Journal of Bioethical Inquiry最新文献

There has been much discussion about the tactics used by the Israeli Defence Forces (IDF) and government in the conflict in Gaza following October 7, 2023, which have caused, among other things, systematic destruction of hospitals and schools, the deaths of large numbers of civilians, including women and children, mass starvation, and denial of humanitarian aid. The Israeli government and IDF have sought to justify their actions using ethical arguments, many of which relate to their proclaimed role as the representatives of the Jewish state and of Jewish culture and history. Arguing from the extensive corpus of Jewish ethical thought, extending back thousands of years, this article poses a simple question: Are the above actions by the Israeli government and IDF in Gaza consistent with the ethical tradition of Judaism and the obligations that flow from it? To answer this question, key texts are analysed, especially the Hebrew Bible and the Talmud, and multiple arguments are examined, taking into account the complexities of context and diverse interpretive theories. The paper is presented in two parts, the first discussing the question and methodological issues and the second providing the data and conclusions. We conclude that the alleged acts of the Israeli government and IDF in Gaza are clearly and directly contrary to the Judaic tradition of ethics as it has developed over the millennia. The conduct of the war cannot truthfully be presented in any meaningful sense as representing, or indeed, consistent with, Jewish culture or ethics. These findings have potentially far-reaching consequences, including for the claimed status of Israel as a Jewish state, the relationship between criticism of the government of Israel and the scourge of antisemitism, and the identity of Jewish people both within and outside Israel.

Hospital ethics committees (HECs) traditionally focus on clinical ethics but are increasingly recognized for their potential role in addressing organizational ethics, particularly in the allocation of charity care resources. This commentary explores the expanded role of HECs in charity care allocation, emphasizing the core ethical principles of justice, transparency, and accountability. We discuss the need for HECs to develop expertise in organizational ethics, differentiate between emergency and chronic resource allocation, and apply value-based insurance design principles to set service boundaries. By adopting an egalitarian approach to justice, HECs can help reduce health disparities and ensure equitable access to charity care. Enhanced transparency and accountability through clear criteria, regular audits, and public reporting are also vital. This paper underscores the importance of integrating these ethical principles into healthcare resource allocation to promote health equity and maintain the financial sustainability of healthcare institutions.

A key maxim guiding the introduction of new technologies, including those utilizing artificial intelligence, is that such technologies should carry rewards of "convenience": indeed, the more "convenient" a new technology is considered to be, the more likely it is to be welcomed and adopted. Rudimentary examples from last century include the microwave, washing machine, and dishwasher; more recent innovations from the present century include portable navigation systems, online shopping applications, internet search engines, smart phones, telehealth, automated workplace systems and processes, email and messaging technologies, and-most recently-large language models that are able to undertake multiple complex tasks. Each of these technologies offers a variety of benefits. However, a unifying feature is that all have been considered to enhance convenience, understood as saving time and/or effort. In this paper we explore the provenance and meaning of the-usually unexamined-concept of convenience, identifying an unexpected link with erosion of values and depletion of the diversity and richness of personal experiences. We conclude that the prioritization of convenience as a driver of innovation carries with it risks, which may go unnoticed or be difficult to discern.

Nigeria's governance of genomic and biobanking research is hindered by inadequate regulatory frameworks that fail to address critical ethical and legal issues, such as data sharing, genomic sovereignty, informed consent, and benefit sharing. These governance gaps compromise participant rights, undermine trust, and hinder the equitable management of genetic resources. This study proposes an Indigenous Jurisprudential Framework (IJF) that integrates customary law and stewardship principles to create a culturally relevant governance model for genomic and biobanking research. Customary law, which emphasizes communal ownership and collective decision-making, provides a culturally grounded foundation for research governance, while stewardship principles advocate for the responsible management and preservation of genetic resources. By merging these approaches, the IJF aims to enhance ethical oversight, ensure equitable benefit sharing, and rebuild trust between researchers and participants. The framework also seeks to mitigate the exploitation of genetic resources, strengthen Nigeria's position in global scientific collaborations, and promote sustainable development by aligning research practices with local values. This research, grounded in a systematic literature review, offers a practical, context-specific solution that bridges traditional values with contemporary ethical standards, addressing the governance challenges in Nigeria's genomic and biobanking research. The IJF not only provides a model for Nigeria but also offers insights for other countries grappling with similar governance issues, particularly in regions with pluralistic legal systems and rich cultural traditions.

Alcohol use causes significant harms and is extensively regulated by governments, but alcohol-related questions are under-explored in public health ethics. To inform future work in this area, I conducted interviews with key informants from alcohol research and policy work in Australia. Thematic analysis of interviews identified a range of ethical issues that can be categorized under six themes: ethical issues in alcohol research; ethical issues raised by judgements about alcohol use; ethical issues raised by alcohol policies; ethical issues in policy processes; ethical questions about policy aims; and ethical issues in how alcohol problems are defined. The study provides direction for future research on problems that are underexplored in the ethics literature. These include problems arising from the influence of industry in alcohol research and policy, the question of how to develop research and policy without generating stigma, and social justice issues connected to alcohol-related stereotypes and judgements.

A long-standing debate has persisted on whether reciprocity reasonably justifies the priority rules in organ allocation as some countries (e.g., Israel, Singapore, Chile, and China) have adopted this priority policy based on reciprocity. This paper reviews the ethical dilemmas and challenges of incorporating reciprocity into a priority system by considering the following five aspects: (1) It exacerbates the risk of incorporating moral values in the organ allocation context. (2) It is incompatible with the reciprocity inherent in the gift- or gratitude-based relationship in organ allocation. (3) The concept of "reciprocity," which easily extends the idea of "moral desert," could, thus, exacerbate social inequalities. (4) In the context of incentives instead of rewards, priority rules in organ allocation need not involve the obligation of reciprocity. (5) Reciprocity acceptability does not invariably translate into efficacy. In sum, reciprocity is not an appropriate moral rationale for being established as a priority rule in organ allocation, and alternatives such as altruism or charity (virtue)-though associated with several feasibility and fairness-related concerns-seem preferable.

In birth literature, there is a consensus that birth narratives incorporating a strong sense of agency contribute to the person's well-being postpartum and beyond. In this article, I aimed to develop an ecological perspective on the emergence of birthing-self narratives and analyse the restrictions experienced in forming empowering birth narratives from the affordance perspective. The concept of affordance has equipped philosophers with a useful tool to study organism-environment relations and to look beyond dualities such as internal and external, biological and environmental, physical and social etc. I argue that this conceptual framework can be fruitful in understanding the emergence of agency and selfhood during birth. Authentic birthing-self narratives are necessarily rooted in the encompassing birth assemblages and reconceptualizing birth assemblage as a system producing narrative affordances for the birthing-self may contribute (1) to supporting a contextual account of self-experience and agency in birth and (2) to illustrate through birth the complexity of the affordance space in which human organisms develop self-experiences. In this study, I dwell on my research and analyse three birthing-self narratives to illustrate how feelings of a birthing body intra-act with physical, social, institutional, and discursive space to shape affordances for narrating the birthing-self.

Rural communities experience well-documented systemic disparities in health access and outcomes in comparison to urban populations. However, the ethical dimensions of these disparities have received only limited attention, and ethical issues related to rural health research have received even less. With the COVID-19 pandemic casting new light on these inequities, we conducted a scoping review to determine how much has been written on ethical issues in rural health research and which ethical issues are most prevalent. Four overarching ethical themes emerged through the search: resource inequity, underrepresentation, the benefits of community-based research, and challenges related to participant autonomy. Additionally, the search revealed a dearth of articles on ethical issues in rural health research, particularly in the United States. Thus, we propose four recommendations to revitalize and guide ethics discussions of research in rural communities, including growing the literature on ethical issues in rural U.S. communities, encouraging collaboration between rural health and bioethics researchers, improving recognition of rural heterogeneity, and addressing new issues in light of COVID-19. Acting on these recommendations would expand and support rural research efforts and ultimately help ameliorate rural-urban health inequities.