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Building an Opt-Out Model for Service-Level Consent in the Context of New Data Regulations. 在新数据法规的背景下建立服务级同意的选择退出模型。
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-07-01 DOI: 10.1093/phe/phab030
A R Howarth, C S Estcourt, R E Ashcroft, J A Cassell

The General Data Protection Regulation (GDPR) was introduced in 2018 to harmonize data privacy and security laws across the European Union (EU). It applies to any organization collecting personal data in the EU. To date, service-level consent has been used as a proportionate approach for clinical trials, which implement low-risk, routine, service-wide interventions for which individual consent is considered inappropriate. In the context of public health research, GDPR now requires that individuals have the option to choose whether their data may be used for research, which presents a challenge when consent has been given by the clinical service and not by individual service users. We report here on development of a pragmatic opt-out solution to this consent paradox in the context of a partner notification intervention trial in sexual health clinics in the UK. Our approach supports the individual's right to withhold their data from trial analysis while routinely offering the same care to all patients.

《通用数据保护条例》(GDPR)于2018年出台,旨在协调整个欧盟(EU)的数据隐私和安全法律。它适用于在欧盟收集个人数据的任何组织。迄今为止,服务水平的同意已被用作临床试验的比例方法,这些临床试验实施低风险、常规、全服务范围的干预措施,个人同意被认为是不合适的。在公共卫生研究的背景下,GDPR现在要求个人有权选择是否将其数据用于研究,这在临床服务而不是个人服务用户同意的情况下提出了挑战。我们在这里报告在英国性健康诊所的合作伙伴通知干预试验的背景下,这种同意悖论的务实选择退出解决方案的发展。我们的方法支持个人对试验分析保留数据的权利,同时为所有患者提供常规的相同护理。
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引用次数: 2
Academic and community hernia center websites in the United States fail to meet healthcare literacy standards of readability. 美国的学术和社区疝气中心网站在可读性方面不符合医疗保健扫盲标准。
IF 2.3 3区 哲学 Q2 ETHICS Pub Date : 2022-06-01 Epub Date: 2022-03-27 DOI: 10.1007/s10029-022-02584-z
S Docimo, K Seeras, R Acho, A Pryor, K Spaniolas

Background: Health literacy is considered the single best predictor of health status. Organizations including the American Medical Association (AMA) and the National Institutes of Health (NIH) have recommended that the readability of patient education materials not exceed the sixth-grade level. Our study focuses on the readability of self-designated hernia centers websites at both academic and community organizations across the United States to determine their ability to dispense patient information at an appropriate reading level.

Methods: A search was conducted utilizing the Google search engine. The key words "Hernia Center" and "University Hernia Center" were used to identify links to surgical programs within the United States. The following readability tests were conducted via the program: Flesch-Kincaid Grade Level (FKGL), Gunning Fox Index (GFI), Coleman-Liau Index (CLI), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) score.

Results: Of 96 websites, zero (0%) had fulfilled the recommended reading level in all four tests. The mean test scores for all non-academic centers (n = 50) were as follows: FKGL (11.14 ± 2.68), GFI (14.39 ± 3.07), CLI (9.29 ± 2.48) and SMOG (13.38 ± 2.03). The mean test scores [SK1] for all academic programs (n = 46) were as follows: FKGL (11.7 ± 2.66), GFI (15.01 ± 2.99), CLI (9.34 ± 1.91) and SMOG (13.71 ± 2.02). A one-sample t test was performed to compare the FKGL, GFI, CLI, and SMOG scores for each hernia center to a value of 6.9 (6.9 or less is considered an acceptable reading level) and a p value of 0.001 for all four tests were noted demonstrating statistical significance. The Academic and Community readability scores for both groups were compared to each other with a two-sample t test with a p value of > 0.05 for all four tests and there were no statistically significant differences.

Conclusion: Neither Academic nor Community hernia centers met the appropriate reading level of sixth-grade or less. Steps moving forward to improve patient comprehension and/or involving with their care should include appropriate reading level material, identification of a patient with a low literacy level with intervention or additional counseling when appropriate, and the addition of adjunct learning materials such as videos.

背景:健康素养被认为是预测健康状况的最佳指标。美国医学会(AMA)和美国国立卫生研究院(NIH)等组织建议,患者教育材料的可读性不应超过六年级水平。我们的研究重点是美国学术机构和社区组织中自我指定的疝气中心网站的可读性,以确定它们是否有能力以适当的阅读水平提供患者信息:方法:使用谷歌搜索引擎进行搜索。方法:利用谷歌搜索引擎进行搜索,使用关键词 "疝气中心 "和 "大学疝气中心 "来查找美国的手术项目链接。通过该程序进行了以下可读性测试:Flesch-Kincaid Grade Level (FKGL)、Gunning Fox Index (GFI)、Coleman-Liau Index (CLI)、Simple Measure of Gobbledygook (SMOG) 和 Flesch Reading Ease (FRE) score:在 96 个网站中,有 0 个网站(0%)在所有四项测试中都达到了建议的阅读水平。所有非学术中心(n = 50)的平均测试得分如下:FKGL (11.14 ± 2.68)、GFI (14.39 ± 3.07)、CLI (9.29 ± 2.48) 和 SMOG (13.38 ± 2.03)。所有学术课程(n = 46)的平均测试分数[SK1]如下:FKGL (11.7 ± 2.66)、GFI (15.01 ± 2.99)、CLI (9.34 ± 1.91) 和 SMOG (13.71 ± 2.02)。对每个疝气中心的 FKGL、GFI、CLI 和 SMOG 分数与 6.9 值(6.9 或更低被认为是可接受的阅读水平)进行了单样本 t 检验,结果显示所有四项检验的 p 值均为 0.001,具有统计学意义。用双样本 t 检验比较了学术组和社区组的可读性得分,所有四项检验的 p 值均大于 0.05,差异无统计学意义:结论:学术疝气中心和社区疝气中心均未达到六年级或六年级以下的适当阅读水平。为提高患者的理解能力和/或参与护理,今后的措施应包括适当的阅读水平材料、识别识字水平低的患者并在适当时进行干预或额外辅导,以及增加辅助学习材料(如视频)。
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引用次数: 0
COVID-19 Vaccination Passports: Are They a Threat to Equality? COVID-19 疫苗接种护照:它们对平等构成威胁吗?
IF 1.4 3区 哲学 Q2 ETHICS Pub Date : 2022-04-29 eCollection Date: 2022-04-01 DOI: 10.1093/phe/phac006
Kristin Voigt

In several countries, governments have implemented so-called 'COVID passport' schemes, which restrict access to venues such as bars or sports events to those who are vaccinated against COVID-19 and/or exempt vaccinated individuals from public health measures such as curfews or quarantine requirements. These schemes have been the subject of a heated debate. Concerns about inequality have played an important role in the opposition to such schemes. This article highlights that determining how COVID passports affect equality requires a much more nuanced analysis than is typically assumed. I identify a range of broadly egalitarian considerations that could be affected by the introduction of COVID passport schemes. While these schemes could undermine certain aspects of equality, I argue that they could also be used to promote equality. The magnitude and severity of these different effects, both promoting and undermining equality, depend on how precisely these schemes are framed and the local context in which they are implemented.

在一些国家,政府实施了所谓的 "COVID 护照 "计划,规定只有接种过 COVID-19 疫苗的人才能进入酒吧或体育赛事等场所,并且/或者接种过疫苗的人不受公共卫生措施(如宵禁或检疫要求)的限制。这些计划一直是激烈辩论的主题。对不平等的担忧在反对这些计划的过程中发挥了重要作用。本文强调,要确定 COVID 护照如何影响平等,需要进行比通常假设的更为细致的分析。我指出了一系列可能受到 COVID 护照计划影响的广泛的平等主义考虑因素。虽然这些计划可能会破坏某些方面的平等,但我认为它们也可以用来促进平等。这些促进和破坏平等的不同影响的程度和严重性,取决于如何精确地制定这些计划以及实施这些计划的当地环境。
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引用次数: 0
Public Reason and Public Health: Can Anti-smoking Policies Be Justified According to a Public Reason Account of Justification? 公共理性与公共健康:根据公共理性的正当性解释,禁烟政策是否合理?
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-04-09 DOI: 10.1093/phe/phac007
M. Nielsen
Public reason demands that policies are justified to all reasonable citizens. Public health aims at protecting or improving aggregated health outcomes. Since health is not an uncontroversial value, an insurmountable chasm between public reason and public health seems to preclude any viable synthesis between the two outlooks. For any given public health policy, some reasonable citizen seems to have a reason to support ‘no policy’ over ‘some policy’, meaning that the policy cannot be justified to all. The paper first spells out what exactly this conflict is about. Then, using smoking as a case, the paper outlines a model of reconciliation between public reason and public health that should give us some optimism if we want to have public health policies that are compatible with treating citizens as free and equal in the public reason sense.
公共理性要求政策对所有理性的公民都是合理的。公共卫生旨在保护或改善总体健康结果。既然健康不是一种毫无争议的价值,公共理性和公共健康之间不可逾越的鸿沟似乎排除了将这两种观点进行任何可行的综合。对于任何给定的公共卫生政策,一些理性的公民似乎有理由支持“没有政策”而不是“有政策”,这意味着该政策不可能对所有人都合理。这篇论文首先阐述了这种冲突到底是关于什么的。然后,以吸烟为例,本文概述了公共理性与公共健康之间的和解模式,如果我们希望公共卫生政策与在公共理性意义上将公民视为自由和平等的政策相兼容,这应该会给我们带来一些乐观。
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引用次数: 2
Response: Collective Moral Agents and Their Collective-Level Virtues 回应:集体道德主体及其集体层面的美德
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-04-01 DOI: 10.1093/phe/phac008
K. MacKay
Abstract In this short piece, I attempt to respond to some of the challenges raised by Jessica Nihlén Fahlquist and Karen Meagher in their commentaries on my paper, ‘Public Health Virtue Ethics’. While these authors have made many insightful and challenging remarks, I mostly focus on two questions here: first, about the nature of collectives as moral agents, in response to Nihlén Fahlquist, and second, about the concept of a collective-level virtue, in response to Meagher.
在这篇短文中,我试图回应Jessica nihl n Fahlquist和Karen Meagher对我的论文“公共卫生美德伦理”的评论中提出的一些挑战。虽然这些作者发表了许多富有洞察力和挑战性的言论,但我在这里主要关注两个问题:第一,关于集体作为道德行为体的本质,回应nihl Fahlquist;第二,关于集体层面美德的概念,回应Meagher。
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引用次数: 0
OUP accepted manuscript OUP接受稿件
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/phe/phac002
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引用次数: 2
Pandemic ethics and status quo risk 流行病伦理和现状风险
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/phe/phab031
R. Chappell
Conservative assumptions in medical ethics risk immense harms during a pandemic. Public health institutions and public discourse alike have repeatedly privileged inaction over aggressive medical interventions to address the pandemic, perversely increasing population-wide risks while claiming to be guided by 'caution'. This puzzling disconnect between rhetoric and reality is suggestive of an underlying philosophical confusion. In this paper, I argue that we have been misled by status quo bias-exaggerating the moral significance of the risks inherent in medical interventions, while systematically neglecting the (objectively greater) risks inherent in the status quo prospect of an out-of-control pandemic. By coming to appreciate the possibility and significance of status quo risk, we will be better prepared to respond appropriately when the next pandemic strikes.
在大流行期间,医学伦理的保守假设可能带来巨大危害。公共卫生机构和公共话语都一再倾向于不采取行动,而不是积极的医疗干预措施来应对大流行,这反而增加了全民风险,同时声称以“谨慎”为指导。修辞与现实之间的这种令人困惑的脱节暗示了一种潜在的哲学困惑。在本文中,我认为我们已经被现状偏见所误导——夸大了医疗干预中固有风险的道德意义,而系统地忽视了(客观上更大的)流行病失控的现状前景所固有的风险。通过认识到现状风险的可能性和重要性,我们将更好地做好准备,在下一次大流行来袭时作出适当的反应。
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引用次数: 0
OUP accepted manuscript OUP接受稿件
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/phe/phac003
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引用次数: 0
OUP accepted manuscript OUP接受稿件
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/phe/phac004
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引用次数: 1
OUP accepted manuscript OUP接受稿件
IF 2.1 3区 哲学 Q2 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/phe/phac001
{"title":"OUP accepted manuscript","authors":"","doi":"10.1093/phe/phac001","DOIUrl":"https://doi.org/10.1093/phe/phac001","url":null,"abstract":"","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"1 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61605914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Public Health Ethics
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