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Ethical Relativism and Circumstances of Social and Cultural Contingencies on Informed Consent in the Conduct of Research: Clinical Trials in Nigeria 伦理相对主义与研究中知情同意的社会和文化偶然情况:尼日利亚的临床试验
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-10-13 DOI: 10.1007/s41649-022-00223-4
Sola Aluko-Arowolo, Saheed Akinmayọwa Lawal, Isaac A. Adedeji, Stephen Nwaobilor

There have been debates across the globe for a social and culturally sensitive ethics to meditate a catalyst of template for informed consent (IC) in the conduct of social researches and clinical trial. The study adopted ethical relativism theory to explore social and cultural contingencies on IC with descriptive research design and snowball sampling techniques with a pool of 23 participants randomly and purposively selected amongst the stakeholders including researchers. Seven lecturers and 5 medical practitioners from selected universities, 5 clergy members of different genders and denominations with 2 Imams, 1 chief and 2 traditional health practitioners completing the pool. The data were compiled separately with pseudonym to maintain the anonymity of the participants and content analysed thematically to probe awareness, understanding, patriarchy and religious dimensions on IC. The paper argued that ethics and law regulations must be strengthened to leverage on different individual values, norms and social indices. The paper concluded and suggested that researchers can avoid and resolve ethical dilemmas and maintain research regularity when ethical obligations are well understood and strictly adhered to, and to develop the Informed Consent Evaluation Feedback Tool (ICEFbT) with oversight function from Institution Review Board (IRB) in the universities and research institutes before the commencement of research and/or medical procedures.

在进行社会研究和临床试验时,全球范围内一直在争论一种对社会和文化敏感的伦理,以思考知情同意模板(IC)的催化剂。该研究采用伦理相对主义理论,通过描述性研究设计和滚雪球抽样技术,从包括研究人员在内的利益相关者中随机选择23名参与者,探讨IC的社会和文化偶然性。来自选定大学的7名讲师和5名医生、5名不同性别和教派的神职人员、2名伊玛目、1名首席执行官和2名传统卫生从业者组成了该团队。数据是用假名单独汇编的,以保持参与者的匿名性,内容按主题分析,以探究IC的意识、理解、父权制和宗教维度。论文认为,必须加强道德和法律法规,以利用不同的个人价值观、规范和社会指标。论文总结并建议,当充分理解并严格遵守伦理义务时,研究人员可以避免和解决伦理困境,保持研究的规律性,以及在研究和/或医疗程序开始之前,在大学和研究机构开发具有机构审查委员会监督职能的知情同意评估反馈工具。
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引用次数: 3
Assisted Reproductive Technologies: Comparing Abrahamic Monotheistic Religions 辅助生殖技术:亚伯拉罕一神论宗教比较
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-10-06 DOI: 10.1007/s41649-022-00224-3
Md Shaikh Farid, Sumaia Tasnim

The impact of culture and religion on sexual and reproductive health and behavior has been a developing area of study in contemporary time. Therefore, it is crucial for people using reproductive procedures to understand the religious and theological perspectives on issues relating to reproductive health. This paper compares different perspectives of three Abrahamic faiths, i.e., Judaism, Christianity, and Islam on ARTs. Procreation, family formation, and childbirth within the context of marriage have all been advocated by these three major religions of the world. Judaism permits the use of all assisted reproductive technologies when the oocyte and sperm come from the husband and wife, respectively. The different denominations of Christianity have diverse views on reproductive practices. Although the Vatican does not approve of assisted reproduction, Protestant, Anglican, and other religious groups are free to use it. ARTs are acceptable in Sunni Islam, although they can only be carried out if the couples are married. Shia Islam, however, permits third-party donations to married couples under specific restrictions. This comparison reveals that while the three major world religions utilize assisted reproduction in distinct ways, there are also many comparable aspects of each religion.

文化和宗教对性健康和生殖健康及行为的影响一直是当代研究的一个发展领域。因此,对于使用生殖程序的人来说,了解与生殖健康相关问题的宗教和神学观点至关重要。本文比较了犹太教、基督教和伊斯兰教三种亚伯拉罕信仰对ARTs的不同看法。世界上这三大宗教都提倡在婚姻背景下生育、组建家庭和生育。当卵母细胞和精子分别来自丈夫和妻子时,犹太教允许使用所有辅助生殖技术。基督教的不同教派对生殖习俗有不同的看法。尽管梵蒂冈不批准辅助生殖,但新教、圣公会和其他宗教团体可以自由使用。在逊尼派伊斯兰教中,辅助生殖是可以接受的,尽管只有在夫妇结婚的情况下才能进行。然而,什叶派伊斯兰教在特定限制下允许第三方向已婚夫妇捐款。这种比较表明,虽然世界三大宗教以不同的方式利用辅助生殖,但每种宗教也有许多可比较的方面。
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引用次数: 1
The Surrogacy (Regulation) Act, 2021: A Critique 《代孕(监管)法》,2021:一篇评论
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-20 DOI: 10.1007/s41649-022-00222-5
Soumya Kashyap, Priyanka Tripathi

In vitro fertilization (IVF) and surrogacy have enabled many to achieve their dreams of parenthood. With a turnover of $500 million, reproductive tourism in India has helped transform the country into a “global baby factory.” However, as the surrogacy industry grew, so did concerns of women’s exploitation, commodification of motherhood, and human rights violations. In an effort to prevent women from being exploited, the Indian government had taken successive administrative measures to regulate surrogacy. The Surrogacy (Regulation) Bill, 2016 and Assisted Reproductive Technologies Bill 2008 were introduced in the Parliament to regulate various aspects of surrogacy arrangements. Yet, it was not until 25 January 2022, that the Surrogacy (Regulation) Act, 2021 went into effect. The Act does, however, leave certain important points unaddressed. The article claims that the legislation’s purposeful exclusion of the LGBTQ population and emphasis on “familial altruism” stinks of inequity and moral conservatism. It also delineates the mechanics of altruistic surrogacy by examining documents that illustrate how the connections between money and morality are framed via the framing of altruism. The article therefore demands that a comprehensive dialogue must be held considering the socio-economic realities of Indian society, or else India risks enacting yet another law that cannot be implemented or that society dislikes.

体外受精(IVF)和代孕使许多人实现了为人父母的梦想。印度的生殖旅游业营业额达5亿美元,帮助该国转变为“全球婴儿工厂”。然而,随着代孕行业的发展,人们对女性剥削、母亲商品化和侵犯人权的担忧也随之而来。为了防止妇女受到剥削,印度政府采取了一系列行政措施来规范代孕行为。议会提出了《2016年代孕(监管)法案》和《2008年辅助生殖技术法案》,以监管代孕安排的各个方面。然而,直到2022年1月25日,《2021年代孕(监管)法》才生效。然而,该法案确实没有解决某些重要问题。文章声称,该立法有目的地排斥LGBTQ人群,并强调“家庭利他主义”,这充满了不公平和道德保守主义的味道。它还通过研究一些文件来描述利他主义代孕的机制,这些文件说明了金钱和道德之间的联系是如何通过利他主义的框架来构建的。因此,该条款要求必须考虑到印度社会的社会经济现实进行全面对话,否则印度可能会颁布另一项无法实施或社会不喜欢的法律。
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引用次数: 3
Applying Two-level Utilitarianism and the Principle of Fairness to Mandatory Vaccination during the COVID-19 Pandemic: the Situation in South Korea 新冠肺炎疫情期间两级效用主义和公平原则在强制接种中的应用——韩国情况
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-20 DOI: 10.1007/s41649-022-00221-6
Sungjin Park

In response to the COVID-19 pandemic, Korean society has sought to vaccinate most of its population. Consequently, the Korean government has attempted to make vaccination compulsory by promoting awareness of its benefits. The administration has pushed for mandatory vaccination by claiming that vaccination is more beneficial than harmful, based on a utilitarian view. However, this view is difficult to justify based on the two levels of utilitarianism presented by R. M. Hare. Compulsory vaccination cannot satisfy the universalizability, nor the satisfaction of preference, and exposes the difficulties of utilitarianism. In addition, mandatory vaccination is difficult to justify based on the perspective of fairness theory, that is, “justice as the fairness” of John Rawls and H. L. A. Hart’s principle of fairness. From the point of view of Hare’s utilitarianism and fairness theory, it has been shown that mandatory vaccination is not easily justified. In reality, the power of the state continues to strengthen, and we should examine this situation from a critical point of view.

为应对新冠肺炎疫情,韩国社会已寻求为大部分人口接种疫苗。因此,韩国政府试图通过提高人们对疫苗益处的认识来强制接种疫苗。政府基于功利主义的观点,声称接种疫苗是有益的,而不是有害的,从而推动了强制性疫苗接种。然而,基于R·M·黑尔提出的两个层次的功利主义,这种观点很难被证明是合理的。强制接种既不能满足普遍性,也不能满足偏好,暴露出功利主义的困境。此外,基于公平理论的观点,即约翰·罗尔斯和H.L.A.哈特的公平原则的“公平即正义”,强制接种疫苗是很难证明的。从黑尔的功利主义和公平理论的角度来看,强制接种疫苗并不容易。事实上,国家的权力在不断加强,我们应该从批判的角度来审视这种情况。
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引用次数: 1
Is the Cure Worse than the Disease? The Ethics of Imposing Risk in Public Health 治愈比疾病更糟糕吗?公共卫生中的风险伦理
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-10 DOI: 10.1007/s41649-022-00218-1
Diego S. Silva, Maxwell J. Smith

Abstract

Efforts to improve public health, both in the context of infectious diseases and non-communicable diseases, will often consist of measures that confer risk on some persons to bring about benefits to those same people or others. Still, it is unclear what exactly justifies implementing such measures that impose risk on some people and not others in the context of public health. Herein, we build on existing autonomy-based accounts of ethical risk imposition by arguing that considerations of imposing risk in public health should be centered on a relational autonomy and relational justice approach. Doing so better captures what makes some risk permissible and others not by exploring the importance of power and context in such deliberations. We conclude the paper by applying a relational account of risk imposition in the cases of (a) COVID-19 measures and (b) the regulation of sugar-sweetened beverages to illustrate its explanatory power.

摘要在传染病和非传染病的背景下,改善公共卫生的努力往往包括采取措施,使一些人面临风险,为这些人或其他人带来好处。尽管如此,在公共卫生的背景下,实施这些给一些人带来风险而不是给其他人带来风险的措施的确切理由尚不清楚。在此,我们在现有的基于自主性的道德风险施加解释的基础上,认为在公共卫生中施加风险的考虑应该以关系自主和关系正义的方法为中心。通过探索权力和背景在此类审议中的重要性,这样做可以更好地捕捉到允许一些风险和不允许其他风险的原因。最后,我们在(a)新冠肺炎措施和(b)含糖饮料监管的情况下应用了风险施加的关系描述,以说明其解释力。
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引用次数: 0
Report on the Establishment of the Consortium for Hospital Ethics Committees in Japan and the First Collaboration Conference of Hospital Ethics Committees 关于在日本成立医院伦理委员会联合会和第一届医院伦理委员会合作会议的报告
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-06 DOI: 10.1007/s41649-022-00219-0
Kei Takeshita, Noriko Nagao, Hiroyuki Kaneda, Yasuhiko Miura, Takanobu Kinjo, Yoshiyuki Takimoto

Hospital ethics committees (HECs) are expected to play extremely broad and pivotal roles such as case consultation, education of staffs on healthcare ethics, and institutional policy formation. Despite the growing importance of HECs, there are no standards for setup and operation of HECs, and composition and activities of HECs at each institution are rarely disclosed in Japan. In addition, there is also a lack of information sharing and collaboration among HECs. Therefore, the authors established the Consortium ofHospital Ethics Committees (CHEC) in October 2020, which has been regularly hosting a couple of core activities. One is the Healthcare Ethics Forum, held monthly online for CHEC members to freely discuss HECs and healthcare ethics consultation. The other is the Collaboration Conference of Hospital Ethics Committees, intended to provide a place for HEC members and administrative officers from across Japan to exchange information of their HECs, learn from each other, and cooperate to operate HECs appropriately.In this paper, the authors introduced CHEC as well as reported the results of a questionnaire survey conducted at the first conference among participating facilities, suggesting the diverse structures and activities of HECs in Japan.

医院道德委员会(HEC)预计将发挥极其广泛和关键的作用,如病例咨询、员工医疗道德教育和机构政策制定。尽管HEC的重要性日益增加,但HEC的设立和运营并没有标准,日本也很少披露各机构HEC的组成和活动。此外,HEC之间也缺乏信息共享和协作。因此,作者于2020年10月成立了医院伦理委员会联合会(CHEC),该联合会定期举办一些核心活动。一个是医疗伦理论坛,每月在线举行,CHEC成员可以自由讨论HEC和医疗伦理咨询。另一个是医院伦理委员会合作会议,旨在为来自日本各地的HEC成员和行政官员提供一个交流HEC信息、相互学习和合作以适当运营HEC的场所。在本文中,作者介绍了CHEC,并报告了在第一次会议上对参与机构进行的问卷调查结果,表明日本HEC的结构和活动多种多样。
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引用次数: 2
Making Meaning in Bioethics 在生命伦理学中创造意义
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-06 DOI: 10.1007/s41649-022-00220-7
Graeme T. Laurie
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引用次数: 0
Conception of Saviour Siblings: Religious Views in Malaysia 救世主兄弟的概念:马来西亚的宗教观点。
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-09-03 DOI: 10.1007/s41649-022-00216-3
Chee Ying Kuek, Sharon Kaur a/p Gurmukh Singh

The advancement of human reproductive technology has made it possible for parents with a child affected by a haematological disorder to select and bring into being, a prospective child who can act as a matched stem cell donor. This can be done through the use of preimplantation genetic diagnosis (PGD) coupled with human leukocyte antigen (HLA) typing (PGD-HLA typing), or HLA tying as a standalone procedure, where a healthy embryo, which is an HLA match to the existing sick sibling, is chosen for implantation. The creation of such a sibling (saviour sibling) is normally taken as a last resort when there is no related or unrelated matched donor. While the conception of a saviour sibling may serve as a reliable and realistic treatment option for the ailing child, it also poses new moral questions that challenge a religiously pluralistic society such as Malaysia. The use of PGD-HLA typing may be controversial as it involves creating a life to save a life, selection of compatible human embryos and destruction of the unselected embryos. At present, there is no legal framework regulating the conception of saviour siblings. The development of ethically sound and appropriate local laws and policies should consider the views of religious communities, especially when it involves a controversial subject such as the conception of saviour siblings. This article seeks to explore the perceptions of religious scholars and representatives of the major religions professed and practised in Malaysia, namely Islam, Buddhism, Christianity and Hinduism, through qualitative interviews.

人类生殖技术的进步使有孩子患有血液病的父母有可能选择并产生一个可以作为匹配干细胞捐献者的潜在孩子。这可以通过使用植入前基因诊断(PGD)结合人类白细胞抗原(HLA)分型(PGD-HLA分型)或HLA结合作为一个独立的程序来实现,其中选择与现有患病兄弟姐妹HLA匹配的健康胚胎进行植入。当没有相关或不相关的匹配捐赠者时,创建这样一个兄弟姐妹(救世主兄弟姐妹)通常是最后的手段。虽然救世主兄弟姐妹的概念可能是生病孩子的可靠和现实的治疗选择,但它也提出了新的道德问题,挑战了马来西亚这样的宗教多元化社会。PGD-HLA分型的使用可能会引起争议,因为它涉及创造生命来拯救生命、选择相容的人类胚胎和破坏未选择的胚胎。目前,还没有一个法律框架来规范救世主兄弟姐妹的概念。制定符合道德规范和适当的地方法律和政策时,应考虑宗教团体的意见,尤其是当涉及到诸如救世主兄弟姐妹概念等有争议的主题时。本文试图通过定性访谈,探讨宗教学者和马来西亚主要宗教(即伊斯兰教、佛教、基督教和印度教)代表的看法。
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引用次数: 0
The Status of ‘Mother’ in Gestational Surrogacy: the Shiʿi Jurisprudential Perspective “母亲”在代孕中的地位:什叶派法学视角。
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-08-31 DOI: 10.1007/s41649-022-00217-2
Saeid Nazari Tavakkoli

Abstract

Shiʿi jurists have three different theories with regard to gestational surrogacy and who should be recognized as the mother of the newborn: (1) the surrogate mother (2) or the ovum provider (biological mother) (3) or both of them. The religious law (al-Aḥkam al-sharʿi) regarding the title of ‘mother’ and issues such as inheritance, will (Waṣiya), marriage, and custody have been discussed by Shiʿi jurists but no exact definition of this term has been provided by them. Because the fertilized ovum is considered the origin of humans and the formation of an embryo also determines the kinship of the newborn, the mother of the child is the woman that fetus created by her ovum. It is this woman who has all the rights and responsibilities of a mother; even if the surrogate mother is considered the mother of the child, she has no rights over the child nor does she have any duties towards him/her.

什叶派法学家对妊娠代孕和谁应该被承认为新生儿的母亲有三种不同的理论:(1)代孕母亲(2)或卵子提供者(生母)(3)或两者兼而有之。宗教法ḥKamal-shar’i)关于“母亲”的头衔和继承、遗嘱等问题(Waṣiya)、婚姻和监护权的问题已经被什叶派法学家讨论过,但他们没有提供这个术语的确切定义。因为受精卵被认为是人类的起源,胚胎的形成也决定了新生儿的亲缘关系,所以孩子的母亲是胎儿通过卵子创造的女人。正是这个女人拥有母亲的所有权利和责任;即使代孕母亲被认为是孩子的母亲,她对孩子没有任何权利,也对他/她没有任何义务。
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引用次数: 0
Ongoing Commercialization of Gestational Surrogacy due to Globalization of the Reproductive Market before and after the Pandemic 由于疫情前后生殖市场的全球化,妊娠代孕正在进行商业化
IF 2.9 Q1 Arts and Humanities Pub Date : 2022-08-18 DOI: 10.1007/s41649-022-00215-4
Yuri Hibino

Abstract

Surrogacy tourism in Asian countries has surged in recent decades due to affordable prices and favourable regulations. Although it has recently been banned in many countries, it is still carried out illegally across borders. With demand for surrogacy in developed countries increasing and economically vulnerable Asian women lured by lucrative compensation, there are efforts by guest countries to ease the strict surrogacy regulations in host countries. Despite a shift toward “altruistic surrogacy”, commercial surrogacy persists. Recent research carried out by international organizations that seek to establish a legal relationship between the commissioning parents and children in cross-border surrogacy arrangements, under the guise of the “best interests of the child,” appears to promote a resurgence of overseas commercial surrogacy rather than restrict it. Further commercialization of surrogacy should be prevented by carefully investigating the reality of the surrogacy process.

近几十年来,亚洲国家的代孕旅游由于价格实惠和优惠的法规而激增。尽管它最近在许多国家被禁止,但它仍然是非法越境进行的。随着发达国家对代孕的需求不断增加,经济弱势的亚洲女性受到利润丰厚的补偿的诱惑,东道国正在努力放宽东道国严格的代孕规定。尽管向“无私代孕”转变,商业代孕仍然存在。国际组织最近进行的研究试图在跨境代孕安排中,以“儿童的最大利益”为幌子,在委托父母和儿童之间建立法律关系,这似乎促进了海外商业代孕的复兴,而不是限制它。应通过仔细调查代孕过程的现实情况来防止代孕的进一步商业化。
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引用次数: 3
期刊
Asian Bioethics Review
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