Cambridge Quarterly of Healthcare Ethics

ISSNs: 0963-1801, 1469-2147

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  1.  13
    On Matti Häyry’s “Exit Duty Generator”.Karim Akerma - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):232-237.
    Matti Häyry presents a new ethical theory that he calls “conflict-responsive need-based negative utilitarianism.”1 In this commentary, I present my critical observations on his main points against the more general background of utilitarianism and theories of value.
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  2.  13
    Decisional Capacity After Dark: Is Autonomy Delayed Truly Autonomy Denied?Jacob M. Appel - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):260-266.
    The model for capacity assessment in the United States and much of the Western world relies upon the demonstration of four skills including the ability to communicate a clear, consistent choice. Yet such assessments often occur at only one moment in time, which may result in the patient expressing a choice to the evaluator that is highly inconsistent with the patient’s underlying values and goals, especially if a short-term factor (such as frustration with the hospital staff) distorts the patient’s preferences (...)
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  3. Welfare, Abortion, and Organ Donation: A Reply to the Restrictivist.Emily Carroll & Parker Crutchfield - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):290-295.
    We argued in a recent issue of this journal that if abortion is restricted,1 then there are parallel obligations for parents to donate body parts to their children. The strength of this obligation to donate is proportional to the strength of the abortion restrictions. If abortion is never permissible, then a parent must always donate any organ if they are a match. If abortion is sometimes permissible and sometimes not, then organ donation is sometimes obligatory and sometimes not. Our argument (...)
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  4.  18
    Applying the Peter Parker Principle to Healthcare.James E. Stahl & William A. Nelson - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):271-274.
    The role of power in healthcare can raise many ethical challenges. Power is ownership, whether given, ceded, or taken of another person’s autonomy. When a person has power over someone else, they can control or strongly influence the decision-making freedom of that person. From the principalist perspective1,2 of healthcare ethics, denying a person their freedom to choose, should only occur when justifying conditions related to beneficence and nonmaleficence are sufficiently satisfied. In healthcare, it is rare to be able to identify (...)
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  5.  20
    Baseball and Bioethics Revisited: The Pitch Clock and Age Discrimination in a Timeless Pastime.Joseph J. Fins - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):267-270.
    In this essay, the author reflects on a decade’s old essay on baseball and bioethics inspired by a conversation with the late David Thomasma. In a reprise of his earlier paper, Fins worries that modernity has come to baseball with the advent of the pitch clock and that this innovation brings age discrimination to a timeless pastime.
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  6.  13
    Exit Duty Generator.Matti Häyry - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):217-231.
    This article presents a revised version of negative utilitarianism. Previous versions have relied on a hedonistic theory of value and stated that suffering should be minimized. The traditional rebuttal is that the doctrine in this form morally requires us to end all sentient life. To avoid this, a need-based theory of value is introduced. The frustration of the needs not to suffer and not to have one’s autonomy dwarfed should, prima facie, be decreased. When decreasing the need frustration of some (...)
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  7.  92
    Imposing a Lifestyle: A New Argument for Antinatalism.Matti Häyry & Amanda Sukenick - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):238-259.
    Antinatalism is an emerging philosophy and practice that challenges pronatalism, the prevailing philosophy and practice in reproductive matters. We explore justifications of antinatalism—the arguments from the quality of life, the risk of an intolerable life, the lack of consent, and the asymmetry of good and bad—and argue that none of them supports a concrete, understandable, and convincing moral case for not having children. We identify concentration on possible future individuals who may or may not come to be as the main (...)
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  8.  31
    Theories or No Theories—Is Anything Evolving?Matti Häyry & Tuija Takala - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):151-157.
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  9.  63
    Bioethics Without Theory?Søren Holm - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):159-166.
    The question that this paper tries to answer is Q: “Can good academic bioethics be done without commitment to moral theory?” It is argued that the answer to Q is an unequivocal “Yes” for most of what we could call “critical bioethics,” that is, the kind of bioethics work that primarily criticizes positions or arguments already in the literature or put forward by policymakers. The answer is also “Yes” for much of empirical bioethics. The second part of the paper then (...)
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  10.  25
    Vulnerability Ethics, Abortion, and Organ Donation.Elizabeth Latham - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):300-306.
    In a recent issue of the Cambridge Quarterly of Healthcare Ethics, Emily Carroll and Parker Crutchfield published a paper entitled, “The Duty to Protect, Abortion, and Organ Donation.” They argued that a prohibition on abortion is morally equivalent to a positive mandate for parents to donate organs to their children and that opponents of abortion must be prepared to accept these mandates to remain consistent.
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  11.  16
    A Catholic Perspective on COVID-19.John J. Paris & Brian M. Cummings - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):285-289.
    It took nearly two thousand years for society to recognize the Hippocratic insistence that “the doctor knows best”1 was an inadequate approach to medical decisionmaking. Today, patient-centered medicine has come to understand that the individual patient has a significant role in the decisionmaking process.2.
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  12.  20
    Narrating the Black Body in “Under the Skin” - Review of Linda Villarosa, 2022. Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation. Doubleday.Keisha Ray - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):275-279.
    Poor health is not inherently a part of Black Americans’ bodies; poor health is not in our DNA. But as Linda Villarosa says in Under the Skin “something about being Black has led to the documented poor health of Black Americans.”1 Like many other scholars of Black health have said, Villarosa proposes, and evidence supports, that “the something is racism.”2 Villarosa attributes Black people’s generally inferior health outcomes in areas like pregnancy and birth, pain care, and cardiology to racism and (...)
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  13.  42
    Pragmatism and Experimental Bioethics.Henrik Rydenfelt - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):174-184.
    Pragmatism gained considerable attention in bioethical discussions in the early 21st century. However, some dimensions and contributions of pragmatism to bioethics remain underexplored in both research and practice. It is argued that pragmatism can make a distinctive contribution to bioethics through its concept, developed by Charles S. Peirce and John Dewey, that ethical issues can be resolved through experimental inquiry. Dewey’s proposal that policies can be confirmed or disconfirmed through experimentation is developed by comparing it to the confirmation of scientific (...)
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  14.  16
    Strategic Ambiguity: The Pragmatic Utopianism of Daniel Callahan’s “Bioethics as a Discipline”.Mathias Schütz - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):167-173.
    This article highlights the continuing relevance of a classic bioethical text, “Bioethics as a Discipline,” published by the Hastings Center’s cofounder Daniel Callahan in 1973. Connecting the text’s programmatic recommendations with later reflections and interventions Callahan wrote about the development of bioethics illuminates how the vision Callahan established and the reality this vision helped create were interrelated—just not in the way Callahan had hoped for. Although this portrait relies on an individual perception of the development of bioethics, it might nevertheless, (...)
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  15.  22
    The Role of Exceptionalism in the Evolution of Bioethical Regulation.Sergei Shevchenko & Alexey Zhavoronkov - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):185-197.
    The paper aims to present a critical analysis of the phenomenon and notion of exceptionalism in bioethics. The authors demonstrate that exceptionalism pertains to phenomena that are not (yet) entirely familiar to us and could potentially bear risks regarding their regulation. After an overview of the state of the art, we briefly describe the origins and evolution of the concept, compared to exception and exclusion. In the second step, they look at the overall development debates on genetic exceptionalism, compared to (...)
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  16.  18
    What’s Wrong with Restrictivism?William M. Simkulet - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (2):296-299.
    Emily Carroll and Parker Crutchfield propose a new inconsistency argument against abortion restrictivism. In response, I raised several objections to their argument. Recently Carroll and Crutchfield have replied and seem to be under the impression that I’m a restrictivist. This is puzzling, since my criticism of their view included a very thinly veiled, but purposely more charitable, anti-restrictivist inconsistency argument. In this response, I explain how Carroll and Crutchfield mischaracterize my position and that of the restrictivist.
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  17.  42
    Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting.Andreas Albertsen - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):23-34.
    Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding (...)
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  18.  17
    Social Support: From Exclusion Criteria to Medical Service.Jacob M. Appel - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):17-22.
    One of the criteria used by many transplant centers in assessing psychosocial eligibility for solid organ transplantation is social support. Yet, social support is a highly controversial requirement that has generated ongoing debate between ethicists and clinicians who favor its consideration (i.e., utility maximizers) and those who object to its use on equity grounds (i.e., equity maximizers). The assumption underlying both of these approaches is that social support is not a commodity that can be purchased in the marketplace. This essay (...)
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  19.  26
    Surrogacy and the Fiction of Medical Necessity.Teresa Baron - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):40-47.
    A number of countries and states prohibit surrogacy except in cases of “medical necessity” or for those with specific medical conditions. Healthcare providers in some countries have similar policies restricting the provision of clinical assistance in surrogacy. This paper argues that surrogacy is never medically necessary in any ordinary understanding of this term. The author aims to show first that surrogacy per se is a socio-legal intervention and not a medical one and, second, that the intervention in question does not (...)
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  20.  15
    Lost in Translation.Robert A. Burton - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):135-136.
    “Scleroderma,” the rheumatologist said after examining my stiff swollen arms and legs. “Unfortunately, given your biomarkers, it’s likely to get worse before it gets better, but you never know.” She gave a quick rundown of what I might expect—rapidly progressive skin and joint tightening, GI symptoms, high likelihood of multi-organ involvement…. “Let’s hope for the best.” She paused, then asked if I had any questions.
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  21.  13
    Xenotransplantation Can Be Safe—A Reply.Joachim Denner - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):148-149.
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  22.  28
    Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics.Ryan J. Dougherty & Joseph J. Fins - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):6-16.
    Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term “social bioethics.” Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors (...)
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  23.  19
    Precision Medicine and Rough Justice: Wicked Problems.Leonard M. Fleck - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):1-4.
    What exactly is a “wicked problem”? It is a social or economic problem that is so complex and so interconnected with other issues that it is extraordinarily difficult or impossible to resolve. This is because all proposed resolutions generate equally complex, equally wicked problems. In this essay, I argue that precision medicine, especially in the context of the U.S. healthcare system, generates numerous wicked problems related to distributive justice. Further, I argue that there are no easy solutions to these wicked (...)
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  24.  13
    Breathe.Renee J. Flores - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):137-140.
    This is a personal essay about breasts. It focuses on my experiences as a young girl, moving through adolescence to a history of breast cancer in my family, including my mother’s breast cancer diagnosis. As a physician, patient, and wife, I reflect on the choices that I have to make and what this means for my identity as a woman and mother.
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  25.  17
    Federalism for Bioethics?Leslie Francis & John Francis - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):112-120.
    In the wake of the Dobbs decision withdrawing federal constitutional protection for reproductive rights, the United States is in the throes of federalist conflicts. Some states are enacting draconian prohibitions of abortion or gender-affirming care, whereas other states are attempting to shield providers and their patients seeking care. This article explores standard arguments supporting federalism, including that it allows for cultural differences to remain along with a structure that provides for the advantages of common security and commerce, that it provides (...)
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  26.  31
    Synthesizing Methuselah: The Question of Artificial Agelessness.Richard B. Gibson - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):60-75.
    As biological organisms, we age and, eventually, die. However, age’s deteriorating effects may not be universal. Some theoretical entities, due to their synthetic composition, could exist independently from aging—artificial general intelligence (AGI). With adequate resource access, an AGI could theoretically be ageless and would be, in some sense, immortal. Yet, this need not be inevitable. Designers could imbue AGIs with artificial mortality via an internal shut-off point. The question, though, is, should they? Should researchers curtail an AGI’s potentially endless lifespan (...)
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  27.  38
    If You Must Give Them a Gift, Then Give Them the Gift of Nonexistence.Matti Häyry - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):48-59.
    I present a qualified new defense of antinatalism. It is intended to empower potential parents who worry about their possible children’s life quality in a world threatened by environmental degradation, climate change, and the like. The main elements of the defense are an understanding of antinatalism’s historical nature and contemporary varieties, a positional theory of value based on Epicurean hedonism and Schopenhauerian pessimism, and a sensitive guide for reproductive decision-making in the light of different views on life’s value and risk-taking. (...)
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  28.  20
    A Call to Revise the Declaration of Helsinki’s Placebo Guidelines.Dien Ho - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):141-142.
    Since its introduction in 1964, the World Medical Association’s Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects has enshrined the importance of safeguarding the well-being of human subjects in clinical research. The Declaration has undergone seven revisions, often in response to requests for clarification. I want to argue that the Declaration is in need of another revision in light of recent discoveries in placebo research.
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  29.  18
    Daring to Taste: A Review of Living as a Bird by Vinciane Despret. [REVIEW]Jason D. Keune - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):143-147.
    There is a certain sigh of relief—a sense of coming home—when encountering a concept that deeply reinforces a scholarly path that you have been on for over a decade, especially when that concept is better articulated than anything you have ever produced yourself. It was that home that I found in Vinciane Despret’s Living as a Bird. My mind perked up when I read, “if we are to sound like economists, there is also a price to be paid,”1 and then (...)
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  30.  16
    When Is Something an Alternative? A General Account Applied to Animal-Free Alternatives to Animal Research.Koen Kramer - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):89-101.
    The first “R” from animal research ethics prescribes the replacement of animal experiments with animal-free alternatives. However, the question of when an animal-free method qualifies as an alternative to animal experiments remains unresolved.Drawing lessons from another debate in which the word “alternative” is central, the ethical debate on alternatives to germline genome editing, this paper develops a general account of when something qualifies as an alternative to something. It proposes three ethically significant conditions that technique, method, or approach X must (...)
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  31.  16
    Capacity Reconceptualized: From Assessment Tool to Clinical Intervention.Omar F. Mirza & Jacob M. Appel - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):35-39.
    Capacity evaluation has become a widely used assessment device in clinical practice to determine whether patients have the cognitive ability to render their own medical decisions. Such evaluations, which might be better thought of as “capacity challenges,” are generally thought of as benign tools used to facilitate care. This paper proposes that such challenges should be reconceptualized as significant medical interventions with their own set of risks, side effects, and potentially deleterious consequences. As a result, a cost–benefit analysis should be (...)
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  32.  73
    Artificial Intelligence and Human Enhancement: Can AI Technologies Make Us More (Artificially) Intelligent?Sven Nyholm - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):76-88.
    This paper discusses two opposing views about the relation between artificial intelligence (AI) and human intelligence: on the one hand, a worry that heavy reliance on AI technologies might make people less intelligent and, on the other, a hope that AI technologies might serve as a form of cognitive enhancement. The worry relates to the notion that if we hand over too many intelligence-requiring tasks to AI technologies, we might end up with fewer opportunities to train our own intelligence. Concerning (...)
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  33. More Process, Less Principles: The Ethics of Deploying AI and Robotics in Medicine.Amitabha Palmer & David Schwan - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):121-134.
    Current national and international guidelines for the ethical design and development of artificial intelligence (AI) and robotics emphasize ethical theory. Various governing and advisory bodies have generated sets of broad ethical principles, which institutional decisionmakers are encouraged to apply to particular practical decisions. Although much of this literature examines the ethics of designing and developing AI and robotics, medical institutions typically must make purchase and deployment decisions about technologies that have already been designed and developed. The primary problem facing medical (...)
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  34.  17
    On Moral Nose.Fabrizio Turoldo - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):102-111.
    There are many authors who consider the so-called “moral nose” a valid epistemological tool in the field of morality. The expression was used by George Orwell, following in Friedrich Nietzsche’s footsteps and was very clearly described by Leo Tolstoy. It has also been employed by authors such as Elisabeth Anscombe, Bernard Williams, Noam Chomsky, Stuart Hampshire, Mary Warnock, and Leon Kass. This article examines John Harris’ detailed criticism of what he ironically calls the “olfactory school of moral philosophy.” Harris’ criticism (...)
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  35.  6
    AI-Inclusivity in Healthcare: Motivating an Institutional Epistemic Trust Perspective.Kritika Maheshwari, Christoph Jedan, Imke Christiaans, Mariëlle van Gijn, Els Maeckelberghe & Mirjam Plantinga - 2024 - Cambridge Quarterly of Healthcare Ethics:1-15.
    This paper motivates institutional epistemic trust as an important ethical consideration informing the responsible development and implementation of artificial intelligence (AI) technologies (or AI-inclusivity) in healthcare. Drawing on recent literature on epistemic trust and public trust in science, we start by examining the conditions under which we can have institutional epistemic trust in AI-inclusive healthcare systems and their members as providers of medical information and advice. In particular, we discuss that institutional epistemic trust in AI-inclusive healthcare depends, in part, on (...)
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