Pub Date : 2024-03-01DOI: 10.1007/s11673-023-10296-x
Michael A Ashby
{"title":"Correction to: Far From the Madding Crowd: Health Service Expectations in the \"Country\".","authors":"Michael A Ashby","doi":"10.1007/s11673-023-10296-x","DOIUrl":"10.1007/s11673-023-10296-x","url":null,"abstract":"","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":"209"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239378","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}
Pub Date : 2024-03-01Epub Date: 2024-02-19DOI: 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.
{"title":"Social Distance Warriors Should Not Be Regarded as Moral Exemplars in a Pandemic Nor as Paragons of Politeness: A Response to Shaw.","authors":"Hugh V McLachlan","doi":"10.1007/s11673-023-10329-5","DOIUrl":"10.1007/s11673-023-10329-5","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":"11-14"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900817","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}
Pub Date : 2024-03-01Epub Date: 2023-10-12DOI: 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.
{"title":"Implementation of an Ethics Committee in a University Mental Health Clinic.","authors":"M Azcárraga, S Derive","doi":"10.1007/s11673-023-10301-3","DOIUrl":"10.1007/s11673-023-10301-3","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":"177-184"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219075","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}
Pub Date : 2024-02-26DOI: 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.
{"title":"Applying the Concepts of Benefit and Harm in Malaysian Bioethical Discourse: Analysis of Malaysian Fatwa.","authors":"Abdul Halim Ibrahim, Muhammad Safwan Harun","doi":"10.1007/s11673-024-10345-z","DOIUrl":"https://doi.org/10.1007/s11673-024-10345-z","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974317","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}
Pub Date : 2024-02-15DOI: 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.
{"title":"The \"Bystander at the Switch\" Revisited? Ethical Implications of the Government Strategies Against COVID-19.","authors":"S Stelios, K N Konstantakis, P G Michaelides","doi":"10.1007/s11673-023-10328-6","DOIUrl":"https://doi.org/10.1007/s11673-023-10328-6","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736586","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}
Pub Date : 2024-02-14DOI: 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.
{"title":"Ethical Challenges in Oral Healthcare Services Provided by Non-Governmental Organizations for Refugees in Germany.","authors":"R Kozman, K M Mussie, B Elger, I Wienand, F Jotterand","doi":"10.1007/s11673-023-10327-7","DOIUrl":"https://doi.org/10.1007/s11673-023-10327-7","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730896","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}
Pub Date : 2024-02-13DOI: 10.1007/s11673-023-10330-y
Nitzan Rimon-Zarfaty
{"title":"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.","authors":"Nitzan Rimon-Zarfaty","doi":"10.1007/s11673-023-10330-y","DOIUrl":"https://doi.org/10.1007/s11673-023-10330-y","url":null,"abstract":"","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724717","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}
Pub Date : 2024-02-08DOI: 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.
{"title":"For the Good of the Globe: Moral Reasons for States to Mitigate Global Catastrophic Biological Risks.","authors":"Tess F Johnson","doi":"10.1007/s11673-024-10337-z","DOIUrl":"https://doi.org/10.1007/s11673-024-10337-z","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703941","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}
Pub Date : 2024-02-01DOI: 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.
{"title":"AI-Enhanced Healthcare: Not a new Paradigm for Informed Consent.","authors":"M Pruski","doi":"10.1007/s11673-023-10320-0","DOIUrl":"https://doi.org/10.1007/s11673-023-10320-0","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652073","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}
Pub Date : 2024-01-02DOI: 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.
{"title":"Vaccine Mandates and Cultural Safety","authors":"R. Matthews, K. Menzel","doi":"10.1007/s11673-023-10319-7","DOIUrl":"https://doi.org/10.1007/s11673-023-10319-7","url":null,"abstract":"<p>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.</p>","PeriodicalId":50252,"journal":{"name":"Journal of Bioethical Inquiry","volume":"181 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078745","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}