Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0003
M. Gilliam, D. Roberts
This chapter addresses the historical and current attempts by physicians and legislators to regulate the reproduction of Black, Latina, and Indigenous women, with a particular focus on Black women. It connects the contemporary language promoting long-acting reversible contraception for “risky” populations to past policies coercing Black, Latina, and Indigenous women to use contraception and undergo sterilization. At the same time, these efforts to regulate the reproduction of women of color coincide with a rising number of abortion restrictions and lack of access to abortion and safe motherhood, which affect women of color disproportionately. Black women bear a disproportionate burden of the staggering and rising maternal mortality rate in the United States. These topics are often omitted from discussions about reproductive ethics, and social justice is often neglected as a major ethical principle. Approaching the reproductive freedom of women of color from a reproductive justice perspective, therefore, offers an important way to expand our understanding of reproductive ethics.
{"title":"Why Reproductive Justice Matters to Reproductive Ethics","authors":"M. Gilliam, D. Roberts","doi":"10.1093/med/9780190873028.003.0003","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0003","url":null,"abstract":"This chapter addresses the historical and current attempts by physicians and legislators to regulate the reproduction of Black, Latina, and Indigenous women, with a particular focus on Black women. It connects the contemporary language promoting long-acting reversible contraception for “risky” populations to past policies coercing Black, Latina, and Indigenous women to use contraception and undergo sterilization. At the same time, these efforts to regulate the reproduction of women of color coincide with a rising number of abortion restrictions and lack of access to abortion and safe motherhood, which affect women of color disproportionately. Black women bear a disproportionate burden of the staggering and rising maternal mortality rate in the United States. These topics are often omitted from discussions about reproductive ethics, and social justice is often neglected as a major ethical principle. Approaching the reproductive freedom of women of color from a reproductive justice perspective, therefore, offers an important way to expand our understanding of reproductive ethics.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115670731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0017
J. Flavin, L. Paltrow
Under the guise of “protecting the unborn,” anti-abortion and related measures such as feticide laws are being used as the basis for arresting pregnant women and new mothers. It is often the case that the initial disclosure of information that led to the involvement of criminal law, child welfare, or other state authorities has been made by healthcare professionals, including doctors, nurses, and hospital social workers. Pregnant patients—like other patients—should expect that their medical health is a private matter and that healthcare provider–patient confidentiality will be respected. Such disclosures have legal, social, and public health consequences and frequently lead to interventions that are punitive and counterproductive, not protective. This chapter describes the ethical obligations of healthcare professionals, including their duty to advocate for the protection of confidential information and to work to change unjust practices, policies, and laws.
{"title":"Doing Harm","authors":"J. Flavin, L. Paltrow","doi":"10.1093/med/9780190873028.003.0017","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0017","url":null,"abstract":"Under the guise of “protecting the unborn,” anti-abortion and related measures such as feticide laws are being used as the basis for arresting pregnant women and new mothers. It is often the case that the initial disclosure of information that led to the involvement of criminal law, child welfare, or other state authorities has been made by healthcare professionals, including doctors, nurses, and hospital social workers. Pregnant patients—like other patients—should expect that their medical health is a private matter and that healthcare provider–patient confidentiality will be respected. Such disclosures have legal, social, and public health consequences and frequently lead to interventions that are punitive and counterproductive, not protective. This chapter describes the ethical obligations of healthcare professionals, including their duty to advocate for the protection of confidential information and to work to change unjust practices, policies, and laws.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116588129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0010
H. Ross
Third-party reproduction carries significant legal and ethical challenges. Although well-intentioned mutual desire typically guides parties entering a gestational surrogacy or egg donation arrangement, the potential for conflict cannot be avoided. Because the physician’s role includes treating both their patient (the intended parent/s) and the “third-party patient” (the egg donor or surrogate), the physician should be aware of potential conflicting desires about medical treatment (i.e., an intended parent may desire a triplet pregnancy, while the surrogate may prefer to reduce). Systematic bias should also be considered, as it may result in favoring one patient’s medical needs over the other. The laws in this area are unsettled and in many situations no definitive legal answers are available. Prior to engaging in third-party reproduction each patient should be fully informed of potential medical risks and consult with mental health professionals and independent lawyers to confirm agreement with respect to the arrangement.
{"title":"Who Are Your Patients, and What Happens When They Disagree?","authors":"H. Ross","doi":"10.1093/med/9780190873028.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0010","url":null,"abstract":"Third-party reproduction carries significant legal and ethical challenges. Although well-intentioned mutual desire typically guides parties entering a gestational surrogacy or egg donation arrangement, the potential for conflict cannot be avoided. Because the physician’s role includes treating both their patient (the intended parent/s) and the “third-party patient” (the egg donor or surrogate), the physician should be aware of potential conflicting desires about medical treatment (i.e., an intended parent may desire a triplet pregnancy, while the surrogate may prefer to reduce). Systematic bias should also be considered, as it may result in favoring one patient’s medical needs over the other. The laws in this area are unsettled and in many situations no definitive legal answers are available. Prior to engaging in third-party reproduction each patient should be fully informed of potential medical risks and consult with mental health professionals and independent lawyers to confirm agreement with respect to the arrangement.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133886810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0018
Stephen D. Brown
This chapter analyzes potential biases and competing interests in prenatal counseling when conditions are diagnosed for which intrauterine surgery may be possible. Such counseling often occurs at the multidimensional interface of obstetrics and pediatrics. After considering clinical, social, and historical contexts of such counseling, the chapter presents a case that illustrates how physician demographics, interspecialty differences, divergent clinical experiences, and larger organizational factors may compound practice variation. It considers how biased counseling may influence patients’ decisions and questions whether value-neutral counseling is attainable when such fetal conditions are diagnosed. It concludes that declared commitments to value neutrality cannot insulate pregnant patients from biases and competing interests. In its recommendations, it discusses organizational responses analogous to conflict-of-interest policies. It further suggests that conversations between clinicians and patients that are mutually open about values may enhance rather than undermine patients’ ability to formulate decisions that most closely embody their true preferences.
{"title":"Prenatal Counseling for Maternal–Fetal Surgery","authors":"Stephen D. Brown","doi":"10.1093/med/9780190873028.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0018","url":null,"abstract":"This chapter analyzes potential biases and competing interests in prenatal counseling when conditions are diagnosed for which intrauterine surgery may be possible. Such counseling often occurs at the multidimensional interface of obstetrics and pediatrics. After considering clinical, social, and historical contexts of such counseling, the chapter presents a case that illustrates how physician demographics, interspecialty differences, divergent clinical experiences, and larger organizational factors may compound practice variation. It considers how biased counseling may influence patients’ decisions and questions whether value-neutral counseling is attainable when such fetal conditions are diagnosed. It concludes that declared commitments to value neutrality cannot insulate pregnant patients from biases and competing interests. In its recommendations, it discusses organizational responses analogous to conflict-of-interest policies. It further suggests that conversations between clinicians and patients that are mutually open about values may enhance rather than undermine patients’ ability to formulate decisions that most closely embody their true preferences.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125729052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0015
Katie Watson
Abortion is illegal after viability in most US states. However, the law permits, and ethics require, clinicians to respect pregnant people’s refusal of medical treatment throughout pregnancy and delivery even when it might prevent fetal demise or harm. This chapter explains why these seemingly contradictory standards are in fact consistent. It contextualizes pregnant people’s right to refuse medical intervention within the history of the legal and moral status of women, viable fetuses, and women pregnant with viable fetuses, and argues that the principle of justice breaks the tie that some people perceive between autonomy (of women) and beneficence (to fetuses), pushing the scales in favor of women. Finally, it offers ethically sound steps that obstetricians confronted with refusals should take to maximize care, and it considers the moral distress these unusual cases invariably invoke.
{"title":"Refusing to Force Treatment","authors":"Katie Watson","doi":"10.1093/med/9780190873028.003.0015","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0015","url":null,"abstract":"Abortion is illegal after viability in most US states. However, the law permits, and ethics require, clinicians to respect pregnant people’s refusal of medical treatment throughout pregnancy and delivery even when it might prevent fetal demise or harm. This chapter explains why these seemingly contradictory standards are in fact consistent. It contextualizes pregnant people’s right to refuse medical intervention within the history of the legal and moral status of women, viable fetuses, and women pregnant with viable fetuses, and argues that the principle of justice breaks the tie that some people perceive between autonomy (of women) and beneficence (to fetuses), pushing the scales in favor of women. Finally, it offers ethically sound steps that obstetricians confronted with refusals should take to maximize care, and it considers the moral distress these unusual cases invariably invoke.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126152859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0012
B. D. de Carvalho, J. Rodrigues, T. Woodruff
Advances in cancer treatment, particularly chemotherapeutics, are expected to lead to significant improvements in survival rates. While cancer incidence and death rates are decreasing, quality of life after cancer may be reduced due to early functional failure of the gonads and, consequently, infertility, resulting from either the disease itself or its treatment. This chapter introduces clinicians to the new field of oncofertility and the ethical issues it raises. It will consider the situation of young cancer patients facing reproductive consequences globally, the retrieval of gametes or gonadal tissue from minors, and the use of these tissues long term. The field of oncofertility is new, but ethical considerations regarding reproductive interventions are old. Understanding how we approach these issues on a personal level and from the public’s perspective will be assessed in this chapter.
{"title":"Oncofertility","authors":"B. D. de Carvalho, J. Rodrigues, T. Woodruff","doi":"10.1093/med/9780190873028.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0012","url":null,"abstract":"Advances in cancer treatment, particularly chemotherapeutics, are expected to lead to significant improvements in survival rates. While cancer incidence and death rates are decreasing, quality of life after cancer may be reduced due to early functional failure of the gonads and, consequently, infertility, resulting from either the disease itself or its treatment. This chapter introduces clinicians to the new field of oncofertility and the ethical issues it raises. It will consider the situation of young cancer patients facing reproductive consequences globally, the retrieval of gametes or gonadal tissue from minors, and the use of these tissues long term. The field of oncofertility is new, but ethical considerations regarding reproductive interventions are old. Understanding how we approach these issues on a personal level and from the public’s perspective will be assessed in this chapter.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122015071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0008
L. Harris
This chapter considers epidemiological, historical, and ideological forces that constructed infertility as a “white” ailment and in vitro fertilization (IVF) as a treatment for the infertility of white professional women in their late 30s, 40s, and beyond. The author begins with a case from her own practice and then returns to IVF’s origins in the United States in the 1980s to show how in its practice and its technical details it reproduces race and class inequalities. Ultimately, the author argues that IVF grew out of an ideology of stratified reproduction, in which the fertility, reproduction, and motherhood of white, professional women was valued and that of poor women and women of color was not. While usual bioethical analyses of infertility treatment focus on the questions raised in sensational cases, here the author considers the race and class coding of infertility as a moral issue because, as she concludes, it is a question of whose lives matter.
{"title":"The Reproduction of Stratified (Assisted) Reproduction","authors":"L. Harris","doi":"10.1093/med/9780190873028.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0008","url":null,"abstract":"This chapter considers epidemiological, historical, and ideological forces that constructed infertility as a “white” ailment and in vitro fertilization (IVF) as a treatment for the infertility of white professional women in their late 30s, 40s, and beyond. The author begins with a case from her own practice and then returns to IVF’s origins in the United States in the 1980s to show how in its practice and its technical details it reproduces race and class inequalities. Ultimately, the author argues that IVF grew out of an ideology of stratified reproduction, in which the fertility, reproduction, and motherhood of white, professional women was valued and that of poor women and women of color was not. While usual bioethical analyses of infertility treatment focus on the questions raised in sensational cases, here the author considers the race and class coding of infertility as a moral issue because, as she concludes, it is a question of whose lives matter.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133842345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0016
F. Chervenak, L. Mccullough
Obstetric clinical practice, innovation, and research should be guided by professional ethics in obstetrics. In this chapter, the authors distinguish professional medical ethics from medical ethics and bioethics. They set out an ethical framework for obstetrics based on the invention of professional medical ethics by two eighteenth-century physician-ethicists, John Gregory (1724–1773) and Thomas Percival (1740–1804). Professional ethics in obstetrics appeals to the ethical principles of beneficence and respect for autonomy and the ethical concept of the fetus as a patient. This framework is deployed to provide ethically justified, practical guidance about two ethical challenges in obstetric practice: the professionally responsible role of nondirective counseling of pregnant women about induced abortion and the professionally responsible role of directive counseling about planned home birth. This framework is also deployed to provide ethically justified, practical guidance about professionally responsible obstetric innovation and research for fetal benefit.
{"title":"Professional Ethics in Obstetric Practice, Innovation, and Research","authors":"F. Chervenak, L. Mccullough","doi":"10.1093/med/9780190873028.003.0016","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0016","url":null,"abstract":"Obstetric clinical practice, innovation, and research should be guided by professional ethics in obstetrics. In this chapter, the authors distinguish professional medical ethics from medical ethics and bioethics. They set out an ethical framework for obstetrics based on the invention of professional medical ethics by two eighteenth-century physician-ethicists, John Gregory (1724–1773) and Thomas Percival (1740–1804). Professional ethics in obstetrics appeals to the ethical principles of beneficence and respect for autonomy and the ethical concept of the fetus as a patient. This framework is deployed to provide ethically justified, practical guidance about two ethical challenges in obstetric practice: the professionally responsible role of nondirective counseling of pregnant women about induced abortion and the professionally responsible role of directive counseling about planned home birth. This framework is also deployed to provide ethically justified, practical guidance about professionally responsible obstetric innovation and research for fetal benefit.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134330272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0013
Laurence Brunet, V. Fournier
This chapter compares French and American approaches to assisted reproductive technologies (ART). These countries are a fascinating (and unexplored) mirror: the United States focuses on the individual, while France emphasizes the best interest of society as a whole. This results in an access to ART largely open in the United States, yet all costs are covered by patients, and an access strictly regulated by law in France (and quite restricted until recent changes), yet costs are fully financed. This chapter introduces readers to the legal framework of access to ART in France and its cultural foundations. It highlights the insistence on the “right to privacy” in the United States, a concept much less valued in France, and concludes with a discussion, using clinical cases, of the ethical issues underlying tensions between reproductive autonomy and public policymaking, which differ in both countries.
{"title":"Accessing Reproductive Technology in France","authors":"Laurence Brunet, V. Fournier","doi":"10.1093/med/9780190873028.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0013","url":null,"abstract":"This chapter compares French and American approaches to assisted reproductive technologies (ART). These countries are a fascinating (and unexplored) mirror: the United States focuses on the individual, while France emphasizes the best interest of society as a whole. This results in an access to ART largely open in the United States, yet all costs are covered by patients, and an access strictly regulated by law in France (and quite restricted until recent changes), yet costs are fully financed. This chapter introduces readers to the legal framework of access to ART in France and its cultural foundations. It highlights the insistence on the “right to privacy” in the United States, a concept much less valued in France, and concludes with a discussion, using clinical cases, of the ethical issues underlying tensions between reproductive autonomy and public policymaking, which differ in both countries.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115033432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1093/med/9780190873028.003.0019
Kayte Spector-Bagdady, T. Johnson
This chapter addresses the ethical issues relevant to all academics and academic institutions engaging in global health, with a focus on international experiences in women’s health. The ethical issues for educational and clinical program development, such as sustainability, mutual benefit, and transparency, are relatively new interests. The authors discuss the ethical issues involved with global health research, including funding, community involvement, and informed consent and institutional review boards and argue that sustainability, mutual benefit, and fiscal transparency should be part of formal agreements and memoranda of understanding between academic global health partners; exchanges of learners should be bilateral and equitable; funding should be sustainable and fairly distributed; transcultural and translational issues must be welcomed and valued; research must be ethically grounded because of fundamental disparities between universities in low- and high-income countries; and issues of governance and institutional autonomy must be considered as transnational university partnerships are developed.
{"title":"Ethical Issues in Academic Global Reproductive Health","authors":"Kayte Spector-Bagdady, T. Johnson","doi":"10.1093/med/9780190873028.003.0019","DOIUrl":"https://doi.org/10.1093/med/9780190873028.003.0019","url":null,"abstract":"This chapter addresses the ethical issues relevant to all academics and academic institutions engaging in global health, with a focus on international experiences in women’s health. The ethical issues for educational and clinical program development, such as sustainability, mutual benefit, and transparency, are relatively new interests. The authors discuss the ethical issues involved with global health research, including funding, community involvement, and informed consent and institutional review boards and argue that sustainability, mutual benefit, and fiscal transparency should be part of formal agreements and memoranda of understanding between academic global health partners; exchanges of learners should be bilateral and equitable; funding should be sustainable and fairly distributed; transcultural and translational issues must be welcomed and valued; research must be ethically grounded because of fundamental disparities between universities in low- and high-income countries; and issues of governance and institutional autonomy must be considered as transnational university partnerships are developed.","PeriodicalId":269787,"journal":{"name":"Reproductive Ethics in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130569899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：