Journal of Bioethical Inquiry最新文献

An ethical and legal framework is needed to regulate the rapidly developing human brain organoid research field properly. However, considering the legal issues involved in human brain organoid research remains underdeveloped and scattered. This article reviews the legal issues of human brain organoid research, grouping them into the following five broad themes: (1) consciousness, (2) legal status, (3) consent, (4) ownership, and (5) transplantation. The issues in each topic include both the urgent (e.g., appropriate forms of consent) and the speculative (e.g., protection of conscious human brain organoids). Therefore, we have attempted to be as explicit as possible about the timescale within which each issue will be realized and to prioritize each. Examining these issues has revealed legal issues specific to human brain organoid research and issues common to research in other fields. Further discussion of human brain organoid research from a legal perspective is needed in the future, considering discussions in related fields.

I defend a novel account of the wrong of subjecting people to non-consensual sterilization (NCS), particularly in the context of the state-sponsored eugenics programmes once prevalent in the United States. What makes the eugenicist practice of NCS distinctively wrong, I claim, is its dehumanizing core: the fact that it is tantamount to treating people as nonhuman animals, thereby expressing the degrading social meaning that they have the value of animals. The practice of NCS is prima facie seriously wrong partly, but crucially, on these grounds. I consider and reject accounts of the wrong of NCS that make no reference to its animalizing character, such as that it violates victims' (procreative) autonomy, amounts to treating them merely as a means, inflicts psychological harm on them, or constitutes an affront to their human dignity. My discussion suggests that the critical vocabulary of bioethics should be expanded beyond talk of rights violations, benefits and harms, and equal treatment-and that the language of dehumanization is indispensable to bioethicists.

Objective: To examine i) how ethical frameworks can be used in concrete cases of parent-doctors' disagreements for extremely preterm infants born in the grey zone to guide such difficult decision-making; and ii) what challenges stakeholders may encounter in using these frameworks.

Design: We did a case analysis of a concrete case of parent-doctor disagreement in the grey zone using two ethical frameworks: the best interest standard and the zone of parental discretion.

Results: Both ethical frameworks entailed similar advantages and challenges. They have the potential 1) to facilitate decision-making because they follow a structured method; 2) to clarify the situation because all relevant ethical issues are explored; and 3) to facilitate reaching an agreement because all parties can explain their views. We identified three main challenges. First, how to objectively evaluate the risk of severe disability. Second, parents' interests should be considered but it is not clear to what extent. Third, this is a value-laden situation and different people have different values, meaning that the frameworks are at least partially subjective.

Conclusions: These challenges do not mean that the ethical frameworks are faulty; rather, they reflect the complexity and the sensitivity of cases in the grey zone.

I embark on the writing of this short note not as an expert in ethics or a seasoned war analyst but rather as an involved observer nudged into the spotlight by a colleague's overestimation of my insight into the Israel-Hamas conflict. I approach this task with scepticism yet hoping to morph it into a form of therapy. My own therapy, a means to break the shackles of silence that have gripped not only myself but, I suspect, many others in Israel.

Bioethicists, through their writings, have been known to represent the conscience of the times. Speaking up against injustices, they have acted as moral compasses in the past. The events of October 7, 2023 and the resulting armed onslaught of Israeli forces on Gaza has created a huge humanitarian crisis. However, response of the global bioethics community appears muffled. In order to gain an objective insight, we conducted a scoping review of articles published on the current conflict in the top ten bioethics journals, as classified by Google metrics. Broadening this search, we included relevant grey literature and selected medical and global health journals in our review. All types of articles published from the initiation of the conflict to the end of March 2024 were included. Findings from our exercise highlight the paucity of articles published on this crisis. This apparent indifference towards the Gaza crisis can be explained either by reluctance by bioethicists to write on this issue or perhaps due to editorial restraints. We argue that bioethicists, instead of focusing on esoteric issues, have a greater moral responsibility to speak out against injustices in Gaza. Their silence amounts to complicity and erodes the very foundations of the discipline of bioethics.

This paper reviews briefly the main approaches in the literature on ethics of war and suggests the need to move beyond an ethic of justice towards an ethic of care. The analysis problematizes dominant understandings of "just war" and "just peace" in the literature and highlights that incorporating elements of an ethic of care, our understanding of ethics of war and peace can be redefined, sharpened, and redeployed through an enlarged ethical lens. The author suggests that scholars and practitioners in different fields of study and domains of social and political life can make important contributions by defining, elucidating, and advocating why both perspectives, those of ethic of justice and care, together allow us to capture the prospects of a broader understanding and the practice of peace.

As the science and technology of the brain and mind develop, so do the ways in which brains and minds may be surveilled and manipulated. Some cognitive libertarians worry that these developments undermine cognitive liberty or "freedom of thought." I argue that protecting an individual's cognitive liberty undermines others' ability to use their own cognitive liberty. Given that the threatening devices and processes are not relevantly different from ordinary and frequent intrusions upon one's brain and mind, strong protections of cognitive liberty may proscribe neurotechnological intrusions but also ordinary intrusions. Thus, the cognitive libertarian position "hog-ties" others' use of their own liberties. This problem for the cognitive libertarian is the same problem that ordinary libertarianism faces in protecting individual rights to property and person. But the libertarian strategies for resolving the problem don't work for the cognitive libertarian. I conclude that the right to mental privacy is weaker than what cognitive libertarians want it to be.

Background Ethical conflicts generate difficulties in daily clinical activity. Which methods of ethical advice are most frequently used to resolve them among Spanish doctors has not been studied. The objective of this study is to describe what methods hospital internal medicine physicians in Spain use to resolve their ethical doubts and which they consider most useful. Design A cross-sectional observational study was conducted through a voluntary and anonymous survey and distributed through an ad hoc platform of the Spanish Society of Internal Medicine. Measures We measured methods by which to resolve doubts, types of tools sought, frequency of consulting the Clinical Ethics Committees, and satisfaction with resolution of ethical issues. Results Of 261 internists surveyed, 86 per cent resolve their ethical doubts with assistance, the most frequently used method being consultation with colleagues (58.6 per cent), followed by using specific protocols or guides (11.8 per cent) and consultation with experts in bioethics (9.6 per cent). The most preferred tools are the creation of protocols (30.3 per cent) and the establishment of a consultant/expert in bioethics (27.8 per cent). Conclusions Internists in Spain usually seek assistance to resolve their ethical doubts. Consulting colleagues is the most frequently adopted method. The majority regard tools to resolve ethical conflicts as necessary, seeking above all protocols and consultants/experts in bioethics.

Introduction: The disclosure of information that identifies deceased organ donors and/or organ transplant recipients by organ donation agencies and transplant centres is regulated in Australia by state and territory legislation, yet a significant number of donor family members and transplant recipients independently establish contact with each other.

Aim: To describe and synthesize Australian laws and guidelines on the disclosure of identifying information.

Method: Legislation and guidelines relevant to organ donation and transplantation were obtained following a search of government and DonateLife network websites. Information about the regulation of identity disclosure was extracted and synthesised using a process guided by Walt and Gilson's (1994) policy analysis framework.

Findings: Nineteen documents were examined. Six guidelines refer to and were consistent with current legislation. Four documents did not address identity disclosure. All jurisdictions prohibit healthcare professionals from disclosing identifying information. In three states, the prohibition extends to all members of the public including donor family members and transplant recipients.

Conclusion: Restrictions on identity disclosure have implications for public promotion of donation and transplantation where sharing of stories and images of organ donors and transplant recipients is common. Further research is required to understand the perspective of donor family members, transplant recipients, and healthcare professionals impacted by the current laws.