Pub Date : 2024-10-24DOI: 10.1080/15265161.2024.2416128
Thomas Haustein,Ralf J Jox
Waiting lists are a standard approach to managing excess demand in elective health care. While waiting times are an important policy issue, the ethical validity of the first come, first served (FCFS) principle as such is rarely questioned. Presenting a psychiatric day hospital where all eligible patients have roughly equal claims as a case study, we criticize the reflex use of FCFS for allocation of elective psychiatric care, consider conditions under which this may not be the optimal strategy, and discuss alternatives. We conclude that in our example prioritizing more recent referrals (last come, first served [LCFS]) makes more sense, clinically and ethically. Where several referrals arrive (near-)simultaneously under LCFS, we propose that a higher level of scrutiny be applied to detect possible good reasons for prioritizing one of them. We believe that our observations can be applied to other health care settings that share relevant characteristics with our case.
{"title":"Allocation of Treatment Slots in Elective Mental Health Care-Are Waiting Lists the Ethically Most Appropriate Option?","authors":"Thomas Haustein,Ralf J Jox","doi":"10.1080/15265161.2024.2416128","DOIUrl":"https://doi.org/10.1080/15265161.2024.2416128","url":null,"abstract":"Waiting lists are a standard approach to managing excess demand in elective health care. While waiting times are an important policy issue, the ethical validity of the first come, first served (FCFS) principle as such is rarely questioned. Presenting a psychiatric day hospital where all eligible patients have roughly equal claims as a case study, we criticize the reflex use of FCFS for allocation of elective psychiatric care, consider conditions under which this may not be the optimal strategy, and discuss alternatives. We conclude that in our example prioritizing more recent referrals (last come, first served [LCFS]) makes more sense, clinically and ethically. Where several referrals arrive (near-)simultaneously under LCFS, we propose that a higher level of scrutiny be applied to detect possible good reasons for prioritizing one of them. We believe that our observations can be applied to other health care settings that share relevant characteristics with our case.","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"236 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1080/15265161.2024.2416143
Moti Gorin,Jilles Smids
{"title":"Errors, Omissions, and Pediatric Gender Medicine.","authors":"Moti Gorin,Jilles Smids","doi":"10.1080/15265161.2024.2416143","DOIUrl":"https://doi.org/10.1080/15265161.2024.2416143","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"13 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-21DOI: 10.1080/15265161.2024.2416122
Matthew Shea
There has been increasing awareness of the medical and moral challenges in the care of unrepresented patients: those who cannot make their own medical decisions, do not have any surrogate decision maker, and have not indicated their treatment preferences. Most discussions have focused on procedural questions such as who should make decisions for these patients. An issue that has not gotten enough attention is the ethical standard that should govern medical decision making. I explore the question of which ethical standard provides better justification for end-of-life decisions for unrepresented patients. Two options are considered: the conventional and less demanding best interest standard, and the novel and more demanding medical futility standard. I explain the similarities and differences between these two standards, examine arguments for and against each one, and suggest that the medical futility standard is ethically superior and should replace the established best interest standard.
{"title":"The Ethical Standard for End-of-Life Decisions for Unrepresented Patients.","authors":"Matthew Shea","doi":"10.1080/15265161.2024.2416122","DOIUrl":"https://doi.org/10.1080/15265161.2024.2416122","url":null,"abstract":"There has been increasing awareness of the medical and moral challenges in the care of unrepresented patients: those who cannot make their own medical decisions, do not have any surrogate decision maker, and have not indicated their treatment preferences. Most discussions have focused on procedural questions such as who should make decisions for these patients. An issue that has not gotten enough attention is the ethical standard that should govern medical decision making. I explore the question of which ethical standard provides better justification for end-of-life decisions for unrepresented patients. Two options are considered: the conventional and less demanding best interest standard, and the novel and more demanding medical futility standard. I explain the similarities and differences between these two standards, examine arguments for and against each one, and suggest that the medical futility standard is ethically superior and should replace the established best interest standard.","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"81 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2402186
Lorenah E Vásquez,Miriam Rich,Lisa Campo-Engelstein
{"title":"Beyond Policing Bodies: A Broader Conception of Fairness in Women's Sports.","authors":"Lorenah E Vásquez,Miriam Rich,Lisa Campo-Engelstein","doi":"10.1080/15265161.2024.2402186","DOIUrl":"https://doi.org/10.1080/15265161.2024.2402186","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"40 1","pages":"29-30"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2399848
Mariam Habhab,Michelle T Pham
{"title":"Medical Interpretation Services: Challenges for LEP Communities.","authors":"Mariam Habhab,Michelle T Pham","doi":"10.1080/15265161.2024.2399848","DOIUrl":"https://doi.org/10.1080/15265161.2024.2399848","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"18 1","pages":"72-74"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2399855
Anna C F Lewis,Sarah Polcz
{"title":"What Is Considered \"Fair\" Depends on the Purposes of Elite Sports.","authors":"Anna C F Lewis,Sarah Polcz","doi":"10.1080/15265161.2024.2399855","DOIUrl":"https://doi.org/10.1080/15265161.2024.2399855","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"9 1","pages":"35-37"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2399841
Tiffany Bystra, Jacob Moses
Published in The American Journal of Bioethics (Vol. 24, No. 11, 2024)
发表于《美国生物伦理学杂志》（第 24 卷第 11 期，2024 年）
{"title":"Federalism and Infrastructural Responsibility","authors":"Tiffany Bystra, Jacob Moses","doi":"10.1080/15265161.2024.2399841","DOIUrl":"https://doi.org/10.1080/15265161.2024.2399841","url":null,"abstract":"Published in The American Journal of Bioethics (Vol. 24, No. 11, 2024)","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2399859
Pam R. Sailors, Charlene Weaving
Published in The American Journal of Bioethics (Vol. 24, No. 11, 2024)
发表于《美国生物伦理学杂志》（第 24 卷第 11 期，2024 年）
{"title":"Categorically Complicated","authors":"Pam R. Sailors, Charlene Weaving","doi":"10.1080/15265161.2024.2399859","DOIUrl":"https://doi.org/10.1080/15265161.2024.2399859","url":null,"abstract":"Published in The American Journal of Bioethics (Vol. 24, No. 11, 2024)","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2402179
Vishala Mishra,Damián E Blasi,Joseph P Dexter
{"title":"Bridging Ethics and Evidence: Language as a Critical Determinant of Health Equity.","authors":"Vishala Mishra,Damián E Blasi,Joseph P Dexter","doi":"10.1080/15265161.2024.2402179","DOIUrl":"https://doi.org/10.1080/15265161.2024.2402179","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"13 1","pages":"66-69"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1080/15265161.2024.2399833
Thaddeus Mason Pope
{"title":"Patients with Limited English Proficiency: Legal Mandates for Language Assistance Services.","authors":"Thaddeus Mason Pope","doi":"10.1080/15265161.2024.2399833","DOIUrl":"https://doi.org/10.1080/15265161.2024.2399833","url":null,"abstract":"","PeriodicalId":501008,"journal":{"name":"The American Journal of Bioethics","volume":"43 1","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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