Journal of Medical Ethics

ISSN: 0306-6800

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  1.  17
    Questioning our presumptions about the presumption of capacity.Isabel Marie Astrachan, Alexander Ruck Keene & Scott Y. H. Kim - 2024 - Journal of Medical Ethics 50 (7):471-475.
    All contemporary frameworks of mental capacity stipulate that we must begin from the presumption that an adult has capacity. This presumption is crucial, as it manifests respect for autonomy and guards against prejudice and paternalism on the part of the evaluator. Given its ubiquity, we might presume that we all understand the presumption’s meaning and application in the same way. Evidence demonstrates that this is not the case and that this has led to harm in vulnerable persons. There is thus (...)
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  2.  9
    Harmonising green informed consent with autonomous clinical decision-making: a reply to Resnik and Pugh.Eva Sayone Cohen, Dionne Sofia Kringos, Wouter Johan Karel Hehenkamp & Cristina Richie - 2024 - Journal of Medical Ethics 50 (7):498-500.
    Resnik and Pugh recently explored the ethical implications of routinely integrating environmental concerns into clinical decision-making. While we share their concern for the holistic well-being of patients, our response offers a different clinical and bioethical stance on green informed consent and patient autonomy. Contrary to the authors’ lack of data to support their concerns about provider and patient willingness to engage in climate-related conversations, we provide evidence supporting their sustainability engagement and stress the importance of a proactive, anticipatory approach in (...)
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  3.  8
    Exemplarist medical ethics.Daniel Daly - 2024 - Journal of Medical Ethics 50 (7):447-451.
    The field of medical ethics, such as the discipline of ethics in general, has traditionally focused on moral dilemmas and quandaries at the expense of ‘everyday’ moral issues. The methodologies, norms and principles of the field reflect this. Although the principle of double effect works well in adjudicating the provision of life-shortening medications to relieve pain, it fails to guide the vast majority of mundane moral decisions that providers make daily. This article contends that exemplarist medical ethics provides action guidance (...)
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  4.  4
    Revisiting the ought implies can dictum in light of disruptive medical innovation.Michiel De Proost & Seppe Segers - 2024 - Journal of Medical Ethics 50 (7):466-470.
    It is a dominant dictum in ethics that ‘ought implies can’ (OIC): if an agent morally ought to do an action, the agent must be capable of performing that action. Yet, with current technological developments, such as in direct-to-consumer genomics, big data analytics and wearable technologies, there may be reasons to reorient this ethical principle. It is our modest aim in this article to explore how the current wave of allegedly disruptive innovation calls for a renewed interest for this dictum. (...)
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  5.  21
    The ethics of coercion in mental healthcare: the role of structural racism.Mirjam Faissner & Esther Braun - 2024 - Journal of Medical Ethics 50 (7):476-481.
    In mental health ethics, it is generally assumed that coercive measures are sometimes justified when persons with mental illness endanger themselves or others. Coercive measures are regarded as ethically justified only when certain criteria are fulfilled: for example, the intervention must be proportional in relation to the potential harm. In this paper, we demonstrate shortcomings of this established ethical framework in cases where people with mental illness experience structural racism. By drawing on a case example from mental healthcare, we first (...)
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  6.  43
    Please wear a mask: a systematic case for mask wearing mandates.Roberto Fumagalli - 2024 - Journal of Medical Ethics 50 (7):501-510.
    This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates (MWM). The paper argues for two main claims of general interest in favour of MWM. First, MWM provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against MWM may justify some exemptions for specific categories (...)
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  7.  1
    Reducing the risk of NHS disasters.Edwin Jesudason - 2024 - Journal of Medical Ethics 50 (7):482-488.
    How could we better use public inquiries to stem the recurrence of healthcare failures? The question seems ever relevant, prompted this time by the inquiry into how former nurse Letby was able to murder newborns under National Health Service care. While criminality, like Letby’s, can be readily condemned, other factors like poor leadership and culture seem more often regretted than reformed. I would argue this is where inquiries struggle, in the space between ethics and law—with what is awful but lawful. (...)
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  8.  31
    Consent to testing for brain death.Barry Lyons & Mary Donnelly - 2024 - Journal of Medical Ethics 50 (7):442-446.
    Canada has recently published a new Clinical Practice Guideline on the diagnosis and management of brain death. It states that consent is not necessary to carry out the interventions required to make the diagnosis. A supporting article not only sets out the arguments for this but also contends that ‘UK laws similarly carve out an exception, excusing clinicians from a prima facie duty to get consent’. This is supplemented by the claim that recent court decisions in the UK similarly confirm (...)
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  9.  9
    Courts, rights and the critically brain-injured patient.Barry Lyons & Mary Donnelly - 2024 - Journal of Medical Ethics 50 (7):496-497.
    The reality of current clinical practice in the UK is that where a patient’s family refuses to agree to testing for brain stem death (BD), such cases will ultimately end up in court. This situation is true of both adults and children and reinforced by recent legal cases. While recourse to the courts might be regrettable in such tragic cases, if public trust in the medical diagnosis of BD is to be maintained all aspects of the process must be conducted (...)
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  10.  13
    Ethical issues arising from the government allocation of physicians to rural areas: a case study from Japan.Masatoshi Matsumoto & Tatsuki Aikyo - 2024 - Journal of Medical Ethics 50 (7):460-465.
    The geographically inequitable distribution of physicians has long posed a serious social problem in Japan. The government tackled this problem by establishing and managing Jichi Medical University (JMU) and regional quotas (RQs) for medical schools. JMU/RQs recruit local students who hope to work as physicians in rural areas, educate them for 6 years without tuition (JMU) or with scholarship (RQs), and after graduation, assign them to their home prefectures for 9 years, including 4–6 years of rural service. JMU/RQs entrants now (...)
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  11.  26
    No consent for brain death testing.Thaddeus Mason Pope, Alexander Ruck Keene & Jennifer Chandler - 2024 - Journal of Medical Ethics 50 (7):494-495.
    The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the court (...)
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  12.  29
    Green bioethics, patient autonomy and informed consent in healthcare.David B. Resnik & Jonathan Pugh - 2024 - Journal of Medical Ethics 50 (7):489-493.
    Green bioethics is an area of research and scholarship that examines the impact of healthcare practices and policies on the environment and emphasises environmental values, such as ecological sustainability and stewardship. Some green bioethicists have argued that healthcare providers should inform patients about the environmental impacts of treatments and advocate for options that minimise adverse impacts. While disclosure of information pertaining to the environmental impacts of treatments could facilitate autonomous decision-making and strengthen the patient–provider relationship in situations where patients have (...)
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  13.  15
    Clinicians and AI use: where is the professional guidance?Helen Smith, John Downer & Jonathan Ives - 2024 - Journal of Medical Ethics 50 (7):437-441.
    With the introduction of artificial intelligence (AI) to healthcare, there is also a need for professional guidance to support its use. New (2022) reports from National Health Service AI Lab & Health Education England focus on healthcare workers’ understanding and confidence in AI clinical decision support systems (AI-CDDSs), and are concerned with developing trust in, and the trustworthiness of these systems. While they offer guidance to aid developers and purchasers of such systems, they offer little specific guidance for the clinical (...)
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  14. Ethical implications of disparities in translation genomic medicine: from research to practice.Mehrunisha Suleman, Michael J. Parker & Nadeem Qureshi - 2024 - Journal of Medical Ethics 50 (7):435-436.
    Genomic medicine has the potential to contribute to the development of an array of novel technologies within the clinical armoury, making possible early detection and management of high-risk conditions such as cancer. While significant impact has already been felt in the context of rare inherited single gene disorders, much of the advancement in patient care through genomic medicine more broadly is going to be made possible by research involving large data sets that enable analyses of multiple genetic variants that contribute (...)
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  15.  4
    Can the courts be viewed as an appropriate vehicle to settle clinical unease?Bernadette Wren & Alexander Ruck Keene - 2024 - Journal of Medical Ethics 50 (7):452-459.
    This paper is an exploration of the state of ‘clinical unease’ experienced by clinicians in contexts where professional judgement—grounded in clinical knowledge, critical reflection and a sound grasp of the law—indicates that there is more than one ethically defensible way to proceed. The question posed is whether the courts can be viewed as an appropriate vehicle to settle clinical unease by providing a ruling that clarifies the legal and ethical issues arising in the case, even in situations where there is (...)
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  16.  4
    Comparative ethical evaluation of epigenome editing and genome editing in medicine: first steps and future directions.Karla Alex & Eva C. Winkler - 2024 - Journal of Medical Ethics 50 (6):398-406.
    Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions about GE are voluminous. (...)
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  17.  16
    Towards an environmentally sensitive healthcare ethics: ten tasks and one model.Kristine Bærøe, Anand Singh Bhopal & TOrbjørn Gundersen - 2024 - Journal of Medical Ethics 50 (6):382-383.
    In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...)
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  18.  37
    Medically assisted dying in Canada and unjust social conditions: a response to Wiebe and Mullin.Timothy Christie & Madeline Li - 2024 - Journal of Medical Ethics 50 (6):423-424.
    In the paper, titled ‘Choosing death in unjust conditions: hope, autonomy and harm reduction,’ Wiebe and Mullin argue that people living in unjust social conditions are sufficiently autonomous to request medical assistance in dying (MAiD). The ethical issue is that some people may request MAiD primarily because of unjust social conditions, not their illness, disease, disability or decline in capability. It is easily agreed that people living in unjust social conditions can be autonomous. Nevertheless, Wiebe and Mullin fail to appreciate (...)
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  19.  8
    Autonomy is not a sufficient basis for analysing the choice for medical assistance in dying in unjust conditions: in favour of a dignity-based approach.Maria DiDanieli - 2024 - Journal of Medical Ethics 50 (6):421-422.
    In their paper titledChoosing death in unjust conditions: hope, autonomy and harm reduction,Wiebe and Mullin argue against the stance of diminished autonomy in chronically ill, disabled patients living in unjust sociopolitical environments who pursue medical assistance in dying (MAiD). They suggest that it would be paternalistic to deny these people this choice and conclude that MAiD should actually be seen as a form of harm reduction for them.This response to their article argues that basing discussions surrounding this important topic on (...)
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  20.  4
    Anticipatory regulation, anticipatory ethics: preparing for the future.Zoe Fritz - 2024 - Journal of Medical Ethics 50 (6):361-362.
    We have all become used to the rapid change around us, and with it, the shifting landscape of medical ethics. It appears, however, that the acceleration phase of change in biomedical sciences is only just beginning, and we need to be prepared for new challenges ahead. This issue of the journal considers several of them: in epigenome editing, 1 in bioprinting 2 and in cryonics. 3 With all of these developments, we need to be doing our ethical thinking proactively rather (...)
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  21.  19
    Is ageing undesirable? An ethical analysis.Pablo García-Barranquero, Joan Llorca Albareda & Gonzalo Díaz-Cobacho - 2024 - Journal of Medical Ethics 50 (6):413-419.
    The technical possibilities of biomedicine open up the opportunity to intervene in ageing itself with the aim of mitigating, reducing or eliminating it. However, before undertaking these changes or rejecting them outright, it is necessary to ask ourselves if what would be lost by doing so really has much value. This article will analyse the desirability of ageing from an individual point of view, without circumscribing this question to the desirability or undesirability of death. First, we will present the three (...)
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  22.  13
    Is ageing still undesirable? A reply to Räsänen.Pablo García-Barranquero, Joan Llorca Albareda & Gonzalo Díaz-Cobacho - 2024 - Journal of Medical Ethics 50 (6):427-428.
    We have recently stated the reasons why we claim that biological ageing is undesirable. Räsänen has responded to our article by arguing that this process has certain desirable aspects and, therefore, our position is inconsistent. Räsänen develops two arguments to defend his position. We will call the first the argument from the totality of the ageing process and the second the argument from the reduced goods of the ageing process. In this reply, we will give reasons to show that both (...)
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  23.  8
    A physician’s identity can never be reconfigured to put climate protection on par with an individual patient’s best interests.Narcyz Ghinea - 2024 - Journal of Medical Ethics 50 (6):375-375.
    In their article, van Gils Schmidt and Salloch defend the claim that physicians have a duty to protect the climate. The logic of the argument in broad terms is that (i) there is a relationship between climate change and the burden of disease, (ii) the healthcare sector is a significant emitter of global greenhouse gasses, thereby enhancing the burden of disease and (iii) since doctors are advocates of health and stakeholders in the healthcare sector, they have a duty to respond (...)
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  24.  21
    Compulsory vaccination protects autonomy.Garrett Gooch & Abraham Graber - 2024 - Journal of Medical Ethics 50 (6):431-432.
    In a recent article in this journal, Kowalik argues that compulsory vaccination unjustifiably infringes on the autonomy of vaccine refusers. While accepting Kowalik’s central premises, we argue that, when appropriately expanded in scope, autonomy considerations do not undermine the justifiability of compulsory vaccination. Vulnerable individuals—including the very old, the very young and those with compromised immune systems—face an omnipresent risk of contracting a potentially fatal vaccine-preventable illness and are thus prevented from accessing public goods by coercive pressure. Consequently, when we (...)
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  25.  14
    Ethical analysis of the first porcine cardiac xenotransplantation.Christopher Gyngell, Megan Munsie, Misao Fujita, Carrie Thiessen, Julian Savulescu & Igor E. Konstantinov - 2024 - Journal of Medical Ethics 50 (6):363-367.
    In this article, we provide an ethical analysis of the first porcine cardiac xenotransplant, performed in Maryland, USA in early 2022. David Bennett was offered the experimental procedure after he was deemed ineligible for human heart transplantation and mechanical circulatory support, based on a history of non-compliance. It was reported that Mr Bennett’s previous instances of non-compliance were for medically non-life-threatening conditions years earlier, where the risks of non-compliance were not as high. We argue that, in Mr Bennett’s case, a (...)
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  26.  40
    Mourning the frozen: considering the relational implications of cryonics.Robin Hillenbrink & Christopher Simon Wareham - 2024 - Journal of Medical Ethics 50 (6):388-391.
    Cryonics is the preservation of legally dead human bodies at the temperature of liquid nitrogen in the hope that future technologies will be able to revive them. In philosophical debates surrounding this practice, arguments often focus on prudential implications of cryopreservation, or moral arguments on a societal level. In this paper, we claim that this debate is incomplete, since it does not take into account a significant relational concern about cryonics. Specifically, we argue that attention should be paid to the (...)
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  27.  9
    Navigating climate responsibility: a critical examination of healthcare professionals’ moral duties.Sapfo Lignou & James Hart - 2024 - Journal of Medical Ethics 50 (6):376-377.
    In their upcoming article, Henk Jasper van Gils-Schmidt and Sabine Salloch highlight the supposed responsibilities of healthcare professionals in addressing the global health challenges posed by climate change. They argue that healthcare professionals’ duties to future generations and their ‘climate-related obligations’ have been neglected, primarily due to potential conflicts with other responsibilities, such as providing optimal care to current patients and maintaining patient trust. The authors suggest that these competing obligations should be viewed as part of the multifaceted identities individuals (...)
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  28.  15
    Constructing appropriate bioprinting regulations: the ethical importance of recognising a liminal technology.Megan Frances Moss - 2024 - Journal of Medical Ethics 50 (6):392-397.
    This article provides an analysis of bioprinting personalised medical device technology and its ethical challenges to regulation and research ethics. I argue the inclusion of bioprinting applications within existing regulatory frameworks does not adequately address the technologies disruption to the traditionally siloed activities of research and treatment. Using the conceptual framework of liminality, I offer a meaningful way to engage with this technology and address some identified concerns with how it will be categorised and the appropriate recognition of its evidentiary (...)
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  29.  8
    Beneficence cannot justify voluntary euthanasia and physician-assisted suicide.Petros Panayiotou - 2024 - Journal of Medical Ethics 50 (6):384-387.
    The patient’s autonomy and well-being are sometimes seen as central to the ethical justification of voluntary euthanasia (VE) and physician-assisted suicide (PAS). While respecting the patient’s wish to die plausibly promotes the patient’s autonomy, it is less obvious how alleviating the patient’s suffering through death benefits the patient. Death eliminates the subject, so how can we intelligibly maintain that the patient’s well-being is promoted when she/he no longer exists? This article interrogates two typical answers given by philosophers: (a) that death (...)
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  30. When biological ageing is desirable? A reply to García-Barranquero et al.Joona Räsänen - 2024 - Journal of Medical Ethics 50 (6):425-426.
    García-Barranquero et al explore the desirability of human ageing. They differentiate between chronological and biological views of ageing and contend that the positive aspects of ageing are solely linked to chronological ageing. Consequently, the authors embrace the potential for technological interventions in biological ageing. Contrary to their stance, I argue that there are sometimes desirable aspects associated with biological ageing. Therefore, proposals aiming to eliminate, mitigate or diminish biological ageing are not without problems.
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  31.  22
    Sabr_ and _Shukr: doing justice to medical futility.Sara Riaz - 2024 - Journal of Medical Ethics 50 (6):433-434.
    Medicine is no stranger to patience. In fact, the word ‘patient’ has an etymology stemming from the Latin word ‘patiens’, describing the one who tolerates suffering.1 In this sense, the cornerstone of medicine, the patient–physician relationship, reflects passive language, ‘to suffer’. This suffering must be understood, and should be most intimately understood by those who provide care that is beyond a patient’s reach. The case of patients and their loved ones requesting medically futile care at the end of life is (...)
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  32.  20
    Focusing attention on physicians’ climate-related duties may risk missing the bigger picture: towards a systems approach to health and climate.Gabby Samuel, Sarah Briggs, Kate Lyle & Anneke M. Lucassen - 2024 - Journal of Medical Ethics 50 (6):380-381.
    Gils-Schmidt and Salloch recognise that human and climate health are inextricably linked, and that mitigating healthcare-associated climate harms is essential for protecting human health.1 They argue that physicians have a duty to consider how their own practices contribute to climate change, including during their interactions with patients. Acknowledging the potential for conflicts between this duty and the provision of individual patient care, they propose the application of Korsgaard’s neo-Kantian account of practical identities to help navigate such scenarios. In this commentary, (...)
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  33.  12
    On Ageing and Maturing.William Simkulet - 2024 - Journal of Medical Ethics 50 (6):429-430.
    Räsänen draws a distinction between chronological age and biological age and argues that biological ageing is (sometimes) desirable. To demonstrate this, he asks us to consider the case of April, who like Karel Čapek’s Elina Makropulos, has stopped biologically ageing. Unlike Makropulos, though, April’s biological ageing was halted before puberty, so she will never mature into adulthood. Räsänen contends this case shows ageing can be desirable, but this equivocates between maturing and ageing. Here I argue biological ageing, or the wear (...)
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  34.  7
    Physicians’ duty to climate protection as an expression of their professional identity: a defence from Korsgaard’s neo-Kantian moral framework.Henk Jasper van Gils-Schmidt & Sabine Salloch - 2024 - Journal of Medical Ethics 50 (6):368-374.
    The medical profession is observing a rising number of calls to action considering the threat that climate change poses to global human health. Theory-led bioethical analyses of the scope and weight of physicians’ normative duty towards climate protection and its conflict with individual patient care are currently scarce. This article offers an analysis of the normative issues at stake by using Korsgaard’s neo-Kantian moral account of practical identities. We begin by showing the case of physicians’ duty to climate protection, before (...)
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  35.  9
    The micro-level of climate protection in healthcare and physicians’ professional ethos: a reply to the commentaries.Henk Jasper van Gils-Schmidt & Sabine Salloch - 2024 - Journal of Medical Ethics 50 (6):378-379.
    We are extremely grateful for the insightful and thought-provoking commentaries on our feature article.1 We have distilled four themes emerging from the commentaries, and we would also like to address one misunderstanding of our argument that has appeared. In our article, we explicitly acknowledge that major decisions relevant for climate protection take place at the mesolevels and macrolevels of healthcare, a point raised again in some of the commentaries.2–4 Climate protection is a societal issue, and we thank these authors for (...)
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  36.  94
    Choosing death in unjust conditions: hope, autonomy and harm reduction.Kayla Wiebe & Amy Mullin - 2024 - Journal of Medical Ethics 50 (6):407-412.
    In this essay, we consider questions arising from cases in which people request medical assistance in dying (MAiD) in unjust social circumstances. We develop our argument by asking two questions. First, can decisions made in the context of unjust social circumstance be meaningfully autonomous? We understand ‘unjust social circumstances’ to be circumstances in which people do not have meaningful access to the range of options to which they are entitled and ‘autonomy’ as self-governance in the service of personally meaningful goals, (...)
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  37.  13
    AAPT, pregnancy loss and planning ahead.Victoria Adkins & Elizabeth Chloe Romanis - 2024 - Journal of Medical Ethics 50 (5):318-319.
    The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied in clinical (...)
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  38.  11
    Pregnancy loss care should not be biased in favour of human gestation.Andrea Bidoli - 2024 - Journal of Medical Ethics 50 (5):312-313.
    In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, they (...)
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  39.  23
    Defending the impairment argument.Bruce Philip Blackshaw - 2024 - Journal of Medical Ethics 50 (5):342-344.
    Kyle van Oosterum and Emma Curran have recently argued that the impairment argument against abortion is weak and accomplishes little. They also claim that impairment fails to explain what makes giving a child fetal alcohol syndrome (FAS) immoral, which is an important premise of the argument. Here, I explain that the impairment argument is not as weak as they believe. Further, I argue that impairment offers a superior explanation for what makes giving a child FAS immoral than their proposal based (...)
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  40.  11
    Procreative loss without pregnancy loss: the limitations of fetal-centric conceptions of pregnancy.Hannah Carpenter, Georgia Loutrianakis, Peyton Baker, Tiffany Bystra & Lisa Campo-Engelstein - 2024 - Journal of Medical Ethics 50 (5):310-311.
    In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite fetal demise due to abortion restrictions and choosing to selectively reduce a multifetal pregnancy. Our analysis buttresses the (...)
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  41.  5
    Overcoming (false) dichotomies to address ethical issues of artificial placentas.Alice Cavolo - 2024 - Journal of Medical Ethics 50 (5):308-309.
    Romanis and Adkins discuss pregnancy loss in relation to artificial amnion and placenta technology (AAPT) for treatment of extremely preterm infants.1 I agree with the authors that AAPT, although it is expected to provide better care for extremely preterm infants, will also be challenging for parents. I, therefore, commend Romanis and Adkins for promoting a more holistic care that includes parents and pregnant persons. However, I believe that they create two false dichotomies, one between the pregnant person/parent and the fetus/child (...)
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  42. The Pregnancy Rescue Case: a reply to Hendricks.Nathan William Davies - 2024 - Journal of Medical Ethics 50 (5):345-346.
    In ‘The Pregnancy Rescue Case: why abortion is immoral’, Hendricks presents The Pregnancy Rescue Case. In this reply I argue that even if it would be better (i.e., less bad) for the abortion to be prevented in The Pregnancy Rescue Case, that does not mean that typical abortions are impermissible. I also argue that there is a possible explanation, consistent with the pro-choice view and empirically testable, as to why people would think it better for the abortion to be prevented (...)
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  43.  27
    Four problems for the pregnancy rescue case.Alex Gillham - 2024 - Journal of Medical Ethics 50 (5):340-341.
    The pregnancy rescue case (PRC) is supposed to show that when forced between preventing a fetus from being killed and preventing someone from remaining unwillingly pregnant, we are morally required to do the former. If this is true, then Hendricks argues that the typical abortion is morally wrong. I pose four problems for PRC and how Hendricks uses it here. First, one might simply deny the intuition Hendricks takes PRC to pump for reasons having to do with the moral status (...)
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  44.  7
    Conscientious commitment, professional obligations and abortion provision after the reversal of Roe v Wade.Alberto Giubilini, Udo Schuklenk, Francesca Minerva & Julian Savulescu - 2024 - Journal of Medical Ethics 50 (5):351-358.
    We argue that, in certain circumstances, doctors might beprofessionallyjustified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best (...)
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  45. The Pregnancy Rescue Case: why abortion is immoral.Perry Hendricks - 2024 - Journal of Medical Ethics 50 (5):332-334.
    In cases in which we must choose between either (i) preventing a woman from remaining unwillingly pregnant or (ii) preventing a fetus from being killed, we should prevent the fetus from being killed. But this suggests that in typical cases abortion is wrong: typical abortions involve preventing a woman from remaining unwillingly pregnant over preventing a fetus from being killed. And so abortion is typically wrong—and this holds whether or not fetuses are persons.
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  46.  7
    Discussion of off-target and tentative genomic findings may sometimes be necessary to allow evaluation of their clinical significance.Rachel H. Horton, William L. Macken, Robert D. S. Pitceathly & Anneke M. Lucassen - 2024 - Journal of Medical Ethics 50 (5):295-298.
    We discuss a case where clinical genomic investigation of muscle weakness unexpectedly found a genetic variant that might (or might not) predispose to kidney cancer. We argue that despite its off-target and uncertain nature, this variant should be discussed with the man who had the test, not because it is medical information, but because this discussion would allow the further clinical evaluation that might lead it to becoming so. We argue that while prominent ethical debates around genomics often take ‘results’ (...)
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  47.  7
    Against tiebreaking arguments in priority setting.Borgar Jølstad & Erik Gustavsson - 2024 - Journal of Medical Ethics 50 (5):320-323.
    Fair priority setting is based on morally sound criteria. Still, there will be cases when these criteria, our primary considerations, are tied and therefore do not help us in choosing one allocation over another. It is sometimes suggested that such cases can be handled by tiebreakers. In this paper, we discuss two versions of tiebreakers suggested in the literature. One version is to preserve fairness or impartiality by holding a lottery. The other version is to allow secondary considerations, considerations that (...)
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  48.  8
    Pregnancy loss in the context of AAPT: speculation over substance?Susan Kennedy - 2024 - Journal of Medical Ethics 50 (5):314-315.
    Romanis and Adkins explore the near-term prospect of artificial amnion and placenta technology (AAPT) which is being developed to supplement the gestational process following the premature ending of a pregnancy.1 While fetal-centric narratives prevail in discussions surrounding AAPT, the authors subvert this trend by centering the experience of pregnant persons with respect to pregnancy loss. The overarching aim of their paper is to move beyond a ‘philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding [AAPT]’ (Romanis and (...)
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  49. Medical AI: is trust really the issue?Jakob Thrane Mainz - 2024 - Journal of Medical Ethics 50 (5):349-350.
    I discuss an influential argument put forward by Hatherley in theJournal of Medical Ethics. Drawing on influential philosophical accounts of interpersonal trust, Hatherley claims that medical artificial intelligence is capable of being reliable, but not trustworthy. Furthermore, Hatherley argues that trust generates moral obligations on behalf of the trustee. For instance, when a patient trusts a clinician, it generates certain moral obligations on behalf of the clinician for her to do what she is entrusted to do. I make three objections (...)
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  50.  2
    Ethics briefing.Natalie Michaux, Emma Meaburn & Rebecca Mussell - 2024 - Journal of Medical Ethics 50 (5):359-360.
    Several European countries have recently started taking steps to protect access to abortion. France is one of these, with a bill having made its way through the legislature to enshrine the ‘liberté garantie’ (‘guaranteed freedom’) to an abortion in its constitution. It is the first country in the world to explicitly include abortion access in its constitution. Although abortion was decriminalised in France in 1975, proponents of the bill stated that they were motivated by protecting freedom for future generations (rather (...)
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  51.  11
    Lowering the age limit of access to the identity of the gamete donor by donor offspring: the argument against.Guido Pennings - 2024 - Journal of Medical Ethics 50 (5):292-294.
    Countries that abolished donor anonymity have imposed age limits for access to certain types of information by donor offspring. In the UK and the Netherlands, a debate has started on whether these age limits should be lowered or abolished all together. This article presents some arguments against lowering the age limits as a general rule for all donor children. The focus is on whether one should give a child the right to obtain the identity of the donor at an earlier (...)
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  52.  19
    Artificial placentas, pregnancy loss and loss-sensitive care.Elizabeth Chloe Romanis & Victoria Adkins - 2024 - Journal of Medical Ethics 50 (5):299-307.
    In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...)
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  53.  15
    Rights and duties of genetic counsellors in Germany related to relatives at risk: comparative thoughts on the German Genetic Diagnostics Act.Susanne A. Schneider & Uwe H. Schneider - 2024 - Journal of Medical Ethics 50 (5):324-331.
    Genetic testing has familial implications. Counsellors find themselves in (moral) conflict between medical confidentiality (towards the patient) and a potential right or even duty to warn at-risk relatives. Legal regulations vary between countries. English literature about German law is scarce. We reviewed the literature of relevant legal cases, focussing on German law, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This article aims to familiarise counsellors with their responsibilities, compare the situation between countries and point out (...)
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  54.  20
    Addressing or reinforcing injustice? Artificial amnion and placenta technology, loss-sensitive care and racial inequities in preterm birth.Sophie L. Schott, Faith Fletcher, Alice Story & April Adams - 2024 - Journal of Medical Ethics 50 (5):316-317.
    Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm birth (...)
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  55.  3
    The ethical is political: Israel’s production of health scarcity in Gaza.Arianne Shahvisi - 2024 - Journal of Medical Ethics 50 (5):289-291.
    One of the most important motifs within (medical) ethics is scarcity: where essential (health) resources are scarce, urgent ethical questions arise. Over the last decade, at least 250 papers addressing the allocation of scarce health resources have been published in the Journal of Medical Ethics alone.1 In the typical set-up, the authors introduce a situation of scarcity and then review and adjudicate the available or recommended courses of action, sometimes through the lens of a pet normative ethical theory. It is (...)
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  56.  7
    On the importance of consistency: a response to Giubilini et al.Xavier Symons - 2024 - Journal of Medical Ethics 50 (5):347-348.
    Giubiliniet aloffer some helpful reflections on the conscientious provision of medical care and whether and in what circumstances professional associations ought to support the conscientious provision of abortion in circumstances where abortion is banned or heavily restricted. I have several reservations, however, about the argument developed in the article. First, the essay makes questionable use of the case of Savita Halappanavar to justify its central argument about conscientious provision. Second, there is an apparent inconsistency between this article and the authors’ (...)
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  57. Impairing the Impairment Argument.Kyle van Oosterum & Emma J. Curran - 2024 - Journal of Medical Ethics 50 (5):335-339.
    Blackshaw and Hendricks have recently developed and defended the impairment argument against abortion, arguing that the immorality of giving a child fetal alcohol syndrome (FAS) provides us with reason to believe that abortion is immoral. In this paper, we forward two criticisms of the impairment argument. First, we highlight that, as it currently stands, the argument is very weak and accomplishes very little. Second, we argue that Blackshaw and Hendricks are fundamentally mistaken about what makes giving a child FAS immoral. (...)
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  58.  16
    Incision or insertion makes a medical intervention invasive. Commentary on ‘What makes a medical intervention invasive?’.Paul Affleck, Julia Cons & Simon E. Kolstoe - 2024 - Journal of Medical Ethics 50 (4):242-243.
    De Marco and colleagues claim that the standard account of invasiveness as commonly encountered ‘…does not capture all uses of the term in relation to medical interventions1 ’. This is open to challenge. Their first example is ‘non-invasive prenatal testing’. Because it involves puncturing the skin to obtain blood, De Marco et al take this as an example of how an incision or insertion is not sufficient to make an intervention invasive; here is a procedure that involves an incision, but (...)
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  59.  23
    The name of the game: a Wittgensteinian view of ‘invasiveness’.Stacy S. Chen, Connor T. A. Brenna, Matthew Cho, Liam G. McCoy & Sunit Das - 2024 - Journal of Medical Ethics 50 (4):240-241.
    In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...)
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  60.  55
    What makes a medical intervention invasive?Gabriel De Marco, Jannieke Simons, Lisa Forsberg & Thomas Douglas - 2024 - Journal of Medical Ethics 50 (4):226-233.
    The classification of medical interventions as either invasive or non-invasive is commonly regarded to be morally important. On the most commonly endorsed account of invasiveness, a medical intervention is invasive if and only if it involves either breaking the skin (‘incision’) or inserting an object into the body (‘insertion’). Building on recent discussions of the concept of invasiveness, we show that this standard account fails to capture three aspects of existing usage of the concept of invasiveness in relation to medical (...)
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  61.  13
    What makes a medical intervention invasive? A reply to commentaries.Gabriel De Marco, Jannieke Simons, Lisa Forsberg & Thomas Douglas - 2024 - Journal of Medical Ethics 50 (4):244-245.
    We are grateful to the commentators for their close reading of our article 1 and for their challenging and interesting responses to it. We do not have space to respond to all of the objections that they raise, so in this reply, we address only a selection of them. Some commentaries question the usefulness of developing an account of the sort we provide, 2 or of revising the Standard Account (SA) in doing so. 3–5 Our schema is intended to provide (...)
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  62.  36
    Research ethics and public trust in vaccines: the case of COVID-19 challenge trials.Nir Eyal - 2024 - Journal of Medical Ethics 50 (4):278-284.
    Despite their clearly demonstrated safety and effectiveness, approved vaccines against COVID-19 are commonly mistrusted. Nations should find and implement effective ways to boost vaccine confidence. But the implications for ethical vaccine development are less straightforward than some have assumed. Opponents of COVID-19 vaccine challenge trials, in particular, made speculative or empirically implausible warnings on this matter, some of which, if applied consistently, would have ruled out most COVID-19 vaccine trials and many non-pharmaceutical responses.
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  63.  26
    Medical ethics, equity and social justice.Lucy Frith - 2024 - Journal of Medical Ethics 50 (4):221-221.
    As John McMillan notes in January’s editorial,1 many countries are reflecting on how they responded to the COVID-19 pandemic, what went wrong and how responses to such system shocks can be better managed in the future. However, while it is tempting to think that the COVID-19 pandemic is over and that what is now needed is a reflection on how countries could have responded better, some of the underlying issues and problems COVID-19 both highlighted and created are still with us. (...)
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  64.  21
    Blaming the unvaccinated during the COVID-19 pandemic: the roles of political ideology and risk perceptions in the USA.Maja Graso, Karl Aquino, Fan Xuan Chen & Kevin Bardosh - 2024 - Journal of Medical Ethics 50 (4):246-252.
    Individuals unvaccinated against COVID-19 (C19) experienced prejudice and blame for the pandemic. Because people vastly overestimate C19 risks, we examined whether these negative judgements could be partially understood as a form of scapegoating (ie, blaming a group unfairly for an undesirable outcome) and whether political ideology (previously shown to shape risk perceptions in the USA) moderates scapegoating of the unvaccinated. We grounded our analyses in scapegoating literature and risk perception during C19. We obtained support for our speculations through two vignette-based (...)
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  65.  6
    Ethical considerations for psychedelic-assisted therapy in military clinical settings.Scott Hoener, Aaron Wolfgang, David Nissan & Edmund Howe - 2024 - Journal of Medical Ethics 50 (4):258-262.
    Psychedelic treatments, particularly 3,4-methylenedioxymethamphetamine (MDMA)-assisted and psilocybin-assisted therapies, have recently seen renewed interest in their clinical potential to treat various mental health conditions. Clinical trials for both MDMA-assisted and psilocybin-assisted therapies have shown to be highly efficacious for post-traumatic stress disorder and major depression. Recent research trials for psychedelic-assisted therapies (PAT) have demonstrated that although they are resource-intensive, their effects are rapid-acting, durable and cost-effective. These results have generated enthusiasm among researchers seeking to investigate psychedelic therapies in active-duty service members (...)
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  66.  17
    Redefining mental invasiveness in psychiatric treatments: insights from schizophrenia and depression therapies.Craig Waldence McFarland & Justis Victoria Gordon - 2024 - Journal of Medical Ethics 50 (4):238-239.
    Over 50% of the world population will develop a psychiatric disorder in their lifetime.1 In the realm of psychiatric treatment, two primary modalities have been established: pharmacotherapy and psychotherapy. Yet, pharmacological interventions often take precedence as the initial treatment choice despite their comparable outcomes, severe side effects and disputed evidence of their efficacy. This preference for medication foregrounds a vital re-examination of what it means to be invasive in medical treatments, namely in psychiatric care. De Marco et al challenge the (...)
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  67.  7
    Vaccine mandates for prospective versus existing employees: reply to Smith.Tyler Paetkau - 2024 - Journal of Medical Ethics 50 (4):285-286.
    Employment-based vaccine mandates have worse consequences for existing than prospective employees. Prospective employees are not yet dependent on a particular employment arrangement, so they are better positioned to respond to such mandates. Yet despite this asymmetry in consequences, Smith argues that if vaccine mandates are justified for prospective employees, they are similarly justified for existing employees. This paper responds to Smith’s argument. First, Smith holds that bona fide occupational requirements are actions that are necessary for the safe and effective completion (...)
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  68.  9
    Reassessing the VaxTax.Nathan Petrovic - 2024 - Journal of Medical Ethics 50 (4):222-225.
    To counter the imbalance in vaccine distribution during the COVID-19 pandemic, Albertsen and more recently Germaniet alhave suggested a new system of taxation coined as ‘VaxTax’ that would force higher-income countries to fund the access of low-income and middle-income countries (LMICs) to new vaccines in times of pandemic. I will argue that this idea faces numerous challenges of ethical, sociopolitical and economical nature that may hinder any effort to solve the numerous health challenges that LMICs face. I argue that while (...)
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  69.  43
    Gene–environment interaction: why genetic enhancement might never be distributed fairly.Sinead Prince - 2024 - Journal of Medical Ethics 50 (4):272-277.
    Ethical debates around genetic enhancement tend to include an argument that the technology will eventually be fairly accessible once available. That we can fairly distribute genetic enhancement has become a moral defence of genetic enhancement. Two distribution solutions are argued for, the first being equal distribution. Equality of access is generally believed to be the fairest and most just method of distribution. Second, equitable distribution: providing genetic enhancements to reduce social inequalities. In this paper, I make two claims. I first (...)
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  70.  15
    Enhancing social value considerations in prioritising publicly funded biomedical research: the vital role of peer review.Katherine W. Saylor & Steven Joffe - 2024 - Journal of Medical Ethics 50 (4):253-257.
    The main goal of publicly funded biomedical research is to generate social value through the creation and application of knowledge that can improve the well-being of current and future people. Prioritising research with the greatest potential social value is crucial for good stewardship of limited public resources and ensuring ethical involvement of research participants. At the National Institutes of Health (NIH), peer reviewers hold the expertise and responsibility for social value assessment and resulting prioritisation at the project level. However, previous (...)
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  71.  7
    Rethinking medical invasiveness in the clinical encounter.Stephanie K. Slack & Nathan Higgins - 2024 - Journal of Medical Ethics 50 (4):234-235.
    De Marco et al 1 argue that the standard account of medical ‘invasiveness’ (as ‘incision’ or ‘insertion’) fails to capture three aspects of its existing use, namely that invasiveness can come in degrees, often depends on features of alternative medical interventions and can be non-physical. They propose a new schematic account that suggests that medical interventions can possess ‘basic invasiveness’ (which can come in degrees and of which they suggest at least two types: physical and mental), and ‘threshold invasiveness’ which (...)
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  72.  5
    The ethics of firing unvaccinated employees.Maxwell J. Smith - 2024 - Journal of Medical Ethics 50 (4):268-271.
    Some organisations make vaccination a condition of employment. This means prospective employees must demonstrate they have been vaccinated (eg, against measles) to be hired. But it also means organisations must decide whether _existing_ employees should be expected to meet newly introduced vaccination conditions (eg, against COVID-19). Unlike prospective employees who will not be _hired_ if they do not meet vaccination conditions, existing employees who fail to meet new vaccination conditions risk being _fired_. The latter seems worse than the former. Hence, (...)
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  73.  14
    Navigating the ambiguity of invasiveness: is it warranted? A response to De Marco et al.Nicholas Shane Tito - 2024 - Journal of Medical Ethics 50 (4):236-237.
    Authors De Marco and colleagues have presented a new model on the concept of invasiveness, redefining both its technical definition and practical implementation.1 While the authors raise valid critiques regarding the discrepancy in definitions, I cannot help but wonder about the purpose of redefining terms for which little confusion, if any, exists? This commentary seeks to scrutinise the rationale supporting the new model in the absence of significant clinical confusion and to explore the implications for clinical practice. Initially, one may (...)
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  74.  24
    A human right to pleasure? Sexuality, autonomy and egalitarian strategies.Jon Wittrock - 2024 - Journal of Medical Ethics 50 (4):263-267.
    A growing focus on pleasure in human rights discourse has been used to address patterns of sexual exclusion, often when addressing the problems of people with disabilities (PWD). As convincingly argued by Liberman, however, not all PWD suffer from sexual exclusion, and not all who suffer from sexual exclusion are PWD. Danaher and Liberman have thus argued in various ways for a broader range of measures, addressing sexual exclusion. This article builds on previous research and offers a conceptual framework for (...)
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  75.  20
    ‘False hope’ in assisted reproduction: the normative significance of the external outlook and moral negotiation.Dorian Accoe & Seppe Segers - 2024 - Journal of Medical Ethics 50 (3):181-184.
    Despite the frequent invocation of ‘false hope’ and possible related moral concerns in the context of assisted reproduction technologies, a focused ethical and conceptual problematisation of this concept seems to be lacking. We argue that an invocation of ‘false hope’ only makes sense if the fulfilment of a desired outcome (eg, a successful fertility treatment) is impossible, and if it is attributed from an external perspective. The evaluation incurred by this third party may foreclose a given perspective from being an (...)
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  76.  42
    Gillick competence: an inadequate guide to the ethics of involving adolescents in decision-making.Avraham Bart, Georgina Antonia Hall & Lynn Gillam - 2024 - Journal of Medical Ethics 50 (3):157-162.
    Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive. In this paper, we argue that its utility is far more limited, and hence over-reliance on Gillick risks undermining rather than promoting ethically appropriate adolescent involvement. We demonstrate that Gillick (...)
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  77.  64
    Abortion and the basis of equality: a reply to Miller.Alexander Bozzo - 2024 - Journal of Medical Ethics 50 (3):207-208.
    Miller has recently argued that the standard liberal and moderate positions on abortion are incapable of grounding the claim that ‘all non-disabled adult humans are equal’. The reason, he claims, is such accounts base the intrinsic moral worth of a human being on some property (or set of properties) which comes in degrees. In contrast, he argues that moral equality must reside in some binary property, such as the property of being human. In this paper, I offer three criticisms of (...)
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  78.  36
    Igwebuike: an African concept for an inclusive medical ethics.Luis Cordeiro-Rodrigues & Ada Agada - 2024 - Journal of Medical Ethics 50 (3):219-220.
    Igwebuike is a traditional knowledge system undergirded by the metaphysical assumption that the world is a totality of interconnected and interrelated entities.1–4 African scholars in West Africa often invoke igwebuike to make sense of African ethical, social and political perspectives that are grounded in the theory of Afro-communitarianism. Afro-communitarianism is primarily a socioethical theory that is concerned with the articulation of the moral relationship between the individual and the community. The term igwebuike is derived from the Igbo root words igwe (...)
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  79.  26
    Gain-of-function research and model organisms in biology.Nicholas G. Evans & Charles H. Pence - 2024 - Journal of Medical Ethics 50 (3):201-206.
    So-called ‘gain-of-function’ (GOF) research is virological research that results in a virus substantially more virulent or transmissible than its wild antecedent. GOF research has been subject to ethical analysis in the past, but the methods of GOF research have to date been underexamined by philosophers in these analyses. Here, we examine the typical animal used in influenza GOF experiments, the ferret, and show how despite its longstanding use, it does not easily satisfy the desirable criteria for ananimal model. We then (...)
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  80.  22
    Addressing bias in artificial intelligence for public health surveillance.Lidia Flores, Seungjun Kim & Sean D. Young - 2024 - Journal of Medical Ethics 50 (3):190-194.
    Components of artificial intelligence (AI) for analysing social big data, such as natural language processing (NLP) algorithms, have improved the timeliness and robustness of health data. NLP techniques have been implemented to analyse large volumes of text from social media platforms to gain insights on disease symptoms, understand barriers to care and predict disease outbreaks. However, AI-based decisions may contain biases that could misrepresent populations, skew results or lead to errors. Bias, within the scope of this paper, is described as (...)
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  81.  37
    Undermining autonomy and consent: the transformative experience of disease.Bjørn Hofmann - 2024 - Journal of Medical Ethics 50 (3):195-200.
    Disease radically changes the life of many people and satisfies formal criteria for being a transformative experience. According to the influential philosophy of Paul, transformative experiences undermine traditional criteria for rational decision-making. Thus, the transformative experience of disease can challenge basic principles and rules in medical ethics, such as patient autonomy and informed consent. This article applies Paul’s theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the very (...)
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  82.  8
    Dear WMA, please better engage LMICs and say more about environmental sustainability.Cheryl C. Macpherson & Anna Cyrus-Murden - 2024 - Journal of Medical Ethics 50 (3):175-176.
    Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised (...)
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  83. ICoME and the legitimacy of professional self-regulation.Afsheen Mansoori & Eli Garrett Schantz - 2024 - Journal of Medical Ethics 50 (3):173-174.
    After an intensive 4-year process, the World Medical Association (WMA) has revised its International Code of Medical Ethics (ICoME). In their report outlining this process, Parsa-Parsi et al not only describe how the WMA sought to ‘cultivat[e] international agreement’ on a ‘global medical ethos’, but also outline the philosophical framework of the ICoME: how the WMA, as the ‘global representation of the medical profession’, created and revised the ICoME through the process of international professional self-regulation.1 However, there is a significant (...)
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  84.  16
    UK doctors’ strikes 2023: not only justified but, arguably, supererogatory.Doug McConnell & Darren Mann - 2024 - Journal of Medical Ethics 50 (3):152-156.
    The 2023 doctors’ strikes in the UK have elicited a familiar moral outcry that such strikes are morally wrong. We consider five arguments that might be thought to show doctors’ strikes are morally impermissible but show that they all fail. The most we can conclude from such arguments is that doctors’ strikes are morally permissible in a narrower range of circumstances than strikes in other sectors.We then outline two independent but compatible justifications for doctors’ strikes, one that appeals to doctors’ (...)
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  85.  17
    The wrong word for the job? The ethics of collecting data on ‘race’ in academic publishing.John McMillan, Brian D. Earp, Wing May Kong, Mehrunisha Suleman & Arianne Shahvisi - 2024 - Journal of Medical Ethics 50 (3):149-151.
    Socially responsible publishers, such as the BMJ Publishing Group, have demonstrated a commitment to health equity and working towards rectifying the structural racism that exists both in healthcare and in medical publishing.1 The commitment of academic publishers to collecting information relevant to promoting equity and diversity is important and commendable where it leads to that result.2 However, collecting sensitive demographic data is not a morally neutral activity. Rather, it carries with it both known and potential risks. Among these are issues (...)
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  86.  46
    Human equality and the impermissibility of abortion: a response to Bozzo.Calum Miller - 2024 - Journal of Medical Ethics 50 (3):209-211.
    I have recently offered a defence of human equality, and consequently an argument against abortion. This has been objected to by Bozzo, on the grounds that my account of human equality is unclear and could be grounded in utilitarian or Kantian ethics, that my account struggles to ground the permissibility of therapeutic abortions, and that my proposed foundation for human equality itself is parasitic on a scalar property which generates the same difficulties I am attempting to solve. I provide an (...)
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  87.  20
    The revised International Code of Medical Ethics: an exercise in international professional ethical self-regulation.Ramin W. Parsa-Parsi, Raanan Gillon & Urban Wiesing - 2024 - Journal of Medical Ethics 50 (3):163-168.
    The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial (...)
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  88.  26
    The revised International Code of Medical Ethics: responses to some important questions.Ramin W. Parsa-Parsi, Raanan Gillon & Urban Wiesing - 2024 - Journal of Medical Ethics 50 (3):179-180.
    We thank our commentators for their thoughtful responses to our paper1 covering among other issues the relationships of ethics law and professional codes, the tensions between ethical universalism and cultural relativism and the phenomenon of moral judgement required when ethical norms conflict, including the norms of patient care versus obligations to others both now and in the future. Although the comments deserve more extensive discussion, in what follows we respond briefly to specific aspects of each commentary and remind readers that (...)
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  89.  26
    First among equals? Adaptive preferences and the limits of autonomy in medical ethics.Susan Pennings & Xavier Symons - 2024 - Journal of Medical Ethics 50 (3):212-218.
    Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others. In this paper, we consider whether _inappropriately adaptive preferences_—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, (...)
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  90.  21
    Abortion restrictions: the case for conscientious non-compliance on the part of providers.Pierce Randall & Jacob Mago - 2024 - Journal of Medical Ethics 50 (3):185-189.
    This paper offers a qualified defence of physician non-compliance with antiabortion legislation in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. The paper examines two ethically troubling trends of post-Dobbs legislation: narrow and vague maternal health exemption clauses and mandatory reporting of miscarriages in jurisdictions where patients may criminal prosecution for medically induced abortions. It then examines and defends a professional obligation on the part of physicians to comply with the law. This obligation, however, (...)
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  91.  22
    Can medical ethics truly be independent of law?Abeezar I. Sarela - 2024 - Journal of Medical Ethics 50 (3):177-178.
    Parsa-Parsi et al assert that the International Code of Medical Ethics (ICoME) provides a professional standard that overrides conflicting national legal norms.1 While this claim is made in the context of laws that require doctors to participate in ‘acts of torture, or other cruel, inhuman, or degrading practices and punishments’ (para10 of ICoME), the underlying premise that medical ethics supersedes law requires scrutiny. It is clear that medical ethics and law are linked inextricably, but there is unresolved debate about the (...)
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  92.  17
    Complication for a greener medical ethics code: assisted reproduction.Seppe Segers & Michiel De Proost - 2024 - Journal of Medical Ethics 50 (3):169-170.
    Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics for healthcare’s contribution to climate change. Recent research analyses, for instance, the ‘greening’ of informed consent and related bioethical principles.2 3 It is (...)
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  93.  17
    ICoME and the moral significance of telemedicine.Victor Chidi Wolemonwu, Chiedozie Godian Ike, Rosangela Barcaro & Emanuela Midolo - 2024 - Journal of Medical Ethics 50 (3):171-172.
    Parsa-Parsi et al systematically discuss and elucidate contentious and non-controversial ethical issues that emerged during the ICoME (International Code of Medical Ethics) revision process and the consensus they achieved. The ethical issues discussed include the physician’s duty to act in the best interests of patients and to ensure they are protected from the unjustifiable risk of harm, respect for patient autonomy and the duties of physicians during emergencies, among others. This paper examines paragraph 26, which requires doctors to provide only (...)
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  94.  7
    Time to treat the climate and nature crisis as one indivisible global health emergency.Chris Zielinski - 2024 - Journal of Medical Ethics 50 (3):2-2.
    Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of (...)
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  95.  38
    Consent-GPT: is it ethical to delegate procedural consent to conversational AI?Jemima Winifred Allen, Brian D. Earp, Julian Koplin & Dominic Wilkinson - 2024 - Journal of Medical Ethics 50 (2):77-83.
    Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...)
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  96.  35
    Exploring the potential utility of AI large language models for medical ethics: an expert panel evaluation of GPT-4.Michael Balas, Jordan Joseph Wadden, Philip C. Hébert, Eric Mathison, Marika D. Warren, Victoria Seavilleklein, Daniel Wyzynski, Alison Callahan, Sean A. Crawford, Parnian Arjmand & Edsel B. Ing - 2024 - Journal of Medical Ethics 50 (2):90-96.
    Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...)
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  97.  17
    COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities.Kevin Bardosh, Allison Krug, Euzebiusz Jamrozik, Trudo Lemmens, Salmaan Keshavjee, Vinay Prasad, Marty A. Makary, Stefan Baral & Tracy Beth Høeg - 2024 - Journal of Medical Ethics 50 (2):126-138.
    In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...)
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  98.  22
    But I accepted these disadvantages! Can you be discriminated against by holding a right?Alma K. Barner - 2024 - Journal of Medical Ethics 50 (2):120-121.
    To show that discrimination against the terminally ill is a real and worrisome phenomenon Reed presents four examples1. Here, I focus on the final two: right-to-try and right-to-die laws. I argue that they are not instances of discrimination, because they grant rights. Reed appears to have overlooked that rights differ from obligations in ways that leave his argumentation unsuccessful. According to the most prominent theory of rights, rights function to protect the personal interests of their holders.2 For that reason, strengthening (...)
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  99.  18
    Open AI meets open notes: surveillance capitalism, patient privacy and online record access.Charlotte Blease - 2024 - Journal of Medical Ethics 50 (2):84-89.
    Patient online record access (ORA) is spreading worldwide, and in some countries, including Sweden, and the USA, access is advanced with patients obtaining rapid access to their full records. In the UK context, from 31 October 2023 as part of the new NHS England general practitioner (GP) contract it will be mandatory for GPs to offer ORA to patients aged 16 and older. Patients report many benefits from reading their clinical records including feeling more empowered, better understanding and remembering their (...)
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  100.  35
    Assessing the performance of ChatGPT in bioethics: a large language model’s moral compass in medicine.Jamie Chen, Angelo Cadiente, Lora J. Kasselman & Bryan Pilkington - 2024 - Journal of Medical Ethics 50 (2):97-101.
    Chat Generative Pre-Trained Transformer (ChatGPT) has been a growing point of interest in medical education yet has not been assessed in the field of bioethics. This study evaluated the accuracy of ChatGPT-3.5 (April 2023 version) in answering text-based, multiple choice bioethics questions at the level of US third-year and fourth-year medical students. A total of 114 bioethical questions were identified from the widely utilised question banks UWorld and AMBOSS. Accuracy, bioethical categories, difficulty levels, specialty data, error analysis and character count (...)
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  101.  9
    Terminalism and how dying patients are conditioned as docile bodies.John Han - 2024 - Journal of Medical Ethics 50 (2):116-117.
    Philip Reed (2023) argues that discrimination against (non-acutely) dying patients constitutes a unique kind—which he calls terminalism—because their status as persons with terminal illness marks them with a socially salient identity which, by means of direct and indirect discrimination, limits their sets of choices and resources, such as in hospice care or organ transplant policies. 1 Importantly, Reed also argues that while terminalism is an increasingly prevalent normative phenomenon, it has been overlooked in the literature, ‘hiding in plain sight’ as (...)
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  102.  13
    University-age vaccine mandates: reply to Lam and Nichols.Tracy Beth Høeg, Allison Krug, Stefan Baral, Euzebiusz Jamrozik, Salmaan Keshavjee, Trudo Lemmens, Vinay Prasad, Martin A. Makary & Kevin Bardosh - 2024 - Journal of Medical Ethics 50 (2):143-145.
    We thank Leo Lam and Taylor Nichols for their response1 to our paper ‘COVID-19 vaccine boosters for young adults: a risk–benefit assessment and ethical analysis of mandate policies at universities’.2 In our paper, we demonstrate that the risk–benefit calculus to mandate boosters for young adults aged 18–29 is a net risk intervention. The authors assert that we have made three inappropriate comparisons of benefits versus risks of the mRNA vaccine booster dose in this age group. We provide our response to (...)
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  103.  27
    Ethics of college vaccine mandates, using reasonable comparisons.Leo L. Lam & Taylor Nichols - 2024 - Journal of Medical Ethics 50 (2):140-142.
    In the paper ‘COVID-19 vaccine boosters for young adults: a risk–benefit assessment and ethical analysis of mandate policies at universities,’ Bardoshet alargued that college mandates of the COVID-19 booster vaccine are unethical. The authors came to this conclusion by performing three different sets of comparisons of benefits versus risks using referenced data and argued that the harm outweighs the risk in all three cases. In this response article, we argue that the authors frame their arguments by comparing values that are (...)
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  104.  34
    Giving the terminally ill access to euthanasia is not discriminatory: a response to Reed.Jordan MacKenzie - 2024 - Journal of Medical Ethics 50 (2):123-123.
    Philip Reed argues that laws that grant people access to euthanasia on the basis of terminal illness are discriminatory. In support of this claim, he offers an argument by analogy: it would be discriminatory to offer a person access to euthanasia because they are women or because they are disabled, as such restricted access would send the message ‘that life as a woman or as a disabled person is (very often) not worth living’.1 And so it must also be discriminatory (...)
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  105.  17
    Unconditional access to non-invasive prenatal testing (NIPT) for adult-onset conditions: a defence.India R. Marks, Catherine Mills & Katrien Devolder - 2024 - Journal of Medical Ethics 50 (2):102-107.
    Over the past decade, non-invasive prenatal testing (NIPT) has been adopted into routine obstetric care to screen for fetal sex, trisomies 21, 18 and 13, sex chromosome aneuploidies and fetal sex determination. It is predicted that the scope of NIPT will be expanded in the future, including screening for adult-onset conditions (AOCs). Some ethicists have proposed that using NIPT to detect severe autosomal AOCs that cannot be prevented or treated, such as Huntington’s disease, should only be offered to prospective parents (...)
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  106.  18
    Examining right to try practices.Leslie Jasmine Morgan & Michelle T. Pham - 2024 - Journal of Medical Ethics 50 (2):118-119.
    In ‘Discrimination Against the Dying’, Phillip Reed argues that terminally ill patients are subjected to a distinct form of discrimination called ‘terminalism’. One of Reed’s primary examples of terminalism is right to try laws, which offer terminally ill patients the option to request medications that are not FDA-approved and without IRB involvement. In this analysis, we consider additional contextual factors about right to try, suggesting that it may not neatly count as an exemplar of terminalism. When pursued with appropriate protocols (...)
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  107.  7
    Ethics briefing.Rebecca Mussell, Ranveig Svenning Berg & Allison Milbrath - 2024 - Journal of Medical Ethics 50 (2):147-148.
    Proposals to modernise fertility law in the UK In November 2023, the Human Fertilisation and Embryology Authority (HFEA) published recommendations 1 for changes to the Human Fertilisation and Embryology Act. 2 The HFEA regulates fertility treatments and embryo research in the UK. The recommendations were informed by a public consultation process during which the HFEA heard from patients, professionals and others with an interest in the regulations. The consultation ran from February - April 2023 and received just over 6800 responses. (...)
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  108.  22
    Discrimination against the dying.Philip Reed - 2024 - Journal of Medical Ethics 50 (2):108-114.
    The purpose of this paper is to identify a kind of discrimination that has hitherto gone unrecognised. ‘Terminalism’ is discrimination against the dying, or treating the terminally ill worse than they would expect to be treated if they were not dying. I provide four examples from healthcare settings of this kind of discrimination: hospice eligibility requirements, allocation protocols for scarce medical resources, right to try laws and right to die laws. I conclude by offering some reflections on why discrimination against (...)
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  109.  32
    Terminalism and assisted suicide.Philip Reed - 2024 - Journal of Medical Ethics 50 (2):124-125.
    Four of the commentaries criticised my claim that assisted suicide for the terminally ill is discriminatory. 1 They were united in this judgement roughly because they insisted that assisted suicide is in fact a benefit and not a harm. I concede that if it is a benefit, then there is no way in which the terminally ill can be disadvantaged by it and hence no way it can be an instance of discrimination. I pointed out in the article that this (...)
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  110.  19
    Is medical aid in dying discriminatory?Christopher A. Riddle - 2024 - Journal of Medical Ethics 50 (2):122-122.
    In _Discrimination Against the Dying_, Philip Reed argues, among other things, that ‘right to die laws (euthanasia and assisted suicide) also exhibit terminalism when they restrict eligibility to the terminally ill’. 1 Additionally, he suggests ‘the availability of the option of assisted death only for the terminally ill negatively influences the terminally ill who wish to live by causing them to doubt their choice’. 1 I argue that on scrutiny, neither of these two points hold. First, we routinely limit a (...)
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  111.  12
    Assisted dying programmes are not discriminatory against the dying.Ben Sarbey - 2024 - Journal of Medical Ethics 50 (2):115-115.
    Some jurisdictions that allow assisted dying require participating patients to have a terminal illness. This includes all Australian and US states where assisted dying is allowed. 1 Philip Reed 2 argues that this requirement constitutes discrimination against the dying. As Reed 2 argues: ‘assisted death laws that limit their services to the dying discriminate against them because death is offered to them to solve their problems’. This discrimination could take two forms: (1) via harm to dying patients as a group (...)
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  112.  17
    Beyond algorithmic trust: interpersonal aspects on consent delegation to LLMs.Zeineb Sassi, Michael Hahn, Sascha Eickmann, Anne Herrmann-Johns & Max Tretter - 2024 - Journal of Medical Ethics 50 (2):139-139.
    In their article ‘Consent-GPT: is it ethical to delegate procedural consent to conversational AI?’, Allen et al 1 explore the ethical complexities involved in handing over parts of the process of obtaining medical consent to conversational Artificial Intelligence (AI) systems, that is, AI-driven large language models (LLMs) trained to interact with patients to inform them about upcoming medical procedures and assist in the process of obtaining informed consent.1 They focus specifically on challenges related to accuracy (4–5), trust (5), privacy (5), (...)
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  113.  33
    Generative AI and medical ethics: the state of play.Hazem Zohny, Sebastian Porsdam Mann, Brian D. Earp & John McMillan - 2024 - Journal of Medical Ethics 50 (2):75-76.
    Since their public launch, a little over a year ago, large language models (LLMs) have inspired a flurry of analysis about what their implications might be for medical ethics, and for society more broadly. 1 Much of the recent debate has moved beyond categorical evaluations of the permissibility or impermissibility of LLM use in different general contexts (eg, at work or school), to more fine-grained discussions of the criteria that should govern their appropriate use in specific domains or towards certain (...)
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  114.  32
    Misunderstanding moral status: a reply to Robinson.Giulia Cavaliere & Francesca Cesarano - 2024 - Journal of Medical Ethics 50 (1):24-25.
    In Pregnancy and superior moral status: A proposal for two thresholds of personhood, Robinson argues that pregnant women are unique beings with superior moral status (MS) to that of other adult human beings. Robinson’s defence of this view relies on metaphysical and moral claims. The first set of claims concerns the ontological status of the pregnant woman, whom she considers a ‘unique organism’,‘more than just one person’and ‘numerically increased’.1 The second set of claims concerns the ‘superior’ MS of the pregnant (...)
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  115.  25
    Abortion policies at the bedside: incorporating an ethical framework in the analysis and development of abortion legislation.Alicia E. Hersey, Jai-Me Potter-Rutledge & Benjamin P. Brown - 2024 - Journal of Medical Ethics 50 (1):2-5.
    About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the (...)
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  116.  16
    Responsibility and decision-making authority in using clinical decision support systems: an empirical-ethical exploration of German prospective professionals’ preferences and concerns.Florian Funer, Wenke Liedtke, Sara Tinnemeyer, Andrea Diana Klausen, Diana Schneider, Helena U. Zacharias, Martin Langanke & Sabine Salloch - 2024 - Journal of Medical Ethics 50 (1):6-11.
    Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of responsibility and decision-making (...)
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  117.  24
    Wrongful discrimination against non-pregnant people?Kasper Lippert-Rasmussen, Andreas Bengtson & Hugo Cosette-Lefebvre - 2024 - Journal of Medical Ethics 50 (1):26-27.
    Heloise Robinson argues that pregnant women have a higher moral status than non-pregnant persons and that, for this reason, pregnant women ought to be treated ‘noticeably’ better than non-pregnant persons.1 In this commentary, we present two challenges to Robinson’s argument. First, the compounding disadvantage objection: treating involuntarily, non-pregnant women worse than voluntarily pregnant women unjustly compounds their disadvantage. Second, the identity objection: treating non-pregnant people worse than pregnant people amounts to pro tanto wrongful discrimination based on a fundamental aspect of (...)
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  118.  14
    A Nietzschean critique of liberal eugenics.Donovan Tateshi Miyasaki - 2024 - Journal of Medical Ethics 50 (1):62-69.
    Ethical debates about liberal eugenics frequently focus on the supposed unnaturalness of its means and possible harm to autonomy. I present a Nietzsche-inspired critique focusing on intention rather than means and harm to abilities rather than to autonomy. I first critique subjective eugenics, the selection of extrinsically valuable traits, drawing on Nietzsche’s notion of ‘slavish’ values reducible to the negation of another’s good. Subjective eugenics slavishly evaluates traits relative to a negatively evaluated norm (eg, above-average intelligence), disguising a harmful intention (...)
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  119.  15
    Supervaluation of pregnant women is reductive of women.Jennifer Parks & Timothy F. Murphy - 2024 - Journal of Medical Ethics 50 (1):29-30.
    Robinson argues that by certain threshold criteria, pregnant women qualify for a higher moral status by reason of their pregnancies. While her intention is to make this a status upgrade for women, we worry that it may result in a status downgrade for women as a class, by presupposing and reinforcing women’s value in relation to their reproductive labour. Historically, central to feminist analysis is resistance to reductive accounts of women in relation to their reproductivity. For example, de Beauvoir addressed (...)
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  120.  14
    Why the nuclear option? Supporting pregnant women without new categories of moral status.J. Burke Rea - 2024 - Journal of Medical Ethics 50 (1):20-21.
    Recourse to a being’s moral status is the ‘nuclear option’ of moral theorising—it tells us not only what obligations we have and to what degree, but whether we have obligations to them in the first place and whether their moral concern trumps concern for other beings simply in virtue of the kind of being they are. As such, we should only explain obligations in terms of a being’s moral status if doing so is principled and necessary to defend that obligation. (...)
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  121.  19
    Defending superior moral status in pregnancy: a response to commentaries.Heloise Robinson - 2024 - Journal of Medical Ethics 50 (1):31-32.
    In my feature article, ‘Pregnancy and superior moral status: a proposal for two thresholds of personhood’,1 I argue that there are reasons to recognise that pregnant women have a superior moral status. This is a new argument on personhood in philosophy, and I am not surprised that it has generated some discussion. While I am grateful that many authors have engaged with my ideas, I have not identified from the six commentaries any aspect in my approach that would need to (...)
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  122.  18
    Justice for women/gestators: superior personhood or plain old feminism?Amanda Roth - 2024 - Journal of Medical Ethics 50 (1):22-23.
    Robinson offers the ‘superior personhood’ approach (SPA) to capture the value of gestation and ground justice for women/gestators.1 SPA holds that women/gestators are more than mere persons given the reality of pregnancy and the vital role women/gestators play in reproduction.1 In this commentary, I speak to some background context perhaps relevant to SPA, lay out areas of agreement with Robinson and then raise four worries about the approach. In my view, the devaluing of gestation and injustice for women/gestators need rectifying, (...)
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  123.  10
    Webinar report: stakeholder perspectives on informed consent for the use of genomic data by commercial entities.Baergen Schultz, Francis E. Agamah, Cornelius Ewuoso, Ebony B. Madden, Jennifer Troyer, Michelle Skelton & Erisa Mwaka - 2024 - Journal of Medical Ethics 50 (1):57-61.
    In July 2020, the H3Africa Ethics and Community Engagement (E&CE) Working Group organised a webinar with ethics committee members and biomedical researchers from various African institutions throughout the Continent to discuss the issue of whether and how biological samples for scientific research may be accessed by commercial entities when broad consents obtained for the samples are silent. 128 people including Research Ethics Committee members (10), H3Africa researchers (46) including members of the E&CE working group, biomedical researchers not associated with H3Africa (...)
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  124.  8
    In critique of moral resilience: UK healthcare professionals’ experiences working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic.Louise Tomkow, Gabrielle Prager, Kitty Worthing & Rebecca Farrington - 2024 - Journal of Medical Ethics 50 (1):33-38.
    This research explores the experiences of UK NHS healthcare professionals working with asylum applicants housed in contingency accommodation during the COVID-19 pandemic. Using a critical understanding of the concept of moral resilience as a theoretical framework, we explore how the difficult circumstances in which they worked were navigated, and the extent to which moral suffering led to moral transformation. Ten staff from a general practice participated in semistructured interviews. Encountering the harms endured by people seeking asylum prior to arrival in (...)
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  125.  15
    Single women’s access to egg freezing in mainland China: an ethicolegal analysis.Hao Wang - 2024 - Journal of Medical Ethics 50 (1):50-56.
    In the name of safeguarding public interests and ethical principles, China’s National Health Commission bans unmarried women from using assisted reproductive technology (ART), including egg freezing. Supported by local governments, the ban has restricted single women’s reproductive rights nationwide. Although some courts bypassed the ban to allow widowed single women to use ART, they have not adopted a position in favour of single women’s reproductive autonomy, but quite the contrary. Faced with calls to relax the ban and allow single women (...)
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  126.  17
    Ethics of antibiotic allergy.Yu Yi Xiang, George S. Heriot & Euzebiusz Jamrozik - 2024 - Journal of Medical Ethics 50 (1):39-44.
    Antibiotic allergies are commonly reported among patients, but most do not experience reactions on rechallenge with the same agents. These reported allergies complicate management of infections in patients labelled as having penicillin allergy, including serious infections where penicillin-based antibiotics are the first-line (most effective and least toxic) treatment option. Allergy labels are rarely questioned in clinical practice, with many clinicians opting for inferior second-line antibiotics to avoid a perceived risk of allergy. Reported allergies thereby can have significant impacts on patients (...)
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  127.  13
    Ethics of ‘Counting Me In’: framing the implications of direct-to-patient genomics research.Tenny R. Zhang - 2024 - Journal of Medical Ethics 50 (1):45-49.
    Count Me In (CMI) was launched in 2015 as a patient-driven research initiative aimed at accelerating the study of cancer genomics through direct participant engagement, electronic consent and open-access data sharing. It is an example of a large-scale direct-to-patient (DTP) research project which has since enrolled thousands of individuals. Within the broad scope of ‘citizen science’, DTP genomics research is defined here as a specific form of ‘top-down’ research endeavour developed and overseen by institutions within the traditional human subjects research (...)
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  128.  88
    No, Pregnancy is Not a Disease.Nicholas Colgrove & Daniel Rodger - 2024 - Journal of Medical Ethics (Online first):1-3.
    Anna Smajdor and Joona Räsänen argue that we have good reason to classify pregnancy as a disease. They discuss five accounts of disease and argue that each account either implies that pregnancy is a disease or, if it does not, it faces problems. This strategy allows Smajdor and Räsänen to avoid articulating their own account of disease. Consequently, they cannot establish that pregnancy is a disease, only that plausible accounts of disease suggest this. Some readers will dismiss Smajdor and Räsänen’s (...)
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  129.  99
    Keeping it in the family: reproduction beyond genetic parenthood.Daniela Cutas & Anna Smajdor - 2024 - Journal of Medical Ethics.
    Recent decades have seen the facilitation of unconventional or even extraordinary reproductive endeavours. Sperm has been harvested from dying or deceased men at the request of their wives; reproductive tissue has been surgically removed from children at the request of their parents; deceased adults’ frozen embryos have been claimed by their parents, in order to create grandchildren; wombs have been transplanted from mothers to their daughters. What is needed for requests to be honoured by healthcare staff is that they align (...)
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    Failing to deliver: why pregnancy is not a disease.Paul Rezkalla & Emmanuel Smith - 2024 - Journal of Medical Ethics (N/A):1-2.
    In their article ’Is Pregnancy a Disease? A Normative Approach’, Anna Smajdor and Joona Räsänen contend that, on several of the most prominent accounts of disease, pregnancy should be considered a disease. More specifically, of the five accounts they discuss, each renders pregnancy a disease or suffers serious conceptual problems otherwise. They take issue specifically with the dysfunction account of disease and argue that it suffers several theoretical difficulties. In this response, we focus on defending the dysfunction account against their (...)
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