The international conference "Pour des intelligences artificielles au service du corps vulnerable : Les contreforts de l'ethique et du droit" held in December 2021 at the Universite catholique de Lyon, in France, explored whether artificial intelligence (AI) be a lever to restore equality between poor and rich, women and men, the disabled, the elderly? In the context of the Covid-19 pandemic, this question is being asked everywhere, including various international bodies, such as the United Nations (UN) and the International Communications Union (ICU). This question requires an impact analysis (leverage) of AI that can generate more social justice (reduction of inequalities). How can we produce such an analysis so that AI can benefit everyone without excluding citizens from marginalized communities? The difficult ethical problem to solve is the following: how far does the impact of AI maximize justice by reducing inequalities? Here the analysis relies on knowledge of AI features that can have a real or negative impact. The purpose of this paper will be to show, based on our framework for analyzing technology impacts and various published texts, the strengths and weaknesses of AI, to answer this question. Applying this framework, we proceed as follows: 1) situate the complex problem of inequalities: those that are generational and socio-economic in nature to which AI has little impact;inequalities to which AI can have an impact, including digital inclusion and social inequalities;2) situate the terminology of AI: weak (algorithms) or complete (decisional and autonomous) AI;3) do an analysis of inequalities: digital inclusion and social inequalities showing the strengths and weaknesses of AI.
{"title":"L’intelligence artificielle : un levier permettant de restaurer l’égalité ?","authors":"Jean-Pierre Béland","doi":"10.7202/1089798ar","DOIUrl":"https://doi.org/10.7202/1089798ar","url":null,"abstract":"The international conference \"Pour des intelligences artificielles au service du corps vulnerable : Les contreforts de l'ethique et du droit\" held in December 2021 at the Universite catholique de Lyon, in France, explored whether artificial intelligence (AI) be a lever to restore equality between poor and rich, women and men, the disabled, the elderly? In the context of the Covid-19 pandemic, this question is being asked everywhere, including various international bodies, such as the United Nations (UN) and the International Communications Union (ICU). This question requires an impact analysis (leverage) of AI that can generate more social justice (reduction of inequalities). How can we produce such an analysis so that AI can benefit everyone without excluding citizens from marginalized communities? The difficult ethical problem to solve is the following: how far does the impact of AI maximize justice by reducing inequalities? Here the analysis relies on knowledge of AI features that can have a real or negative impact. The purpose of this paper will be to show, based on our framework for analyzing technology impacts and various published texts, the strengths and weaknesses of AI, to answer this question. Applying this framework, we proceed as follows: 1) situate the complex problem of inequalities: those that are generational and socio-economic in nature to which AI has little impact;inequalities to which AI can have an impact, including digital inclusion and social inequalities;2) situate the terminology of AI: weak (algorithms) or complete (decisional and autonomous) AI;3) do an analysis of inequalities: digital inclusion and social inequalities showing the strengths and weaknesses of AI.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248937","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}
The main objection to genetic enhancement is that it will create a “genetic apartheid,” deepening existing inequalities. This paper offers considerations that can weaken the inequality argument against genetic enhancement. First, I question the dichotomy of treatment versus enhancement since the differences between the two are unclear. Second, I argue that human enhancement is part of human nature and that there is no sound reason to accept it in other domains while rejecting it in genetics. The paper also demonstrates that inequality is present in every dimension of society, that “God-given” genetics is profoundly unequal, Résumé Abstract La principale objection à l’amélioration génétique est qu’elle créera un “apartheid génétique”, aggravant les inégalités existantes. Cet article met en lumière des considérations qui peuvent affaiblir l’argument de l’inégalité contre l’amélioration génétique. Tout d’abord, je remets en question la dichotomie entre traitement et amélioration, car les différences entre les deux ne sont pas claires. Deuxièmement, je démontre que l’amélioration humaine fait partie de la nature humaine et qu’il n’y a aucune raison valable de l’accepter dans d’autres domaines tout en la rejetant en génétique. L’article démontre également que l’inégalité est présente dans toutes les dimensions de la société, que la génétique “divine” est profondément inégale et que l’amélioration génétique peut fonctionner comme un mécanisme permettant d’atteindre une nouvelle égalité génétique. Toutefois, l’article souligne que l’égalité génétique n’est pas, en soi, une valeur à laquelle aspirer si elle nous conduit à une communauté uniforme d’êtres humains réduits. L’égalité génétique n’a de valeur que si elle améliore l’humanité en général. paper against differences between the two are unclear. Second, I argue that human enhancement is part of human nature and that there is no sound reason to accept it in other domains while rejecting it in genetics. The paper also demonstrates that inequality is present in every dimension of society, that “God-given” genetics is profoundly unequal, and that genetic enhancement can operate as a mechanism by which a new genetic equality can be achieved. However, the paper underlines that genetic equality is not, per se, a value to which we ought to aspire if it leads us to a uniform community of downsized human beings. Genetic equality is only valuable if it enhances humankind in general.
反对基因增强的主要理由是，它将造成“基因隔离”，加深现有的不平等。本文提供了一些可以削弱反对基因增强的不平等论点的考虑。首先，我质疑治疗与强化的二分法，因为两者之间的差异尚不清楚。其次，我认为人类的增强是人性的一部分，没有合理的理由在其他领域接受它，而在遗传学领域拒绝它。本文还论证了不平等存在于社会的每一个维度，“上帝赋予”的遗传是深刻的不平等。[摘要]La principale反对(原则上反对):和/或;这篇文章符合下列条件，即考虑到所有的薪金和薪金，即关于薪金和薪金的论点，即薪金和薪金。除此之外，我们还提出了两个问题:一是治疗与治疗的二分法，二是治疗与治疗的二分法;二是治疗与治疗的二分法。在这一过程中，如果一个人的行为与他的个人行为无关，那么他的个人行为与他的个人行为无关，他的个人行为与他的个人行为无关。L 'inegalite L 'article demontre并非是现在,在所有维度de la法国,乘缆车genetique“神圣”est profondement inegale et, L 'amelioration genetique可以函数像联合国mecanisme permettant d 'atteindre一个新式平等genetique。图特福斯先生，我的第一个问题是，我知道我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值，我的个人价值。L 'egalite genetique n ' de值如果elle ameliore L 'humanite一般。关于两者之间差异的论文尚不清楚。其次，我认为人类的增强是人性的一部分，没有合理的理由在其他领域接受它，而在遗传学领域拒绝它。这篇论文还表明，不平等存在于社会的各个方面，“上帝赋予”的基因是非常不平等的，基因增强可以作为一种机制来实现新的基因平等。然而，这篇论文强调，基因平等本身并不是一种我们应该追求的价值，如果它将我们引向一个由缩小的人类组成的统一社区的话。基因平等只有在提高人类整体水平时才有价值。
{"title":"The Better I Can Be: In Defence of Human Enhancement for a New Genetic Equality","authors":"Vera Lúcia Carapeto Raposo","doi":"10.7202/1089801ar","DOIUrl":"https://doi.org/10.7202/1089801ar","url":null,"abstract":"The main objection to genetic enhancement is that it will create a “genetic apartheid,” deepening existing inequalities. This paper offers considerations that can weaken the inequality argument against genetic enhancement. First, I question the dichotomy of treatment versus enhancement since the differences between the two are unclear. Second, I argue that human enhancement is part of human nature and that there is no sound reason to accept it in other domains while rejecting it in genetics. The paper also demonstrates that inequality is present in every dimension of society, that “God-given” genetics is profoundly unequal, Résumé Abstract La principale objection à l’amélioration génétique est qu’elle créera un “apartheid génétique”, aggravant les inégalités existantes. Cet article met en lumière des considérations qui peuvent affaiblir l’argument de l’inégalité contre l’amélioration génétique. Tout d’abord, je remets en question la dichotomie entre traitement et amélioration, car les différences entre les deux ne sont pas claires. Deuxièmement, je démontre que l’amélioration humaine fait partie de la nature humaine et qu’il n’y a aucune raison valable de l’accepter dans d’autres domaines tout en la rejetant en génétique. L’article démontre également que l’inégalité est présente dans toutes les dimensions de la société, que la génétique “divine” est profondément inégale et que l’amélioration génétique peut fonctionner comme un mécanisme permettant d’atteindre une nouvelle égalité génétique. Toutefois, l’article souligne que l’égalité génétique n’est pas, en soi, une valeur à laquelle aspirer si elle nous conduit à une communauté uniforme d’êtres humains réduits. L’égalité génétique n’a de valeur que si elle améliore l’humanité en général. paper against differences between the two are unclear. Second, I argue that human enhancement is part of human nature and that there is no sound reason to accept it in other domains while rejecting it in genetics. The paper also demonstrates that inequality is present in every dimension of society, that “God-given” genetics is profoundly unequal, and that genetic enhancement can operate as a mechanism by which a new genetic equality can be achieved. However, the paper underlines that genetic equality is not, per se, a value to which we ought to aspire if it leads us to a uniform community of downsized human beings. Genetic equality is only valuable if it enhances humankind in general.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71249030","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}
{"title":"Harlequin Bioethics, Servant of Two Masters","authors":"J. Bélisle-Pipon","doi":"10.7202/1089802ar","DOIUrl":"https://doi.org/10.7202/1089802ar","url":null,"abstract":"","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71249045","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}
In the context of the COVID-19 pandemic, decision-making practices related to the allocation of medical resources and the treatment of the elderly inform us about the ethics present in the health care setting and at the societal level. The comparison between decision-making in the daily context and the particularity of a pandemic ethics highlights the transition between a non-pandemic ethics and a "pandethics". The public health ethics approach, particularly utilitarian, has been brought forward in a prominent way in the ethical debates and dilemmas surrounding resource allocation and prioritization. By raising the oppositions and issues associated with age rationing discourses and choices, the question of the treatment of the elderly in the context of COVID-19, and the ageism experienced in this context, emerges. At the same time, difficult ethical decisions and choices are intertwined with the caregiver's duty to care, and therefore the possibility of moral injury. Conflict emerges between ethical decision-making practices and the caregiver's personal or professional values, as the balance between various duties is upset. Alternative approaches and ethics are thus put forward in light of the situations experienced, particularly in the context of long-term care. The thesis developed here aims to support the added value of anthropology to decision-making processes and its more formal integration into well-known approaches in bioethics. Using an anthropological perspective, I conclude by exploring avenues of reflection associated with the ethics of discussion, vulnerability, feminism, or care as other ways of approaching decision-making in the context of a pandemic, at a time when ethical and social reflection is essential.
{"title":"Prise de décision, répartition des ressources médicales et personnes âgées en contexte de COVID-19 : une anthropologie de et pour la bioéthique","authors":"Alizée Lajeunesse","doi":"10.7202/1094692ar","DOIUrl":"https://doi.org/10.7202/1094692ar","url":null,"abstract":"In the context of the COVID-19 pandemic, decision-making practices related to the allocation of medical resources and the treatment of the elderly inform us about the ethics present in the health care setting and at the societal level. The comparison between decision-making in the daily context and the particularity of a pandemic ethics highlights the transition between a non-pandemic ethics and a \"pandethics\". The public health ethics approach, particularly utilitarian, has been brought forward in a prominent way in the ethical debates and dilemmas surrounding resource allocation and prioritization. By raising the oppositions and issues associated with age rationing discourses and choices, the question of the treatment of the elderly in the context of COVID-19, and the ageism experienced in this context, emerges. At the same time, difficult ethical decisions and choices are intertwined with the caregiver's duty to care, and therefore the possibility of moral injury. Conflict emerges between ethical decision-making practices and the caregiver's personal or professional values, as the balance between various duties is upset. Alternative approaches and ethics are thus put forward in light of the situations experienced, particularly in the context of long-term care. The thesis developed here aims to support the added value of anthropology to decision-making processes and its more formal integration into well-known approaches in bioethics. Using an anthropological perspective, I conclude by exploring avenues of reflection associated with the ethics of discussion, vulnerability, feminism, or care as other ways of approaching decision-making in the context of a pandemic, at a time when ethical and social reflection is essential.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255820","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}
Marilou Charron, J. Bélisle-Pipon, V. Couture, B. Williams-Jones, V. Ravitsky, C. Dupras
Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. The survey, in which forty-five Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists "in the field". Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions.
{"title":"Impacts of the Early COVID-19 Pandemic on the Work of Bioethicists in Canada","authors":"Marilou Charron, J. Bélisle-Pipon, V. Couture, B. Williams-Jones, V. Ravitsky, C. Dupras","doi":"10.7202/1094693ar","DOIUrl":"https://doi.org/10.7202/1094693ar","url":null,"abstract":"Bioethics experts played a key role in ensuring a coherent ethical response to the COVID-19 pandemic in the fields of healthcare, public health, and scientific research in Canada. In the province of Quebec, a group of academic and practicing bioethicists met periodically in the early months of the pandemic to discuss approaches and solutions to ethical dilemmas encountered during the crisis. These meetings created the opportunity for a national survey of bioethics practitioners from different fields. The survey, in which forty-five Canadian bioethics practitioners (clinical ethicists, ethicist members of REBs and government health policy ethicists, or any bioethicist practicing outside of academia) participated, explored their concerns, challenges and opportunities during the first wave of the pandemic, with the objective of informing bioethics research about the difficulties experienced by bioethicists \"in the field\". Participants reported increased stress levels, increased workloads, and a greater proportion of their work being devoted to public health ethics. Most of their concerns focused on groups other than themselves, such as health professionals, patients, research participants, and people in vulnerable socio-economic situations. An optimism about the future of bioethics was noted due to an increased awareness of the importance of bioethics by the public and by health and research institutions.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255873","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}
Recent evidence shows significant potential for therapies involving psychedelic substances such as psilocybin and MDMA to improve clinical outcomes for patients experiencing various mental disorders. However, research to date focuses almost exclusively on adults. I argue that adolescents should be included in research into psychedelic therapies. First, I demonstrate the pressing need for novel interventions to address the growing mental health burden of adolescents, and I draw on empirical evidence to show that research into psychedelic therapies presents an opportunity to address this shortfall. Secondly, I argue that psychedelics pose low risk to young patients, particularly relative to existing psychiatric medications. I then address two major concerns specific to adolescent contexts. First, I address the risks of using psychedelic substances at earlier stages of physiological and cognitive development. I note that the lack of understanding of the risks underscores the need for including adolescents in research. I then address the added complexity of consent in the adolescent context. I highlight some additional concerns that should be addressed in an “enhanced” informed consent process for adolescents and defend the view that capable adolescents should be able to consent to psychedelic interventions. I ultimately hold that including adolescents in emerging psychedelic research has the potential to substantiate innovative treatments that could improve their clinical outcomes, long-term mental health and quality of life. Résumé Abstract Des données récentes montrent que les thérapies faisant appel à des substances psychédéliques telles que la psilocybine et la MDMA ont un potentiel important pour améliorer les résultats cliniques des patients souffrant de divers troubles mentaux. Cependant, les recherches menées à ce jour se concentrent presque exclusivement sur les adultes. Je soutiens que les adolescents devraient être inclus dans la recherche sur les thérapies psychédéliques. Tout d’abord, je démontre le besoin urgent de nouvelles interventions pour répondre au fardeau croissant de la santé mentale des adolescents, et je m’appuie sur des preuves empiriques pour montrer que la recherche sur les thérapies psychédéliques offre une opportunité de répondre à ce manque. Deuxièmement, je soutiens que les psychédéliques présentent un faible risque pour les jeunes patients, en particulier par rapport aux médicaments psychiatriques existants. J’aborde ensuite deux préoccupations majeures spécifiques aux contextes adolescents. Premièrement, j’aborde les risques liés à l’utilisation de substances psychédéliques à des stades précoces du développement physiologique et cognitif. Je note que le manque de compréhension de ces risques souligne la nécessité d’inclure les adolescents dans la recherche. J’aborde ensuite la complexité supplémentaire du consentement dans le contexte des adolescents. Je souligne certaines préoccupations supplémentaires qui devraien
最近的证据表明，涉及迷幻物质(如裸盖菇素和MDMA)的治疗有很大的潜力，可以改善患有各种精神障碍的患者的临床结果。然而，迄今为止的研究几乎都集中在成年人身上。我认为青少年应该被纳入迷幻疗法的研究。首先，我证明了迫切需要新的干预措施来解决青少年日益增长的心理健康负担，我利用经验证据表明，对迷幻疗法的研究提供了一个解决这一不足的机会。其次，我认为致幻剂对年轻患者的风险较低，特别是与现有的精神药物相比。然后，我将针对青少年具体情况提出两个主要问题。首先，我讨论了在生理和认知发展的早期阶段使用致幻剂的风险。我注意到，由于缺乏对这些风险的了解，因此需要将青少年纳入研究。然后，我谈到了在青少年背景下同意的复杂性。我强调了在“加强”青少年知情同意程序中应该解决的一些其他问题，并捍卫有能力的青少年应该能够同意迷幻干预的观点。我最终认为，将青少年纳入新兴的迷幻药研究有可能证实创新的治疗方法，可以改善他们的临床结果、长期心理健康和生活质量。摘要:抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁、抑郁。独立的，les研究mensames，因为你的注意力集中在成年人的排他上。关于青少年畸形的调查être包括关于精神障碍的调查。在国外，我们认为，在青少年的心理健康方面，我们有必要采取新的干预措施，帮助他们改善心理健康状况;在青少年的心理健康方面，我们有必要采取新的干预措施，防止他们的经验不足;在青少年的心理健康方面，我们有机会改善他们的心理健康状况。精神障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍障碍我在国外的ensuite deux prassicoccupations majres spsamcifiques aux contextes青少年。首先，在物质的利用上，在精神上，在生理上，在生理上，在认知上，在心理上，在生理上，在生理上。“我注意到，在过去的一年里，所有的人都有可能被监禁，”他说，“所有的人都有可能被监禁。”在青少年的情况下，青少年的同意是不可避免的。我souligne某些职业supplementaires, devraient可能abordees突起中consentement eclaire ameliore倒les青少年,等我捍卫本les青少年看到你们devraient可能在序de consentir des psychedeliques干预措施。《青少年的最后阶段》、《关于精神障碍的研究》、《关于心理障碍的研究》、《关于心理障碍的研究》、《关于心理障碍的研究》、《关于心理障碍的研究》、《关于青少年的研究》、《关于心理障碍的研究》、《关于心理障碍的研究》、《关于心理障碍的长期研究》和《关于生活质量的研究》。最近的证据表明，涉及迷幻物质(如裸盖菇素和MDMA)的治疗有很大的潜力，可以改善患有各种精神障碍的患者的临床结果。然而，迄今为止的研究几乎都集中在成年人身上。我认为青少年应该被纳入迷幻疗法的研究。首先，我证明了迫切需要新的干预措施来解决青少年日益增长的心理健康负担，我利用经验证据表明，对迷幻疗法的研究提供了一个解决这一不足的机会。其次，我认为致幻剂对年轻患者的风险较低，特别是与现有的精神药物相比。然后，我将针对青少年具体情况提出两个主要问题。首先，我讨论了在生理和认知发展的早期阶段使用致幻剂的风险。我注意到，由于缺乏对这些风险的了解，因此需要将青少年纳入研究。然后，我谈到了在青少年背景下同意的复杂性。我强调了在“加强”青少年知情同意程序中应该解决的一些其他问题，并捍卫有能力的青少年应该能够同意迷幻干预的观点。 我最终认为，将青少年纳入新兴的迷幻药研究有可能证实创新的治疗方法，可以改善他们的临床结果、长期心理健康和生活质量。18岁及以上成年人的证据表明，迷幻剂辅助疗法可以帮助18岁以下经历类似心理健康挑战的青少年，特别是那些对目前基于证据的干预措施没有反应的青少年。随机临床试验表明，裸盖菇素辅助治疗和氯胺酮治疗是一种安全有效的治疗方法，可以对传统治疗无效的重度抑郁症成年患者产生显著、快速和持续的抗抑郁效果(17-19)。MDMA辅助心理治疗必须是一种有效和创新的治疗方法，证据表明伊博加因、裸盖菇素、死藤水可能表明，对于阿片类药物和其他物质的使用，裸盖菇素和lsd辅助的心理治疗可以减少患有生命限制疾病的患者的焦虑
{"title":"Should Adolescents be Included in Emerging Psychedelic Research?","authors":"K. Rajwani","doi":"10.7202/1089784ar","DOIUrl":"https://doi.org/10.7202/1089784ar","url":null,"abstract":"Recent evidence shows significant potential for therapies involving psychedelic substances such as psilocybin and MDMA to improve clinical outcomes for patients experiencing various mental disorders. However, research to date focuses almost exclusively on adults. I argue that adolescents should be included in research into psychedelic therapies. First, I demonstrate the pressing need for novel interventions to address the growing mental health burden of adolescents, and I draw on empirical evidence to show that research into psychedelic therapies presents an opportunity to address this shortfall. Secondly, I argue that psychedelics pose low risk to young patients, particularly relative to existing psychiatric medications. I then address two major concerns specific to adolescent contexts. First, I address the risks of using psychedelic substances at earlier stages of physiological and cognitive development. I note that the lack of understanding of the risks underscores the need for including adolescents in research. I then address the added complexity of consent in the adolescent context. I highlight some additional concerns that should be addressed in an “enhanced” informed consent process for adolescents and defend the view that capable adolescents should be able to consent to psychedelic interventions. I ultimately hold that including adolescents in emerging psychedelic research has the potential to substantiate innovative treatments that could improve their clinical outcomes, long-term mental health and quality of life. Résumé Abstract Des données récentes montrent que les thérapies faisant appel à des substances psychédéliques telles que la psilocybine et la MDMA ont un potentiel important pour améliorer les résultats cliniques des patients souffrant de divers troubles mentaux. Cependant, les recherches menées à ce jour se concentrent presque exclusivement sur les adultes. Je soutiens que les adolescents devraient être inclus dans la recherche sur les thérapies psychédéliques. Tout d’abord, je démontre le besoin urgent de nouvelles interventions pour répondre au fardeau croissant de la santé mentale des adolescents, et je m’appuie sur des preuves empiriques pour montrer que la recherche sur les thérapies psychédéliques offre une opportunité de répondre à ce manque. Deuxièmement, je soutiens que les psychédéliques présentent un faible risque pour les jeunes patients, en particulier par rapport aux médicaments psychiatriques existants. J’aborde ensuite deux préoccupations majeures spécifiques aux contextes adolescents. Premièrement, j’aborde les risques liés à l’utilisation de substances psychédéliques à des stades précoces du développement physiologique et cognitif. Je note que le manque de compréhension de ces risques souligne la nécessité d’inclure les adolescents dans la recherche. J’aborde ensuite la complexité supplémentaire du consentement dans le contexte des adolescents. Je souligne certaines préoccupations supplémentaires qui devraien","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248576","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}
Louis-Toussaint-Cécile Bernier, Stéphane Bernatchez, Alexandra Sweeney Beaudry
Il semble que la mise en œuvre des droits reconnus par les législateurs et les tribunaux en contexte d’avortement tardif et d’aide médicale à mourir connaît, en pratique, un problème d’effectuation. En effet, nous nous trouvons actuellement dans une ère où le droit accorde énormément d’importance à l’autonomie individuelle dans le domaine médical, mais où les pratiques et les autres normativités viennent considérablement limiter cette autonomie. Il convient, dès lors, de poser un regard critique sur le concept d’autonomie en contexte d’avortement tardif et d’aide médicale à mourir. Ces constats soulèvent des questionnements sur le rôle et les limites du droit étatique lorsque transposé en contexte clinique, ainsi que sur le peu d’attention que porte le droit aux destinataires de la norme. Le défi consiste alors à faire cohabiter les différentes normes et valeurs afin que les mécanismes de prises de décisions traduisent un souci réel d’assurer le vivre ensemble. we are currently in an era where the law places great importance on individual autonomy in the medical field, but where practices and other normativities considerably limit this autonomy. It is therefore appropriate to take a critical look at the concept of autonomy in the context of late-term abortion and medical aid in dying. These observations raise questions about the role and limits of state law when transposed into a clinical context, as well as about the lack of attention paid by the law to the recipients of the norm. The challenge is to ensure that the different norms and values coexist so that the decision-making mechanisms reflect a genuine concern for living together.
{"title":"L’avortement tardif et l’aide médicale à mourir au-delà de l’autonomie individuelle : comment réguler les pratiques pour assurer le vivre ensemble ?","authors":"Louis-Toussaint-Cécile Bernier, Stéphane Bernatchez, Alexandra Sweeney Beaudry","doi":"10.7202/1089781ar","DOIUrl":"https://doi.org/10.7202/1089781ar","url":null,"abstract":"Il semble que la mise en œuvre des droits reconnus par les législateurs et les tribunaux en contexte d’avortement tardif et d’aide médicale à mourir connaît, en pratique, un problème d’effectuation. En effet, nous nous trouvons actuellement dans une ère où le droit accorde énormément d’importance à l’autonomie individuelle dans le domaine médical, mais où les pratiques et les autres normativités viennent considérablement limiter cette autonomie. Il convient, dès lors, de poser un regard critique sur le concept d’autonomie en contexte d’avortement tardif et d’aide médicale à mourir. Ces constats soulèvent des questionnements sur le rôle et les limites du droit étatique lorsque transposé en contexte clinique, ainsi que sur le peu d’attention que porte le droit aux destinataires de la norme. Le défi consiste alors à faire cohabiter les différentes normes et valeurs afin que les mécanismes de prises de décisions traduisent un souci réel d’assurer le vivre ensemble. we are currently in an era where the law places great importance on individual autonomy in the medical field, but where practices and other normativities considerably limit this autonomy. It is therefore appropriate to take a critical look at the concept of autonomy in the context of late-term abortion and medical aid in dying. These observations raise questions about the role and limits of state law when transposed into a clinical context, as well as about the lack of attention paid by the law to the recipients of the norm. The challenge is to ensure that the different norms and values coexist so that the decision-making mechanisms reflect a genuine concern for living together.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248701","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}
Florian Lafargue, Charlotte Lafaure, Ronan Le Bars, C. Roy
In general, the reference to age in our society is both accepted and subject to debate. As in other countries, the COVID-19 pandemic in France has shaken the coherence of our health system. The fear engendered has changed the reference points: the notion of triage has appeared and has replaced that of common prioritization in medicine. In this health crisis situation, is the possible use of an age criterion relevant and does it call into question the principle of intergenerational justice? We will try to answer this question in light of the arguments presented by Axel Gosseries and V??ronique Fournier during a discussion organized by the Association EthicA during the ???Questions d?????thiques??? conference held in Nantes in November 2020.
{"title":"COVID-19 : la levée du tabou autour du critère de l’âge ?","authors":"Florian Lafargue, Charlotte Lafaure, Ronan Le Bars, C. Roy","doi":"10.7202/1089796ar","DOIUrl":"https://doi.org/10.7202/1089796ar","url":null,"abstract":"In general, the reference to age in our society is both accepted and subject to debate. As in other countries, the COVID-19 pandemic in France has shaken the coherence of our health system. The fear engendered has changed the reference points: the notion of triage has appeared and has replaced that of common prioritization in medicine. In this health crisis situation, is the possible use of an age criterion relevant and does it call into question the principle of intergenerational justice? We will try to answer this question in light of the arguments presented by Axel Gosseries and V??ronique Fournier during a discussion organized by the Association EthicA during the ???Questions d?????thiques??? conference held in Nantes in November 2020.","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71248867","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}
{"title":"De la bonne intention à l’infantilisation : quand des allochtones s’immiscent dans une recherche en milieu autochtone","authors":"Laurence Hamel-Charest","doi":"10.7202/1089800ar","DOIUrl":"https://doi.org/10.7202/1089800ar","url":null,"abstract":"","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71249015","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}
{"title":"10 Years On: Looking Back in Order to Move Forward into the Future","authors":"B. Williams-Jones, Aliya O Affdal","doi":"10.7202/1094691ar","DOIUrl":"https://doi.org/10.7202/1094691ar","url":null,"abstract":"","PeriodicalId":37334,"journal":{"name":"Canadian Journal of Bioethics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71255761","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}
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