Kennedy Institute of Ethics Journal最新文献

Racial disparities in pain treatment are well documented. Such disparities are explained with reference to factors related to providers, health care structures, and patient behaviors. Racial differences in pain experiences, although well documented, are less well understood. Explanations for such differences usually involve genetic or psychological factors. Here, we argue that racial differences in pain experiences might also be explained by disparities in pain treatment. Based on what we know about the nature of pain, particularly the cognitive and affective aspects of the phenomenon, it is likely that disparities in the treatment of racialized patients can lead to significant racial differences in pain experience that show up at the population level. We argue that the failure of research programs to consider this causal factor is an example of white ignorance. We also consider several implications of the link between racial disparities in pain treatment and racial differences in pain experience.

An emerging line of research in bioethics questions whether enhanced love is less significant or valuable than otherwise, where "enhanced love" generally refers to cases where drugs (e.g., oxytocin, etc.) are relied on to maintain romantic relationships. Separate from these debates is a recent body of literature on the philosophy and psychology of "Virtual Reality (VR) dating," where romantic relationships are developed and sustained in a way that is mediated by VR. Interestingly, these discussions have proceeded largely independently from each other. This article considers whether and to what extent philosophical arguments leveled against the value of enhanced love in the pharmacological case extend to cases where loving relationships are technologically mediated via VR rather than pharmacologically mediated. It will be argued that, while some worries about the pharmacological case do not extend over in a way that will be particularly problematic for VR, two (of the four arguments considered) are more prima facie serious. I conclude by suggesting why even these stronger argument strategies are not insurmountable and, thus, that there is reason to be cautiously optimistic that VR-mediated love can largely withstand variations on the bioconservative critiques that target pharmacologically enhanced love.

In this article, I argue that adolescent medical transition is ethical by analogizing it to abortion and birth control. The interventions are similar insofar as they intervene on healthy physiological states by reason of the person's fundamental self-conception and desired life, and their effectiveness is defined by their ability to achieve patients' embodiment goals. Since the evidence of mental health benefits is comparable between adolescent medical transition, abortion, and birth control, disallowing transition-related interventions would betray an unacceptable double standard. While great enough risks can override autonomy over fundamental aspects of personal identity, I demonstrate that the available scientific evidence does not corroborate the view that adolescent medical transition is dangerous. Consequently, adolescent medical transition should be recognized as ethical and remain available.

While the literature on psychedelic medicine emphasizes the importance of set and setting alongside the quality of subjective drug effects for therapeutic efficacy, few scholars have explored the therapeutic frameworks that are used alongside psychedelics in the lab or in the clinic. Based on a narrative analysis of the treatment manual and post-session experience reports from a pilot study of psilocybin-assisted treatment for tobacco smoking cessation, this article examines how therapeutic frameworks interact with the psychedelic substance in ways that can rapidly reshape participants' identity and sense of self. We identified multiple domains relating to identity shift that appear to serve as smoking cessation mechanisms during psilocybin sessions, each of which had an identifiable presence in the manualized treatment. As psychedelic medicine becomes mainstream, consensual and evidence-based approaches to psychedelic-assisted identity shift that respect patient autonomy and encourage empowerment should become areas of focus in the emergent field of psychedelic bioethics.