Ethics, Medicine and Public Health最新文献_第10页

Prevalence of depression, suicidal ideation, and its risk factors in leprosy patients: A systematic review 麻风病患者抑郁、自杀意念患病率及其危险因素：一项系统综述

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101116

G. Keerthana , S. Neeraja , S. Padmakar , S. Kousar Sada , G. Bhargavi

Background

Leprosy is a chronic disease with significant physical, psychological, and social implications. The disability and stigma associated with leprosy can lead to mental health challenges including depression and suicidal ideation (SI). Understanding these condition’s prevalence and risk factors is critical to improving the mental status of affected individuals.

Methods

PRISMA guidelines were used to perform this systematic review. Databases like Google Scholar, Scopus, PubMed, PsycINFO, and Embase were used to collect articles using the following terms: leprosy, Hansen’s disease, suicidal ideation, depression, and psychosocial factors. The Joanna Briggs Institute's critical assessment checklist tool was used to assess the methodological quality of the research studies.

Results

This systematic review includes seventeen studies. Depression prevalence among leprosy patients ranged from 12.5% to 89.8%, while SI prevalence varied from 6.7% to 76%. The majority of studies employed the Patient Health Questionnaire (PHQ-9) to assess depression. Gender, disability, unemployment, age, marital status, and stigma were the most frequently reported risk factors for depression among leprosy patients. Psychiatric comorbidities are the leading risk factor for SI in leprosy patients.

Conclusion

Depression and SI are widespread among patients with leprosy, emphazing the critical importance of incorporating mental health treatments into leprosy care programs. Reducing stigma, strengthening social support systems, and offering psychological counselling are vital strategies to address these challenges and improve patient health.

麻风病是一种慢性疾病，具有显著的生理、心理和社会影响。与麻风病相关的残疾和污名可导致精神健康挑战，包括抑郁和自杀意念。了解这些疾病的患病率和危险因素对于改善受影响个体的精神状态至关重要。方法采用sprisma指南进行系统评价。使用谷歌Scholar、Scopus、PubMed、PsycINFO和Embase等数据库收集使用以下术语的文章：麻风病、汉森病、自杀意念、抑郁症和社会心理因素。乔安娜布里格斯研究所的关键评估清单工具被用来评估研究的方法学质量。结果本系统综述包括17项研究。麻风病患者的抑郁患病率从12.5%到89.8%不等，而SI患病率从6.7%到76%不等。大多数研究采用患者健康问卷（PHQ-9）来评估抑郁症。性别、残疾、失业、年龄、婚姻状况和耻辱是麻风病患者中最常报告的抑郁风险因素。精神合并症是麻风病患者SI的主要危险因素。结论麻风病患者普遍存在抑郁和SI，强调将心理健康治疗纳入麻风病护理方案的重要性。减少耻辱感、加强社会支持系统和提供心理咨询是应对这些挑战和改善患者健康的重要战略。

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引用次数: 0

Magical-religious, social or psychiatric zombie: Interdisciplinary analysis of new recent cases of « zombies » in Haiti 魔法-宗教，社会或精神僵尸：海地最近新的“僵尸”案例的跨学科分析

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101100

J.-R. Senatus , P. Charlier

Background

Haitian zombies are an anthropological entity corresponding to four legal, administrative, and pathological states: ritual poisoning with social death, criminal poisoning, psychiatric disorders, and identity theft.

Methodology

In this article, we review the latest data from the anthropological, legal, and medical literature on this uniquely Haitian phenomenon. We also discuss new, unpublished cases recently examined in Haitian courts, with clear implications for public health and law.

Results

These new cases question the status of the human person, the identification, and the care of individuals desocialized and deliberately placed in a state of social death.

Conclusion

An interdisciplinary approach is absolutely necessary, with collaboration between the humanities and fundamental sciences, around this complex phenomenon of zombies in Haiti. Their frequency (around 50,000, for a total population of around 11 million inhabitants) is certainly marginal, but significant, and constitutes a real public health problem, as well as a relevant concept in medical anthropology and health law.

海地僵尸是一种人类学实体，与四种法律、行政和病理状态相对应：仪式中毒与社会死亡、刑事中毒、精神障碍和身份盗窃。在这篇文章中，我们回顾了关于海地这一独特现象的人类学、法学和医学文献的最新数据。我们还讨论了海地法院最近审查的未公布的新案件，这些案件对公共卫生和法律具有明确的影响。结果这些新病例对人的身份、鉴定和对非社会化和故意置于社会死亡状态的个人的护理提出了质疑。在人文科学和基础科学的合作下，采用跨学科的方法来研究海地僵尸这一复杂现象是绝对必要的。它们的发生频率（约5万例，总人口约1 100万）当然是微不足道的，但意义重大，构成了一个真正的公共卫生问题，也是医学人类学和卫生法中的一个相关概念。

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引用次数: 0

Genetics’ exceptionality – A short perspective from clinical care 遗传学的特殊性-从临床护理的简短观点

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101104

C. Bourgain

Genetics exceptionality relies on the strong imaginaries associated with this particular type of biological information – its capacity to disclose the invisible intimate- and on the concerns for controlling its possibly negative social impacts – the genetic information is always both highly specific and shared within families and populations. The paper claims that together with specific legal frameworks, this exceptionality is also embodied by the amount of effort performed in the clinic to control the strong uncertainties associated with the usage of this scientific knowledge in care contexts.

遗传学的特殊性依赖于与这种特殊类型的生物信息相关的强烈想象--它能够揭示不可见的亲密关系--以及对控制其可能产生的负面社会影响的关注--遗传信息总是高度特殊的，并且在家庭和人群中共享。本文认为，除了具体的法律框架外，这种特殊性还体现在诊所为控制在护理环境中使用这种科学知识所带来的巨大不确定性而付出的努力。

引用次数: 0

Mysterious illness outbreaks in the Democratic Republic of Congo: A multidimensional public health emergency 刚果民主共和国神秘疾病暴发：多层面突发公共卫生事件

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101069

M.M. Hassan , I.I. Okon , O.J. Okesanya , M.M. Ahmed

引用次数: 0

A comprehensive analysis of mental illness and neurological dysfunction in Tamil cinema: A questionnaire-based survey and its outcomes

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101115

T. Gangadharan , A. Jayaraman

Background

Mass media significantly shape public perceptions, and Tamil cinema (Kollywood) plays a vital role in this cultural narrative. However, it often perpetuates stereotypes associated with mental illness, contributing to stigma and misunderstanding within society. Given the growing influence of cinema, it is essential to examine how psychiatric conditions are represented in Kollywood films and the impact these portrayals have on public perception.

Methodology

The study analyzed Tamil-language films from the past four decades that depicted psychiatric illnesses. A Google search was conducted to compile a list of relevant Kollywood movies. Each film was then screened and evaluated based on character demographics, exhibited symptoms, diagnoses, and the scientific accuracy of these portrayals. A total of twenty-eight films from the last 45 years were analyzed. Additionally, a questionnaire-based survey was administered to the general public to assess perceptions of mental illness and neurological dysfunction as depicted in Tamil cinema.

Results/Discussion

The analysis revealed that most characters with mental health issues were portrayed as middle-aged, unmarried, employed, and from affluent backgrounds. The most commonly depicted symptom was aggression, and the dominant diagnosis presented was psychopathy. These portrayals often showed a decline in the characters’ mental health over time. Survey responses indicated that such cinematic depictions significantly influence audience perceptions, reinforcing negative stereotypes and contributing to the social stigma surrounding mental illness.

Conclusion/Perspectives

The study highlights the critical role of Kollywood in shaping societal attitudes toward mental health. The recurring inaccuracies and dramatized portrayals in films can perpetuate misinformation and reinforce stigma. By drawing attention to these trends, this research calls for more accurate, sensitive, and responsible representations of mental illness in Tamil cinema, with the potential to foster awareness, empathy, and destigmatization in the broader public consciousness.

大众传媒极大地塑造了公众的观念，泰米尔电影（Kollywood）在这种文化叙事中起着至关重要的作用。然而，它往往使与精神疾病有关的陈规定型观念永久化，造成社会上的耻辱和误解。鉴于电影的影响力越来越大，有必要研究一下精神疾病是如何在科莱坞电影中表现出来的，以及这些描绘对公众认知的影响。该研究分析了过去四十年来描绘精神疾病的泰米尔语电影。在谷歌上进行了搜索，以编制相关的Kollywood电影列表。然后对每部电影进行筛选，并根据人物特征、表现出的症状、诊断和这些描述的科学准确性进行评估。总共分析了过去45年里的28部电影。此外，对一般公众进行了一项基于问卷的调查，以评估泰米尔电影中所描述的精神疾病和神经功能障碍的看法。结果/讨论分析显示，大多数有心理健康问题的角色被描述为中年、未婚、有工作和富裕背景。最常见的症状是攻击性，主要的诊断是精神病。随着时间的推移，这些角色的心理健康状况往往会下降。调查结果表明，这种电影描述显著影响了观众的看法，强化了负面的刻板印象，并助长了围绕精神疾病的社会污名。结论/观点该研究强调了考莱坞在塑造社会对心理健康的态度方面的关键作用。电影中反复出现的不准确和戏剧化的描述可能会使错误信息永久化，并加剧污名。通过引起人们对这些趋势的关注，本研究呼吁在泰米尔电影中对精神疾病进行更准确、更敏感和更负责任的表现，从而有可能在更广泛的公众意识中培养意识、同情和去污名化。

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引用次数: 0

Integrating basic obstetric ultrasound into midwifery training to reduce maternal mortality in Somalia: World midwifery day reflection 将基本产科超声纳入助产培训以降低索马里孕产妇死亡率：世界助产日反思

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101118

H.M. Nur , M.M. Ahmed , N.I. Dirie

引用次数: 0

Falling birthrate and rising C-section: Post-pandemic evidence from New York 出生率下降和剖腹产率上升：纽约疫情后的证据

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101174

M. Rabbani , Z. Akbari

Background

The literature documents the effects of the pandemic on birthrate, birthweight, and pregnancy complications. However, the evidence is mixed on the persistence of these effects post-pandemic.

Objective

This study examined whether birthrate has decline with the onset of the pandemic, if the effects subsided post-pandemic, and whether there are discrepancies by race and ethnicity, or between vaginal delivery and C-section.

Methods

Using the 2012–2022 hospital inpatient discharge data of New York, we implemented fixed-effects regression models to estimate changes in birthrate and delivery method composition. The study was conducted at the Zip-Code level, and eliminated the effect of time-invariant characteristics such as geographic and demo- graphic discrepancies.

Results

Birthrate was declining pre-pandemic by 1.11% annually. The onset of the pandemic in 2020 led to an additional 7.61% decline in birthrate, which did not revert to the pre-pandemic trajectory in subsequent years, indicating a persistent decline. The post-pandemic decline was more pronounced in vaginal deliveries, with weak evidence of a drop in C-sections. In our sample, C-sections generate 61% more revenue than vaginal deliveries, suggesting that healthcare providers may have increased C-section rates to offset revenue losses from declining birthrates.

Conclusions

The pandemic accelerated an ongoing decline in birthrate, and this decline has persisted post-pandemic. The shift in delivery method composition raises concerns about potential financial incentives influencing clinical decisions. Further research is needed to confirm whether hospitals are upselling C-sections in response to declining births.

文献记录了大流行对出生率、出生体重和妊娠并发症的影响。然而，关于大流行后这些影响是否持续存在的证据不一。目的本研究考察出生率是否随着大流行的发生而下降，大流行后影响是否消退，以及种族和民族之间是否存在差异，或者阴道分娩和剖腹产之间是否存在差异。方法利用2012-2022年纽约住院出院数据，采用固定效应回归模型估计出生率和分娩方式构成的变化。该研究是在邮政编码水平上进行的，并消除了地理和人口差异等时不变特征的影响。结果大流行前出生率以每年1.11%的速度下降。2020年大流行的爆发导致出生率进一步下降7.61%，在随后的几年里，出生率没有恢复到大流行前的轨迹，这表明出生率持续下降。大流行后，阴道分娩的下降更为明显，剖腹产下降的迹象并不明显。在我们的样本中，剖腹产产生的收入比阴道分娩多61%，这表明医疗保健提供者可能提高了剖腹产率，以抵消出生率下降带来的收入损失。大流行加速了出生率的持续下降，这种下降在大流行后持续存在。递送方法组成的转变引起了对影响临床决策的潜在财务激励的关注。需要进一步的研究来证实医院是否为了应对出生率下降而追加销售剖腹产。

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引用次数: 0

Conducting ethical research with young mothers: Key considerations for methodology and engagement 对年轻母亲进行伦理研究：方法和参与的关键考虑因素

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101145

C. Laurenzi , M. Thabeng , C. Busakhwe , N. Waluwalu , N. Woollett , S. Lindani , U. Maluleke , M. Tomlinson , E. Toska

Introduction

Adolescent engagement can enhance research by offering opportunities for empowerment and equity, and increasing relevance. However, to be effective, engagement should uphold ethical principles—particularly for adolescents who are exposed to adversities, including those who become mothers at a young age.

Methods and results

We share five key insights in this paper from our ongoing work with young mothers living with HIV between 16–20 years of age in the Eastern Cape, South Africa, focusing on ethics and methods to maximize engagement. Insights were derived through a series of arts-based activities in participatory workshops with young mothers held in April 2024 and March 2025 (n = 40). First, research with young mothers should respond to evidence gaps about their needs, while also recognizing young mothers as multi-dimensional young people. Second, ethical, equitable engagement from recruitment to closing is paramount; we focus specifically on recruitment and consent processes. Third, research with young mothers should balance between tailoring options towards individuals’ preferences and comfort level, while also structuring types of engagement; arts-based methods can provide a medium for such engagement. Fourth, the format and forum of participant engagement can shape research outputs and experiences, particularly with more sensitive topics and populations. Finally, a working protocol for referrals and follow-ups is essential, and should be easily operationalized, adapted, and updated.

Conclusions

These insights provide context for other researchers engaging with young mothers or other youth facing complex life events in low-resource settings. Ethical practices and participatory methods can support more dynamic knowledge exchange and generate meaningful findings, contributing to more responsive programs and policies.

青少年的参与可以通过提供赋权和公平的机会以及增加相关性来加强研究。然而，要想有效，参与应该坚持道德原则，特别是对那些面临逆境的青少年，包括那些年轻时就成为母亲的青少年。方法和结果我们在本文中分享了我们对南非东开普省16-20岁感染艾滋病毒的年轻母亲的持续工作的五个关键见解，重点是伦理和方法，以最大限度地提高参与。通过2024年4月和2025年3月举办的一系列以艺术为基础的参与性讲习班（n = 40），获得了见解。首先，针对年轻母亲的研究应回应有关其需求的证据差距，同时也认识到年轻母亲是多方面的年轻人。其次，从招聘到结案，道德、公平的参与至关重要；我们特别关注招聘和同意流程。第三，针对年轻母亲的研究应在根据个人偏好和舒适度量身定制选择和构建参与类型之间取得平衡；基于艺术的方法可以为这种参与提供媒介。第四，参与者参与的形式和论坛可以影响研究成果和经验，特别是对于更敏感的主题和人群。最后，转诊和后续工作的工作协议是必不可少的，并且应该易于操作、调整和更新。这些见解为其他研究人员研究在低资源环境下面临复杂生活事件的年轻母亲或其他年轻人提供了背景。道德实践和参与性方法可以支持更有活力的知识交流，产生有意义的发现，有助于制定更具响应性的方案和政策。

{"title":"Conducting ethical research with young mothers: Key considerations for methodology and engagement","authors":"C. Laurenzi , M. Thabeng , C. Busakhwe , N. Waluwalu , N. Woollett , S. Lindani , U. Maluleke , M. Tomlinson , E. Toska","doi":"10.1016/j.jemep.2025.101145","DOIUrl":"10.1016/j.jemep.2025.101145","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescent engagement can enhance research by offering opportunities for empowerment and equity, and increasing relevance. However, to be effective, engagement should uphold ethical principles—particularly for adolescents who are exposed to adversities, including those who become mothers at a young age.</div></div><div><h3>Methods and results</h3><div>We share five key insights in this paper from our ongoing work with young mothers living with HIV between 16–20 years of age in the Eastern Cape, South Africa, focusing on ethics and methods to maximize engagement. Insights were derived through a series of arts-based activities in participatory workshops with young mothers held in April 2024 and March 2025 (<em>n</em> = 40). First, research with young mothers should respond to evidence gaps about their needs, while also recognizing young mothers as multi-dimensional young people. Second, ethical, equitable engagement from recruitment to closing is paramount; we focus specifically on recruitment and consent processes. Third, research with young mothers should balance between tailoring options towards individuals’ preferences and comfort level, while also structuring types of engagement; arts-based methods can provide a medium for such engagement. Fourth, the format and forum of participant engagement can shape research outputs and experiences, particularly with more sensitive topics and populations. Finally, a working protocol for referrals and follow-ups is essential, and should be easily operationalized, adapted, and updated.</div></div><div><h3>Conclusions</h3><div>These insights provide context for other researchers engaging with young mothers or other youth facing complex life events in low-resource settings. Ethical practices and participatory methods can support more dynamic knowledge exchange and generate meaningful findings, contributing to more responsive programs and policies.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101145"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322153","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}

引用次数: 0

Mindfulness Based Sufism Intervention: Systematic Literature Review 基于正念的苏菲主义干预：系统文献综述

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101180

S. Rejeki , Haryono , Sunawan , Mulawarman , A. Hakim

Introduction

Mindfulness has its roots in Buddhist spirituality, but the concept can be applied across religious traditions. Religion, ethics, and spirituality play an important role in the practice of mindfulness, but there is concern among Muslim scholars that adaptations of mindfulness rooted in Buddhist traditions and developed in the West may bring cultural influences that are inconsistent with Islamic teachings.

Objectives

This systematic review aims to explore the concept of mindfulness based Sufism intervention in various literature and examine existing evidence regarding the effectiveness of mindfulness based Sufism intervention on mental health.

Methods

The databases used in the search were PubMed, Sage, Springer and Taylor & Francis. The scope of this review intentionally includes both conceptual and empirical studies, encompassing a wide range of research types such as field-based interventions, observational studies, and literature analyses. The population focus is general Muslims, without restriction to specific subgroups. The keywords used in the search are “Sufism” OR “Islamic” AND “Mindfulness”. Journal articles were screened using the PRISMA method. There were 10 articles related mindfulness and Sufism that met the inclusion criteria as data for analysis.

Results

Based on the results of the literature review, it can be found that mindfulness can be used as an intervention by Muslims by adapting traditions in Islamic spirituality or Sufism. The concept of mindfulness based Sufism intervention can be found in this literature review through several Islamic spiritual practices, namely shalat khusyu, prayer, dhikr and muraqabah. It has been proven to provide significant benefits in reducing symptoms of anxiety, depression and fatigue, as well as improving mental health.

Conclusion

Mindfulness-Based Sufism Intervention (MBSI) offers a culturally grounded, ethically informed, and theologically integrated approach to enhance mental health among Muslim communities

正念起源于佛教精神，但这个概念可以应用于各种宗教传统。宗教、伦理和灵性在正念的实践中发挥着重要作用，但穆斯林学者担心，对根植于佛教传统并在西方发展起来的正念的适应，可能会带来与伊斯兰教义不一致的文化影响。目的本系统综述旨在探讨苏菲主义正念干预在不同文献中的概念，并检验苏菲主义正念干预对心理健康有效性的现有证据。方法检索数据库为PubMed、Sage、施普林格和Taylor &； Francis。本综述的范围包括概念研究和实证研究，涵盖了广泛的研究类型，如实地干预、观察性研究和文献分析。人口重点是一般穆斯林，不限于特定的子群体。搜索中使用的关键词是“苏菲主义”或“伊斯兰教”和“正念”。使用PRISMA方法筛选期刊文章。有10篇与正念和苏菲主义相关的文章符合纳入标准作为分析数据。结果基于文献回顾的结果，可以发现正念可以作为一种干预，穆斯林可以通过适应伊斯兰精神或苏菲主义的传统。在这篇文献综述中，我们可以通过几个伊斯兰精神实践，即shalat khusyu、祈祷、dhikr和muraqabah，找到基于正念的苏菲主义干预的概念。它已被证明在减轻焦虑、抑郁和疲劳症状以及改善心理健康方面提供了显著的好处。基于正念的苏菲主义干预（MBSI）提供了一种文化基础、伦理信息和神学综合的方法来增强穆斯林社区的心理健康

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引用次数: 0

Navigating the legal vacuum: An ethical analysis of brain death, fetal personhood, and maternal autonomy in the post-roe era: Lessons from Smith v. Georgia 在法律真空中导航：后roe时代对脑死亡、胎儿人格和母亲自主权的伦理分析：史密斯诉乔治亚案的教训

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101187

C. Kooli

Background

The Dobbs v. Jackson Women's Health Organization decision has fragmented U.S. abortion law, leading to stringent state-level fetal personhood statutes. This creates acute ethical and medical dilemmas, particularly when a pregnant individual is declared brain dead, a legally recognized state of death. The tension between continuing pregnancy for fetal viability and respecting the deceased's autonomy presents an unresolved conflict.

Objective

This paper conducts an ethical analysis of the Smith v. Georgia case, wherein Adriana Smith, a brain-dead pregnant woman, was reportedly maintained on life support due to concerns over Georgia's fetal personhood law.

Methods

We review publicly available case details, legal interpretations, and apply core bioethical principles (autonomy, beneficence, non-maleficence, justice) to dissect the inherent ethical and practical conflicts.

Results

Ms. Smith's case exposed a critical legal vacuum: despite being brain dead, her body was reportedly sustained due to perceived legal mandates, conflicting with her family's wishes. The Georgia Attorney General's subsequent clarification that removing life support from a brain-dead individual is not an abortion highlighted this overreach. This situation violates the deceased's autonomy, places undue psychological burdens on families, creates moral distress for healthcare providers, and raises significant public health concerns regarding resource allocation and the long-term well-being of children born into such unique circumstances.

Conclusion

The Smith v. Georgia case underscores the urgent need for clear legal and ethical guidance at the nexus of brain death, pregnancy, and fetal personhood. We advocate for legislative amendments to clarify non-applicability of fetal personhood in brain death, reaffirming post-mortem autonomy, and establishing comprehensive social and psychological support systems for families and children involved in such tragic scenarios.

多布斯诉杰克逊妇女健康组织案的判决使美国堕胎法支离破碎，导致了严格的州一级胎儿人格法规。这造成了严重的伦理和医学困境，特别是当一个怀孕的人被宣布脑死亡时，这是一种法律承认的死亡状态。为了胎儿生存能力而继续怀孕和尊重死者的自主权之间的紧张关系是一个未解决的冲突。本文对Smith诉Georgia一案进行了伦理分析，该案件中，脑死亡孕妇Adriana Smith由于对Georgia的胎儿人格法的担忧而被维持生命支持。方法我们回顾了公开的案例细节、法律解释，并运用核心的生命伦理原则（自主、有益、无害、正义）来剖析内在的伦理和实践冲突。史密斯的案件暴露了一个关键的法律真空：尽管她已经脑死亡，但据报道，她的尸体是根据法律规定保存的，这与她家人的意愿相冲突。乔治亚州司法部长随后澄清说，从脑死亡的人身上撤掉生命维持设备不是堕胎，这凸显了这种越权行为。这种情况侵犯了死者的自主权，给家庭带来了不必要的心理负担，给医疗保健提供者造成了道德上的困扰，并引起了对资源分配和在这种特殊情况下出生的儿童长期福祉的重大公共卫生关切。Smith诉Georgia案强调了对脑死亡、怀孕和胎儿人格关系的明确的法律和伦理指导的迫切需要。我们主张修改立法，明确胎儿人格在脑死亡中的不适用性，重申死后自主权，并为涉及此类悲剧情景的家庭和儿童建立全面的社会和心理支持系统。

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引用次数: 0