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Defending the de dicto approach to the non-identity problem. 为解决非同一性问题的专制方法辩护。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-06-26 DOI: 10.1007/s40592-023-00177-9
Joona Räsänen

Is it wrong to create a blind child, for example by in vitro fertilization, if you could create a sighted child instead? Intuitively many people believe it is wrong, but this belief is difficult to justify. When there is a possibility to create and select either 'blind' or 'sighted' embryos choosing a set of 'blind' embryos seems to harm no-one since choosing 'sighted' embryos would create a different child altogether. So when the parents choose 'blind' embryos, they give some specific individual a life that is the only option for her. Because her life is worth living (as blind peoples' lives are), the parents have not wronged the child by creating her. This is the reasoning behind the famous non-identity problem. I suggest that the non-identity problem is based on a misunderstanding. I claim that when choosing a 'blind' embryo, prospective parents harm 'their child', whoever she or he will be. Put another way: parents harm their child in the de dicto sense and that is morally wrong.

如果你可以创造一个视力正常的孩子,那么通过体外受精创造一个失明的孩子是错的吗?直觉上,许多人认为这是错误的,但这种信念很难证明是正确的。当有可能创造和选择“失明”或“有视力”的胚胎时,选择一组“失明”的胚胎似乎不会伤害任何人,因为选择“有视力”的胚胎会创造一个完全不同的孩子。因此,当父母选择“盲”胚胎时,他们会给某个特定的个体一个生命,这是她唯一的选择。因为她的生命是值得活下去的(就像盲人的生命一样),父母并没有因为创造了她而冤枉了孩子。这就是著名的非同一性问题背后的原因。我认为非同一性问题是基于一种误解。我声称,当选择一个“盲目”的胚胎时,准父母伤害了“他们的孩子”,无论她或他将是谁。换句话说:父母伤害他们的孩子是出于自愿,这在道德上是错误的。
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引用次数: 0
A review of G. R. McLean, ethical basics for the caring professions: knowledge and skills for thoughtful practice (1st ed. Abingdon, Oxon: Routledge, 2022. 240 p.). G.R.McLean,《护理职业的伦理基础:深思熟虑的实践的知识和技能》(第1版,Abingdon,Oxon:Routledge,2022)。240页)。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-11-04 DOI: 10.1007/s40592-023-00184-w
Michael Shepanski
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引用次数: 0
Resistance and the delivery of healthcare in Australian immigration detention centres. 澳大利亚移民拘留中心的抵抗和医疗服务。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI: 10.1007/s40592-023-00182-y
Ryan Essex, Michael Dudley

There are few issues that have been as vexing for the Australian healthcare community as the Australian governments policy of mandatory, indefinite, immigration detention. While many concepts have been used to begin to describe the many dilemmas faced by healthcare professionals and their resolution, they are limited, perhaps most fundamentally by the fact that immigration detention is antithetical to health and wellbeing. Furthermore, and while most advice recognises that the abolition of detention is the only option in overcoming these issues, it provides little guidance on how action within detention could contribute to this. Drawing on the work of political theorists and the broader sociological literature, we will introduce and apply a form of action that has not yet been considered for healthcare workers within detention, resistance. We will draw on several examples from the literature to show how everyday resistance could be enacted in healthcare and immigration detention settings. We argue that the concept of resistance has several conceptual and practical advantages over much existing guidance for healthcare workers in these environments, namely that it politicises care and has synergies with other efforts aimed at the abolition of detention. We also offer some reflections on the justifiability of such action, arguing that it is largely consistent with the existing guidance produced by all major healthcare bodies in Australia.

对于澳大利亚医疗保健界来说,很少有什么问题像澳大利亚政府的强制性、无限期移民拘留政策那样令人烦恼。虽然许多概念已经被用来描述医疗专业人员面临的许多困境及其解决方案,但它们是有限的,也许最根本的原因是移民拘留与健康和福祉背道而驰。此外,尽管大多数建议都承认,废除拘留是克服这些问题的唯一选择,但它几乎没有就拘留内的行动如何促进这一点提供指导。根据政治理论家的工作和更广泛的社会学文献,我们将介绍并应用一种尚未被考虑用于拘留、抵抗中的医护人员的行动形式。我们将借鉴文献中的几个例子,展示如何在医疗保健和移民拘留环境中实施日常抵抗。我们认为,与这些环境中针对医护人员的许多现有指导相比,抵抗的概念在概念和实践上有几个优势,即它将护理政治化,并与其他旨在废除拘留的努力协同作用。我们还对这种行动的正当性进行了一些思考,认为这在很大程度上与澳大利亚所有主要医疗机构制定的现有指导意见一致。
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引用次数: 0
Taking embodiment seriously in public policy and practice: adopting a procedural approach to health and welfare. 在公共政策和实践中认真体现:对健康和福利采取程序性方法。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-11-04 DOI: 10.1007/s40592-023-00183-x
Joseph T F Roberts

It is a common refrain amongst phenomenologists, disability theorists, and feminist legal theorists that medical practice pays insufficient attention to people's embodiment. The complaint that we take insufficient account of people's embodiment isn't limited to the clinical interaction. It has also been directed at healthcare regulation and welfare policy. In this paper, I examine the arguments for taking embodiment seriously in both medical practice and welfare policy, concluding we have good reasons to take better account of people's embodiment. I then set out two challenges to taking embodiment seriously in public policy. First, given the amount of variation in how people are embodied, there is strong possibility that adjusting policy to benefit particular individuals based on an appreciation of their embodied experiences could be detrimental towards other individuals. The second challenge concerns how to ensure that people's testimony about their first-person embodied experience is subject to adequate scrutiny without this resulting in epistemic injustice. I argue that the solution to both of these challenges is to devise a just procedure for soliciting people's testimony and taking it into account in the policy development process. As such, I also provide an outline of what a just procedure should look like.

现象学家、残疾理论家和女权主义法律理论家普遍认为,医疗实践对人的化身关注不足。抱怨我们没有充分考虑到人们的具体情况,这不仅限于临床互动。它还针对医疗监管和福利政策。在这篇论文中,我考察了在医疗实践和福利政策中认真对待化身的论点,得出的结论是我们有充分的理由更好地考虑人们的化身。然后,我提出了在公共政策中认真对待具体化的两个挑战。首先,考虑到人的具体体现方式存在很大差异,基于对特定个人具体经历的欣赏来调整政策以使其受益的可能性很大,这可能会对其他人不利。第二个挑战涉及如何确保人们对其第一人称体验的证词受到充分的审查,而不会导致认识上的不公正。我认为,解决这两个挑战的办法是制定一个公正的程序,征求人们的证词,并在政策制定过程中予以考虑。因此,我还概述了公正程序应该是什么样子。
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引用次数: 0
How did organ donation in Israel become a club membership model? From civic to communal solidarity in organ sharing. 以色列的器官捐献是如何变成俱乐部会员制模式的?器官共享从公民团结到社区团结。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-09-09 DOI: 10.1007/s40592-023-00179-7
Hagai Boas

Figuring out what pushes individuals to become organ donors has become the holy grail of social scientists interested in transplantations. In this paper I concentrate on solidarity as a determinant of organ donation and examine it through the history of organ donation in Israel. By following the history of transplantation policies since 1968 and examining them in relation to different types of solidarities, this paper leads to a nuanced understanding of the ties between solidarity and health policy. Attempts to foster an all-encompassing consensus on the definition of brain death yielded the Transplantation and the Brain-Respiratory Death Laws of 2008. It was hoped that a wide "civic solidarity" would render Israel self-sufficient in its organ economy. However, the failure of the law led to the breakdown of civic solidarity in organ donation. As a result, initiatives such as the priority policy and non-directed living organ donations, developed out of a narrower conception of solidarity. Juxtaposing these initiatives sheds light on macro level processes for policy makers and suggests solidarity as a key bioethical concept to understand organ donation policies.

弄清是什么促使个人成为器官捐献者已成为对器官移植感兴趣的社会科学家的圣杯。在本文中,我将团结作为器官捐献的一个决定因素,并通过以色列器官捐献的历史对其进行研究。通过跟踪自 1968 年以来的移植政策历史,并将其与不同类型的团结关系联系起来进行研究,本文将对团结与卫生政策之间的联系有一个细致入微的理解。为了就脑死亡的定义达成全面共识,以色列于 2008 年颁布了《移植法》和《脑呼吸死亡法》。人们希望广泛的 "公民团结 "能使以色列的器官经济自给自足。然而,该法的失败导致公民在器官捐献方面的团结遭到破坏。因此,优先政策和非定向活体器官捐献等举措是在更狭隘的团结概念基础上发展起来的。将这些举措并列起来,可为政策制定者提供宏观层面进程的启示,并建议将团结作为理解器官捐献政策的关键生物伦理概念。
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引用次数: 0
Respecting living kidney donor autonomy: an argument for liberalising living kidney donor acceptance criteria. 尊重活体肾供者的自主权:放宽活体肾供者接受标准的论点。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2022-12-09 DOI: 10.1007/s40592-022-00166-4
Alison C Weightman, Simon Coghlan, Philip A Clayton

Doctors routinely refuse donation offers from prospective living kidney donors with certain comorbidities such as diabetes or obesity out of concern for donor wellbeing. This refusal occurs despite the ongoing shortage of kidney transplants and the superior performance of living donor kidney transplants compared to those from deceased donors. In this paper, we argue that this paternalistic refusal by doctors is unjustified and that, within limits, there should be greater acceptance of such donations. We begin by describing possible weak and strong paternalistic justifications of current conservative donor acceptance guidelines and practices. We then justify our position by outlining the frequently under-recognised benefits and the routinely overestimated harms of such donation, before discussing the need to respect the autonomy of willing donors with certain comorbidities. Finally, we respond to a number of possible objections to our proposal for more liberal kidney donor acceptance criteria. We use the situation in Australia as our case study, but our argument is applicable to comparable situations around the world.

出于对捐赠者健康的考虑,医生通常会拒绝患有某些合并症(如糖尿病或肥胖)的活体肾脏捐赠者的捐赠。尽管肾移植持续短缺,活体供体肾移植的性能优于已故供体肾移植,但这种拒绝仍在发生。在本文中,我们认为医生这种家长式的拒绝是不合理的,在一定范围内,应该更多地接受这种捐赠。我们首先描述当前保守的捐助者接受指导方针和做法的可能的弱和强家长式的理由。然后,我们通过概述这种捐赠经常被低估的好处和通常被高估的危害来证明我们的立场,然后讨论尊重具有某些合并症的自愿捐赠者的自主权的必要性。最后,我们回应了一些可能反对我们建议更自由的肾脏捐赠者接受标准的意见。我们以澳大利亚的情况作为案例研究,但我们的论点适用于世界各地的类似情况。
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引用次数: 1
The relationship between speculation and translation in Bioethics: methods and methodologies. 生物伦理学中思辨与翻译的关系:方法论与方法论。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-09-28 DOI: 10.1007/s40592-023-00181-z
Tess Johnson, Elizabeth Chloe Romanis

There are increasing pressures for bioethics to emphasise 'translation'. Against this backdrop, we defend 'speculative bioethics'. We explore speculation as an important tool and line of bioethical inquiry. Further, we examine the relationship between speculation and translational bioethics and posit that speculation can support translational work. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it supports translational work. Second, speculation might be a first step prior to translational work on a topic. Finally, speculative bioethics might constitute different content altogether, without translational objectives. For each conception of speculative bioethics, important methodological aspects determine whether it constitutes good bioethics research. We conclude that whether speculative bioethics is compatible with translational bioethics-and to what extent-depends on whether it is being employed as tool or content. Applying standards of impact uniformly across bioethics may inappropriately limit speculative bioethics.

生物伦理学强调“翻译”的压力越来越大。在这种背景下,我们为“推测性生物伦理学”辩护。我们将思辨作为生物伦理学研究的一个重要工具和途径。此外,我们研究了推测与翻译生物伦理学之间的关系,并认为推测可以支持翻译工作。首先,推测性研究可能是通过一个新的视角对当代问题进行伦理分析,在这种情况下,它支持翻译工作。其次,推测可能是对某个主题进行翻译工作之前的第一步。最后,推测性的生物伦理学可能完全构成不同的内容,而没有转化的目标。对于每一个推测性生物伦理学的概念,重要的方法论方面决定了它是否构成良好的生物伦理学研究。我们得出的结论是,推测性生物伦理学是否与转化性生物伦理学兼容,在多大程度上取决于它是作为工具还是内容使用。在生物伦理学中统一应用影响标准可能会不适当地限制推测性的生物伦理学。
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引用次数: 0
Ethics and non-evidence based therapies: Portuguese perspective in a global setting. 伦理和非循证疗法:全球背景下的葡萄牙视角。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2022-12-31 DOI: 10.1007/s40592-022-00172-6
João Madruga Dias

A contemporary serious lack of scientific knowledge by the general public and many decision-makers is now quite perceptible, both globally and in Portugal. Living in a science-driven technological world filled with scientific illiteracy is dangerous and a path toward disaster. Recent years brought a fairly strong global movement promoting the so-called "alternative therapy" that also affected Portugal. I propose an evidence-based ethics reflection and argumentation, both encompassing the global and the specific Portuguese reality. I debate the specific arguments used in favour of alternative therapies, demonstrating the inherent fallacies of thought, deliberate manipulation of words and concepts, and the dire consequences for global and local health politics by following this line of biased reasoning.

当代公众和许多决策者严重缺乏科学知识,这在全球和葡萄牙都很明显。生活在一个充斥着科学文盲的科学驱动的技术世界是危险的,是通往灾难的道路。近年来,全球掀起了一场声势浩大的“另类疗法”运动,葡萄牙也受到了影响。我提出一种基于证据的道德反思和论证,既包括全球现实,也包括具体的葡萄牙现实。我对支持替代疗法的具体论点进行了辩论,展示了思想的内在谬误、对词汇和概念的蓄意操纵,以及遵循这种有偏见的推理路线对全球和地方卫生政治的可怕后果。
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引用次数: 0
Protecting civil Liberties in a cognitively enhanced future: the role of classical liberalism. 在认知增强的未来中保护公民自由:古典自由主义的作用。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-07-10 DOI: 10.1007/s40592-023-00178-8
Michael Gentzel

A prominent concern in the literature on the ethics of human enhancement is that unequal access to future technology will exacerbate existing societal inequalities. The philosopher Daniel Wikler has argued that a futuristic cognitively enhanced majority would be justified in restricting the civil liberties of the unenhanced minority population for their own good in the same way that, mutatis mutandis, the cognitively normal majority are now justified in restricting the civil liberties of those deemed to be cognitively incompetent. Contrary to this argument, the author of this manuscript presents and defends The Liberal Argument to Protect Cognitive 'Normals'. According to this argument, while classical liberalism authorizes the cognitively competent to paternalistically restrict the civil liberties of the cognitively incompetent, classical liberalism does not authorize the cognitively enhanced to paternalistically restrict the civil liberties of the cognitively normal. Two additional arguments are developed in support of The Liberal Argument to Protect Cognitive 'Normals'. The author of this manuscript concludes by suggesting that classical liberalism could be valuable for protecting the civil liberties of disenfranchised groups in a future in which enhancement technology could exacerbate existing societal inequalities.

关于人类增强的伦理文献中一个突出的担忧是,对未来技术的不平等获取将加剧现有的社会不平等。哲学家丹尼尔·威克勒(Daniel Wikler)认为,未来的认知能力增强的多数人有理由为了自己的利益限制未增强的少数人的公民自由,就像经过必要修改后,认知能力正常的多数人现在有理由限制那些被认为认知能力低下的人的公民自由一样。与这一论点相反,本手稿的作者提出并捍卫了保护认知“正常”的自由主义论点。根据这一观点,古典自由主义允许认知能力强的人以家长式的方式限制认知能力不强的人的公民自由,但古典自由主义不允许认知能力强的人以家长式的方式限制认知正常的人的公民自由。为了支持《保护认知“正常”的自由主义论点》,还提出了另外两个论点。这篇手稿的作者最后提出,在未来,增强技术可能加剧现有的社会不平等,古典自由主义对于保护被剥夺公民权的群体的公民自由可能是有价值的。
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引用次数: 0
Is a deaf future an "Open" future? Reconsidering the open future argument against deaf embryo selection. 聋人的未来是“开放”的未来吗?重新考虑反对聋人胚胎选择的开放未来论点。
IF 1.6 Q1 Arts and Humanities Pub Date : 2023-12-01 Epub Date: 2023-05-24 DOI: 10.1007/s40592-023-00175-x
Paul A Tubig

One prominent argument against the use of preimplantation genetic diagnosis to select a deaf embryo with the aim of creating a deaf child is that it violates the child's right to an open future. This paper challenges the open future argument against deaf embryo selection, criticizing its major premise that deafness limits a child's opportunity range in ways that compromise their future autonomy. I argue that this premise is not justified and is supported by negative presumptions about deaf embodiments that are suspect and in need of further argumentation. First, available interpretations of the open future concept fail to justify the devaluation of deaf traits as inherently autonomy-diminishing. Second, arguing against deaf embryo selection requires demonstrating that a deaf trait generally constrains opportunity ranges independent of social context. But such analyses neglect important social and relational components of autonomy. For these reasons, merely appealing to the child's right to an open future does not sufficiently support the conclusion that deaf embryo selection is wrong.

反对使用植入前遗传学诊断来选择一个聋哑胚胎以创造一个聋哑儿童的一个突出的论点是,它侵犯了儿童享有开放未来的权利。本文对反对聋人胚胎选择的开放未来观点提出了挑战,批评其主要前提是聋人限制了儿童的机会范围,从而损害了他们未来的自主性。我认为,这个前提是不合理的,并且是由关于聋人的负面假设所支持的,这些假设是可疑的,需要进一步的论证。首先,对开放未来概念的现有解释无法证明失聪特征的贬值是固有的自主性减弱。其次,反对耳聋胚胎选择需要证明耳聋特征通常会限制与社会背景无关的机会范围。但这种分析忽视了自主性的重要社会和关系组成部分。由于这些原因,仅仅呼吁儿童拥有开放未来的权利并不能充分支持失聪胚胎选择是错误的结论。
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引用次数: 0
期刊
Monash Bioethics Review
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