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Embryo Selection in the Context of In Vitro Fertilization. 体外受精条件下的胚胎选择
IF 0.4 Q4 MEDICAL ETHICS Pub Date : 2024-02-01 Epub Date: 2023-06-15 DOI: 10.1177/00243639231169828
Teofilo Giovan S Pugeda

From the Catholic perspective, in vitro fertilization (IVF) is morally problematic because it artificially separates the procreative and unitive aspects of the conjugal act. Embryo selection (ES) in the context of IVF is an injustice against the resulting embryos because it treats them as commodities and works against their right to life by determining their implantation potential in light of their features. The Church opposes the eugenics mentality underlying ES. Meanwhile, the IVF industry increasingly uses artificial intelligence (AI) for ES. However, doing so could worsen the injustice by deepening the disrespect of human lives under the technocratic paradigm. As such, Catholic bioethicists are encouraged to advocate for the Church's teachings with renewed vigor. In this commentary, we will examine (1) ES in the context of IVF, (2) using AI for ES, (3) the moral implications of using AI for ES, and (4) points for further consideration. Summary: Using AI for Embryo selection in the context of IVF deepens the disrespect of human lives under the technocratic paradigm.

从天主教的角度来看,体外受精(IVF)在道德上是有问题的,因为它人为地分离了夫妻行为的生育和结合方面。在体外受精的背景下,胚胎选择(ES)是对最终胚胎的不公正,因为它将胚胎视为商品,并根据胚胎的特征决定其植入潜力,从而侵犯了胚胎的生命权。教会反对ES背后的优生学思想。与此同时,试管婴儿行业越来越多地使用人工智能(AI)进行ES。然而,这样做可能会加深对技术官僚范式下人类生命的不尊重,从而加剧不公正。因此,天主教生物伦理学家被鼓励以新的活力倡导教会的教义。在这篇评论中,我们将研究(1)体外受精背景下的胚胎干细胞,(2)使用人工智能进行胚胎干细胞,(3)使用人工智能进行胚胎干细胞的道德含义,以及(4)需要进一步考虑的要点。摘要:在体外受精的背景下,使用人工智能进行胚胎选择,加深了技术官僚范式下对人类生命的不尊重。
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引用次数: 0
Five-Year Lookback. 五年回顾
IF 0.5 Q2 Arts and Humanities Pub Date : 2024-02-01 Epub Date: 2024-01-30 DOI: 10.1177/00243639231215650
Barbara Golder
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引用次数: 0
The Ethical Physician as Negative Gatekeeper? 伦理医生是消极守门人?
IF 0.4 Q4 MEDICAL ETHICS Pub Date : 2024-02-01 Epub Date: 2023-11-22 DOI: 10.1177/00243639231210192
Michael Manning
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引用次数: 0
The Personalist Basis of the Church's Teaching on Human Sexuality and the Natural Law in the Work of John Paul II. Part I. 约翰·保罗二世著作中教会关于人类性与自然规律教学的人格基础。第一部分
IF 0.5 Q2 Arts and Humanities Pub Date : 2024-02-01 Epub Date: 2023-08-30 DOI: 10.1177/00243639231196720
Maria Fedoryka

Responding to Pope John Paul II's call to give the "ethical grounds and personalistic reasons" behind the Church's teaching on sexual morality, this reflection written over the span of two articles analyzes the norms of the natural law related to human sexuality from a personalist perspective. The key ideas of this study are drawn from two passages: one from Gaudium et spes which states that "The sexual characteristics of man and the human faculty of reproduction wonderfully exceed the dispositions of lower forms of life", the other from Humanae vitae stating that "Conjugal love reveals its true nature and nobility when it is considered in its supreme origin, God, who is love … and it is of supreme importance to have an exact idea of these." Part I provides an overview of natural law theory, explaining what it means that the natural law is not arbitrary, but the moral norms governing our actions in relation to the beings in the world are rooted in the nature and value of those things. Second, on the background of John Paul II's idea that "the body is the person," this article brings to light a type of bodily act (which I call an "embodying act") that is not only bodily, but one that forms an organic union with an act of the spirit. Finally, we examine here the nature of love as consisting of two dimensions: of mutual self-giving as well as the fruitfulness arising from mutual self-gift. The analysis of "embodying acts" together with the analysis of love will be crucial for arriving at one of the main conclusions in Part II, namely, that the Church's moral norms governing the use of the spousal act are not grounded in the biological structure of sex, but in the laws of love.

为了回应教皇约翰·保罗二世的呼吁,给出教会性道德教学背后的“伦理依据和个人化原因”,这篇长达两篇文章的反思从个人化的角度分析了与人类性行为相关的自然法规范。这项研究的关键思想来自两段:一段来自Gaudium et spes,其中指出“人的性特征和人类的繁殖能力远远超过了低级生活形式的倾向”,另一个来自Humanae vitae,他说:“夫妻之爱揭示了它的真实本质和高贵,当它被认为是至高无上的起源时,上帝,谁是爱……对这些有一个确切的想法是极其重要的。”第一部分概述了自然法理论,解释了自然法不是任意的,而是说,支配我们与世界上存在的人的行为的道德规范植根于这些事物的性质和价值。其次,在约翰·保罗二世“身体就是人”思想的背景下,本文揭示了一种身体行为(我称之为“体现行为”),这种行为不仅是身体的,而且与精神行为形成有机结合。最后,我们在这里考察爱的本质,它由两个维度组成:相互的自我给予以及由相互的自我赠与产生的结果。对“具体行为”的分析以及对爱的分析对于得出第二部分的主要结论之一至关重要,即教会关于配偶行为使用的道德规范不是基于性的生物结构,而是基于爱的法律。
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引用次数: 0
The Crumbs 面包屑的
Q2 Arts and Humanities Pub Date : 2023-11-03 DOI: 10.1177/00243639231210208
Benjamin W. Frush
Contemporary medicine strains our ability as practitioners to attend adequately to the patients we serve in their moments of need. The account of Jesus’ interaction with the Canaanite woman depicted in the gospel of Matthew offers a vision of patience, humility, and kindness that we as time and resource-stretched practitioners might emulate when faced with such challenges.
当代医学使我们作为医生在病人需要的时候充分照顾他们的能力变得紧张。马太福音中描述的耶稣与迦南妇人的互动,提供了一个耐心、谦卑和善良的愿景,我们作为时间和资源紧张的从业者,在面对这样的挑战时可能会效仿。
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引用次数: 0
Some Ethical Reflections on AIDS 关于艾滋病的伦理思考
Q2 Arts and Humanities Pub Date : 2023-11-01 DOI: 10.1177/00243639231200633
Michael LaChat
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引用次数: 0
Mifepristone Antagonization with Progesterone to Avert Medication Abortion: A Scoping Review. 米非司酮与黄体酮拮抗剂避免药物流产:一项范围综述。
IF 0.5 Q2 Arts and Humanities Pub Date : 2023-11-01 Epub Date: 2023-05-29 DOI: 10.1177/00243639231176592
Paul L C DeBeasi

The safety and efficacy of mifepristone antagonization with progesterone to avert medication abortion, also known as abortion pill rescue, is a subject of vigorous debate. Two prominent medical associations have taken positions that either entirely reject or fully support its use. This scoping review aimed to gain insight into the safety and efficacy of its use. Analysis of 16 studies showed that the continuing pregnancy rate after ingesting mifepristone alone is ≦25 percent for gestational ages ≦49 days. Analysis of four studies showed that two-thirds of the women who changed their minds and received progesterone after initiating their medication abortion with mifepristone could safely continue their pregnancies. There is no increased maternal or fetal risk from using bioidentical progesterone in early pregnancy. If a woman has already taken mifepristone for her medication abortion and then changes her mind, timely supplementation with progesterone may allow her pregnancy to continue. The conclusion that mifepristone antagonization with progesterone is a safe and effective treatment has implications for medication abortion informed consent. Summary: Two-thirds of the women who changed their minds and received progesterone after initiating their medication abortion with mifepristone could safely continue their pregnancies. If a woman has already taken mifepristone for her medication abortion and then changes her mind, timely supplementation with progesterone may allow her pregnancy to continue. Physicians should disclose this treatment option to their patients at the time of informed consent.

米非司酮与黄体酮拮抗避免药物流产的安全性和有效性,也被称为流产药抢救,是一个激烈争论的主题。两个著名的医学协会采取了完全反对或完全支持使用这种药物的立场。这项范围审查旨在深入了解其使用的安全性和有效性。16项研究分析显示,孕龄≦49天,单独服用米非司酮后继续妊娠率≦25%。对四项研究的分析表明,三分之二的妇女在开始使用米非司酮进行药物流产后改变主意并接受黄体酮治疗,可以安全地继续怀孕。在妊娠早期使用生物同型黄体酮不会增加母体或胎儿的风险。如果妇女已经服用米非司酮进行药物流产,然后改变主意,及时补充黄体酮可能使她的妊娠继续。结论米非司酮与黄体酮拮抗是一种安全有效的治疗方法,对药物流产知情同意具有重要意义。总结:三分之二的妇女在开始米非司酮药物流产后改变主意并接受黄体酮治疗后可以安全地继续妊娠。如果妇女已经服用米非司酮进行药物流产,然后改变主意,及时补充黄体酮可能使她的妊娠继续。医生应在知情同意时向患者披露这种治疗方案。
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引用次数: 0
Physician Ownership for the Virtuous Practice of Medicine. 医师所有权促进医学的良性实践
IF 0.4 Q4 MEDICAL ETHICS Pub Date : 2023-11-01 Epub Date: 2023-07-27 DOI: 10.1177/00243639231190133
Brandon Joa

The shift from physicians as owners or shareholders of practices to being employees of corporations is now a widespread trend with over 50% of physicians now considered employees. If continued, this trend will have profound effects on the medical profession and on physicians' personal lifestyles and sense of agency. However, ownership is not a morally neutral consideration but is important for safeguarding the traditions of virtue in the medical profession. Virtue develops within localized communities of practice and thrives in settings that embody principles such as solidarity, subsidiarity, and participation found in Catholic social teaching. Ownership increases physicians' investment in moral communities where they practice, affording physicians greater agency to benefit these communities according to their best judgment. This ownership can vary by type of organization and degree of shareholding. Because moral communities are the settings in which physicians form virtue, and ownership increases physicians' commitment and investment in communities, I make a principled argument that physicians who value developing virtue should consider having ownership of their practices when planning their careers. Ownership will be an important aspect of any medical ethics based on virtue rather than on principlism.

从医生作为诊所的所有者或股东转变为公司的员工现在是一种普遍的趋势,超过50%的医生现在被视为员工。如果继续下去,这一趋势将对医疗行业、医生的个人生活方式和代理意识产生深远影响。然而,所有权不是一个道德中立的考虑因素,但对于维护医学界的美德传统很重要。美德在当地的实践社区中发展,并在体现天主教社会教学中的团结、辅助和参与等原则的环境中蓬勃发展。所有权增加了医生对执业道德社区的投资,为医生提供了更大的代理权,根据他们的最佳判断使这些社区受益。这种所有权可能因组织类型和持股程度而异。因为道德社区是医生形成美德的环境,所有权增加了医生对社区的承诺和投资,我提出了一个原则性的论点,即重视发展美德的医生在规划职业生涯时应该考虑对自己的实践拥有所有权。所有权将是任何基于美德而非原则的医学伦理的一个重要方面。
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引用次数: 0
Coronavirus Disease Vaccination Among Persons With Disabilities: Understanding Vaccine Perceptions and Hesitancy in Ghana. 在残疾人中接种冠状病毒疫苗:了解加纳对疫苗的看法和犹豫
IF 0.4 Q4 MEDICAL ETHICS Pub Date : 2023-11-01 Epub Date: 2023-06-07 DOI: 10.1177/00243639231178626
Maxwell Peprah Opoku, Shashidhar Belbase, Fred Adusei Nsowah, Kwame Yeboah, William Nketsia, Ahmed Mohamed, Elvis Agyei-Okyere, Michael Amponteng, Reuben Saah, Mohammed Safi

The effects of coronavirus disease 2019 (COVID-19) have been felt globally and in all spheres of life. Developing vaccines was an important milestone in ensuring the protection of lives, but there are concerns about vaccine availability in sub-Saharan African (SSA) countries. The living conditions of persons with disabilities, in particular, in SSA societies have been described as deplorable and unsustainable, and they are at risk of discrimination. Such persons appear to be already struggling to obtain other basic services, and the extent of vaccine accessibility to this population remains unknown. This study aimed to assess the perceptions of persons with disabilities in Ghana of COVID-19 vaccines. Between July 2021 and December 2021, 336 persons with disabilities (hearing, visual, and physical) were recruited from two regions in Ghana. The attitude toward the COVID-19 vaccination scale was adapted for this study. The results showed that persons with disabilities were ambivalent toward vaccination, and differences were observed between participant groups. The background variables found to influence attitude were age, place of residence, educational qualification, gender, and COVID-19 acquisition status. The study concludes with a clarion call to policymakers to expedite public education for persons with disabilities.

2019年冠状病毒病(COVID-19)的影响已经波及全球和生活的各个领域。研制疫苗是确保保护生命的一个重要里程碑,但人们对撒哈拉以南非洲国家的疫苗供应感到关切。残疾人的生活条件,特别是特别福利社会的残疾人的生活条件,被描述为可悲和不可持续的,他们有受到歧视的危险。这些人似乎已经在努力获得其他基本服务,这些人获得疫苗的程度仍然未知。本研究旨在评估加纳残疾人对COVID-19疫苗的看法。在2021年7月至2021年12月期间,从加纳的两个地区招募了336名残疾人(听力、视觉和身体)。对COVID-19疫苗接种量表的态度适用于本研究。结果表明,残疾人对疫苗接种的态度是矛盾的,并且在参与者群体之间观察到差异。影响态度的背景变量包括年龄、居住地、教育程度、性别和COVID-19感染状况。研究报告最后呼吁政策制定者加快对残疾人的公共教育。
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引用次数: 0
Corporate Moral Responsibility, Distributive Justice, the Common Good, and Catholic Social Teaching: The Case of Gilead Sciences and Remdesivir. 企业道德责任、分配正义、公益与天主教社会教学——以吉利德科学和瑞德西韦为例
IF 0.5 Q2 Arts and Humanities Pub Date : 2023-11-01 Epub Date: 2022-08-22 DOI: 10.1177/00243639221116216
Ivencio Ballano

Applying the moral principles of Catholic social teaching's (CST) on capitalism, distributive justice, private ownership, the common good, and the role of the state in the economy as the overall theoretical framework and utilizing secondary data, media reports, and scientific literature, this article explores the corporate moral responsibility of the top drug makers in the ownership and pricing of their essential medicines and COVID-19 vaccines. Specifically, it presents the case of the Gilead Sciences' business strategies and overpricing of Remdesivir drug to illustrate how predatory capitalism undermines the moral responsibility of drug makers and CST's moral principle on the common good in today's pandemic. Distributive justice requires that the publicly funded and developed medicines and vaccines should be priced and distributed fairly to promote the common good and prevent the public from "paying twice" for these essential medicines. Given the public character of these medicines and the demands of social justice, the price of Remdesivir and other essential medicines of Gilead Sciences and Big Pharma for COVID-19 could have been lower than what was officially announced. Ultimately, these medicines could have been made global public health goods in accordance with CST's doctrines on distributive justice, the common good, and the social dimension of private ownership.

将天主教社会教学(CST)关于资本主义、分配正义、私有制、共同利益和国家在经济中的作用的道德原则作为整体理论框架,并利用二手数据、媒体报道和科学文献,本文探讨了顶级制药商在其基本药物和新冠肺炎疫苗的所有权和定价方面的企业道德责任。具体而言,它介绍了吉利德科学公司的商业战略和瑞德西韦药物定价过高的案例,以说明掠夺性资本主义如何破坏制药商的道德责任,以及CST在当今疫情中对共同利益的道德原则。分配正义要求公共资助和开发的药物和疫苗应公平定价和分配,以促进共同利益,防止公众为这些基本药物“支付两次费用”。鉴于这些药物的公共性质和社会正义的要求,瑞德西韦和吉利德科学公司和大型制药公司治疗新冠肺炎的其他基本药物的价格可能低于官方宣布的价格。最终,根据科技委关于分配正义、共同利益和私有制的社会层面的理论,这些药物本可以成为全球公共卫生产品。
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引用次数: 0
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Linacre Quarterly
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