Journal of Bioethical Inquiry最新文献

Many countries have implemented taxes on junk food, believing this to have beneficial health outcomes. The Health Protection Argument maintains that (1) junk food is harmful to health; (2) consumers should reduce their consumption; (3) taxation is an effective means of achieving this goal, and governments should implement effective measures. Consequently, governments should tax junk food for health reasons. However, the premises in this argument are problematic. The definition of junk food and the causal relationship between junk food consumption and health outcomes remain ambiguous. Without clear health standards and justified public reasons, governments should not implement restrictive measures to reduce junk food consumption. Furthermore, the effectiveness of taxation as a policy tool, as well as the justification for prioritizing tax interventions over alternative measures, calls for closer evaluation. Therefore, the conclusion that governments should impose taxes on junk food is not sufficiently justified on health grounds.

This article investigates ethical hazards associated with argumentative shifts following the emergence of combined non-inferiority and efficiency/revenue facilitation (NERF) endpoints, with particular attention to research on artificial intelligence (AI) in health and medicine. The study presented here adopts a Toulmin argumentative analysis approach to investigate the dominant persuasive logics of twenty-three health AI trials evaluating NERF endpoints. In so doing, the article demonstrates how the argumentative logics of NERF trial reports shifts away from health outcomes as the putative evidence base for adopting novel interventions toward an argumentative model that prioritizes economic benefits over patient benefits. Ultimately, the article argues that new logic of NERF endpoints is consistent with and risks accelerating the harms to patient care that arise from increased financialization of the healthcare sector. If the use of NERF endpoints and attendant logics continue to grow unchecked, they could result in significant harms to patient health and well-being.

Not only is excessive consumption of sugar-sweetened beverages (SSB) harmful for health but it also constitutes a significant burden on Australia's healthcare system, with widespread social, economic, and ethical implications. Peak health authorities in Australia and the Grattan Institute have advocated strongly for implementing a tax on SSB to reduce its consumption, based on evidence of compelling health and economic benefits. However, beverage and sugar industries heavily oppose the tax. This article analyses the implementation of an SSB tax in Australia using a set of widely accepted public health ethics principles: effectiveness, proportionality, necessity, least infringement, equity, and transparency. By navigating the moral framework of key ethical issues, this article argues that Australia is justified in implementing an SSB tax, thus adding a nuanced ethical dimension to this important public health policy debate.

While everyone, parents and non-parents alike, benefit from children, parents alone incur the cost of bearing and raising them. Johan Bester argues that, since society tasks parents with the labourious and financially burdensome task of raising children, and children are a social good, society has an obligation to help ease the burden of parenting by offering direct financial compensation to parents. While I agree that society should do much more to support parents, I am not convinced that the support should include direct financial payment to parents. After setting out Bester's arguments for this position and distinguishing it from a similar argument in political science, I offer a series of concerns: parenting is unlike socially beneficial employment-type work; Bester's argument may extend in problematic directions; financial incentives may harm the parent-child relationship; and there are other ways to promote parenting. Despite being critical, the purpose of this paper is to invite further discussion among bioethicists on how society can support parents in the important task of parenting.

This paper addresses bioethical considerations in end-of-life healthcare. It explores Islamic bioethical concepts of karāma and ḥurma, framing them as homeomorphic equivalents to categories of human dignity in Western bioethics. Karāma refers to the inherent honour bestowed by God upon every human being, as distinct from honour as a component that can be accrued; ḥurma signifies the inviolability and sanctity of the human body. The two concepts are related and when combined can be mapped onto Sulmasy's categorizations of intrinsic and attributed dignity. The third category proposed by Sulmasy, inflorescent dignity-human grace and virtue expressed in observable behaviour-is demonstrated through the historical narrations of how Prophet Muhammad faced his last days. The paper notes how these Islamically-grounded notions of dignity are reflected in empirical studies of Muslim populations and uses a case scenario to demonstrate how they can manifest in end-of-life care decisions for Muslim populations.

In this essay, we discuss the results of scientific dogmatism and the backlash it has created in society. We cite various examples from the pandemic to highlight our case. We argue that dogmatism will ultimately put the scientific paradigm in crisis and a different approach is needed to address populism. We further argue science is more digestible when emotional faculties of individuals are considered first. We use a philosophical approach to also describe the dangers of dogmatism and the interplay between technocracy and populism.

In the near future, the electronic health record (EHR) is likely to include patients' genetic information, in addition to other clinical information and administrative data. This warrants some preparatory thought. Presently, in many jurisdictions, adolescents can self-access their EHR, as an acknowledgment of their relative autonomy in areas concerning their health. The foreseeable routine integration of genetic information into the EHR could result, inter alia, in adolescents' inadvertent exposure to misattributed parentage findings emerging from genetic investigations, creating clinical challenges and ethical difficulties. The article reviews policy on the underexplored area of sharing genetic (non-)relatedness information with adolescents. It then considers the clinical perspective of adolescents revealing genetic non-relatedness through the EHR. Next, the article comparatively investigates adolescents' health privacy and EHR-access laws and policies across several jurisdictions. After that, it analyses applicable ethical principles, such as minors' right to know their genetic origins; parents' (contentious) right to know that their child is genetically unrelated to them; the best interests of the child; and minors' autonomy. Finally, we offer an implementable model in which the minor makes an informed choice of consent option, genetic results are segregated from other EHR data, differential access is applied to genetic information; and pre-disclosure medical counselling for adolescent patients is mandated.

This paper argues for a re-balancing of decision-making power in health systems away from metrocentric and technocratic norms and a fundamental re-shaping towards democratic and participatory models of governance. These changes are understood as critical to the objective of improving healthcare access and delivery in regional, rural, and remote communities. In articulating this argument, we highlight the highly political nature of how we structure and govern healthcare delivery, which is imbued with value judgments. We critique currently dominant neo-liberal approaches to healthcare governance that frame the "voices" of local communities as optional inputs into the system, rather than active agents in decision-making processes. From health justice and spatial justice perspectives, public participation in governance may be an important factor to enable improved access to regional, rural, and remote health services and to promote community self-determination.