helping statistical victims. In this paper we explore a possible cognitive debiasing strategy that is being employed in discussions on healthcare priority
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Advance directives for oral feeding in dementia: a response to Shelton and Geppert J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Paul T Menzel
In a recent paper in JME, Shelton and Geppert use an approach by Menzel and Chandler-Cramer to sort out ethical dilemmas about the oral feeding of patients in advanced dementia, ultimately arguing that the usefulness of advance directives about such feeding is highly limited. They misunderstand central aspects of Menzel’s and Chandler-Cramer’s approach, and in making their larger claim that such directives
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Queering the genome: ethical challenges of epigenome editing in same-sex reproduction J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Adrian Villalba
In this article, I explore the ethical dimensions of same-sex reproduction achieved through epigenome editing—an innovative and transformative technique. For the first time, I analyse the potential normativity of this disruptive approach for reproductive purposes, focusing on its implications for lesbian couples seeking genetically related offspring. Epigenome editing offers a compelling solution to
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Right to mental integrity and neurotechnologies: implications of the extended mind thesis J. Med. Eth. (IF 4.1) Pub Date : 2024-02-26 Vera Tesink, Thomas Douglas, Lisa Forsberg, Sjors Ligthart, Gerben Meynen
The possibility of neurotechnological interference with our brain and mind raises questions about the moral rights that would protect against the (mis)use of these technologies. One such moral right that has received recent attention is the right to mental integrity. Though the metaphysical boundaries of the mind are a matter of live debate, most defences of this moral right seem to assume an internalist
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Fetuses are not adult humans: a response to Miller on abortion J. Med. Eth. (IF 4.1) Pub Date : 2024-02-23 Ben Saunders
Miller has recently argued that fetuses have the same inherent value as non-disabled adults. However, we do not need to postulate some property possessed equally by all humans, including fetuses, in order to explain the equality of non-disabled adults. It would suffice if there were some property possessed by all non-disabled adults, but not by fetuses.
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Genetic disenhancement and xenotransplantation: diminishing pigs’ capacity to experience suffering through genetic engineering J. Med. Eth. (IF 4.1) Pub Date : 2024-02-23 Daniel Rodger, Daniel J Hurst, Christopher A Bobier, Xavier Symons
One objection to xenotransplantation is that it will require the large-scale breeding, raising and killing of genetically modified pigs. The pigs will need to be raised in designated pathogen-free facilities and undergo a range of medical tests before having their organs removed and being euthanised. As a result, they will have significantly shortened life expectancies, will experience pain and suffering
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Mitochondrial replacement techniques for treating infertility J. Med. Eth. (IF 4.1) Pub Date : 2024-02-21 Esther Braun
Mitochondrial replacement techniques (MRTs) usually aim to prevent the genetic transmission of maternally inherited mitochondrial diseases. Until now, only the UK and Australia have implemented specific legal regulations of MRTs. In both countries, clinical trials on these techniques are only permissible for cases with a high risk of severe mitochondrial disease in the offspring. However, these techniques
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AAPT, pregnancy loss and planning ahead J. Med. Eth. (IF 4.1) Pub Date : 2024-02-21 Victoria Adkins, Elizabeth Chloe Romanis
The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident
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The ethical canary: narrow reflective equilibrium as a source of moral justification in healthcare priority-setting J. Med. Eth. (IF 4.1) Pub Date : 2024-02-21 Victoria Charlton, Michael J DiStefano
Healthcare priority-setting institutions have good reason to want to demonstrate that their decisions are morally justified—and those who contribute to and use the health service have good reason to hope for the same. However, finding a moral basis on which to evaluate healthcare priority-setting is difficult. Substantive approaches are vulnerable to reasonable disagreement about the appropriate grounds
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Medical authority and expectations of conformity: crystallising a key barrier to person-centred care during labour and childbirth J. Med. Eth. (IF 4.1) Pub Date : 2024-02-21 Anna Nelson
Those giving birth within modern maternity systems are recognised as facing a number of barriers to person-centred care. In this paper, I argue that in order to best facilitate the conditions for positive change, work needs to be done to provide a more granular articulation of the specific barriers. I then offer a nuanced and contextually aware articulation of one key component of the overall failure
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AI, doping and ethics: On why increasing the effectiveness of detecting doping fraud in sport may be morally wrong J. Med. Eth. (IF 4.1) Pub Date : 2024-02-21 Thomas Søbirk Petersen, Sebastian Jon Holmen, Jesper Ryberg
In this article, our aim is to show why increasing the effectiveness of detecting doping fraud in sport by the use of artificial intelligence (AI) may be morally wrong. The first argument in favour of this conclusion is that using AI to make a non-ideal antidoping policy even more effective can be morally wrong. Whether the increased effectiveness is morally wrong depends on whether you believe that
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Extending patient-centred communication to non-speaking intellectually disabled persons J. Med. Eth. (IF 4.1) Pub Date : 2024-02-19 Ally Peabody Smith, Ashley Feinsinger
Patient-centred communication is widely regarded as a best practice in contemporary medical care, both in terms of maximising health outcomes and respecting persons. However, not all patients communicate in ways that are easily understood by clinicians and other healthcare professionals. This is especially so for patients with non-speaking intellectual disabilities. We argue that assumptions about
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The wrong word for the job? The ethics of collecting data on ‘race’ in academic publishing J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 John McMillan, Brian D Earp, Wing May Kong, Mehrunisha Suleman, Arianne Shahvisi
Socially responsible publishers, such as the BMJ Publishing Group, have demonstrated a commitment to health equity and working towards rectifying the structural racism that exists both in healthcare and in medical publishing.1 The commitment of academic publishers to collecting information relevant to promoting equity and diversity is important and commendable where it leads to that result.2 However
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UK doctors’ strikes 2023: not only justified but, arguably, supererogatory J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Doug McConnell, Darren Mann
The 2023 doctors’ strikes in the UK have elicited a familiar moral outcry that such strikes are morally wrong. We consider five arguments that might be thought to show doctors’ strikes are morally impermissible but show that they all fail. The most we can conclude from such arguments is that doctors’ strikes are morally permissible in a narrower range of circumstances than strikes in other sectors
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Gillick competence: an inadequate guide to the ethics of involving adolescents in decision-making J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Avraham Bart, Georgina Antonia Hall, Lynn Gillam
Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive
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The revised International Code of Medical Ethics: an exercise in international professional ethical self-regulation J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Ramin W Parsa-Parsi, Raanan Gillon, Urban Wiesing
The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption
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Complication for a greener medical ethics code: assisted reproduction J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Seppe Segers, Michiel De Proost
Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics
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ICoME and the moral significance of telemedicine J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Victor Chidi Wolemonwu, Chiedozie Godian Ike, Rosangela Barcaro, Emanuela Midolo
Parsa-Parsi et al systematically discuss and elucidate contentious and non-controversial ethical issues that emerged during the ICoME (International Code of Medical Ethics) revision process and the consensus they achieved. The ethical issues discussed include the physician’s duty to act in the best interests of patients and to ensure they are protected from the unjustifiable risk of harm, respect for
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ICoME and the legitimacy of professional self-regulation J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Afsheen Mansoori, Eli Garrett Schantz
After an intensive 4-year process, the World Medical Association (WMA) has revised its International Code of Medical Ethics (ICoME). In their report outlining this process, Parsa-Parsi et al not only describe how the WMA sought to ‘cultivat[e] international agreement’ on a ‘global medical ethos’, but also outline the philosophical framework of the ICoME: how the WMA, as the ‘global representation of
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Dear WMA, please better engage LMICs and say more about environmental sustainability J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Cheryl C Macpherson, Anna Cyrus-Murden
Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country
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Can medical ethics truly be independent of law? J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Abeezar I Sarela
Parsa-Parsi et al assert that the International Code of Medical Ethics (ICoME) provides a professional standard that overrides conflicting national legal norms.1 While this claim is made in the context of laws that require doctors to participate in ‘acts of torture, or other cruel, inhuman, or degrading practices and punishments’ (para10 of ICoME), the underlying premise that medical ethics supersedes
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The revised International Code of Medical Ethics: responses to some important questions J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Ramin W Parsa-Parsi, Raanan Gillon, Urban Wiesing
We thank our commentators for their thoughtful responses to our paper1 covering among other issues the relationships of ethics law and professional codes, the tensions between ethical universalism and cultural relativism and the phenomenon of moral judgement required when ethical norms conflict, including the norms of patient care versus obligations to others both now and in the future. Although the
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‘False hope’ in assisted reproduction: the normative significance of the external outlook and moral negotiation J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Dorian Accoe, Seppe Segers
Despite the frequent invocation of ‘false hope’ and possible related moral concerns in the context of assisted reproduction technologies, a focused ethical and conceptual problematisation of this concept seems to be lacking. We argue that an invocation of ‘false hope’ only makes sense if the fulfilment of a desired outcome (eg, a successful fertility treatment) is impossible, and if it is attributed
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Abortion restrictions: the case for conscientious non-compliance on the part of providers J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Pierce Randall, Jacob Mago
This paper offers a qualified defence of physician non-compliance with antiabortion legislation in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. The paper examines two ethically troubling trends of post-Dobbs legislation: narrow and vague maternal health exemption clauses and mandatory reporting of miscarriages in jurisdictions where patients may criminal
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Addressing bias in artificial intelligence for public health surveillance J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Lidia Flores, Seungjun Kim, Sean D Young
Components of artificial intelligence (AI) for analysing social big data, such as natural language processing (NLP) algorithms, have improved the timeliness and robustness of health data. NLP techniques have been implemented to analyse large volumes of text from social media platforms to gain insights on disease symptoms, understand barriers to care and predict disease outbreaks. However, AI-based
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Undermining autonomy and consent: the transformative experience of disease J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Bjørn Hofmann
Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed
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Gain-of-function research and model organisms in biology J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Nicholas G Evans, Charles H Pence
So-called ‘gain-of-function’ (GOF) research is virological research that results in a virus substantially more virulent or transmissible than its wild antecedent. GOF research has been subject to ethical analysis in the past, but the methods of GOF research have to date been underexamined by philosophers in these analyses. Here, we examine the typical animal used in influenza GOF experiments, the ferret
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Abortion and the basis of equality: a reply to Miller J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Alexander Bozzo
Miller has recently argued that the standard liberal and moderate positions on abortion are incapable of grounding the claim that ‘all non-disabled adult humans are equal’. The reason, he claims, is such accounts base the intrinsic moral worth of a human being on some property (or set of properties) which comes in degrees. In contrast, he argues that moral equality must reside in some binary property
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Human equality and the impermissibility of abortion: a response to Bozzo J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Calum Miller
I have recently offered a defence of human equality, and consequently an argument against abortion. This has been objected to by Bozzo, on the grounds that my account of human equality is unclear and could be grounded in utilitarian or Kantian ethics, that my account struggles to ground the permissibility of therapeutic abortions, and that my proposed foundation for human equality itself is parasitic
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First among equals? Adaptive preferences and the limits of autonomy in medical ethics J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Susan Pennings, Xavier Symons
Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others. In this paper, we consider whether inappropriately adaptive preferences —preferences that are based on and that may perpetuate social injustice—should
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Igwebuike: an African concept for an inclusive medical ethics J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Luis Cordeiro‐Rodrigues, Ada Agada
Igwebuike is a traditional knowledge system undergirded by the metaphysical assumption that the world is a totality of interconnected and interrelated entities.1–4 African scholars in West Africa often invoke igwebuike to make sense of African ethical, social and political perspectives that are grounded in the theory of Afro-communitarianism. Afro-communitarianism is primarily a socioethical theory
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Time to treat the climate and nature crisis as one indivisible global health emergency J. Med. Eth. (IF 4.1) Pub Date : 2024-03-01 Chris Zielinski
Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and
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Pregnancy loss care should not be biased in favour of human gestation J. Med. Eth. (IF 4.1) Pub Date : 2024-02-13 Andrea Bidoli
In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals
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Addressing or reinforcing injustice? Artificial amnion and placenta technology, loss-sensitive care and racial inequities in preterm birth J. Med. Eth. (IF 4.1) Pub Date : 2024-02-13 Sophie L Schott, Faith Fletcher, Alice Story, April Adams
Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic
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Courts, rights and the critically brain-injured patient J. Med. Eth. (IF 4.1) Pub Date : 2024-02-12 Barry Lyons, Mary Donnelly
The reality of current clinical practice in the UK is that where a patient’s family refuses to agree to testing for brain stem death (BD), such cases will ultimately end up in court. This situation is true of both adults and children and reinforced by recent legal cases. While recourse to the courts might be regrettable in such tragic cases, if public trust in the medical diagnosis of BD is to be maintained
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Ethical argument for establishing good manufacturing practice for phage therapy in the UK J. Med. Eth. (IF 4.1) Pub Date : 2024-02-11 Mehrunisha Suleman, Jason R Clark, Susan Bull, Joshua D Jones
Antimicrobial resistance (AMR) poses an increasing threat to patient care and population health and there is a growing need for novel therapies to tackle AMR. Bacteriophage (phage) therapy is a re-emerging antimicrobial strategy with the potential to transform how bacterial infections are treated in patients and populations. Currently, in the UK, phages can be used as unlicensed medicinal products
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Impairing the impairment argument J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Kyle van Oosterum, Emma J Curran
Blackshaw and Hendricks have recently developed and defended the impairment argument against abortion, arguing that the immorality of giving a child fetal alcohol syndrome (FAS) provides us with reason to believe that abortion is immoral. In this paper, we forward two criticisms of the impairment argument. First, we highlight that, as it currently stands, the argument is very weak and accomplishes
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Restraint in somatic healthcare: how should it be regulated? J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Amina Guenna Holmgren, Ann-Christin von Vogelsang, Anna Lindblad, Niklas Juth
Restraint is regularly used in somatic healthcare settings, and countries have chosen different paths to regulate restraint in somatic healthcare. One overarching problem when regulating restraint is to ensure that patients with reduced decision-making capacity receive the care they need and at the same time ensure that patients with a sufficient degree of decision-making capacity are not forced into
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Consent to testing for brain death J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Barry Lyons, Mary Donnelly
Canada has recently published a new Clinical Practice Guideline on the diagnosis and management of brain death. It states that consent is not necessary to carry out the interventions required to make the diagnosis. A supporting article not only sets out the arguments for this but also contends that ‘UK laws similarly carve out an exception, excusing clinicians from a prima facie duty to get consent’
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Sport-related concussion research agenda beyond medical science: culture, ethics, science, policy J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Mike McNamee, Lynley C Anderson, Pascal Borry, Silvia Camporesi, Wayne Derman, Soren Holm, Taryn Rebecca Knox, Bert Leuridan, Sigmund Loland, Francisco Javier Lopez Frias, Ludovica Lorusso, Dominic Malcolm, David McArdle, Brad Partridge, Thomas Schramme, Mike Weed
The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain
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Justification of principles for healthcare priority setting: the relevance and roles of empirical studies exploring public values J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Erik Gustavsson, Lars Lindblom
How should scarce healthcare resources be distributed? This is a contentious issue that became especially pressing during the pandemic. It is often emphasised that studies exploring public views about this question provide valuable input to the issue of healthcare priority setting. While there has been a vast number of such studies it is rarely articulated, more specifically, what the results from
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A human right to pleasure? Sexuality, autonomy and egalitarian strategies J. Med. Eth. (IF 4.1) Pub Date : 2024-02-08 Jon Wittrock
A growing focus on pleasure in human rights discourse has been used to address patterns of sexual exclusion, often when addressing the problems of people with disabilities (PWD). As convincingly argued by Liberman, however, not all PWD suffer from sexual exclusion, and not all who suffer from sexual exclusion are PWD. Danaher and Liberman have thus argued in various ways for a broader range of measures
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Procreative loss without pregnancy loss: the limitations of fetal-centric conceptions of pregnancy J. Med. Eth. (IF 4.1) Pub Date : 2024-02-07 Hannah Carpenter, Georgia Loutrianakis, Peyton Baker, Tiffany Bystra, Lisa Campo-Engelstein
In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite
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Overcoming (false) dichotomies to address ethical issues of artificial placentas J. Med. Eth. (IF 4.1) Pub Date : 2024-02-07 Alice Cavolo
Romanis and Adkins discuss pregnancy loss in relation to artificial amnion and placenta technology (AAPT) for treatment of extremely preterm infants.1 I agree with the authors that AAPT, although it is expected to provide better care for extremely preterm infants, will also be challenging for parents. I, therefore, commend Romanis and Adkins for promoting a more holistic care that includes parents
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Pregnancy loss in the context of AAPT: speculation over substance? J. Med. Eth. (IF 4.1) Pub Date : 2024-02-06 Susan Kennedy
Romanis and Adkins explore the near-term prospect of artificial amnion and placenta technology (AAPT) which is being developed to supplement the gestational process following the premature ending of a pregnancy.1 While fetal-centric narratives prevail in discussions surrounding AAPT, the authors subvert this trend by centering the experience of pregnant persons with respect to pregnancy loss. The overarching
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Beyond coercion: reframing the influencing other in medically assisted death J. Med. Eth. (IF 4.1) Pub Date : 2024-02-06 Mara Buchbinder, Noah Berens
This essay considers how we are to understand the decision to end one’s life under medical aid-in-dying (MAID) statutes and the role of influencing others. Bioethical concerns about the potential for abuse in MAID have focused predominantly on the risk of coercion and other forms of undue influence. Most bioethical analyses of relational influences in MAID have been made by opponents of MAID, who argue
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What makes a medical intervention invasive? A reply to commentaries J. Med. Eth. (IF 4.1) Pub Date : 2024-02-05 Gabriel De Marco, Jannieke Simons, Lisa Forsberg, Thomas Douglas
We are grateful to the commentators for their close reading of our article1 and for their challenging and interesting responses to it. We do not have space to respond to all of the objections that they raise, so in this reply, we address only a selection of them. Some commentaries question the usefulness of developing an account of the sort we provide,2 or of revising the Standard Account (SA) in doing
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Future pandemics and the urge to ‘do something’ J. Med. Eth. (IF 4.1) Pub Date : 2024-02-02 Adam Lerner, Nir Eyal
Research with enhanced potential pandemic pathogens (ePPP) makes pathogens substantially more lethal, communicable, immunosuppressive or otherwise capable of triggering a pandemic. We briefly relay an existing argument that the benefits of ePPP research do not outweigh its risks and then consider why proponents of these arguments continue to confidently endorse them. We argue that these endorsements