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Ethical Reflection on the "QR code Dilemma" Faced by Older People During COVID-19 in China. 对中国 COVID-19 期间老年人面临的 "二维码困境 "的伦理反思。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2024-01-31 DOI: 10.1007/s11673-023-10317-9
J Han, Z Xu, Y Ma

The widespread application of QR code technology is best represented by the health codes used in China's pandemic prevention and control. This technology has enhanced the country's ability to manage the pandemic by achieving higher efficiency and accuracy. Unfortunately, a certain segment of the older population has encountered difficulties in adapting and maintaining their daily activities. This indicates the limitations of QR code technology in achieving social isolation. This article argues that for a more comprehensive pandemic prevention and control policy system to be established, managing the implementation of this very technology should be done in a more humane fashion, i.e. under the guidance of three moral principles: benevolence, justice, and non-maleficence. By doing so, implementation of QR code technology is done in a way that is not only conducive to COVID-19 prevention and control but also mitigate marginalization of the older people. In the post-pandemic era, the socialization of digital technology will accelerate. Therefore, in the field of public health, we should direct attention not only to the fair distribution of resources but also to the issue of identity that arises due to digital divide.

最能体现二维码技术广泛应用的是中国大流行病防控中使用的健康码。这项技术通过提高效率和准确性,增强了国家管理大流行病的能力。遗憾的是,一部分老年人在适应和维持日常活动方面遇到了困难。这表明二维码技术在实现社会隔离方面存在局限性。本文认为,要建立更加全面的大流行病防控政策体系,就应该以更加人性化的方式来管理这项技术的实施,即在三个道德原则(仁、义、非恶意)的指导下进行。这样,二维码技术的实施不仅有利于 COVID-19 的防控,还能缓解老年人被边缘化的问题。在后流行病时代,数字技术的社会化进程将加快。因此,在公共卫生领域,我们不仅要关注资源的公平分配,更要关注因数字鸿沟而产生的身份认同问题。
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引用次数: 0
Ethical Considerations in Research With People From Refugee and Asylum Seeker Backgrounds: A Systematic Review of National and International Ethics Guidelines. 以难民和寻求庇护者为背景的研究中的伦理考虑:对国家和国际伦理准则的系统回顾。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-10-27 DOI: 10.1007/s11673-023-10297-w
Natasha Davidson, Karin Hammarberg, Jane Fisher

Refugees and asylum seekers may experience challenges related to pre-arrival experiences, structural disadvantage after migration and during resettlement requiring the need for special protection when participating in research. The aim was to review if and how people with refugee and asylum seeker backgrounds have had their need for special protection addressed in national and international research ethics guidelines. A systematic search of grey literature was undertaken. The search yielded 2187 documents of which fourteen met the inclusion criteria. Few guidelines addressed specific ethical considerations for vulnerable groups much less people with refugee and asylum seeker backgrounds. One guideline explicitly addressed vulnerability for refugees and asylums seekers. To ensure members of ethics committees and researchers consider the potential challenges of conducting research with these groups, guidelines may need to be supplemented with a refugee and asylum seeker specific research ethics framework. Such a framework may be necessary to optimally protect people with refugee and asylum seeker backgrounds in research.

难民和寻求庇护者可能会遇到与抵达前经历、移民后和重新安置期间的结构性劣势有关的挑战,在参与研究时需要特殊保护。其目的是审查具有难民和寻求庇护者背景的人是否以及如何在国家和国际研究伦理准则中解决他们对特殊保护的需求。对灰色文献进行了系统的检索。这次搜索共产生2187份文件,其中14份符合入选标准。很少有指导方针涉及弱势群体的具体道德考虑,更不用说有难民和寻求庇护者背景的人了。一项准则明确指出了难民和寻求庇护者的脆弱性。为了确保伦理委员会成员和研究人员考虑到与这些群体进行研究的潜在挑战,可能需要用针对难民和寻求庇护者的研究伦理框架来补充指导方针。这样一个框架对于在研究中最佳地保护具有难民和寻求庇护者背景的人可能是必要的。
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引用次数: 0
Medically Assisted Death and the Ends of Medicine. 医学辅助死亡与医学终结。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-10-27 DOI: 10.1007/s11673-023-10288-x
Eric Vogelstein

This paper aims to refute a common line of argument that it is immoral for physicians to engage in medical assistance in death (MAiD), i.e., the practices of euthanasia and physician-assisted suicide. The argument in question is based on the notion that participating in MAiD is contrary to the professional-role obligations of physicians, due to MAiD's putative inconsistency with the ends of medicine. The paper describes several major flaws from which that argument suffers.

本文旨在驳斥一种常见的论点,即医生参与死亡医疗救助(MAiD)是不道德的,即安乐死和医生协助自杀的做法。有争议的论点是基于这样一种观点,即参与MAiD违背了医生的职业角色义务,因为MAiD被认为与医学的目的不一致。这篇论文描述了这一论点存在的几个主要缺陷。
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引用次数: 0
The Ethical Assessment of the Stay-At-Home Order in South Africa in Light of The Universal Declaration of Bioethics And Human Rights (UNESCO). 根据《世界生物伦理与人权宣言》对南非居家令的伦理评估(联合国教科文组织)。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-10-26 DOI: 10.1007/s11673-023-10304-0
A L Rheeder

The South African government announced the much-discussed stay-at-home order between March 27 and April 30, 2020, during what was known as lockdown level 5, which meant that citizens were not allowed to leave their homes. The objective of this study is to assess the stay-at-home order against the global principles of the UDBHR. It is deducible that, in reference to the UDBHR, the government possessed the right to curtail individual liberty, thereby not infringing on Article 5 of the UDBHR and therefore, in this context, passes the test of the UDBHR. However, it remains uncertain at present whether the limitation of freedom imposed by the South African stay-at-home order was successful in controlling the spread of COVID-19 and protecting individuals from harm. Initial investigations also indicate that individuals who are particularly vulnerable may not have received equitable treatment in accordance with the principle outlined in Article 10, therefore, it can be cautiously and modestly argued that the stay-at-home order does not withstand scrutiny when assessed against the UDBHR. Given the continued discussion about the efficacy of limiting freedom to control the spread of COVID-19, and the growing conviction that the advancement of justice is being called into question, the notion of least restriction ought to be considered seriously. Ten Have (2022) is correct in asserting that global bioethics should also seriously consider other principles beyond an almost exclusive focus on limiting individual freedom. The preliminary conclusion is that the potential implementation of the stay-at-home order in the future must be seriously reconsidered.

南非政府在2020年3月27日至4月30日期间宣布了备受讨论的居家令,当时的封锁级别为5级,这意味着公民不得离开自己的家。本研究的目的是根据UDBHR的全球原则评估居家令。可以推断,就UDBHR而言,政府拥有限制个人自由的权利,因此没有侵犯UDBHR第5条,因此,在这种情况下,通过了UDBHR的测试。然而,目前仍不确定南非居家令对自由的限制是否成功地控制了新冠肺炎的传播并保护了个人免受伤害。初步调查还表明,根据第10条所述原则,特别脆弱的个人可能没有得到公平的待遇,因此,可以谨慎而适度地辩称,在根据UDBHR进行评估时,居家令经不起审查。鉴于对限制自由以控制新冠肺炎传播的有效性的持续讨论,以及人们越来越相信推进司法受到质疑,应该认真考虑限制最少的概念。Ten Have(2022)断言,全球生物伦理学也应该认真考虑其他原则,而不仅仅是限制个人自由,这是正确的。初步结论是,必须认真考虑未来可能实施的居家令。
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引用次数: 0
Suggestion for Determining Treatment Strategies in Dental Ethics. 确定牙科伦理治疗策略的建议。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-11-30 DOI: 10.1007/s11673-023-10310-2
Szilárd D Kovács

Contemporary medicine views health as the individual's physical, mental, and social well-being. Oral health plays a crucial role in one's well-being, as the oral cavity and its surrounding regions execute essential functions in verbal and nonverbal communication, sensing, digestion, and significantly contribute to aesthetic appearance. The multifaceted nature of the notion of oral health, as well as the patient's needs and autonomous will result in various treatment options for the same oral state, favouring often contrasting ethical values and different aspects of oral health. The objective of this article is to suggest alternative treatment strategies in dentistry with respect to the following factors: extent of rehabilitation, preserving one's anatomical structures, aesthetic outcome, number of sessions, patient autonomy. Additionally, this article describes the suggested treatment strategies in an ethical context and determines the conditions of their employment. The suggested treatment strategies are divided in two categories, extensive treatment strategies focusing on the patient's entire craniofacial complex, while specific treatment strategies focus on specific paramount issues.

现代医学认为健康是个人的身体、精神和社会福祉。口腔健康在一个人的健康中起着至关重要的作用,因为口腔及其周围区域在语言和非语言交流、感知、消化方面发挥着重要作用,并对美观有重要贡献。口腔健康概念的多面性,以及患者的需求和自主性,将导致同一口腔状态的不同治疗选择,往往有利于对比的伦理价值观和口腔健康的不同方面。这篇文章的目的是建议替代治疗策略在牙科方面的以下因素:康复的程度,保留一个人的解剖结构,美观的结果,会议的次数,病人的自主权。此外,本文描述了在道德背景下建议的治疗策略,并确定了他们的就业条件。建议的治疗策略分为两类,广泛的治疗策略侧重于患者的整个颅面复合体,而特定的治疗策略侧重于特定的最重要的问题。
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引用次数: 0
The Evolution of Forensic Genomics: Regulating Massively Parallel Sequencing. 法医基因组学的进化:调节大规模平行测序。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-11-15 DOI: 10.1007/s11673-023-10316-w
Marcus Smith, Seumas Miller

Forensic genomics now enables law enforcement agencies to undertake rapid and detailed analysis of suspect samples using a technique known as massively parallel sequencing (MPS), including information such as physical traits, biological ancestry, and medical conditions. This article discusses the implications of MPS and provides ethical analysis, drawing on the concept of joint rights applicable to genomic data, and the concept of collective moral responsibility (understood as joint moral responsibility) that are applicable to law enforcement investigations that utilize genomic data. The widespread and unconstrained use of this technology without appropriate legal protections of individual moral rights and associated accountability mechanisms, could potentially not only involve violations of individual moral rights but also lead to an unacceptable shift in the balance of power between governments and the citizenry. We argue that in light of the rights of victims and the security benefits for society, there is a collective moral responsibility for individuals to submit their DNA to law enforcement and for MPS to be used where other, less invasive techniques are not effective. However, this application should be limited by legislation, including that any data obtained should be directly relevant to the investigation and should be destroyed at the conclusion of the investigation.

法医基因组学现在使执法机构能够使用大规模平行测序(MPS)技术对可疑样本进行快速和详细的分析,包括物理特征、生物血统和医疗状况等信息。本文讨论了MPS的含义,并提供了伦理分析,借鉴了适用于基因组数据的共同权利概念,以及适用于利用基因组数据的执法调查的集体道德责任(理解为共同道德责任)概念。如果没有适当的法律保护个人的道德权利和相关的问责机制,广泛和无限制地使用这种技术,不仅可能涉及侵犯个人的道德权利,而且还可能导致政府与公民之间的权力平衡发生不可接受的变化。我们认为,考虑到受害者的权利和社会的安全利益,个人有集体的道德责任向执法部门提交他们的DNA,在其他侵入性较小的技术无效的情况下使用MPS。然而,这种适用应受到立法的限制,包括所取得的任何资料应与调查直接有关,并应在调查结束时销毁。
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引用次数: 0
Two Decades of the JBI, Where to Next? 联合履行机构成立二十年,下一步何去何从?
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 DOI: 10.1007/s11673-024-10380-w
Michael A Ashby
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引用次数: 0
Psychiatric Illness and Clinical Negligence: When Can "Secondary Victims" Successfully Claim for Damages? Recent Developments from the United Kingdom. 精神疾病与临床过失:次要受害者 "何时能成功索赔?英国的最新发展。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2024-05-22 DOI: 10.1007/s11673-024-10346-y
Edward S Dove

On January 11, 2024, the United Kingdom (U.K.) Supreme Court rendered its judgment in Paul v Royal Wolverhampton NHS Trust, restricting the circumstances in which "secondary victims" can successfully claim for damages in clinical negligence cases. This ruling has provided welcome clarity regarding the scope of negligently caused "pure" psychiatric illness claims, but the judgment may well prove controversial. In this article, I trace the facts and opinion from the majority and also discuss an important dissenting opinion. I then reflect on what the ruling means for psychiatric illness claims by secondary victims, and more broadly on the implications for clinical negligence law. I suggest that while much-needed clarity has been injected in this area of the law, it is difficult, reading the majority of the Supreme Court's emphasis on the restricted scope of a medical practitioner's duty, to envision a scenario in which secondary victim could ever succeed in a clinical negligence context.

2024 年 1 月 11 日,英国最高法院在保罗诉皇家伍尔弗汉普顿 NHS 信托公司一案中做出判决,限制了 "二次受害者 "在临床过失案件中成功索赔的情形。这一判决明确了因疏忽而导致的 "纯粹 "精神病索赔的范围,值得欢迎,但这一判决很可能会引起争议。在本文中,我将追溯事实和多数意见,并讨论一份重要的反对意见。然后,我将思考该判决对二次受害者的精神疾病索赔意味着什么,以及对临床过失法更广泛的影响。我认为,虽然这一领域的法律已经得到了亟需的澄清,但从最高法院多数人对医疗从业者责任限制范围的强调来看,很难设想在临床过失的情况下,次要受害者能够胜诉。
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引用次数: 0
Putting "Epistemic Injustice" to Work in Bioethics: Beyond Nonmaleficence. 将“认识上的不公正”应用于生命伦理学:超越非恶意。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2023-11-13 DOI: 10.1007/s11673-023-10314-y
S Wallaert, S Segers

We expand on Della Croce's ambition to interpret "epistemic injustice" as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce's attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson's concept of "contributory injustice" and Scheman's concept of "perceptual autonomy," we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy.

我们扩展了Della Croce的野心,将“认识上的不公正”解释为使用有影响力的四原则框架中的非恶意行为的具体说明。从概念、道德和启发式的角度来看,这是一条诱人的思路。虽然这是值得称赞的,但德拉·克罗齐的尝试仍然是试探性的。我们对它的批判也是如此。然而,我们接受挑战,批判性地解决两个相互关联的问题。首先,我们扩大分析,包括对解释学不公正的讨论。我们认为,如果对认知不公正的适当考虑需要的不仅仅是医学中的消极伦理义务,那么应该探索解释学不公正的维度,作为达到这种积极义务的途径。其次,相关地,我们认为这可能包括超越个人层面的道德责任,即:在结构层面采取行动的积极义务。在多森的“促成性不公正”概念和图式的“感知自主性”概念的基础上,我们认为证言和解释性正义的优点不仅可以为消极的行为禁止(即非恶意行为)提供额外的内容,还可以为积极的行为要求(如尊重患者的自主性)提供额外的内容。
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引用次数: 0
Gender Affirming Hormone Treatment for Trans Adolescents: A Four Principles Analysis. 变性青少年的性别肯定激素治疗:四项原则分析。
IF 1.8 3区 哲学 Q2 ETHICS Pub Date : 2024-06-01 Epub Date: 2024-01-19 DOI: 10.1007/s11673-023-10313-z
Hane Htut Maung

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the opposition to gender affirming hormone treatment for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong.

性别平权激素治疗是变性青少年护理的一个重要部分,可使他们发展出与其所确认的性别相一致的第二性征。越来越多的实证证据表明,性别平权激素治疗对变性青少年的心理健康和社会福祉大有裨益。然而,在一些国家,变性青少年接受性别平权激素治疗最近受到严格限制。虽然反对为变性青少年提供性别平权激素治疗在一定程度上是出于意识形态的动机,但这也反映了人们对这种治疗是否弊大于利的争论。因此,有必要对变性青少年接受性别肯定激素治疗的伦理问题进行系统而全面的哲学分析。在此,我借鉴汤姆-博尚普(Tom Beauchamp)和詹姆斯-柴尔德里斯(James Childress)的生物医学伦理学四原则,提出这样一种分析方法。基于 "受益"、"非渎职"、"自主 "和 "公正 "的考虑,我认为,从伦理上讲,为同意接受治疗的变性青少年提供获得性别肯定激素治疗的机会是必要的,而目前对这种治疗的限制从伦理上讲是错误的。
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引用次数: 0
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Journal of Bioethical Inquiry
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