Monash Bioethics Review最新文献

The use of Artificial Intelligence (AI) in healthcare is growing quickly and offers big improvements in medical diagnostics, treatment planning, and patient care. However, people often don't trust AI systems, which prevents them from being widely used. This article looks at both the philosophical and practical issues of trust in healthcare AI systems. First, we provide an overview of the current state of AI in healthcare. Then, we review existing research on trust in technology. Based on our findings, we identify three main factors that affect trust in AI: Technology-Related Factors (transparency, reliability, safety), Healthcare Context Factors (how well AI fits into healthcare settings, proper training for professionals), and Individual User Factors (user experience and attitudes toward AI). Our results show that continuous human oversight, strong regulations, and ethical considerations are essential. Addressing these areas is key to making sure AI systems in healthcare are reliable, transparent, and trusted by both healthcare professionals and patients.

Anna Smajdor and Joona Räsänen argue that pregnancy should be classified as a disease (In: Is Pregnancy a Disease? A Normative Approach, vol 51, 2025). But their argument faces a problem not yet raised by other critics (see In: Pregnancy, Pain and Pathology: A Reply to Smajdor and Räsänen, vol 51, 2025; In: No, Pregnancy Is Not a Disease, vol 51, 2025; In: Failing to Deliver: Why Pregnancy Is Not a Disease, vol 51, 2025). To classify a phenomenon, e.g., pregnancy, as belonging to a category, e.g., disease, one must characterize the category as well as the phenomenon. But Smajdor and Räsänen do neither. Indeed, they reject every apparent candidate theory of disease, and they do not define pregnancy. The closest they come to characterizing disease' is positing the converse of Quill Kukla's criteria for non-disease (In: Infertility, Epistemic Risk, and Disease Definitions, vol 196, 2019). The converse of Kukla's criteria are: (1) there is agreement and consistency between definitions, (2) a unified physical syndrome is present, (3) the risks are medical rather than social, and (4) the risks are not only 'risks' within a particular set of social values (In: Is Pregnancy a Disease? A Normative Approach, vol 51, 2025). Smajdor and Räsänen then claim that pregnancy meets these criteria. But contra what they argue, I show that pregnancy fails to meet these criteria, or that, at best, whether or not pregnancy meets some of them is not established. If Smajdor and Räsänen abandon even those suggested criteria, however, they have no basis for classifying pregnancy-whatever it is-in any way at all. On these grounds, I contend they have not shown that pregnancy should be classified as a disease.

More than ten million people worldwide suffer a stroke each year, and one in three survivors will experience language problems, known as post-stroke aphasia. However, the literature reveals that the most severe cases of post-stroke aphasia are systematically excluded from clinical research due to the difficulty or inability of these individuals to communicate their consent. Consequently, both their physical and psychological health, as well as their inalienable rights as human beings, are severely affected. Therefore, this work aims to critically analyze the North American principlist bioethics of Beauchamp and Childress as a theoretical basis to assess the participation of individuals with severe post-stroke aphasia in clinical research and to propose a reorientation of bioethical analysis towards the principles established because of the BIOMED-II project, relatively recent in Europe. Taking the last one into consideration, and along with the most important international bioethical treaties, there seems to be sufficient justification for the participation of individuals with severe post-stroke aphasia in clinical research if its four principles are respected: the principle of autonomy, understood in line with the Kantian moral idea of treating individuals as ends in themselves, and the principles of dignity, integrity, and vulnerability.

This paper examines bioethical considerations of research conducted in Sub-Saharan Africa (SSA), where a notable scarcity persists in literature addressing region-specific bioethical issues. Although bioethics-related activities have encountered challenges surpassing existing protocol safeguards, emerging evidence demonstrates growing recognition of integrated scientific and ethical principles within African medical research. Maintaining research continuity in resource-limited settings necessitates bridging critical gaps between informed consent procedures and participants' actual understanding. This narrative review assesses progress, identifies persistent challenges, and outlines future directions for clinical trials and medical research in SSA, with particular focus on adherence to established bioethical standards and integration of local normative frameworks. Our analysis reveals a significant increase in publications featuring rigorous ethical discourse about bioethical research in Africa, with particular emphasis on SSA, in recent years. The review underscores substantial deficits in ethical conduct, including frequent non-compliance with fundamental principles: informed consent, autonomy, beneficence, and non-maleficence. Furthermore, we identify a paucity of evidence concerning methodologies to improve the efficacy and quality of ethical review mechanisms.

Two normative studies in empirical bioethics on the bio-ethical issues associated with the refusal of cancer patients to be vaccinated against COVID-19 or flu at the hospital, in France, applying a 'neopotterian theory of global bioethics', have been published, respectively in 2022 and 2023. Since then, substancial progress in this theory have also been published, in 2024. The publication formalizes why and, above all, how global bioethics should integrate 'moral pluralism'. Based on these advances, we performed a normative re-analysis of the secondary information extracted from the two empirical bioethics' publications. At the end of the day, the solutions are now more explicitly discerned, which are different forms of indirect obligation for vaccination - to be understood as a more or less strong incentive to vaccinate rather than a legally formalized obligation. These solutions could have an appreciable relevance in mainland France, less in French overseas territories, even in other countries.

After more than fifty years of debate on the definition of death, there remains no consensus among bioethicists. This article identifies the conflicting interests represented by various groups within the bioethics community as the primary cause of this stalemate. It argues that the impasse can be overcome if bioethicists recognize these conflicting interests as the fundamental reason for their disagreements, rather than viewing the dispute as primarily concerning the scientifically adequate concept of death. This article proposes a strategy on how to reach a consensus. The core idea in this regard is that the definition of death, in a socially important sense, needs to protect the interests of individual members of society.

This study aimed to verify the effect of financial incentives and the feeling of guilt in the formation of the intention to donate organs of relatives' post-mortem. The method used was a single factor experiment, with the manipulation of financial compensations under three conditions (low value, medium value, high value) and altruism as a control group. In a convenience sample, 152 Brazilian individuals participated in the study. The results reveal that the greater the financial incentives, the lower the intention to donate, and that the greater the amount of money, the greater the feeling of guilt and the lower the intention to donate. This relationship between guilt and the formation of intent to donate contributes to a better understanding of the role of subjective norms in the formation of intent to donate organs, shedding light on the understanding of social behavior that involves post-mortem organ donation.

Researchers developing artificial amnion and placenta technology (AAPT) regard this endeavor as one to enhance outcomes in neonatal intensive care units (NICU), by reducing mortality and morbidity for extremely premature neonates. While other applications can be imagined and have been the topic of ethical debate, there is discontent about bioethical considerations of potential AAPT applications beyond NICU praxis. Dismissed as 'speculative', the latter allegedly cloud 'real' ethical work necessary for clinical translation. This trope requires ethical attention, since it goes to the heart of bioethical praxis as an effort of studying emerging technologies like AAPT, and as a critical enterprise tethering ethical contemplation to empirics and uncovering value-ladenness of empirical 'facts'. We explore different functions of speculation in ethics, after which we examine the main criticisms against the purported speculative implementation of AAPT. We then address how defining a practice as speculative reveals more about research priorities and biases, than about some quality of the practice. Labeling scenarios as 'speculative' seems to function as an argument in and of itself, rather than that an argument is provided for labeling certain scenarios as speculative, and why this matters. More: the 'speculation argument' can be extended to the translational aims of AAPT, its potential risks, and the assumed 'benefits' in terms of mortality and morbidity. Projections about 'morbidity' and 'quality of life' that do not start from insights and experiences of members of the disability community are precisely the type of speculation that should be questioned from a critical ethics perspective.