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  1.  15
    Institutional Conscientious Objection to Medical Assistance in Dying in Canada: A Critical Analysis of the Personnel-Based Arguments.Nicholas Abernethy - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):43-52.
    Debate rages over whether Canadian provincial and territorial governments should allow healthcare institutions to conscientiously object to providing medical assistance in dying (MAiD). This issue is likely to end up in court soon through challenges from patients, clinicians, or advocacy groups such as Dying With Dignity Canada. When it does, one key question for the courts will be whether allowing institutional conscientious objection (ICO) to MAiD respects (i.e., shows due regard for) the consciences of the objecting healthcare institutions, understood as (...)
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  2.  19
    The Ethics of Humanitarian Innovation: Mapping Values Statements and Engaging with Value-Sensitive Design.Lilia Brahimi, Gautham Krishnaraj, John Pringle, Lisa Schwartz, Dónal O’Mathúna & Matthew Hunt - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):1-10.
    The humanitarian sector continually faces organizational and operational challenges to respond to the needs of populations affected by war, disaster, displacement, and health emergencies. With the goal of improving the effectiveness and efficiency of response efforts, humanitarian innovation initiatives seek to develop, test, and scale a variety of novel and adapted practices, products, and systems. The innovation process raises important ethical considerations, such as appropriately engaging crisis-affected populations in defining problems and identifying potential solutions, mitigating risks, ensuring accountability, sharing benefits (...)
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  3.  17
    COVID-19: Falling Apart and Bouncing Back. A Collective Autoethnography Focused on Bioethics Education.Katrien Dercon, Mateusz Domaradzki, Herman T. Elisenberg, Aleksandra Głos, Ragnhild Handeland, Agnieszka Popowicz & Jan Piasecki - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):76-89.
    The COVID-19 pandemic disrupted academic life worldwide for students as well as educators. The purpose of this study is to shed light on the collective adversity experienced by international medical students and bioethics educators caused by the COVID-19 pandemic in relation to both personal and academic life. The authors wrote their subjective memoirs and then analyzed them using a collective autoethnography method in order to find the similarities and differences between their experiences. The results reveal some consistent patterns in experience (...)
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  4.  13
    Kevorkian’s Legacy.Michael Gordon - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):143-148.
    This history of the modern introduction of assisted suicide in North America follow a tortuous course, with complete rejection of the idea, to implementation in many of its jurisdictions. North America was not a leader in this approach to end-of-life care, with the Netherlands and Belgium playing that role. Tracing the path from a felonious and ethically anathematic place in North American society it was resurrected into a legally and ethically acceptable practice over a period of two decades. The historical (...)
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  5.  9
    “Home to Fail” Discharges: A Question of Motivation.Christinia Landry - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):136-139.
    Sending patients “home to fail” while anticipating their speedy readmittance is, prima facie, ethically troubling as are all unsafe discharges. However, “home to fail” cases may also be covertly ethically troubling insofar as they raise questions of medical paternalism due to a motivational component which drives these types of cases: by discharging a patient “home to fail” she will come to appreciate that living at home is unsafe and thus unwise, prompting her to choose differently in the future.
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  6.  11
    Online Portals for Sharing Health Research: Comparative Guidance amid Regulatory Uncertainty.Michael Lang & Ma'N. H. Zawati - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):66-75.
    Online resources offer a uniquely efficient way of sharing health research with scientists and the public. Using web portals to make results and study information available to diverse audiences could work to accelerate research translation and empower patients to play a more active role in their care. But using online tools to broadly share health information raises several challenging ethical and regulatory questions. Issues such as equity, privacy, and patient empowerment may create challenges for regulators, portal developers, as well as (...)
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  7.  8
    Recent Canadian Negligence Decisions Relating to Prenatal Care: Implications for Physicians’ Screening Practices.Blake Murdoch - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):133-135.
    This article summarizes several Canadian court decisions from 2015 onward stemming from wrongful birth and wrongful life litigation. Plaintiff success often turns on whether causation is established, on a balance of probabilities, between a physician’s breach of standard of care and the harm to the parents and/or the child later born. Physicians’ failure to offer or order screening or diagnostic tests has been a source of wrongful birth liability, as too can be failure to ensure patient understanding of results. Physicians (...)
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  8.  5
    The Rule of Rescue in the Era of Precision Medicine, HLA Eplet Matching, and Organ Allocation.Blake Murdoch, Darren N. Wagner, Shaifali Sandal & Karen Sherwood - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):36-42.
    Precision medicine can put clinicians in a position where they must act more as resource allocators than their traditional role as patient advocates. In the allocation of transplantable organs and tissues, the use of eplet matching will enhance precision medicine but, in doing so, generate a tension with the present reliance on rule of rescue and justice-based factors for allocations. Matching donor and recipient human leukocyte antigens (HLA) is shown to benefit virtually all types of solid organ transplants yet, until (...)
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  9.  17
    A Scoping Review of Ethical and Legal Issues in Behavioural Variant Frontotemporal Dementia.Anirudh Nair, Colleen M. Berryessa & Veljko Dubljevic - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):120-132.
    Behavioural variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia characterized by changes in personality, social behaviour, and cognition. Although neural abnormalities cause bvFTD patients to struggle with inhibiting problematic behaviour, they are generally considered fully autonomous individuals. Subsequently, bvFTD patients demonstrate understanding of right and wrong but are unable to act in accordance with moral norms. To investigate the ethical, legal, and social issues associated with bvFTD, we conducted a scoping review of academic literature with inclusion & exclusion (...)
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  10.  7
    For Women Only? Reconsidering Gender Requirements for Uterine Transplantation Recipients.Darren N. Wagner - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):53-65.
    Uterine transplantation is an experimental procedure currently available only to cisgender women recipients suffering from absolute uterine factor infertility. Clinicians, researchers, and advocates have advanced the possibility of providing these quality-of-life transplantations to transgender women. This article examines the ethical and practical implications of removing sex- and gender-based requirements entirely for uterine transplantation recipients. Given the significant costs and risks, and the modest quality-of-life benefits, ethical arguments against offering uterine transplantations to people who do not identify as women but are (...)
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  11.  12
    Operationalizing Equity in Surgical Prioritization.Kayla Wiebe, Simon Kelley, Annie Fecteau, Mark Levine, Iram Blajchman, Randi Zlotnik Shaul & Roxanne Kirsch - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (2):11-19.
    The allocation of critical care resources and triaging patients garnered a great deal of attention during the COVID-19 pandemic, but there is a paucity of guidance regarding the ethical aspects of resource allocation and patient prioritization in ‘normal’ circumstances for Canadian healthcare systems. One context where allocation and prioritization decisions are required are surgical waitlists, which have been globally exacerbated due to the COVID-19 pandemic. In this paper, we detail the process used to develop an ethics framework to support prioritization (...)
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  12.  8
    Respect for Patient Confidentiality Must Not Be Dependent Upon a Fee: The Case of Adolescents’ Access to Contraceptives in Ontario.Julien Brisson - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):116-117.
    In Ontario, adolescents can be confidentially prescribed contraceptives. However, some adolescents must pay pharmacies to have their confidentiality respected when it comes to contraceptives; if their parents’ private insurance plan covers them, the adolescent has to pay out of pocket to be given contraceptive in a confidential manner. It is unethical to make anyone pay to have their confidentiality respected, particularly for a vulnerable population like adolescents who tend to be economically disadvantaged.
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  13.  8
    Allen Buchanan, Our Moral Fate (2020).Guido Calderini - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):100-101.
    In debates surrounding the biomedical enhancement of human morality, it is widely believed that morality was evolutionarily shaped to be rigidly tribal. Allen Buchanan challenges this assumption by making the case that a plastic morality that responds to our environment would be evolutionarily favored, and thus the best way to shape human morality going forward would not be through biomedical interventions, but by designing better institutions.
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  14.  17
    Where Do I Go to Wait? Ethical Considerations During the 90 Day Reflection Period for MAiD.Kesi Disha, Andria Bianchi, Ruby Shanker & Nikolija Lukich - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):70-74.
    Canada’s Medical Assistance in Dying (MAID) legislation changed in 2021; persons without a reasonably foreseeable natural death (RFND) could now be eligible for MAID and would have to wait at least 90 days before their intervention. This legislative change caused a new ethically complex question to arise, which we explore in this commentary, namely: Where should individuals without a RFND wait (for 90 days) in a publicly funded health system?
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  15.  37
    An Ethics Journey: From Kant to Assisted Suicide.Michael Gordon - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):106-108.
    Most of us would agree with the almost trite saying that “life is a journey”. Of course it is, unless it ends tragically at birth, and even then it is a very short journey. All of us can describe how we got from one stage in life to another, whether personal, family, education or career. Many journeys seem to be in an almost straight line while others meander from one place to another, changing direction and alternating goals, sometimes zigging back (...)
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  16.  11
    The Blessings of Books.Michael Gordon - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):102-105.
    The attack on the written word is not new. It has happened many times through history, especially in modern times as the availability of books has grown so rapidly. It is most often in authoritarian regimes that books are deemed a potential threat, and the elimination of this threat a means to maintain control of a potentially rebellious population. Probably the most heinous of book banning and burnings occurred during Nazi rule, prior to and during the Second World War. To (...)
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  17.  11
    The Invisibility of the Asian American Identity in North American Bioethics.Katherine Huerne - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):109-115.
    This Perspective sheds light on the major barriers behind Asian American invisibility in bioethics, such as the inconsistencies in defining a coherent identity in North American society, the systemic mechanisms of invisibility from history to healthcare based on immigration status, and scarcity of bioethics literature about their perspectives. The consequences of Asian American invisibility in bioethics and healthcare practises are also discussed, including a reflection of the interconnected mechanisms between academic bioethical theory and healthcare practises that perpetuate Asian American invisibility. (...)
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  18.  12
    An Ethics-informed, Policy-based Approach to the Management of Challenges Posed by Living-at-Risk, Frequent Users of Emergency Departments.Jeffrey Kirby & Lisbeth Witthoefft Nielsen - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):44-55.
    The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...)
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  19.  12
    Developing a New Clinical Ethics Framework for Rehab: A Pre-Implementation Evaluation from the Perspective of Future Users.Line Leblanc, Sophie Ménard, Christophe Maiano, Louis Perron, Catherine Baril & Nicole Ouellette-Hughes - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):24-33.
    Clinical ethics is widely recognised as an essential contribution to the quality of health and psychosocial service delivery. However, the lack of a common understanding of ethics within teams and insufficient organisational support often limits its optimal integration into the workplace. To address this problem, the clinical ethics committee of a rehabilitation centre developed a new clinical ethics framework based on a theoretical model and conducted a pre-implementation evaluation by interviewing future users. The study estimated the acceptability and initial adoption (...)
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  20.  17
    Love Without Food: Supporting Families End-of-Life Care Decisions for Critically Ill Late-Stage Cancer Patients.Amitabha Palmer - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):81-83.
    In some families, there is an inseparable connection between showing love, caring, and providing food. These conceptual connections can create tension between families and care teams over end-of-life care for critically ill late-stage cachexic patients with cancer when families demand that their loved one receive feeds. This case study describes how to dissolve these tensions without compromising the family’s values or the medical team’s ethical duty of nonmaleficence.
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  21.  11
    Collecting Race-Based Data in Health Research: A Critical Analysis of the Ongoing Challenges and Next Steps for Canada.Fatima Sheikh, Alison E. Fox-Robichaud & Lisa Schwartz - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):75-80.
    The COVID-19 pandemic has had a global effect. The disproportionate impact on Indigenous peoples and racialized groups has brought ethical challenges to the forefront in research and clinical practice. In Canada, the Tri-Council Policy Statement (TCPS2), and specifically the principle of justice, emphasizes additional care for individuals “whose circumstances make them vulnerable”, including Indigenous and racialized communities. In the absence of race-based data to measure and inform health research and clinical practice, we run the risk of causing more harm and (...)
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  22.  8
    Migrating Metaphors: Why We Should Be Concerned About a ‘War on Mental Illness’ in the Aftermath of COVID-19.Kaitlin Sibbald - 2023 - Canadian Journal of Bioethics / Revue canadienne de bioéthique 6 (1):13-23.
    In the aftermath of the ongoing COVID-19 pandemic, there is a predicted (and emerging) increase in experiences of mental illness. This phenomenon has been described as “the next pandemic”, suggesting that the concepts used to understand and respond to the COVID-19 pandemic are being transferred to conceptualize mental illness. The COVID-19 pandemic was, and continues to be, framed in public media using military metaphors, which can potentially migrate to conceptualizations of mental illness along with pandemic rhetoric. Given that metaphors shape (...)
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