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Correction to: Far From the Madding Crowd: Health Service Expectations in the "Country". 更正为远离喧嚣的人群:国家 "对医疗服务的期望。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-03-01 DOI: 10.1007/s11673-023-10296-x
Michael A Ashby
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引用次数: 0
Social Distance Warriors Should Not Be Regarded as Moral Exemplars in a Pandemic Nor as Paragons of Politeness: A Response to Shaw. 社会距离战士不应被视为大流行病中的道德楷模,也不应被视为礼貌的典范:对肖的回应
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-03-01 Epub Date: 2024-02-19 DOI: 10.1007/s11673-023-10329-5
Hugh V McLachlan

In a recent article, Shaw contrasts his own supposed good behaviour, as that of a self-proclaimed "social distance warrior" with the alleged rude behaviour of one of his relatives, Jack, at social events in the former's house in Scotland in the early stages of the COVID-19 pandemic. He does so to illustrate and support his claims that it was wrong and rude to fail to comply with the governmental advice regarding social distancing because we had a responsibility "to minimize risk" and not wrong nor rude to challenge and cajole those people who failed to do so. This article shows that his claims are contestable. It suggests that his own behaviour was no better than Jack's.

在最近的一篇文章中,肖将自己自称为 "社会距离战士 "的良好行为与他的一位亲戚杰克在 COVID-19 大流行初期在苏格兰前者家中的社交活动中的粗鲁行为进行了对比。他这样做是为了说明和支持他的主张,即不遵守政府关于保持社交距离的建议是错误和粗鲁的,因为我们有责任 "将风险降到最低",而对那些没有这样做的人提出质疑和劝说则不是错误和粗鲁的。这篇文章表明,他的说法是有争议的。它表明,他自己的行为并不比杰克的行为好多少。
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引用次数: 0
Implementation of an Ethics Committee in a University Mental Health Clinic. 在大学心理健康诊所实施道德委员会。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-03-01 Epub Date: 2023-10-12 DOI: 10.1007/s11673-023-10301-3
M Azcárraga, S Derive

Mental disorders in university students are very frequent, therefore higher education institutions have established in-campus mental healthcare centres. These clinics have particular characteristics that differ from other mental health centres, as they report to and represent an educational institution, while at the same time looking after the interests and well-being of patients requesting assistance, thus generating unique bioethical conflicts. Ethics Committees are useful tools to offer support to mental health professionals in making ethical decisions. In order to respond to these issues, it was decided that an Ethics Committee would be created in the mental health clinic of a private university in Mexico City. This article describes the implementation process for this Committee, its duties and scope, as well as the case work and review methodology. A list of the most frequent ethical conflicts is attached, jointly with the ethical analysis of the cases treated throughout the year and a half or work by the Committee.

大学生的心理障碍非常常见,因此高等教育机构在校园内设立了心理保健中心。这些诊所具有不同于其他心理健康中心的特殊特征,因为它们向教育机构报告并代表教育机构,同时照顾请求援助的患者的利益和福祉,从而产生独特的生物伦理冲突。道德委员会是为心理健康专业人员做出道德决策提供支持的有用工具。为了应对这些问题,决定在墨西哥城一所私立大学的心理健康诊所成立一个道德委员会。本文介绍了该委员会的执行过程、职责和范围,以及个案工作和审查方法。附上一份最常见的道德冲突清单,以及对一年半内处理的案件或委员会工作的道德分析。
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引用次数: 0
Applying the Concepts of Benefit and Harm in Malaysian Bioethical Discourse: Analysis of Malaysian Fatwa. 在马来西亚生物伦理论述中应用 "利益 "与 "伤害 "的概念:马来西亚法特瓦分析。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-26 DOI: 10.1007/s11673-024-10345-z
Abdul Halim Ibrahim, Muhammad Safwan Harun

Rapid developments in science and technology have resulted in novel discoveries, leading to new questions particularly related to human values and ethics. Every discovery and technology has positive and negative implications and affects human lives either directly or indirectly, involving all walks of life. Bioethical discourse in Malaysia must consider the multiracial and multireligious background of Malaysia and especially the Islamic view as the majority of Malaysians are Muslims and Islam is the religion of the federation. This article discusses several selected bioethical issues in Malaysia by studying the application of maṣlaḥah (the public good) and mafsadah (evil and harms) in Malaysian Islamic rulings (fatwas). This article uses the critical interpretation approach, as this is an ethical, interpretive, textual, and contextual analysis. In a situation when there is a conflict between maṣlaḥah and avoidance of mafsadah, it is preferred to attempt to address both needs. However, if maṣlaḥah and avoidance of mafsadah are mutually exclusive, the decision to choose must be made by weighing (tarjīḥ) and choosing the one which is superior. The maṣlaḥah and mafsadah concepts play vital and significant roles in bioethical discourse to realize human essential interests, namely faith, life, lineage, intellect, and property, thus achieving maqāṣid al-sharī'ah (the ultimate goal of sharia). This concept helps in guiding bioethical discussions, especially in determining the priority between achieving benefits and avoiding harms. The application of this concept will also assist Malaysian authorities in formulating appropriate rulings, especially bioethical issues related to Malaysian Muslims' lives.

科学技术的飞速发展带来了新的发现,引发了新的问题,尤其是与人类价值观和伦理有关的问题。每一项发现和技术都有积极和消极的影响,直接或间接地影响着人类的生活,涉及到各行各业。马来西亚的生物伦理讨论必须考虑到马来西亚的多种族和多宗教背景,特别是伊斯兰教的观点,因为大多数马来西亚人是穆斯林,伊斯兰教是联邦的宗教。本文通过研究马来西亚伊斯兰教裁决(法特瓦)中 maṣlaḥah(公共利益)和 mafsadah(邪恶与伤害)的应用,讨论了马来西亚若干选定的生物伦理问题。本文采用批判性解释方法,因为这是一种伦理、解释、文本和语境分析。在 "圣行"(maṣlaḥah)与避免 "恶行"(mafsadah)之间存在冲突的情况下,最好尝试同时满足这两种需求。但是,如果 "为真主而活 "和避免 "误入歧途 "是相互排斥的,则必须通过权衡(tarjīḥ)来决定取舍,并选择其中优越者。maṣlaḥah和mafsadah的概念在生命伦理学的论述中发挥着至关重要的作用,以实现人类的基本利益,即信仰、生命、血统、智力和财产,从而实现maqāṣid al-sharī'ah(伊斯兰教法的终极目标)。这一概念有助于指导生物伦理讨论,特别是确定实现利益和避免伤害之间的优先顺序。这一概念的应用也将有助于马来西亚当局制定适当的裁决,特别是与马来西亚穆斯林生活相关的生物伦理问题。
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引用次数: 0
The "Bystander at the Switch" Revisited? Ethical Implications of the Government Strategies Against COVID-19. 重新审视 "开关旁观者"?政府针对 COVID-19 所采取策略的伦理意义。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-15 DOI: 10.1007/s11673-023-10328-6
S Stelios, K N Konstantakis, P G Michaelides

Suppose COVID-19 is the runaway tram in the famous moral thought experiment, known as the "Bystander at the Switch." Consider the two differentiated responses of governments around the world to this new threat, namely the option of quarantine/lockdown and herd immunity. Can we contrast the hypothetical with the real scenario? What do the institutional decisions and strategies for dealing with the virus, in the beginning of 2020, signify in a normative moral framework? This paper investigates these possibilities in order to highlight the similarities and, more importantly, the differences that exist between utilitarianism and Kantian ethics. Analysis shows that the hypothetical scenario can never be fully compared to the complex multifactorial nature of the real world. But if a comparison is attempted, the most obvious difference between the two governmental strategies is the concept of duty within the Kantian perspective. Ultimately, it is a matter of comparing freedom and life. Attributing a moral "priority ticket" to one or the other can be analysed through interpersonal aggregation.

假设 COVID-19 是著名的道德思想实验 "开关旁观者 "中失控的电车。考虑世界各国政府对这一新威胁的两种不同反应,即隔离/封锁和群体免疫。我们能否将假设与真实情况进行对比?2020 年初应对病毒的机构决策和战略在规范性道德框架中意味着什么?本文探讨了这些可能性,以突出功利主义与康德伦理学之间的相似之处,更重要的是,两者之间的不同之处。分析表明,假设的情景永远无法与现实世界复杂的多因素性质相提并论。但如果试图进行比较,两种政府策略之间最明显的区别在于康德视角中的责任概念。归根结底,这是一个比较自由与生命的问题。将道德 "优先票 "归于其中之一,可以通过人际聚合进行分析。
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引用次数: 0
Ethical Challenges in Oral Healthcare Services Provided by Non-Governmental Organizations for Refugees in Germany. 德国非政府组织为难民提供口腔保健服务的伦理挑战。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-14 DOI: 10.1007/s11673-023-10327-7
R Kozman, K M Mussie, B Elger, I Wienand, F Jotterand

Oral healthcare is attracting much attention after decades of neglect from policymakers. Recent studies have shown a strong association between oral and overall health, which can lead to serious health problems. Availability of oral healthcare services is an essential part of ensuring universal healthcare coverage. More importantly, current gaps in its accessibility by minority or marginalized population groups are crucial public health as well as ethical concerns. One notable effort to address this issue comes from Non-Governmental Organizations (NGOs), which offer oral healthcare services for non-insured refugees. However, the challenge remains that these care services are not comprehensive, which has implications for the refugees' oral and general health. In this article, we discuss this complex issue in the German healthcare context by including ethical reflections. Therefore, the purpose of this article is to discuss the ethical challenges related to oral healthcare services provided by NGOs for refugees in Germany. First, we will introduce the general oral healthcare context worldwide and in Germany. Second, we will provide a general description of the oral healthcare services provided by NGOs for refugees in Germany, as well as an overview of existing gaps. This will provide us with the context for our third and most important task-discussing the ethical implications of the gaps. In doing so, and since the ethical implications can be several, we demarcate the scope of our analysis by focusing on the specific ethical issues of justice, harm, and autonomy. Finally, we offer some recommendations for how to move forward.

口腔保健在被政策制定者忽视几十年后,正在引起广泛关注。最近的研究表明,口腔健康与整体健康之间存在密切联系,可能导致严重的健康问题。提供口腔保健服务是确保全民医保的重要组成部分。更重要的是,目前少数群体或边缘化群体在获得口腔保健服务方面存在的差距是至关重要的公共卫生和道德问题。非政府组织(NGO)为解决这一问题做出了显著努力,为没有保险的难民提供口腔医疗服务。然而,这些医疗服务并不全面,这对难民的口腔健康和总体健康都有影响。在本文中,我们将通过伦理反思,讨论德国医疗保健背景下的这一复杂问题。因此,本文旨在讨论非政府组织为德国难民提供的口腔医疗服务所面临的伦理挑战。首先,我们将介绍全球和德国的一般口腔医疗背景。其次,我们将概括介绍非政府组织为德国难民提供的口腔医疗服务,并概述现有的差距。这将为我们的第三项也是最重要的任务--讨论差距的伦理影响--提供背景。在此过程中,由于伦理影响可能是多方面的,我们将重点放在正义、伤害和自主性等具体的伦理问题上,从而划定我们的分析范围。最后,我们就如何向前迈进提出了一些建议。
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引用次数: 0
Review of Ethical Challenges of Organ Transplantation: Current Debates and International Perspectives : Hansen, Solveig Lena, and Silke Schicktanz (eds). 2021. Ethical Challenges of Organ Transplantation: Current Debates and International Perspectives . Bielefeld: Transcript Verlag. ISBN 978-3-8376-4643-6. 回顾《器官移植的伦理挑战》:当前辩论与国际视角》:Hansen, Solveig Lena, and Silke Schicktanz (eds).2021.器官移植的伦理挑战:当前辩论与国际视角 .Bielefeld: Transcript Verlag.ISBN 978-3-8376-4643-6。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-13 DOI: 10.1007/s11673-023-10330-y
Nitzan Rimon-Zarfaty
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引用次数: 0
For the Good of the Globe: Moral Reasons for States to Mitigate Global Catastrophic Biological Risks. 为了全球的利益:各国减轻全球灾难性生物风险的道德理由》。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-08 DOI: 10.1007/s11673-024-10337-z
Tess F Johnson

Actions to prepare for and prevent pandemics are a common topic for bioethical analysis. However, little attention has been paid to global catastrophic biological risks more broadly, including pandemics with artificial origins, the creation of agents for biological warfare, and harmful outcomes of human genome editing. What's more, international policy discussions often focus on economic arguments for state action, ignoring a key potential set of reasons for states to mitigate global catastrophic biological risks: moral reasons. In this paper, I frame the mitigation of such risks as a global public good, and I explore three possible categories of moral reasons that might motivate states to provide this global public good: nationalism, cosmopolitanism, and interstate obligations. Whilst there are strong objections to moral nationalism as a reason for states to act, moral cosmopolitanism may provide a broad reason which is further supplemented for individual states through the elaboration of interstate moral obligations. The obligations I consider are moral leadership, fairness, and reciprocity. Moral reasons for individual states action may more effectively or more appropriately motivate states to mitigate global catastrophic biological risks.

防备和预防大流行病的行动是生物伦理分析的一个常见话题。然而,人们很少关注更广泛的全球灾难性生物风险,包括人工起源的大流行病、生物战制剂的产生以及人类基因组编辑的有害结果。更重要的是,国际政策讨论往往侧重于国家行动的经济论据,而忽视了国家减缓全球灾难性生物风险的一系列关键潜在原因:道德原因。在本文中,我将减轻此类风险视为一种全球公益,并探讨了可能促使国家提供这种全球公益的三类道德理由:民族主义、世界主义和国家间义务。虽然有人强烈反对将道义民族主义作为国家采取行动的理由,但道义世界主义可以提供一个广泛的理由,而国家间道义义务的阐述则进一步补充了这一理由。我所考虑的义务包括道德领导、公平和互惠。单个国家采取行动的道德理由可能会更有效或更恰当地激励各国减轻全球灾难性生物风险。
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引用次数: 0
AI-Enhanced Healthcare: Not a new Paradigm for Informed Consent. 人工智能增强医疗:不是知情同意的新范式。
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-02-01 DOI: 10.1007/s11673-023-10320-0
M Pruski

With the increasing prevalence of artificial intelligence (AI) and other digital technologies in healthcare, the ethical debate surrounding their adoption is becoming more prominent. Here I consider the issue of gaining informed patient consent to AI-enhanced care from the vantage point of the United Kingdom's National Health Service setting. I build my discussion around two claims from the World Health Organization: that healthcare services should not be denied to individuals who refuse AI-enhanced care and that there is no precedence to seeking patient consent to AI-enhanced care. I discus U.K. law relating to patient consent and the General Data Protection Regulation to show that current standards relating to patient consent are adequate for AI-enhanced care. I then suggest that in the future it may not be possible to guarantee patient access to non-AI-enhanced healthcare, in a similar way to how we do not offer patients manual alternatives to automated healthcare processes. Throughout my discussion I focus on the issues of patient choice and veracity in the patient-clinician relationship. Finally, I suggest that the best way to protect patients from potential harms associated with the introduction of AI to patient care is not via an overly burdensome patient consent process but via evaluation and regulation of AI technologies.

随着人工智能(AI)和其他数字技术在医疗保健领域的日益普及,围绕其应用的伦理辩论也变得越来越突出。在此,我将从英国国民健康服务的角度出发,探讨如何获得患者对人工智能增强型医疗服务的知情同意。我围绕世界卫生组织的两个主张展开讨论:一是不应拒绝为拒绝人工智能增强型医疗服务的个人提供医疗服务;二是寻求患者对人工智能增强型医疗服务的同意没有先例可循。我讨论了与患者同意有关的英国法律和《通用数据保护条例》,以说明目前与患者同意有关的标准足以满足人工智能增强型医疗的要求。然后,我提出,未来可能无法保证患者获得非人工智能增强型医疗服务,就像我们无法为患者提供人工替代自动医疗流程一样。在整个讨论过程中,我将重点放在患者与医生关系中的患者选择和真实性问题上。最后,我建议,保护患者免受与将人工智能引入患者护理相关的潜在伤害的最佳方式不是通过过于繁琐的患者同意程序,而是通过对人工智能技术的评估和监管。
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引用次数: 0
Vaccine Mandates and Cultural Safety 疫苗规定与文化安全
IF 2.4 3区 哲学 Q2 ETHICS Pub Date : 2024-01-02 DOI: 10.1007/s11673-023-10319-7
R. Matthews, K. Menzel

The issues and problems of mandatory vaccination policy and roll out in First Nations communities are unique and do not concern the safety and effectiveness of vaccines. These issues are also independent of more specific arguments of mandatory vaccination of healthcare workers as a condition of employment. As important as these issues are, they do not consider the complex politics of ongoing settler colonialism and First Nations community relations. In this paper, we also set aside the very real problems of disinformation, hesitancy, scientific and health illiteracy, and other concerns that drive vaccine hesitancy and refusal. These affect all communities, including First Nations communities. We, instead describe the dominant arguments in favour of mandatory vaccination and critique them in terms of the disputed legitimacy of Settler-Colonial decision-making as it impacts First Nations communities. We contend cultural responsiveness and safety—not state compulsion—must remain the first principles of any engagement—including vaccination—with First Nations Peoples, families, and communities.

原住民社区的强制疫苗接种政策和推广所涉及的问题是独特的,与疫苗的安全性和有效性无关。这些问题也独立于将医护人员强制接种疫苗作为就业条件这一更为具体的论点。尽管这些问题很重要,但它们并没有考虑到当前定居者殖民主义和原住民社区关系的复杂政治。在本文中,我们还撇开了虚假信息、犹豫不决、不懂科学和健康知识以及其他导致犹豫不决和拒绝接种疫苗的现实问题。这些问题影响着所有社区,包括原住民社区。相反,我们描述了支持强制疫苗接种的主要论点,并从定居殖民决策的合法性争议角度对其进行了批判,因为这影响到了原住民社区。我们认为,文化响应和安全--而非国家强制--必须始终是与原住民、家庭和社区进行任何接触(包括疫苗接种)的首要原则。
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引用次数: 0
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Journal of Bioethical Inquiry
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