Cambridge Quarterly of Healthcare Ethics

ISSNs: 0963-1801, 1469-2147

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  1.  3
    Ethical Issues in Cerebral Organoid Research.Gardar Arnason, Anja Pichl & Robert Ranisch - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):515-517.
    About ten years ago, reports of lab-grown “mini brains” or “brains in a dish” appeared in the media, falling somewhere between the curious and the alarming. The trigger of these reports was a new method to grow three-dimensional neural tissue from human stem cells that recapitulates, to some degree, the early development of brain tissue. Despite their relatively small size and other limitations, such model systems capture in part the structure and functions of regions of the human brain and can (...)
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  2.  6
    A Tale of Two Chimeras: Applying the Six Principles to Human Brain Organoid Xenotransplantation.Andrew J. Barnhart & Kris Dierickx - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):555-571.
    Cerebral organoid models in-of-themselves are considered as an alternative to research animal models. But their developmental and biological limitations currently inhibit the probability that organoids can fully replace animal models. Furthermore, these organoid limitations have, somewhat ironically, brought researchers back to the animal model via xenotransplantation, thus creating hybrids and chimeras. In addition to attempting to study and overcome cerebral organoid limitations, transplanting cerebral organoids into animal models brings an opportunity to observe behavioral changes in the animal itself. Traditional animal (...)
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  3.  4
    Ethical Implications in Making Use of Human Cerebral Organoids for Investigating Stress—Related Mechanisms and Disorders.Katherine Bassil & Dorothee Horstkötter - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):529-541.
    The generation of three-dimensional cerebral organoids from human-induced pluripotent stem cells (hPSC) has facilitated the investigation of mechanisms underlying several neuropsychiatric disorders, including stress-related disorders, namely major depressive disorder and post-traumatic stress disorder. Generating hPSC-derived neurons, cerebral organoids, and even assembloids (or multi-organoid complexes) can facilitate research into biomarkers for stress susceptibility or resilience and may even bring about advances in personalized medicine and biomarker research for stress-related psychiatric disorders. Nevertheless, cerebral organoid research does not come without its own set (...)
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  4.  3
    What Do Chimeras Think About?Benjamin Capps - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):496-514.
    Non-human animal chimeras, containing human neurological cells, have been created in the laboratory. Despite a great deal of debate, the status of such beings has not been resolved. Under normal definitions, such a being could either be unconventionally human or abnormally animal. Practical investigations in animal sentience, artificial intelligence, and now chimera research, suggest that such beings may be assumed to have no legal rights, so philosophy could provide a different answer. In this vein, therefore, we can ask: What would (...)
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  5. Moral Uncertainty and Our Relationships with Unknown Minds.John Danaher - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):482-495.
    We are sometimes unsure of the moral status of our relationships with other entities. Recent case studies in this uncertainty include our relationships with artificial agents (robots, assistant AI, etc.), animals, and patients with “locked-in” syndrome. Do these entities have basic moral standing? Could they count as true friends or lovers? What should we do when we do not know the answer to these questions? An influential line of reasoning suggests that, in such cases of moral uncertainty, we need meta-moral (...)
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  6.  5
    Reconsidering the Many Disorders of Consciousness.Walter Glannon - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):455-459.
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  7.  2
    On the Legal Status of Human Cerebral Organoids: Lessons from Animal Law.Joshua Jowitt - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):572-581.
    This paper will ask whether the legal status presently afforded to nonhuman animals ought to influence regulatory debates concerning human cerebral organoids. The New York Courts recently refused to grant a writ of habeas corpus to Happy the Elephant as she was property rather than a legal person while at the same time accepting that she is a moral patient deserving of rights protection. An undesirable situation has therefore arisen in which the law holds a being with moral status to (...)
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  8.  5
    Consciousness and the Ethics of Human Brain Organoid Research.Karola Kreitmair - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):518-528.
    The possibility of consciousness in human brain organoids is sometimes viewed as determinative in terms of the moral status such entities possess, and, in turn, in terms of the research protections such entities are due. This commonsense view aligns with a prominent stance in neurology and neuroscience that consciousness admits of degrees. My paper outlines these views and provides an argument for why this picture of correlating degrees of consciousness with moral status and research protections is mistaken. I then provide (...)
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  9.  8
    Human Brain Organoids: Why There Can Be Moral Concerns If They Grow Up in the Lab and Are Transplanted or Destroyed.Andrea Lavazza & Massimo Reichlin - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):582-596.
    Human brain organoids (HBOs) are three-dimensional biological entities grown in the laboratory in order to recapitulate the structure and functions of the adult human brain. They can be taken to be novel living entities for their specific features and uses. As a contribution to the ongoing discussion on the use of HBOs, the authors identify three sets of reasons for moral concern. The first set of reasons regards the potential emergence of sentience/consciousness in HBOs that would endow them with a (...)
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  10.  22
    Minding Rights: Mapping Ethical and Legal Foundations of ‘Neurorights’.Sjors Ligthart, Marcello Ienca, Gerben Meynen, Fruzsina Molnar-Gabor, Roberto Andorno, Christoph Bublitz, Paul Catley, Lisa Claydon, Thomas Douglas, Nita Farahany, Joseph J. Fins, Sara Goering, Pim Haselager, Fabrice Jotterand, Andrea Lavazza, Allan McCay, Abel Wajnerman Paz, Stephen Rainey, Jesper Ryberg & Philipp Kellmeyer - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):461-481.
    The rise of neurotechnologies, especially in combination with artificial intelligence (AI)-based methods for brain data analytics, has given rise to concerns around the protection of mental privacy, mental integrity and cognitive liberty – often framed as “neurorights” in ethical, legal, and policy discussions. Several states are now looking at including neurorights into their constitutional legal frameworks, and international institutions and organizations, such as UNESCO and the Council of Europe, are taking an active interest in developing international policy and governance guidelines (...)
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  11.  10
    Placebo Effects: The Meaning of Care in Medicine by Pekka Louhiala. [REVIEW]Rebecca Macy - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):602-605.
    Pekka Louhiala crosses disciplines and decades to present a remarkably detailed review of the existing literature on placebos, placebo effects, and related concepts. The problem at hand—and Louhiala does aptly frame it as a problem—is a striking lack of consensus among researchers, scholars, and clinicians regarding virtually all aspects of the placebo topic. In capturing the complexity of this problem, Louhiala expertly compiles an extensive catalog of placebo literature that effectively gives the reader both a map of the territory and (...)
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  12.  5
    Cerebral Organoid Research Ethics and Pinning the Tail on the Donkey.Alex McKeown - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):542-554.
    The risk of creating cerebral organoids/assembloids conscious enough to suffer is a recurrent concern in organoid research ethics. On one hand, we should, apparently, avoid discovering how to distinguish between organoids that it would be permissible (non-conscious) and impermissible (conscious) to use in research, since if successful we would create organoids that suffer. On the other, if we do not, the risk persists that research might inadvertently continue to cause organoids to suffer. Moreover, since modeling some brain disorders may require (...)
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  13.  2
    Brain Model Technology and Its Implications.Alysson R. Muotri - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (4):597-601.
    The complexity of the human brain creates a spectrum of sophisticated behavioral repertoires, such as language, tool use, self-awareness, symbolic thought, cultural learning, and consciousness. Understanding how the human brain achieves that has been a longstanding challenge for neuroscientists and may bring insights into the evolution of human cognition and disease states. Human pluripotent stem cells could differentiate into specialized cell types and tissues in vitro. From this pluripotent state, it is possible to generate models of the human brain, such (...)
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  14.  6
    On Interpretation and Appreciation. A European Human Rights Perspective on Dobbs.Martin Buijsen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):323-336.
    In June 2022, the Supreme Court of the United States overturned Roe v. Wade. The European Court of Human Rights is also expected to decide on several abortion cases. In this paper, the interpretative approaches of both courts are compared. Whereas the U.S. Supreme Court in Dobbs v. Jackson Women’s Health Organization decided on an originalist approach to the Constitution, the highest European court has always regarded the European Convention on Human Rights as a living instrument. As a result, domestic (...)
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  15.  3
    Eating in Isolation: A Normative Comparison of Force Feeding and Solitary Confinement.Emma Buzath & Zohar Lederman - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):414-424.
    The practice of solitary confinement (SC) is established within the literature as a common occurrence of torture within the prison system, and many international and national human rights organizations have called for its abolition. A somewhat more contentious topic in the literature is the practice of force feeding (FF) of hunger-striking prisoners. The paper aims to make a case against FF by establishing a parity argument that states the following: If SC is considered an immoral practice (and indeed it should (...)
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  16.  3
    Dobbs, the Intrusive State, and the Future of Solidarity.Christine Nero Coughlin & Nancy M. P. King - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):344-356.
    The intrusive state has long viewed women as fetal containers. The Dobbs decision goes further, essentially causing women to vanish when fetuses are abstracted from their relationships to pregnant persons. The ways in which women are first controlled and then made invisible are clearly connected with the move from obedience to omission that has historically affected black Americans. When personal decisionmaking and participation in democracy are regarded as threats, those threatened restrict decisional freedom and political power, deepening structural injustices relating (...)
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  17.  6
    Anarchy and Its Overlooked Role in Health and Healthcare.Ryan Essex - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):397-405.
    In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of (...)
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  18.  5
    Abortion and “Zombie” Laws: Who Is Accountable?Leonard M. Fleck - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):307-308.
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  19.  3
    The Dobbs Decision: Can It Be Justified by Public Reason?Leonard M. Fleck - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):310-322.
    John Rawls has held up as a model of public reason the U.S. Supreme Court. I argue that the Dobbs Court is justifiably criticized for failing to respect public reason. First, the entire opinion is governed by an originalist ideological logic almost entirely incongruent with public reason in a liberal, pluralistic, democratic society. Second, Alito’s emphasis on “ordered liberty” seems completely at odds with the “disordered liberty” regarding abortion already evident among the states. Third, describing the embryo/fetus from conception until (...)
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  20.  4
    Roe v. Wade and the Predatory State Interest in Protecting Future Cannon Fodder.Matti Häyry - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):434-442.
    The reversal of Roe v. Wade by the U.S. Supreme Court allowed the states to regulate terminations of pregnancy more autonomously than during 1973–2022. Those who think that women should be legally entitled to abortions at their own request are suggesting that annulling the reversal could be an option. This would mean continued reliance on the interpretation of privacy that Roe v. Wade stood on. The interpretation does not have the moral support that its supporters think. This can be shown (...)
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  21.  4
    On the Ethics of Withholding and Withdrawing Unwarranted Diagnoses.Bjørn Morten Hofmann & Marianne Lea - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):425-433.
    The number of diagnoses and the number of persons having diagnoses have increased substantially, and studies indicate that diagnoses are given or upheld even if they are unwarranted, that is, that they do not satisfy professionally accepted diagnostic criteria. In this article, the authors investigate the ethics of withholding and withdrawing unwarranted diagnoses. First, they investigate ethical aspects that make it difficult to withhold and to withdraw such diagnoses. Second, they scrutinize whether there are psychological factors, both in persons/patients and (...)
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  22.  5
    The Stability of Political Compromise—Abortion Legislation in Denmark and Norway.Søren Holm - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):337-343.
    In the 1970s, both Denmark and Norway passed abortion legislation that is still the basis for the regulation of abortion in these countries. The legislation was fairly liberal with abortion on demand until 12 weeks of gestation and a permission system for later abortions. This article provides a brief history of the developments leading up to these political compromises and an analysis of the reasons why they have proved remarkably stable. It ends by looking at some factors that may now (...)
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  23.  34
    Kantian Conscientious Objection: A Reply to Kennett.Ryan Kulesa - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):450-453.
    In her paper, “The cost of conscience: Kant on conscience and conscientious objection,” Jeanette Kennett argues that a Kantian view of conscientious objection in medicine would bar physicians from refusing to perform certain practices based on conscience. I offer a response in the following manner: First, I reconstruct her main argument; second, I present a more accurate picture of Kant’s view of conscience. I conclude that, given a Kantian framework, a physician should be allowed to refuse to perform practices that (...)
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  24.  4
    Kantian Conscientious Objection: A Reply to Kennett—ERRATUM.Ryan Kulesa - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):454-454.
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  25.  3
    The Value of the Patient Voice: A Review of Salt in My Soul by Mallory Smith. [REVIEW]Michelle LaBonte - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):443-446.
    Mallory Smith’s posthumously published book, Salt in My Soul: An Unfinished Life, is an insightful and moving account of one young woman’s experience living with a chronic, often invisible, illness.1 Mallory was diagnosed with cystic fibrosis (CF) at age three and began writing in a journal when she was 15. According to those close to her, Mallory wrote consistently over the span of 10 years, until shortly before she died at age 25 from complications related to a double lung transplant. (...)
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  26.  10
    A Critical Analysis of Dobbs v. Jackson Women’s Health Organization and the Consequences of Fetal Personhood.Bertha Alvarez Manninen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):357-367.
    In this paper, I will examine the Supreme Court of the United States’ (SCOTUS) arguments in the majority decision in Dobbs v. Jackson Women’s Health Organization, and I will show how some of those arguments are flawed. Primarily, I will show that the right to bodily autonomy is a well-established right, both in the courts and in societal practices, and that the right to an abortion should be understood as an example of the right to bodily autonomy or bodily integrity. (...)
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  27.  3
    A Balance of Rights: The Italian Way to the Abortion Controversy.Massimo Reichlin & Andrea Lavazza - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):368-377.
    The U.S. Supreme Court’s Dobbs ruling triggered a global debate about access to abortion and the legislative models governing it. In the United States, there was a sudden reversal of federal guidance about pregnancy termination that is unprecedented in Western and high-income countries. The strong polarization on the issue of abortion and the difficulty of finding a point of compromise lead one to consider the experiences of countries that have had different paths. Italy stands as a candidate for being a (...)
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  28.  7
    Abortion Access and the Benefits and Limitations of Abortion- Permissive Legal Frameworks: Lessons from the United Kingdom.Elizabeth Chloe Romanis - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):378-390.
    This paper argues that abortion access is an important subject for bioethics scholarship and reflects on the relationship between legal frameworks and access to care. The author uses the example of the United Kingdom to examine the benefits and limitations of abortion-permissive legal frameworks in terms of access. These are legal frameworks that enable the provision of abortion but subject to restrictions. An abortion-permissive regime—first in Great Britain and then in Northern Ireland—has gone some way to improving access to care (...)
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  29.  3
    Physicians Controlling Women’s Reproductive Choices: The Slow Liberalization of Abortion Laws in Finland.Tuija Takala & Matti Häyry - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):391-396.
    This paper provides an overview of the development and the sociopolitical background of legislation pertaining to abortion in Finland from the nineteenth century to the current day. The first Abortion Act came to force in 1950. Before that, abortions were handled under criminal law. The 1950 law was restrictive and allowed abortions in very limited circumstances only. Its main aim was to reduce the number of abortions and especially illegal abortions. It was not very successful in reaching these goals, but, (...)
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  30.  2
    The Moral Bindingness of Advance Directives.Gianluca Montanari Vergallo - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):447-449.
    Professor Latham has written a thought-provoking commentary1 on my paper about advance directives.2 I am grateful for this opportunity to integrate the debate on the moral binding nature of these manifestations of will.
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  31.  4
    When Appearances Matter: A Taxonomy and Ethics for Demographic-Based Provider Requests.Carrie C. Wu & Jacob M. Appel - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):406-413.
    Requests by patients for providers of specific demographic backgrounds pose an ongoing challenge for hospitals, policymakers, and ethicists. These requests may stem from a wide variety of motivations; some may be consistent with broader societal values, although many others may reflect prejudices inconsistent with justice, equity, and decency. This paper proposes a taxonomy designed to assist healthcare institutions in addressing such cases in a consistent and equitable manner. The paper then reviews a range of ethical and logistical challenges raised by (...)
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  32.  8
    Germline Gene Editing: The Gender Issues.Iñigo de Miguel Beriain, Ekain Payán Ellacuria & Begoña Sanz - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):186-192.
    Human germline gene editing constitutes an extremely promising technology; at the same time, however, it raises remarkable ethical, legal, and social issues. Although many of these issues have been largely explored by the academic literature, there are gender issues embedded in the process that have not received the attention they deserve. This paper examines ways in which this new tool necessarily affects males and females differently—both in rewards and perils. The authors conclude that there is an urgent need to include (...)
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  33.  2
    Commentary on Rissfeldt: The Small Matter of the Doctor’s Autonomy.Martin Buijsen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):263-269.
    In his article, Thomas Rissfeldt argues the compatibility of palliative care with euthanasia and assisted suicide.1 By his account, many working within the field of palliative care feel that euthanasia and physician-assisted suicide are incompatible with palliative care. Wrongly, according to the author, since (1) the aims of palliative care and euthanasia/assisted suicide are not different, (2) euthanasia and assisted suicide are compatible with the fundamental role of the physician as healer, and (3) euthanasia and assisted suicide do not necessarily (...)
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  34. Reluctant Rulers: Policy, Politics, and Assisted Reproduction Technology in Japan.Silvia Croydon - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):289-299.
    This article puts the spotlight on the world’s largest artificial reproduction technology (ART) industry—that of Japan, seeking to explain the exceptional tardiness of the government there to install a comprehensive legal framework that regulates these practices. By relying on minutes from a conversation with an influential parliamentarian active in this area, as well as official documents, media reports, and an interview conducted with key physicians, the article reconstructs the historical trajectory leading to the enactment in December 2020 of the Assisted (...)
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  35.  2
    Trusting the Government to Do the Right Thing: Data Ethics in Australia’s Pandemic Response.Sally Dalton-Brown - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):222-230.
    After a brief overview of ethical issues in an Australian context catalyzed by the current pandemic, this article focuses on data protection in the light of recent debates about COVID-19 data tracking in Australia and globally. This article looks at the issue of trust as a fundamental principle of effective and ethical COVID-safe measures undertaken by the government. Key to ensuring such trust are Habermasian participatory dialogs, which assume trust as a condition of authentic illocution, and an emphasis on short-term (...)
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  36. Healthcare Priorities: The “Young” and the “Old”.Ben Davies - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):174-185.
    Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have a (...)
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  37. Fear of Dementia and the Obligation to Provide Aggregate Research Results to Study Participants—ADDENDUM.Mackenzie Graham, Francesca Farina, Craig W. Ritchie, Brian Lawlor & Lorina Naci - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):306-306.
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  38.  22
    Healthcare Professionals’ Conflicts When Treating Transgender Youth: Is It Necessary to Prioritize Protection Over Respect?Maximiliane Hädicke, Manuel Föcker, Georg Romer & Claudia Wiesemann - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):193-201.
    Increasingly, transgender minors are seeking medical care such as puberty-suppressing or gender-affirming hormone therapies. Yet, whether these interventions should be performed at all is highly controversial. Some healthcare practitioners oppose irreversible interventions, considering it their duty to protect children from harm. Others view minors, like adults, as transgender individuals who must be protected from discrimination. The underlying ethical question is presented as a problem of priority. Is it primarily relevant that minors are involved? Or should decision makers focus on the (...)
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  39.  7
    Cost-Effectiveness, Incompleteness, and Discrimination.Anders Herlitz - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):163-173.
    This paper argues that cost-effectiveness analysis in the healthcare sector introduces a discrimination risk that has thus far been underappreciated and outlines some approaches one can take toward this. It is argued that appropriate standards used in cost-effectiveness analysis in the healthcare sector fail to always fully determine an optimal option, which entails that cost-effectiveness analysis often leaves decision makers with large sets of permissible options. Larger sets of permissible options increase the role of decision makers’ biases, whims, and prejudices, (...)
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  40.  3
    Improving the Implementation of Advance Directives in Spain.Benjamín Herreros, Pablo Gella, Emanuele Valenti, Octavio Márquez, Beatriz Moreno & Tayra Velasco - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):270-275.
    Since 2002, legislation in Spain has allowed for the creation and documentation of end-of-life decisionmaking. Over the intervening years, the actual implementation of such documents is very low. Through extensive analysis of the literature, this article explores the current status of the use of and attitudes toward advance directives in Spain and then proposes strategies for improvement in their implementation.
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  41.  19
    Cost-Effectiveness and the Avoidance of Discrimination in Healthcare: Can We Have Both?Kasper Lippert-Rasmussen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):202-215.
    Many ethical theorists believe that a given distribution of healthcare is morally justified only if (1) it is cost-effective and (2) it does not discriminate against older adults and disabled people. However, if (3) cost-effectiveness involves maximizing the number of quality-adjusted life-years (QALYs) added by a given unit of healthcare resource, or cost, it seems the pursuit of cost-effectiveness will inevitably discriminate against older adults and disabled patients. I show why this trilemma is harder to escape than some theorists think. (...)
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  42.  3
    QALYs, Disability Discrimination, and the Role of Adaptation in the Capacity to Recover: The Patient-Sensitive Health-Related Quality of Life Account.Julia Mosquera - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):154-162.
    Quality-Adjusted Life Years (QALYs) and Disability-Adjusted Life Years (DALYs) are two of the most commonly used health measures to determine resource prioritization and the population burden of disease, respectively. There are different types of problems with the use of QALYs and DALYs for measuring health benefits. Some of these problems have to do with measurement, for example, the weights they ascribe to health states might fail to reflect with exact accuracy the actual well-being or health levels of individuals. But even (...)
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  43.  2
    Motherhood, Fairness, and Flourishing: Widening Reproductive Choices in Saudi Arabia.Ruaim Muaygil - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):276-288.
    In a landmark Fatwa, Saudi Arabia’s highest religious authority—The Council of Senior Scholars—declared the Islamic permissibility of oocyte cryopreservation. The fatwa sanctioned the retrieval, preservation, and future use of oocytes, ovarian tissue, and whole ovaries from cancer patients receiving gonadotoxic interventions. Although momentous, the fatwa’s specification of cancer patients effectively rendered this technology unavailable to others to whom it may be similarly beneficial, including patients with other medical conditions or patients seeking elective cryopreservation. This article argues in favor of widening (...)
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  44.  1
    The Ethical Acceptability of a Recipient’s Choice of Donor in Directed and Nondirected Transplantation: Japanese Perspective.Eisuke Nakazawa, Margie H. Shaw & Akira Akabayashi - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):216-221.
    In organ transplantation, there is a lack of ethical discussion about the recipient’s right not to receive a transplant. Using the current situation of living organ transplantation and deceased organ transplantation in Japan as an example, we prospectively discussed to what extent the recipient’s right not to receive a transplant is ethically acceptable. In directed transplantation from a living donor, a recipient may refuse organ donation from a particular donor. It is preferable that a recipient’s request for organ donation from (...)
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  45.  5
    Disability Discrimination and Patient-Sensitive Health-Related Quality of Life.Lasse Nielsen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):142-153.
    It is generally accepted that morally justified healthcare rationing must be non-discriminatory and cost-effective. However, given conventional concepts of cost-effectiveness, resources spent on disabled people are spent less cost-effectively, ceteris paribus, than resources spent on non-disabled people. Thus, it is reasonable to assume that standard cost-effectiveness discriminates against the disabled. Call this the disability discrimination problem. Part of the disability discrimination involved in cost-effectiveness stems from the way in which health-related quality of life is accounted for and measured. This paper (...)
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  46. Clarifying the Discussion on Prioritization and Discrimination in Healthcare.Joona Räsänen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):139-140.
    Discrimination is an important real-life issue that affects many individuals and groups. It is also a fruitful field of study that intersects several disciplines and methods. This Special Section brings together papers on discrimination and prioritization in healthcare from leading scholars in bioethics and closely related fields.
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  47.  10
    Euthanasia and Assisted Suicide Are Compatible with Palliative Care and Are Not Rendered Redundant by It.Thomas D. Riisfeldt - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):254-262.
    It is often argued by health professionals working within the field of palliative care that palliative care and euthanasia/assisted suicide are incompatible. Across the literature, this claim is grounded on the three claims that (1) palliative care and euthanasia/assisted suicide have different aims, (2) euthanasia/assisted suicide is at odds with the doctor’s fundamental role as a healer, and (3) euthanasia/assisted suicide constitutes patient abandonment. Furthermore, even if palliative care and euthanasia/assisted suicide are compatible, it is often argued that the availability (...)
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  48.  1
    Moral Distress Under Structural Violence: Clinician Experience in Brazil Caring for Low-Income Families of Children with Severe Disabilities.Ana Carolina Gahyva Sale & Carolyn Smith-Morris - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):231-243.
    Rigorous attention has been paid to moral distress among healthcare professionals, largely in high-income settings. More obscure is the presence and impact of moral distress in contexts of chronic poverty and structural violence. Intercultural ethics research and dialogue can help reveal how the long-term presence of morally distressing conditions might influence the moral experience and agency of healthcare providers. This article discusses mixed-methods research at one nongovernmental social support agency and clinic in Rio de Janeiro, Brazil. Chronic levels of moral (...)
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  49. Moral Distress Under Structural Violence: Clinician Experience in Brazil Caring for Low-Income Families of Children with Severe Disabilities—ERRATUM.Ana Carolina Gahyva Sale & Carolyn Smith-Morris - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):305-305.
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  50.  3
    Mobile Health in China: Well Integrated or a New Divide?Lujia Sun & Martin Buijsen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):244-253.
    The application of mobile health holds promises of achieving greater accessibility in the evolving health care sector. The active engagement of private actors drives its growth, while the challenges that exist between health care privatization and equitable access are a concern. This article selects the private internet hospital in China as a case study. It indicates that a market-oriented regulatory mechanism of private mobile health will contribute little to improving health equity from the perspectives of egalitarians and libertarians. By integrating (...)
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  51.  1
    Review of Dranove and Burns, 2021. Big Med: Megaproviders and the High Cost of Health Care in America[REVIEW]Lauren A. Taylor - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):300-304.
    David Dranove and Lawton Burn’s new collaboration Big Med: Megaproviders and the High Cost of Health Care in America provides readers with a comprehensive tutorial on consolidation in United States healthcare markets over the past 40 years. Although the book is most explicitly aimed at those who look around and wonder how we arrived at a healthcare landscape dominated by giants, anyone with a serious interest in the prices of U.S. healthcare will want to have this rigorous and timely treatment (...)
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  52.  3
    Reconsidering Capacity to Appoint a Healthcare Proxy.Jacob M. Appel - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):69-75.
    Clinicians are often called upon to assess the capacity of a patient to appoint a healthcare agent. Although a consensus has emerged that the standard for such assessment should differ from that for capacity to render specific healthcare decisions, exactly what standard should be employed remains unsettled and differs by jurisdiction. The current models in use draw heavily upon analogous methods used in clinical assessment, such as the “four skills” approach. This essay proposes an alternative model that relies upon categorization (...)
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  53.  3
    Anything Goes? Analyzing Varied Understandings of Assent.Giles Birchley - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):76-89.
    Assent to medical research or treatment may be an intuitively attractive way to address the area between incapacity and capacity that might otherwise be subject to a best interests assessment. Assent has become a widely disseminated concept in law, research, and clinical ethics, but little conceptual work on assent has so far occurred. An exploration of use of assent in treatment and research in children and people with dementia suggests that at least five claims are made on behalf of assent. (...)
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  54.  52
    Existential Suffering as a Legitimization of Euthanasia.Jasper Doomen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):14-25.
    Several countries have legalized euthanasia on the basis of medically diagnosable suffering over the last decennial; the criteria to which they adhere differ. The topic of this article is euthanasia on the basis of existential suffering. This article presents a recent proposal to legalize euthanasia for people who experience such suffering and then discusses the issue of what the value of life may be, and whether the standard that life is normally something positive should be accepted. This provides the foundation (...)
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  55.  4
    Bioethics, Ukraine, and the Peril of Silence.Joseph J. Fins - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):1-3.
    By considering the history of bioethics and international humanitarian law, Joseph J. Fins contends that bioethics as an academic and moral community should stand in solidarity with Ukraine as it defends freedom and civility.
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  56.  2
    Nudging, Bullshitting, and the Meta-Nudge.Scott D. Gelfand - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):56-68.
    In “Nudging, Bullshitting, and the Meta-Nudge”, the author responds to William Simkulet’s claim that nudging is bullshitting (according to Harry Frankfurt’s analysis of bullshit and bullshitting), and therefore nudging during the process of informed consent renders consent invalid. The author argues that nudging is not necessarily bullshitting and then explains that although this issue is philosophically interesting, practically speaking, even if nudging is bullshitting, it does not follow that nudging necessarily renders informed consent invalid. This is obviously true in those (...)
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  57.  1
    A Response to Zambrano.John Harris - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):134-137.
    Alexander Zambrano sets out to refute an argument that I have made on a number of occasions over many years since 1992, which he calls “Harris’s Greater Need Argument” (2002).
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  58.  94
    Pandemic Rule-Breakers, Moral Luck, and Blaming the Blameworthy.Jesse Hill - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):41-47.
    This paper takes under consideration a piece by Roger Crisp in which he questions what the problem of moral luck can teach us about COVID-19 lockdown rule-breakers. Taking the position that although such rule-breakers might seem to be new examples of moral luck, Crisp ends up denying the existence of moral luck and argues that moral luck is an outdated notion in so far as it relies on other questionable aspects of morality, that is, retributivist punishment and blame. Although the (...)
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  59.  5
    Frailty as a Priority-Setting Criterion for Potentially Lifesaving Treatment—Self-Fulfilling Prophecy, Circularity, and Indirect Discrimination?Søren Holm & Daniel Joseph Warrington - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):48-55.
    Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor event. Frailty is most frequently assessed in the old using the Clinical Frailty Scale (CSF) which ranks frailty from 1 to 9. This assessment typically takes less than one minute and is not validated in patients with learning difficulties or those under 65 years old. The National Institute for Health and Care Excellence (NICE) developed guidelines that use “frailty” as one of the priority-setting criteria for (...)
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  60.  3
    Two Views of Vulnerability in the Evolution of Canada’s Medical Assistance in Dying Law.Sarah J. Lazin & Jennifer A. Chandler - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):105-117.
    Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable and irremediable (...)
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  61.  6
    The Reification of Non-Human Animals.Silvia Caprioglio Panizza - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):90-104.
    This paper takes up Axel Honneth’s suggestion that we, in the 21st century Western world, should revisit the Marxian idea of reification; unlike Honneth, however, this paper applies reification to the ways in which humans relate to non-human animals, particularly in the context of scientific experiments. Thinking about these practices through the lens of reification, the paper argues, yields a more helpful understanding of what is regarded as problematic in those practices than the standard animal rights approaches. The second part (...)
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  62.  3
    Midlife: A Philosophical Guide by Kieran Setiya, Princeton University Press, 2017.Michael Ridge - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):118-122.
    CQ ReviewThe main goal of the Book Review Section of Cambridge Quarterly is to cultivate a place where scholars can share their thoughts on broad philosophical topics sparked by noteworthy books. Instead of focusing narrowly on works in healthcare ethics, our reviews cast a wider net so that we may reflect on diverse ideas. Please email [email protected] if you have book recommendations or if you are interested in writing a review.
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  63.  4
    Accepting Moral Luck and Taking Responsibility in Public Health Crises.Daniel Tigard - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):34-40.
    We see cases of moral luck arising in recent times, as we face the uncertainties of provisional rules for navigating the coronavirus pandemic. How should we respond to rule-breakers, and how should they view themselves, when they cause harm inadvertently? Although some argue that guilt is unnecessary for any harm that may result from luck, this paper takes moral luck seriously and encourages consideration of the benefits to be achieved by expressions of self-blame amidst troubling circumstances, from pure accidents to (...)
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  64.  4
    Should the Dutch Law on Euthanasia Be Expanded to Include Children?A. A. E. Verhagen & Martin Buijsen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):5-13.
    The 2002 Dutch Euthanasia law applies to patients aged 12 years and older. Developments in end-of-life care and decision-making in the last decade have sparked the debate about usefulness and necessity to extend euthanasia to include children under 12 years of age. This paper describes two opposite positions: the affirmative position of a pediatrician and expert in pediatric palliative care and the negative position of a jurist and specialist in health law.
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  65.  5
    Health, Health Care, and Equality of Opportunity: The Rationale for Universal Health Care.Gry Wester - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):26-33.
    This article discusses what arguments best support universal health care (UHC), with a focus on Norman Daniels’ equality of opportunity account. This justification for UHC hinges on the assumption of a close relationship between health care and health. But in light of empirical research that suggests that health outcomes are shaped to a large extent by factors other than health care, such as income, education, housing, and working conditions, the question arises to what extent health care is really necessary to (...)
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  66.  5
    Organ Conscription and Greater Needs.Alexander Zambrano - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (1):123-133.
    Since its inception, the institution of postmortem organ transplantation has faced the problem of organ shortage: Every year, the demand for donor organs vastly exceeds supply, resulting in the deaths of approximately 8,000 individuals in the United States alone.1 This is in large part due to the fact that the United States, for the most part, operates under an “opt-in” policy in which people are given the opportunity to voluntarily opt-in to organ donation by registering as organ donors.2 In the (...)
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