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Positive and Negative Rights of Conscience: Balancing When Rights Conflict 良心的积极权利和消极权利:权利冲突时的平衡
Pub Date : 2024-07-23 DOI: 10.1177/00243639241262673
Cynthia Jones-Nosacek
Conscientious objection (CO) in medicine has been seen as a negative right, the right to be free from the intervention of others, so as not to be coerced into doing a medical intervention that the objector thinks is immoral. Arguments are now becoming more common calling for protection for the positive right of conscience, the right to perform interventions by the healthcare provider (HCP) even when it goes against the policy of the healthcare institution (HCI) or the law. Rights create obligations. While negative rights only obligate that others not interfere, positive rights create the obligation of others to support the activity. Positive rights of conscience of the HCP impinge on the negative rights of the HCI. They require that the HCI implicitly support the activity of the HCP, which is formal cooperation and can never be justified without the loss of integrity on the part of the HCI. This article will argue, outside of the limitations of CO such as providing care in an emergency when there is no other option, that respect for the negative right of conscience of the HCI outweighs the positive right of the HCP.
医学中的良心反对(CO)一直被视为一种消极权利,即不受他人干预的权利,从而不被强迫进行反对者认为不道德的医疗干预。现在,越来越多的论点要求保护积极的良心权,即医疗服务提供者(HCP)即使在违背医疗机构(HCI)政策或法律的情况下也有权进行干预。权利产生义务。消极权利只要求他人不得干涉,而积极权利则要求他人有义务支持其活动。医疗保健人员的积极良心权利影响到医疗保健机构的消极权利。这些权利要求人机交互机构默示支持人机交互中心的活动,这是一种形式上的合作,如果不丧失人机交互中心的完整性,这种合作是没有正当理由的。本文将论证,在《公约》的限制范围之外,例如在别无选择的情况下提供紧急护理,尊重人道主义机构的消极良心权利大于人道主义机构的积极权利。
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引用次数: 0
Book Review: Ethics Lost in Modernity: Reflections on Wittgenstein and Bioethics by Matthew S Vest 书评:迷失在现代性中的伦理学:马修-S-维斯特(Matthew S Vest)对维特根斯坦和生物伦理学的思考
Pub Date : 2024-07-23 DOI: 10.1177/00243639241265157
Joseph Peter Swindeman
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引用次数: 0
Validation of Ethical COVID-19 Antibody Testing that Adheres to Pro-Life Principles 验证符合伦理的 COVID-19 抗体测试,恪守支持生命的原则
Pub Date : 2024-06-05 DOI: 10.1177/00243639241258538
Kyle C. McKenna, M. Rohall, Daniel Kissinger, Matthew Evans, Elizabeth Wright, Evelyn Nick, Monica Calkins
We describe validation of a COVID-19 antibody test for detection of anti-SARS-CoV-2 receptor-binding domain (RBD) IgG antibodies in blood plasma utilizing ethically sourced reagents not derived from aborted fetal cell lines. The test demonstrated specificity of 100% (95% confidence intervals 77.2–100%) and sensitivity of 100% (95% confidence intervals 79.6–100%) when evaluating blood specimens previously determined to be negative ( n = 13) or positive for anti-SARS-CoV-2 RBD IgG antibodies due to natural SARS-CoV-2 exposure ( n = 13) or COVID-19 vaccination ( n = 15). The test was used to screen 230 blood specimens from individuals with unknown SARS-CoV-2 exposure ( n = 103) or that were naturally exposed to SARS-CoV-2 ( n = 44), received a COVID-19 vaccine ( n = 66), or received a COVID-19 vaccine before or after SARS-CoV-2 exposure ( n = 17). Ninety-nine percent (95% confidence intervals 95.7–100%) of the 127 blood specimens from individuals that were naturally exposed, vaccinated, or both vaccinated and naturally exposed were positive for anti-SARS-CoV-2 RBD IgG which was consistent with the high sensitivity of our test. This COVID-19 antibody test, now named the PL COVID-19 RBD IgG antibody test, represents an effective and ethical alternative to commercially available COVID-19 antibody tests that utilize reagents derived from aborted fetal lines.
我们介绍了一种 COVID-19 抗体检测方法的验证情况,该方法利用符合道德标准的试剂检测血浆中的抗 SARS-CoV-2 受体结合域 (RBD) IgG 抗体,试剂并非来自流产胎儿细胞系。在评估因自然 SARS-CoV-2 暴露(13 人)或接种 COVID-19 疫苗(15 人)而导致的抗 SARS-CoV-2 RBD IgG 抗体阴性(n = 13)或阳性的血液标本时,该检测方法的特异性为 100%(95% 置信区间为 77.2-100%),灵敏度为 100%(95% 置信区间为 79.6-100%)。该试验用于筛查不明SARS-CoV-2暴露者(103人)或自然暴露于SARS-CoV-2者(44人)、接种过COVID-19疫苗者(66人)或在SARS-CoV-2暴露前后接种过COVID-19疫苗者(17人)的230份血液标本。在自然暴露、接种疫苗或既接种疫苗又自然暴露的 127 份血液标本中,99%(95% 置信区间 95.7-100%)的抗 SARS-CoV-2 RBD IgG 呈阳性,这与我们检测的高灵敏度是一致的。该 COVID-19 抗体检测试剂盒现被命名为 PL COVID-19 RBD IgG 抗体检测试剂盒,它是一种有效且符合道德规范的检测方法,可替代市面上使用流产胎儿试剂的 COVID-19 抗体检测试剂盒。
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引用次数: 0
A Claim of Conscience: The Duty to Prove Oneself a Resistor 良心的诉求:证明自己是抵抗者的责任
Pub Date : 2024-05-15 DOI: 10.1177/00243639241251818
Michael Pakaluk, Catherine R. Pakaluk
An important question that arises as regards a member in a gravely unjust system is whether by any act of “resistance,” undertaken at personal risk, he or she proved himself to be set against that system. This was the question posed by de-Nazification experts employed by the U.S. military in occupied Germany after World War II.1 A similar question is posed today by social movements, such as Black Lives Matter, reacting against historical racism in the United States. We argue that, today, those who in conscience, as members of a gravely unjust system, have wanted to reject vaccinations developed or tested using cell lines derived from abortion, should be understood and evaluated in the same way. We believe that such an approach provides perhaps the best hope for the re-invigoration of society through the pro-life ideals embodied in the “gospel of life.”
对于处于严重不公正制度中的成员来说,一个重要的问题是,他或她是否通过冒着个人风险采取的任何 "抵抗 "行动证明了自己与该制度是对立的。这是第二次世界大战后美军在德国占领区聘用的去纳粹化专家提出的问题。1 今天,黑人的生命很重要(Black Lives Matter)等反对美国历史上种族主义的社会运动也提出了类似的问题。我们认为,今天,那些出于良知,作为严重不公正制度的成员,想要拒绝接受使用从堕胎中提取的细胞系开发或测试的疫苗的人,应该以同样的方式来理解和评价。我们认为,这种方法或许是通过 "生命的福音 "所体现的支持生命的理想来重振社会的最大希望。
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引用次数: 0
An Evaluation of Controversial Statements in Etica Teologica Della Vita 对 Etica Teologica Della Vita 中有争议言论的评价
Pub Date : 2024-04-23 DOI: 10.1177/00243639241245316
Elvis I. Šeman, Eamonn M. Mathieson, Umberto P. Villa, Deirdre T. Little, Randy Dlr Juanta, P. Corby, John I. Fleming, Brendan Purcell
The teachings of the Catholic Church on human sexuality, contraception and the treatment of infertility are well established and clearly explained in many Church documents, including Humanae vitae and Familiaris consortio. In 2022, a book was published in Italian which reported on a seminar organised by an Academy of the Catholic Church about the ethics of life. Titled the Theological Ethics of Life (abbreviated ‘ETV’ in Italian), the conclusion of chapter VII contains statements about contraception and assisted reproductive technologies (ART) which, though somewhat difficult to interpret, appear to be controversial with regard to accepted Church teaching on these subjects. This paper presents a detailed analysis by a group of Australian Catholic doctors and ethicists of an English translation of paragraphs 172 and 173 of ETV and concludes that they contain statements which deviate from and contradict accepted Catholic teaching on contraception and ART. The authors also claim that a thorough up-to-date knowledge and understanding of suitable current alternatives to contraception and ART (eg in-vitro fertilisation, IVF) which are safe, effective, readily accessible and consistent with Catholic ethics appears to be lacking in paragraphs 172 and 173 of ETV. The authors suggest a better understanding of currently available methods to assist with fertility care, aided by input from Catholic medical experts working in the areas of Fertility Awareness Methods (FAMs) and Restorative Reproductive Medicine (RRM) would better inform ongoing debates about contraception and ART within the Church and be of service to the Faithful who should be encouraged to pursue these alternatives which are both effective and consistent with Church teaching on human sexuality and morals.
天主教会关于人类性行为、避孕和不孕症治疗的教义已在许多教会文件中得到确立和明确解释,包括《人类的生命》(Humanae vitae)和《教友手册》(Familiaris consortio)。2022 年,一本意大利文书籍出版,报道了天主教会学院组织的关于生命伦理的研讨会。该书题为《生命的神学伦理》(意大利语缩写为 "ETV"),第七章的结论包含了关于避孕和辅助生殖技术(ART)的陈述,虽然有些难以解释,但似乎与教会在这些问题上的公认教导存在争议。本文介绍了一组澳大利亚天主教医生和伦理学家对 ETV 第 172 和 173 段英译本的详细分析,并得出结论认为,这两段中的陈述偏离并违背了天主教关于避孕和辅助生殖技术的公认教义。作者还声称,《教育电视》第 172 和 173 段似乎缺乏对避孕和抗逆转录病毒疗法(如体外受精、试管婴儿)的当前适当替代方法的全面了解和最新认识,这些替代方法安全、有效、易于获得且符合天主教伦理。作者建议,在生育意识方法(FAMs)和恢复性生殖医学(RRM)领域工作的天主教医学专家的帮助下,更好地了解目前可用的辅助生育方法,将更好地为教会内正在进行的有关避孕和抗逆转录病毒疗法的辩论提供信息,并为教友服务,鼓励教友采用这些既有效又符合教会有关人类性行为和道德教导的替代方法。
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引用次数: 0
Vaccine Science Diplomacy and “The Phenomenon of Man” 疫苗科学外交与 "人类现象"
Pub Date : 2024-04-11 DOI: 10.1177/00243639241245105
Peter Hotez
The central tenets of international scientific collaborations leading to the development, testing, and the equitable distribution vaccines to combat poliomyelitis, smallpox, COVID-19, and other devasting infections, first accelerated in the mid-twentieth century. The genesis of vaccine science diplomacy also coincides with the publication of Le Phénomène Humain ( The Phenomenon of Man) shortly after the death of its author, the French Jesuit priest and scientist, Dr. Teilhard de Jardin. Several tenets of Teilhard's posthumous essay, including our collective consciousness, and the “conjugated faces” of science and religion, are relevant to a modern vaccine diplomacy framework, even if Teilhard may not have specifically addressed vaccines in his writings. This could also include the potential for arriving at an “omega point” through international scientific collaboration and joint vaccine development, while simultaneously avoiding the destructive forces of anti-vaccine or anti-science activism. Collaborations between the Vatican, Catholic research universities and institutions, and leaders of the Catholic-majority nations in Africa, Asia, and Latin America in an integrated framework might accelerate these activities as they apply to both pandemic threats and neglected diseases of poverty.
二十世纪中叶,国际科学合作的核心原则首次加速了脊髓灰质炎、天花、COVID-19 和其他致命传染病疫苗的开发、测试和公平分配。疫苗科学外交的起源与《人类现象》(Le Phénomène Humain)一书的作者、法国耶稣会教士兼科学家泰勒哈德-德-雅尔丹(Teilhard de Jardin)博士去世后不久该书的出版不谋而合。泰勒哈德遗作中的一些信条,包括我们的集体意识和科学与宗教的 "共轭面",都与现代疫苗外交框架相关,尽管泰勒哈德在他的著作中可能并没有特别提到疫苗。这也可能包括通过国际科学合作和联合疫苗开发达到 "欧米茄点 "的可能性,同时避免反疫苗或反科学激进主义的破坏力量。梵蒂冈、天主教研究大学和机构以及非洲、亚洲和拉丁美洲天主教占多数国家的领导人在一个综合框架内开展合作,可能会加速这些活动,因为它们既适用于流行病威胁,也适用于被忽视的贫困疾病。
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引用次数: 0
Pre-Exposure Prophylaxis for HIV: Bioethical, Clinical, and Epidemiological Considerations 艾滋病毒暴露前预防:生物伦理、临床和流行病学考虑因素
Pub Date : 2024-03-21 DOI: 10.1177/00243639241239068
John D. Markley
Public health authorities are broadly promoting a strategy known as pre-exposure prophylaxis (PrEP) for the prevention of human immunodeficiency virus (HIV) transmission in the context of high-risk sexual activity and injection drug use. However, there are several limitations to this strategy that are underrecognized. This article reviews the primary literature supporting the use of PrEP and explores the unintended consequences associated with its use. Current public health messaging indicates that PrEP reduces the risk of HIV transmission during sex by 99 percent; however, this figure is based on modeling rather than study findings, and real-world efficacy may be significantly lower. PrEP has been associated with increased rates of sexually transmitted infections, risk compensation, HIV drug resistance, low adherence, and drug side effects. To make fully informed decisions, medical professionals and patients should be aware of these pitfalls. Additionally, this article explores the bioethical implications of prescribing PrEP from a Catholic perspective. Although not always morally illicit, PrEP is most often prescribed in the context of sexual activity outside of marriage between a biological male and female, placing the prescriber in cooperation with activity deemed to be immoral by the Catholic Church. While all medical professionals seeking the common good should aim to reduce the transmission of HIV, not all means are morally licit. Conscience protection for medical professionals opposed to this strategy has become increasingly relevant. Thoughtful discernment is necessary when considering PrEP. Summary: The use of CDC material (figure 1) in this article does not imply endorsement by CDC. The material is in the public domain and available on the CDC website free of charge.
公共卫生部门正在广泛推广一种被称为暴露前预防(PrEP)的策略,用于预防高危性行为和注射吸毒中的人体免疫缺陷病毒(HIV)传播。然而,这一策略存在一些未被充分认识到的局限性。本文回顾了支持使用 PrEP 的主要文献,并探讨了与使用 PrEP 相关的意外后果。目前的公共卫生信息显示,PrEP 可将性行为中传播 HIV 的风险降低 99%;然而,这一数字是基于模型而非研究结果得出的,实际疗效可能要低得多。PrEP 与性传播感染率升高、风险补偿、艾滋病抗药性、依从性低和药物副作用有关。为了做出完全知情的决定,医疗专业人员和患者都应了解这些隐患。此外,本文还从天主教的角度探讨了处方 PrEP 所涉及的生物伦理问题。尽管 PrEP 并不总是道德上非法的,但其处方最常见的情况是在生理上属于男性和女性的婚外性活动中使用,这就使处方者与天主教会认为不道德的活动合作。虽然所有追求共同利益的医疗专业人员都应致力于减少艾滋病毒的传播,但并非所有手段在道德上都是合法的。对反对这一策略的医疗专业人员的良心保护变得越来越重要。在考虑 PrEP 时,有必要进行深思熟虑的辨别。摘要:本文中使用的 CDC 资料(图 1)并不意味着 CDC 的认可。这些材料属于公共领域,可在疾病预防控制中心网站上免费获取。
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引用次数: 0
Reimagining the Discipleship of Marriage Through the Lens of Mark: A Theological Reflection for Bioethical Decision-Making on Contraception in Catholic Healthcare and Marital Life 通过马可福音的视角重新认识婚姻的门训:天主教医疗保健和婚姻生活中有关避孕的生物伦理决策的神学思考
Pub Date : 2024-03-11 DOI: 10.1177/00243639241236857
S. Abbate
Mark 10:13–16, interpreted within the broader context of the Gospel of Mark, using a moral exegetical framework, provides a lens for what welcoming the children refers to in sacramental marital discipleship. Building upon the narrative ethics of Mark, the words and deeds of Jesus, magisterial teachings and writings allow these verses to be reimagined to unveil an interpretation and a praxis for marital and moral life. Accepting the gift of a child in the natural order paves the way for discipleship and ushers in the kingdom of God. Just as Jesus welcomed the children, parents are called to welcome them through unhindered conjugal love. These reflections form a Catholic theology of married life and sexuality and a theology of children that the couple shares with Christ's thoughts and actions.
马可福音》第 10 章第 13-16 节在《马可福音》的大背景下,运用道德训诂学框架进行诠释,为圣事婚姻门徒训练中的 "欢迎孩子 "提供了一个视角。以《马可福音》的叙事伦理、耶稣的言行、教义和著作为基础,对这些经文进行重新阐释,以揭示婚姻和道德生活的诠释和实践。在自然秩序中接受孩子的礼物,为门徒训练铺平了道路,并迎来了天国。正如耶稣欢迎孩子一样,父母也应通过无障碍的夫妻之爱来欢迎孩子。这些思考构成了天主教的婚姻生活和性行为神学,以及夫妻与基督的思想和行动相同的儿童神学。
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引用次数: 0
Delectatio and Recreational Drug Use: Using Aquinas' Account of Pleasure to Argue That Recreational Drug Use Is Immoral 愉悦与娱乐性吸毒:用阿奎那的快感论证娱乐性使用毒品是不道德的
Pub Date : 2024-02-29 DOI: 10.1177/00243639241231595
Matthew McKenna
This article offers a new argument for why recreational drug use is inherently immoral. Typical arguments against recreational drug use focus on legality, purposefully undermining the ability to reason, and harmful health effects. This argument recovers St. Thomas Aquinas' account of delectatio (pleasure) to argue that the pleasure sought in recreational drug use is immoral due to its disproportionality to the good achieved in the act of taking drugs. It then examines the use of alcohol as a helpful example for this argument since the recreational use of alcohol in low quantities is a case which can diminish the applicability of traditional arguments against recreational drug use.
本文提出了一个新的论点,说明为什么娱乐性吸毒本质上是不道德的。反对娱乐性使用毒品的典型论点主要集中在合法性、故意破坏理性能力以及有害健康等方面。本论点重拾圣托马斯-阿奎那(St. Thomas Aquinas)关于 "享乐"(delectatio)的论述,认为娱乐性吸毒所追求的享乐是不道德的,因为它与吸毒行为所获得的益处不相称。然后,它研究了酒精的使用,将其作为这一论点的一个有用例子,因为低量酒精的娱乐性使用可以削弱反对娱乐性使用毒品的传统论点的适用性。
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引用次数: 0
My Life with Bosco 我与博斯科的生活
Pub Date : 2024-02-08 DOI: 10.1177/2755323x241228030
Dierdre Cooper
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引用次数: 0
期刊
The Linacre Quarterly
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