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  1. 'Green bioethics widens the scope of eligible values and overrides patient demand: comment on Parker.Anders Herlitz, Erik Malmqvist & Christian Munthe - 2023 - Journal of Medical Ethics 49 (2):100-101.
    Introduction Parker’s article is a welcome attempt to address the importance of environmental sustainability in the realm of clinical ethics. 1 We support the recent movement to seriously consider the environmental impact of healthcare institutions in bioethics. 2 3 Still, we find two partly linked weaknesses of Parker’s analysis and guideline suggestion. These relate to a need in ‘green’ bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways (...)
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  • Promoting the sustainability of healthcare resources with existing ethical principles: scarce COVID-19 medications, vaccines and principled parsimony.Gerard Vong - 2021 - Journal of Medical Ethics 47 (2):104-105.
    Munthe et al 1 argue for an asymmetry between positive and negative dynamics that justifies a new sustainability principle among the operational principles for ethical healthcare resource allocation. The purported asymmetry is that while positive dynamics are ‘taken into account in present applications of the operational principles…, negative dynamics are not’.1 Positive dynamics occur when allocations in the present lead to there being more healthcare resources per health need in the future, whereas negative dynamics occur when present allocations lead to (...)
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  • Sustainable biobanks: a case study for a green global bioethics.G. Samuel, F. Lucivero & A. M. Lucassen - 2022 - Global Bioethics 33 (1):50-64.
    This paper argues that as we move to redefine global bioethics, there is a need to be attentive to the ethical issues associated with the environmental sustainability of data and digital infrastructures in global health systems. We show that these infrastructures have thus far featured little in environmental impact discussions in the context of health, and we use a case study approach of biobanking to illustrate this. We argue that this missing discussion is problematic because biobanks have environmental impacts associated (...)
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  • Sustainability, equal treatment, and temporal neutrality.Govind Persad - 2021 - Journal of Medical Ethics 47 (2):106-107.
    Addressing distributive justice issues in health policy—ranging from the allocation of health system funding to the allocation of scarce COVID-19 interventions like intensive care unit beds and vaccines—involves the application of ethical principles. Should a principle of sustainability be among them? I suggest that while the value of temporal neutrality underlying such a principle is compelling, it is already implicit in the more basic principle of equal treatment. Munthe et al 1 imagine sustainability accompanying four other principles: need, prognosis, equal (...)
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  • Sustainable healthcare resource allocation, grounding theories and operational principles: response to our commentators.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2022 - Journal of Medical Ethics 48 (1):38-38.
    We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.
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  • Don’t stop thinking about tomorrow.Alexander Guerrero - 2021 - Journal of Medical Ethics 47 (2):100-101.
    Maybe you only have 1000 units of some resource, but 10,000 people need the resource or would benefit from it. One question: why do you control the resource? Leave that aside for now. A second question: how should you allocate the resource? If you are a decision-maker in a health system, and if the resource has to do with medicine or public health, we are in the world of the ethics of scarce resource allocation decisions in healthcare. Munthe et al (...)
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  • Randomised controlled trials in medical AI: ethical considerations.Thomas Grote - 2021 - Journal of Medical Ethics 48 (11):899-906.
    In recent years, there has been a surge of high-profile publications on applications of artificial intelligence (AI) systems for medical diagnosis and prognosis. While AI provides various opportunities for medical practice, there is an emerging consensus that the existing studies show considerable deficits and are unable to establish the clinical benefit of AI systems. Hence, the view that the clinical benefit of AI systems needs to be studied in clinical trials—particularly randomised controlled trials (RCTs)—is gaining ground. However, an issue that (...)
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  • Solidarity, sustainability and medical ethics.Zoë Fritz - 2021 - Journal of Medical Ethics 47 (2):63-64.
    In this issue of the Journal of Medical Ethics arguments are cogently made that sustainability and solidarity should be considered as core medical ethical principles, and that more explicit attention should be given to the complex context in which a decision is made.
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  • Grow the pie, or the resource shuffle? Commentary on Munthe, Fumagalli and Malmqvist.Ben Davies - 2021 - Journal of Medical Ethics 47 (2):98-99.
    John Rawls’s ‘just savings’ principle is among the better-known attempts to outline how we should balance the claims of the present with the claims of the future generations on resources. A central element of Rawls’s approach involves endorsing a sufficientarian approach, where our central obligation is to ensure ‘the conditions needed to establish and to preserve a just basic structure’.1 This engaging paper by Christian Munthe, Davide Fumagalli and Erik Malmqvist (‘the authors’) does not explicitly mention Rawls’s work on this (...)
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  • How the past matters for the future: a luck egalitarian sustainability principle for healthcare resource allocation.Andreas Albertsen - 2021 - Journal of Medical Ethics 47 (2):102-103.
    Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...)
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