Journal of Bioethical Inquiry最新文献

Based on an analysis of a case study from a Victorian case of neonatal hypoxic ischaemic encephalopathy (HIE), I want to propose that in some circumstances it would be desirable to have well-regulated legal provisions, such as the Groningen Protocol (GP), to hasten the death of newborns with catastrophic health conditions in order to reduce suffering. My argument will take the following form: (1) Neonatal euthanasia in form of withholding all (including natural) nutrition and hydration is already practiced in Victoria and considered legal in circumstances of palliative care. (2) In cases where it is already legally practiced, there are better and worse ways to achieve a good death. Ways that result in less suffering, all else being equal, are morally superior and therefore preferable. (3) Lethal injections that result in a painless, controlled death are better than starvation, because it causes less suffering. Therefore, in cases where death as the palliative outcome is either aimed at or unavoidable, injection of a lethal medication is preferable to slow starvation. In well considered circumstances it should therefore be a legal treatment option and considered best practice.

The law and legal processes have a demonstrable impact on the public-health management and lived experience of people living with blood-borne viruses. However, very little is known about how the legal environment informs the experience of chronic hepatitis B or the justiciable issues experienced by people living with and affected by the virus. This article reports on a deliberative consensus process conducted with leaders of hepatitis B-related community organizations in Australia that aimed to identify, characterize, and prioritize the legal issues faced by people in the communities they support. Four priority legal areas were identified in relation to: 1) hepatitis B testing and disclosure; 2) migration law; 3) public health orders; and 4) hepatitis B-related stigma and discrimination. Identifying and describing these areas of law and justiciable issues, and organizing them through a consideration of their urgency, prevalence, and health impacts is a key starting point from which to address the neglect of these issues in current policy and practice, and to support the framing and interpretation of further research with people in affected communities. The results of this deliberative consensus process establish clear priorities for further research and for legal and public health policy, practice, resourcing, and reform.

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.