Biomedical Ethics

Edited by L. Syd M Johnson (SUNY Upstate Medical University)
Assistant editor: Tyler John (Rutgers University - New Brunswick)
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History/traditions: Biomedical Ethics

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  1. In Response to ʺThe Negative Impact of Ad Hoc Committees for Ethical Evaluation: The Case of COVID-19-Related Research in Ecuadorʺ.Tannya Lozada & Miguel Angel Garcia-Bereguiain - forthcoming - Developing World Bioethics.
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  2. Bioethics in Africa: A Contextually Enlightened Analysis of Three Cases.Nancy S. Jecker & Caesar Atuire - forthcoming - Developing World Bioethics.
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  3. Reconsidering Empathy: An Interpersonal Approach and Participatory Arts in the Medical Humanities.Erica L. Cao, Craig D. Blinderman & Ian Cross - forthcoming - Journal of Medical Humanities:1-14.
    The decline of empathy among health professional students, highlighted in the literature on health education, is a concern for medical educators. The evidence suggests that empathy decline is likely to stem more from structural problems in the healthcare system rather than from individual deficits of empathy. In this paper, we argue that a focus on direct empathy development is not effective and possibly detrimental to justice-oriented aims. Drawing on critical and narrative theory, we propose an interpersonal approach to enhance empathic (...)
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  4. The Evolving Social Purpose of Academic Freedom.Shannon Dea - 2021 - Kennedy Institute of Ethics Journal 31 (2):199-222.
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  5. Rude Inquiry: Should Philosophy Be More Polite?Alice MacLachlan - 2021 - Kennedy Institute of Ethics Journal 31 (2):175-198.
    Should philosophers be more polite to one another? The topic of good manners—or, more grandly, civility—has enjoyed a recent renaissance in philosophical circles, but little of the formal discussion has been self-directed: that is, it has not examined the virtues and vices of polite and impolite philosophizing, in particular. This is an oversight; practices of rudeness do rather a lot of work in enacting distinctly philosophical modes of engagement, in ways that both shape and detract from the aims of our (...)
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  6. Hidden Costs of Inquiry: Exploitation, World-Travelling and Marginalized Lives.Audrey Yap - 2021 - Kennedy Institute of Ethics Journal 31 (2):153-173.
    There are many good reasons to learn about the lives of people who have less social privilege than we do. We might want to understand their circumstances in order to have informed opinions on social policy, or to make our institutions more inclusive. We might also want to cultivate empathy for its own sake. Much of this knowledge is gained through social scientific or humanistic research into others' lives. The entitlement to theorize about or study the lives of marginalized others (...)
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  7. Free Speech Skepticism.Susan J. Brison - 2021 - Kennedy Institute of Ethics Journal 31 (2):101-132.
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  8. A Principle-Based Approach to Justify the Use of HIV Self-Testing in South Africa.Tandile Hermanus & Mary O’Grady - forthcoming - Developing World Bioethics.
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  9. Intergenerational Ethics in Africa: Duties to Older Adults in Skipped Generation Households.Nancy S. Jecker - forthcoming - Developing World Bioethics.
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  10. Responsibility Beyond Design: Physicians’ Requirements for Ethical Medical AI.Martin Sand, Juan Manuel Durán & Karin Rolanda Jongsma - forthcoming - Bioethics.
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  11. Erratum To: Treating or Killing? The Divergent Moral Implications of Cardiac Device Deactivation.Bryan C. Pilkington - 2021 - Journal of Medicine and Philosophy 46 (3):377-377.
    J Med Philos, 2020; 45: 28–41; doi:_ 10.1093/jmp/jhz031 _.
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  12. A Genealogy of Autonomy: Freedom, Paternalism, and the Future of the Doctor–Patient Relationship.Quentin I. T. Genuis - 2021 - Journal of Medicine and Philosophy 46 (3):330-349.
    Although the principle of respect for personal autonomy has been the subject of debate for almost 40 years, the conversation has often suffered from lack of clarity regarding the philosophical traditions underlying this principle. In this article, I trace a genealogy of autonomy, first contrasting Kant’s autonomy as moral obligation and Mill’s teleological political liberty. I then show development from Mill’s concept to Beauchamp and Childress’ principle and to Julian Savulescu’s non-teleological autonomy sketch. I argue that, although the reach for (...)
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  13. Reevaluating Conscience Clauses.Tiernan B. Kane - 2021 - Journal of Medicine and Philosophy 46 (3):297-312.
    Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not recognize (...)
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  14. The Most Good You Can Do with Your Kidneys: Effective Altruism and the Organ-Shortage Problem.Ryan Tonkens - 2021 - Journal of Medicine and Philosophy 46 (3):350-376.
    Effective altruism is a growing philosophical and social movement, whose members design their lives in ways aligned with doing the most good that they can do. The main focus of this paper is to explore what effective altruism has to say about the moral obligations people have to do good with their organs, in the face of an organ-shortage problem. It is argued that an effective altruism framework offers a number of valuable theoretical and practical insights relevant to ongoing debate (...)
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  15. If You Love the Forest, Then Do Not Kill the Trees: Health Care and a Place for the Particular.Nicholas Colgrove - 2021 - Journal of Medicine and Philosophy 46 (3):255-271.
    There are numerous ways in which “the particular”—particular individuals, particular ideologies, values, beliefs, and perspectives—are sometimes overlooked, ignored, or even driven out of the healthcare profession. In many such cases, this is bad for patients, practitioners, and the profession. Hence, we should seek to find a place for the particular in health care. Specific topics that I examine in this essay include distribution of health care based on the particular needs of patients, the importance of protecting physicians’ right to conscientious (...)
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  16. Re-Asserting the Specialness of Health Care.Benedict Rumbold - 2021 - Journal of Medicine and Philosophy 46 (3):272-296.
    Is health care “special”? That is, do we have moral reason to treat health care differently from how we treat other sorts of social goods? Intuitively, perhaps, we might think the proper response is “yes.” However, to date, philosophers have often struggled to justify this idea—known as the “specialness thesis about health care” or STHC. In this article, I offer a new justification of STHC, one I take to be immune from objections that have undercut other defenses. Notably, unlike previous (...)
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  17. Meaning and Affect in the Placebo Effect.Daniele Chiffi, Ahti-Veikko Pietarinen & Alessandro Grecucci - 2021 - Journal of Medicine and Philosophy 46 (3):313-329.
    This article presents and defends an integrated view of the placebo effect, termed “affective-meaning-making” model, which draws from theoretical reflection, clinical outcomes, and neurophysiological findings. We consider the theoretical limitations of those proposals associated with the “meaning view” on the placebo effect which leave the general aspects of meaning unspecified, fail to analyze fully the role of emotions and affect, and establish no clear connection between the theoretical, physiological, and psychological aspects of the effect. We point out that a promising (...)
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  18. Socrates in the fMRI Scanner: The Neurofoundations of Morality and the Challenge to Ethics.Jon Rueda - forthcoming - Cambridge Quarterly of Healthcare Ethics.
    The neuroscience of ethics is allegedly having a double impact. First, it is transforming the view of human morality through the discovery of the neurobiological underpinnings that influence moral behavior. Secondly, some neuroscientific findings are radically challenging traditional views on normative ethics. Both claims have some truth but are also overstated. In this article, the author shows that they can be understood together, although with different caveats, under the label of ‘neurofoundationalism’. Whereas the neuroscientific picture of human morality is undoubtedly (...)
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  19. Fallacy of the Last Bed Dilemma.Luca Valera, María A. Carrasco & Ricardo Castro - forthcoming - Journal of Medical Ethics:medethics-2021-107333.
    The COVID-19 pandemic highlights the relevance of adequate decision making at both public health and healthcare levels. A bioethical response to the demand for medical care, supplies and access to critical care is needed. Ethically sound strategies are required for the allocation of increasingly scarce resources, such as rationing critical care beds. In this regard, it is worth mentioning the so-called ‘last bed dilemma’. In this paper, we examine this dilemma, pointing out the main criteria used to solve it and (...)
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  20. Epistemologies of Evidence-Based Medicine: A Plea for Corpus-Based Conceptual Research in the Medical Humanities.Jan Buts, Mona Baker, Saturnino Luz & Eivind Engebretsen - forthcoming - Medicine, Health Care and Philosophy.
    Evidence-based medicine has been the subject of much controversy within and outside the field of medicine, with its detractors characterizing it as reductionist and authoritarian, and its proponents rejecting such characterization as a caricature of the actual practice. At the heart of this controversy is a complex linguistic and social process that cannot be illuminated by appealing to the semantics of the modifier evidence-based. The complexity lies in the nature of evidence as a basic concept that circulates in both expert (...)
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  21. Psychiatric Hospital Ethics Committee Discussions Over a Span of Nearly Three Decades.Michall Ferencz-Kaddari, Abira Reizer, Meni Koslowsky, Ora Nakash & Shai Konas - forthcoming - HEC Forum:1-17.
    Various types of health settings use clinical ethics committees to deal with the ethical issues that confront both healthcare providers and their patients. Although these committees are now more common than ever, changes in the content of ethical dilemmas through the years is still a relatively unexplored area of research. The current study examines the major topics brought to the CEC of a psychiatric hospital in Israel and explores whether there were changes in their frequency across nearly three decades. The (...)
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  22. The Experience of Moral Distress in an Academic Family Medicine Clinic.Dawn Worsham Bourne & Elizabeth Epstein - forthcoming - HEC Forum:1-18.
    Background and ObjectivesPrimary care providers report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies.MethodsThis qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis.ResultsOf 35 eligible participants, 12 completed the (...)
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  23. From Bioethics to Biopolitics: “Playing the Nazi Card” in Public Health Ethics—the Case of Israel.Hagai Boas, Nadav Davidovitch, Dani Filc & Rakefet Zalashik - forthcoming - Bioethics.
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  24. Civil Commitment for Opioid Misuse: Do Short-Term Benefits Outweigh Long-Term Harms?John C. Messinger, Daniel J. Ikeda & Ameet Sarpatwari - forthcoming - Journal of Medical Ethics:medethics-2020-107160.
    In response to a sharp rise in opioid-involved overdose deaths in the USA, states have deployed increasingly aggressive strategies to limit the loss of life, including civil commitment—the forcible detention of individuals whose opioid use presents a clear and convincing danger to themselves or others. While civil commitment often succeeds in providing short-term protection from overdose, emerging evidence suggests that it may be associated with long-term harms, including heightened risk of severe withdrawal, relapse and opioid-involved mortality. To better assess and (...)
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  25. Strange Blood. The Rise and Fall of Lamb Blood Transfusion in 19th Century Medicine and Beyond by Boel Berner, [Transcript]: Open Access, 2020.Ericka Johnson - forthcoming - Journal of Medical Humanities:1-2.
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  26. Evaluation of Artificial Intelligence Clinical Applications: Detailed Case Analyses Show Value of Healthcare Ethics Approach in Identifying Patient Care Issues.Wendy A. Rogers, Heather Draper & Stacy M. Carter - forthcoming - Bioethics.
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  27. Desmond Tutu, George Carey and the Legalization of Euthanasia: A Response.John Keown - forthcoming - Christian Bioethics.
    When two Christian prelates as internationally prominent as Desmond Tutu and George Carey call for the legalization of euthanasia and physician-assisted suicide, their arguments merit close consideration. This article sets out and evaluates their arguments. It concludes that the prelates rehearse the superficial case regularly advanced by euthanasia campaigners and fail adequately to engage with the arguments, both principled and practical, against legalization.
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  28. Justice Through a Wide-Angle Lens.Laura Haupt - 2021 - Hastings Center Report 51 (3):2-2.
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  29. Ending One's Life.Margaret Pabst Battin & Brent M. Kious - 2021 - Hastings Center Report 51 (3):37-47.
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  30. Gene Editing: How Can You Ask “Whether” If You Don't Know “How”?Bryan Cwik - 2021 - Hastings Center Report 51 (3):13-17.
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  31. Reciprocity and Liability Protections During the Covid-19 Pandemic.Valerie Gutmann Koch & Diane E. Hoffmann - 2021 - Hastings Center Report 51 (3):5-7.
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  32. In the Name of Racial Justice: Why Bioethics Should Care About Environmental Toxins.Keisha Ray - 2021 - Hastings Center Report 51 (3):23-26.
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  33. What Has Covid-19 Exposed in Bioethics? Four Myths.Susan M. Wolf - 2021 - Hastings Center Report 51 (3):3-4.
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  34. Centering Across the Center.Ben Wills - 2021 - Hastings Center Report 51 (3):inside_front_cover-inside_front_.
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  35. Exploring the Phenomenon and Ethical Issues of AI Paternalism in Health Apps.Michael Kühler - forthcoming - Bioethics.
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  36. Health Agency and Perfectionism: The Case of Perinatal Health Inequalities.Hafez Ismaili M’Hamdi & Inez de Beaufort - forthcoming - Public Health Ethics.
    Poor pregnancy outcomes and inequalities in these outcomes remain a major challenge, even in prosperous societies that have high-quality health care and public health policy in place. In this article, we propose that justice demands the improvement of what we call the ‘health agency’ of parents-to-be as part of a response to these poor outcomes. We take health agency to have three aspects: the capacity to form health-goals one has reason to value, the control one perceives to have over achieving (...)
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  37. A Leap of Faith: Is There a Formula for “Trustworthy” AI?Matthias Braun, Hannah Bleher & Patrik Hummel - 2021 - Hastings Center Report 51 (3):17-22.
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  38. Legal and Ethical Issues in the Report Heritable Human Genome Editing.I. Glenn Cohen & Eli Y. Adashi - 2021 - Hastings Center Report 51 (3):8-12.
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  39. Out of Africa: A Solidarity-Based Approach to Vaccine Allocation.Nancy Jecker & Caesar Atuire - 2021 - Hastings Center Report 51 (3):27-36.
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  40. Survey of German Medical Students During the COVID-19 Pandemic: Attitudes Toward Volunteering Versus Compulsory Service and Associated Factors.Lorenz Mihatsch, Mira von der Linde, Franziska Knolle, Benjamin Luchting, Konstantinos Dimitriadis & Jens Heyn - forthcoming - Journal of Medical Ethics:medethics-2020-107202.
    Due to the spread of COVID-19, a key challenge was to reduce potential staff shortages in the healthcare sector. Besides recruiting retired healthcare workers, medical students were considered to support this task. Commitment of medical students in Germany during the COVID-19 pandemic was evaluated using an online survey, with particular focus on their burdens and anxieties. This survey was distributed to students within a 2-week period in April and May 2020. Ultimately, 1241 participants were included in the analysis. During the (...)
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  41. Aligning Patient and Physician Views on Educational Pelvic Examinations Under Anaesthesia: The Medical Student Perspective.Sanjana Salwi, Alexandra Erath, Pious D. Patel, Karampreet Kaur & Margaret B. Mitchell - 2021 - Journal of Medical Ethics 47 (6):430-433.
    Recent media articles have stirred controversy over anecdotal reports of medical students practising educational pelvic examinations on women under anaesthesia without explicit consent. The understandable public outrage that followed merits a substantive response from the medical community. As medical students, we offer a unique perspective on consent for trainee involvement informed by the transitional stage we occupy between patient and physician. We start by contextualising the role of educational pelvic examinations under anaesthesia within general clinical skill development in medical education. (...)
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  42. Orphans and the Relational Significance of Birth: A Response to Singh.Christopher A. Bobier - 2021 - Journal of Medical Ethics 47 (6):439-440.
    Prabhpal Singh has defended a relational account of the difference in moral status between fetuses and newborns. Newborns stand in the parent-child relation while fetuses do not, and standing in the parent-child relationship brings with it higher moral status for newborns. Orphans pose a problem for this account because they do not stand in a parent-child relationship. I argue that Singh has not satisfactorily responded to the problem.
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  43. Trust Does Not Need to Be Human: It is Possible to Trust Medical AI.Andrea Ferrario, Michele Loi & Eleonora Viganò - 2021 - Journal of Medical Ethics 47 (6):437-438.
    In his recent article ‘Limits of trust in medical AI,’ Hatherley argues that, if we believe that the motivations that are usually recognised as relevant for interpersonal trust have to be applied to interactions between humans and medical artificial intelligence, then these systems do not appear to be the appropriate objects of trust. In this response, we argue that it is possible to discuss trust in medical artificial intelligence, if one refrains from simply assuming that trust describes human–human interactions. To (...)
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  44. Ethics Briefing.Dominic Norcliffe-Brown, Sophie Brannan, Martin Davies, Veronica English, Rebecca Mussell & Julian C. Sheather - 2021 - Journal of Medical Ethics 47 (6):441-442.
    During the first UK wave of the pandemic, there were two areas of immediate ethical concern for the medical profession. The first was the possibility that life-saving resources could be overwhelmed. Early reports from hospitals in the Italian city of Bergamo suggested that ventilatory support might need rationing and emergency ‘battlefield’ triage was a real possibility.1 In the UK, several professional bodies, including the British Medical Association and the Royal College of Physicians rapidly developed guidance for doctors should triage become (...)
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  45. Ethical Considerations of Recruiting Migrant Workers for Clinical Trials.Bushra Zafreen Amin - 2021 - Journal of Medical Ethics 47 (6):434-436.
    Migrant workers in dormitories are an attractive source of clinical trial participants. However, they are a vulnerable population that has been disproportionately affected by the COVID-19 pandemic. Guidelines on recruiting vulnerable populations for clinical trials have long been established, but ethical considerations for migrant workers have been neglected. This article aims to highlight and explain what researchers recruiting migrant workers must be cognizant of, and offers recommendations to address potential concerns. The considerations raised in this article include: three types of (...)
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  46. Potential for Epistemic Injustice in Evidence-Based Healthcare Policy and Guidance.Jonathan Anthony Michaels - 2021 - Journal of Medical Ethics 47 (6):417-422.
    The rapid development in healthcare technologies in recent years has resulted in the need for health services, whether publicly funded or insurance based, to identify means to maximise the benefits and provide equitable distribution of limited resources. This has resulted in the need for rationing decisions, and there has been considerable debate regarding the substantive and procedural ethical principles that promote distributive justice when making such decisions. In this paper, I argue that while the scientifically rigorous approaches of evidence-based healthcare (...)
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  47. Balancing Professional Obligations and Risks to Providers in Learning Healthcare Systems.Jan Piasecki & Vilius Dranseika - 2021 - Journal of Medical Ethics 47 (6):413-416.
    Clinicians and administrators have a professional obligation to contribute to improvement of healthcare quality. At the same time, participation in embedded research poses risks to healthcare institutions. Disclosure of an institution’s sensitive information could endanger relationships with patients and undermine its reputation. The existing ethical framework for learning healthcare systems does not address the conflict between the OTC and institutional interests. Ethical guidance and policy regulation are needed to create a safe environment for embedded research. In this article we analyse (...)
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  48. Instruments of Health and Harm: How the Procurement of Healthcare Goods Contributes to Global Health Inequality.Mei L. Trueba, Mahmood F. Bhutta & Arianne Shahvisi - 2021 - Journal of Medical Ethics 47 (6):423-429.
    Many healthcare goods, such as surgical instruments, textiles and gloves, are manufactured in unregulated factories and sweatshops where, amongst other labour rights violations, workers are subject to considerable occupational health risks. In this paper we undertake an ethical analysis of the supply of sweatshop-produced surgical goods to healthcare providers, with a specific focus on the National Health Service of the United Kingdom. We contend that while labour abuses and occupational health deficiencies are morally unacceptable in the production of any commodity, (...)
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  49. Simulating (Some) Individuals in a Connected World.Jenny Krutzinna - 2021 - Journal of Medical Ethics 47 (6):403-404.
    Braun explores the use of digital twin technology in medicine with a particular emphasis on the question of how such simulations can represent a person.1 In defining some first conditions for ethically justifiable forms of representation of digital twins, he argues that digital twins do not threaten an embodied person, as long as that person retains control over their simulated representation via dynamic consent, and ideally with the option to choose both form and usage of the simulation. His thoughtful elaboration (...)
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  50. ‘Represent Me: Please! Towards an Ethics of Digital Twins in Medicine’: Commentary.Janina Loh - 2021 - Journal of Medical Ethics 47 (6):412-412.
    Matthias Braun’s1 concise reflections on the ethical challenges posed by digital twins in medicine are briefly supplemented below by a thought that, in my view, seems to run through the text like a thread, but whose ethical implications are not explicitly stated. Braun states in the final paragraph that ‘digital twins do not fundamentally threaten the embodied person’, at least not as long as the person in question has ‘control over her simulated representation’. I agree with this, but would like (...)
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