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Medically Assisted Dying in the Global South 全球南部的医疗协助死亡
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-04-06 DOI: 10.1111/dewb.12450
Udo Schuklenk
<p>As is often the case in discussions of global issues, developments in the global south are somewhat neglected. I noted in a recent Editorial in a previous issue of Developing World Bioethics significant achievements in terms of access to abortion care in a number of countries of the global south.1 This progress is largely ignored in media reports, given most large media organisations focus on the United States and other countries of the global north. The same holds true for developments in the context of medically assisted dying.</p><p>In recent years the number of jurisdictions that have decriminalized or legalized medically assisted dying involving assisted suicide or euthanasia has steadily increased in the global north. A somewhat heated debate continues not so much on the ethical permissibility of assisted dying, but on questions of scope, namely who should be eligible for an assisted death. Most controversial is the inclusion of non-terminally ill, decisionally-capable people with disabilities and/or mental illnesses. I have written elsewhere extensively on these issues.2 Today I want to draw your attention to an entirely different issue. Medical assistance in dying in the global south.</p><p>During the last few years, Developing World Bioethics has seen a remarkable uptick of submissions from countries of the global south that address ethical issues of medically assisted dying in particular countries of the global south. Examples of this include articles on euthanasia in Colombia,3 Chile,4 India,5 Ecuador,6 and China7 (in no particular order). Ecuador and Colombia have legalised active euthanasia, and, in an interesting court case, a court in Peru permitted euthanasia for a particular patient. Chile permits passive euthanasia, as does India.</p><p>At the time of writing court cases are progressing in various countries of the global south, with the aim to see the practice decriminalized or legalized, including, among others, in South Africa. Anton van Niekerk, a long-serving member of our Editorial Board, has been at the forefront of these debates in his native country.8 Willem Landman, a founding Editor of this journal is also actively involved in the South African court case. A peculiar South African contribution to the debates on assisted dying is the question of whether or not such a practice would be contrary to African culture. I am no expert on African culture, but I wonder whether there is a uniform African culture with an uncontroversial universally agreed-on view on assisted dying. Reportedly Teslio Thipanyane, the Head of the South African Human Rights Commission, declared publicly that the country's ‘constitutional rights of dignity and “of every individual to control of his or her own body” are a clear basis for euthanasia or assisted suicide.’ 9 Perhaps there is no such a thing then as an ‘African culture’ voice that would settle at least the question of whether or not euthanasia would be an un-African activity. Unsurprisin
在讨论全球性问题时,全球南部的发展情况往往被忽视。我在上一期《发展中世界生物伦理学》的社论中指出,全球南部一些国家在获得堕胎护理方面取得了重大成就。1 媒体报道在很大程度上忽视了这一进展,因为大多数大型媒体机构都将注意力集中在美国和全球北部的其他国家。医疗协助死亡方面的发展情况也是如此。近年来,全球北方将涉及协助自杀或安乐死的医疗协助死亡非刑罪化或合法化的司法管辖区数量稳步增加。关于协助死亡的伦理允许性,而不是范围问题,即哪些人有资格接受协助死亡,一场有些激烈的辩论仍在继续。最有争议的是将非临终病人、有决定能力的残疾人和/或精神病患者纳入其中。今天,我想提请大家注意一个完全不同的问题。在过去的几年里,《发展中世界生命伦理学》看到了来自全球南部国家的投稿显著增加,这些投稿涉及全球南部特定国家的医疗协助死亡伦理问题。这方面的例子包括有关哥伦比亚、3 智利、4 印度、5 厄瓜多尔6 和中国7 (排名不分先后)安乐死的文章。厄瓜多尔和哥伦比亚已将主动安乐死合法化,在一个有趣的法庭案例中,秘鲁的一家法院允许对特定病人实施安乐死。智利允许被动安乐死,印度也允许被动安乐死。在撰写本报告时,全球南部多个国家的法院正在审理案件,目的是使安乐死合法化或非刑罪化,其中包括南非。安东-范-尼凯尔克(Anton van Niekerk)是本刊编辑委员会的长期成员,在他的祖国,他一直站在这些辩论的前沿。南非对协助死亡辩论的一个独特贡献是,这种做法是否有悖于非洲文化。我不是非洲文化方面的专家,但我想知道是否存在一种统一的非洲文化,对协助死亡有一种没有争议的普遍认同的观点。据报道,南非人权委员会主席特斯利奥-提潘尼亚内(Teslio Thipanyane)公开宣称,南非'宪法规定的尊严权和 "每个人控制自己身体的权利 "是安乐死或协助自杀的明确依据'。9 或许并不存在所谓的 "非洲文化 "声音,至少可以解决安乐死是否是一种非非洲活动的问题。不出所料,令人欣慰的是,与全球北方一样,非洲人似乎对安乐死持有不同的观点。我有兴趣更多地了解全球南部关于这一主题的伦理和政策辩论。例如,在全球南部,医疗保健系统通常比较薄弱,这是否会对这种做法的伦理评估产生影响?各州执行法律法规的能力薄弱是否会对安乐死的伦理评估产生影响?作为本刊的编辑,我鼓励我们的读者对这一主题进行思考,并提交经过深思熟虑的伦理分析供我们审阅,以期这些内容最终能在本刊上发表。我相信,这将丰富目前全球范围内的伦理和政策讨论。
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引用次数: 0
The difficult path to euthanasia in Ecuador: A call for actions for other nations 厄瓜多尔安乐死的艰难之路:呼吁其他国家采取行动。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-03-20 DOI: 10.1111/dewb.12449
Esteban Ortiz-Prado, Jorge Vasconez-Gonzalez, Juan S. Izquierdo-Condoy
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引用次数: 0
A survey of the allocation of scarce resources in Türkiye during the COVID-19 pandemic: Which criteria did healthcare professionals prioritize? 调查 COVID-19 大流行期间土耳其稀缺资源的分配情况:医疗保健专业人员优先考虑哪些标准?
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-03-20 DOI: 10.1111/dewb.12448
Rahime Aydin Er, Gülten Çevik Nasirlier

COVID-19 caused an imbalance between medical resources and the number of patients in Türkiye like in many countries. There was not pandemic-triage system, and this situation led to decision making based on experience, intuition, and judgment of allocation of scarce resources. The research explains the guiding criteria that healthcare professionals used to prioritize the distribution of scarce medical resources during the COVID-19 pandemic. The criteria preferred by 928 healthcare professionals were evaluated when preventive measures for COVID-19 were reduced and so the number of cases increased rapidly. The results indicate that Turkish healthcare professionals largely support the utilitarian approach, which focuses on medical benefit in pandemic. The main problem was that some criteria not approved in COVID-19 triage guidelines were considered important by healthcare professionals. These criteria, which cause discrimination by preventing the provision of fair and equal medical care to patients, are a prominent issue in the study.

与许多国家一样,COVID-19 在土耳其造成了医疗资源与病人数量之间的不平衡。由于没有大流行病分诊系统,在这种情况下,只能根据经验、直觉和判断来决定稀缺资源的分配。研究解释了在 COVID-19 大流行期间,医疗保健专业人员在分配稀缺医疗资源的优先次序时所使用的指导标准。在 COVID-19 预防措施减少、病例数量迅速增加的情况下,对 928 名医疗保健专业人员首选的标准进行了评估。结果表明,土耳其医疗保健专业人员大多支持功利主义方法,即在大流行病中注重医疗效益。主要问题在于,医护人员认为 COVID-19 分诊指南中未批准的一些标准很重要。这些标准造成了歧视,阻碍了为患者提供公平、平等的医疗服务,是研究中的一个突出问题。
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引用次数: 0
The informed consent process: An evaluation of the challenges and adherence of Ghanaian researchers. 知情同意程序:对加纳研究人员面临的挑战和遵守情况的评估。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-03-13 DOI: 10.1111/dewb.12447
Paa-Kwesi Blankson, Florence Akumiah, Amos Laar, Lisa Kearns, Samuel Asiedu Owusu

This study assessed challenges faced by researchers with the informed consent process (ICP). In-depth interviews were used to explore challenges encountered by Investigators, Research assistants, Institutional Review Board members and other stakeholders. An electronic questionnaire was also distributed, consisting of Likert-scale responses to questions on adherence to the ICP, which were derived from the Helsinki Declaration and an informed consent checklist of the US Department of Health and Human Research (HSS). Responses were weighted numerically and scores calculated for each participant. The median score of the level of adherence to the informed consent process was 93%. Most of the respondents (60%) cited the lack of time for the ICP to be a challenge, with 65% indicating a lengthy consent document to be the main challenge with the informed consent document. Challenges with language and communication were the dominant theme among informants. Despite the high adherence of Ghanaian researchers and research assistants to the ICP, challenges are still prevalent, requiring diligent and continuous efforts in research implementation.

本研究评估了研究人员在知情同意程序 (ICP) 中面临的挑战。通过深入访谈,探讨了研究人员、研究助理、机构审查委员会成员和其他利益相关者遇到的挑战。此外,还分发了一份电子问卷,其中包括对有关遵守 ICP 问题的李克特量表式回答,这些问题源自《赫尔辛基宣言》和美国卫生与人类研究部(HSS)的知情同意清单。对每个参与者的回答进行数字加权并计算得分。知情同意程序遵守程度的中位数为 93%。大多数受访者(60%)认为缺乏时间进行 ICP 是一项挑战,65% 的受访者表示冗长的同意文件是知情同意文件的主要挑战。语言和沟通方面的挑战是受访者的主要问题。尽管加纳研究人员和研究助理高度遵守 ICP,但挑战仍然普遍存在,需要在研究实施过程中不断努力。
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引用次数: 0
Biomedical research on autism in low- and middle-income countries: Considerations from the South African context. 中低收入国家的自闭症生物医学研究:南非的考虑因素。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-02-26 DOI: 10.1111/dewb.12446
Siobhan de Lange, Dee Muller, Chloe Dafkin

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by social/communicative difficulties and perseverative behaviours. While research on autism has flourished recently, few studies have been conducted on the disorder in non-Western contexts. In low- and middle-income countries (LMICs), biomedical research on autism is required to better understand the needs of the population and to develop contextually appropriate interventions. However, autistic individuals are a vulnerable study population and LMICs present with various considerations. While the presentation of autism is heterogeneous, stigma is a common social consequence affecting research. Drawing specifically on the South African context, the ethical intersections of these issues are discussed, along with the limitations of the current informed consent process. Community engagement is recommended as an adjunct to informed consent to ensure that biomedical research is conducted in a more inclusive way. Practical pointers are provided for implementing systematic support for conducting community engagement alongside biomedical research.

自闭症谱系障碍(ASD)是一种以社交/沟通障碍和顽固行为为特征的神经发育疾病。虽然有关自闭症的研究近来蓬勃发展,但在非西方环境下对该疾病进行的研究却很少。在低收入和中等收入国家(LMICs),需要对自闭症进行生物医学研究,以更好地了解人群的需求,并制定适合当地情况的干预措施。然而,自闭症患者是一个易受伤害的研究群体,而中低收入国家又有各种不同的考虑因素。虽然自闭症的表现形式多种多样,但污名化是影响研究的常见社会后果。本文以南非的具体情况为背景,讨论了这些问题的伦理交叉点以及当前知情同意程序的局限性。建议将社区参与作为知情同意的辅助手段,以确保以更具包容性的方式开展生物医学研究。本文还提供了一些实用指南,以便为在开展生物医学研究的同时进行社区参与提供系统支持。
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引用次数: 0
From moral rights to legal rights? Lessons from healthcare contexts 从道德权利到法律权利?医疗保健领域的经验教训。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-02-09 DOI: 10.1111/dewb.12444
Michael Da Silva

Many believe the existence of a moral right to some good should lead to recognition of a corresponding legal right to that good. If, for instance, there is a moral right to healthcare, it is natural to believe countries should recognize a legal right to healthcare. This article demonstrates that justifying legal rights to healthcare is more difficult than many assume. The existence of a moral right is insufficient to justify recognition of a corresponding justiciable constitutional right. Further conditions on when it is appropriate to recognize constitutional rights are rarely satisfied in the healthcare case. And focusing on aspirational or statutory rights presents costs for those seeking to justify legal rights on the basis of corresponding moral ones while maintaining empirical challenges for justifying constitutional rights. This suggests movement from a moral right to a corresponding legal one is far from straightforward and justifies examining alternative means of realizing moral socio-economic rights such as the proposed moral right to healthcare.

许多人认为,对某种物品的道德权利的存在应导致承认对该物品的相应法律权利。例如,如果存在获得医疗保健的道德权利,人们自然会认为各国应承认获得医疗保健的法律权利。本文表明,证明医疗保健法律权利的合理性比许多人想象的要困难得多。道德权利的存在不足以证明承认相应的可诉宪法权利是合理的。在医疗保健案件中,很少能满足关于何时适合承认宪法权利的进一步条件。对于那些寻求在相应道德权利的基础上证明法律权利正当性的人来说,专注于愿望权利或法定权利会带来成本,同时在证明宪法权利正当性方面仍面临经验挑战。这表明,从道德权利到相应法律权利的转变远非一蹴而就,因此有必要研究实现道德社会经济权利的其他方式,如拟议的医疗保健道德权利。
{"title":"From moral rights to legal rights? Lessons from healthcare contexts","authors":"Michael Da Silva","doi":"10.1111/dewb.12444","DOIUrl":"10.1111/dewb.12444","url":null,"abstract":"<p>Many believe the existence of a moral right to some good should lead to recognition of a corresponding legal right to that good. If, for instance, there is a moral right to healthcare, it is natural to believe countries should recognize a legal right to healthcare. This article demonstrates that justifying legal rights to healthcare is more difficult than many assume. The existence of a moral right is insufficient to justify recognition of a corresponding justiciable constitutional right. Further conditions on when it is appropriate to recognize constitutional rights are rarely satisfied in the healthcare case. And focusing on aspirational or statutory rights presents costs for those seeking to justify legal rights on the basis of corresponding moral ones while maintaining empirical challenges for justifying constitutional rights. This suggests movement from a moral right to a corresponding legal one is far from straightforward and justifies examining alternative means of realizing moral socio-economic rights such as the proposed moral right to healthcare.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 1","pages":"21-30"},"PeriodicalIF":2.2,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morality and Access to Essential Medicines: Pairing the Theoretical and Practical 道德与基本药物的获取:理论与实践的结合。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-02-08 DOI: 10.1111/dewb.12445
Michael Da Silva SJD, Andreas Albertsen PhD
<p>Access to essential medicines is uneven within and across states. Many persons do not have secure access to medicines necessary to live even less demanding conceptions of the good life, however defined. Questions concerning access to essential medicines implicate fundamental health justice concerns central to the branch of contemporary bioethics concerned with the field's relationship to political philosophy. A striking part of this inequality is its global dimension. Access to essential medicines is particularly restricted for those who live in less affluent countries. These concerns are acute in the context of ‘developing world’ bioethics given that issues in relevant states cluster with other disadvantages and state capacities that are limited in other aspects.</p><p>This situation raises two questions in particular: (1) What makes inequalities in access to essential medicines wrongful? and (2) What can and should be done about it (and by whom)? It is tempting to sever these questions and understandable to do so given their magnitude and scope. Important work treats each independently and thereby provides valuable insights. The first question pertains to core theoretical issues regarding value and justice. Such conceptual concerns can be fruitfully addressed without in-depth analysis of practical details. Indeed, details of real-world cases can skew intuitions about concepts. The second question then appears explicitly practical. One may worry that focusing on ‘philosophical’ questions can stop one from taking necessary action. If, as it would seem, a lack of access to essential medicines is a problem on (almost) any moral view, one may be better served by addressing the problem head-on rather than worrying about the precise nature of the wrong to be addressed.</p><p>However, as readers of this journal are aware, different moral problems can call for different practical responses, and many practical interventions need a clear sense of the problem at hand to properly solve it. Bioethics is partly characterized by its attention to interactions between theoretical and practical questions. Therefore, treating the two questions in tandem can be helpful even if one emphasizes one more than the other. This allows for perspectives where our answers to one inform those given to another.</p><p>The works in this special issue demonstrate how answers to each question implicate answers to the other and the value of treating them in tandem instead of in isolation. Nicole Hassoun's <i>Global Health Impact: Extending Access to Essential Medicines</i>1 provides proof of concept for this dual analysis and is a touchstone for each article. Existing data on absolute and relative access to essential medicines highlights global, regional, national, and even sub-national inequalities that naturally raise questions regarding who (if anyone) is responsible for assisting those who are worse off. In relation to health, these questions also pertain to whether responsi
各州内部和各州之间获得基本药物的情况并不均衡。许多人无法安全地获得必要的药品,以过上即使要求不高的美好生活,无论其定义如何。有关获得基本药物的问题牵涉到基本的健康正义问题,这对当代生命伦理学中有关该领域与政治哲学关系的分支至关重要。这种不平等的一个显著特点是它的全球性。生活在不太富裕国家的人们获得基本药物的机会尤其有限。在 "发展中世界 "的生命伦理学中,这些问题显得尤为突出,因为相关国家的问题与其他方面的不利条件和有限的国家能力密切相关。这种情况特别提出了两个问题:(1) 是什么导致了在获得基本药物方面的不平等? (2) 能够并应该对此采取什么措施(以及由谁来做)?将这些问题割裂开来是很有诱惑力的,而且考虑到这些问题的严重性和范围,这样做也是可以理解的。重要的工作是将每个问题独立处理,从而提供有价值的见解。第一个问题涉及价值与正义的核心理论问题。这些概念性问题无需深入分析实践细节即可得到有效解决。事实上,现实世界中的案例细节可能会扭曲对概念的直觉。那么,第二个问题就显得非常实际了。有人可能会担心,专注于 "哲学 "问题会阻止人们采取必要的行动。然而,正如本刊读者所知,不同的道德问题可能需要不同的实际对策,许多实际干预措施需要对当前问题有清晰的认识,才能妥善解决。生命伦理学的部分特点就是关注理论问题与实践问题之间的相互作用。因此,将这两个问题结合起来处理会有所帮助,即使一个问题比另一个问题更受重视。本特刊中的作品展示了对每个问题的回答如何牵涉到对另一个问题的回答,以及串联而非孤立处理这两个问题的价值。尼科尔-哈松(Nicole Hassoun)的《全球健康影响》:扩大基本药物的可及性1 为这种双重分析提供了概念证明,也是每篇文章的试金石。关于基本药物绝对和相对获取途径的现有数据凸显了全球、地区、国家甚至国家以下各级的不平等,这自然会引发关于谁(如果有的话)有责任帮助那些境况较差的人们的问题。就健康而言,这些问题还涉及到全球不平等的责任是否应由富裕国家、制药公司或富裕个人承担。全球健康影响》以利益为基础,论证了享有最低限度美好生活所必需的基本药物的权利,以及对这一权利的法律承认和执行。全球健康影响》以利益为基础,论证了最低限度美好生活所必需的基本药物权,以及法律对这一权利的承认和执行。然后,它为实现这一权利的方法进行了辩护,从而解决了基本药物获取方面的问题,尤其是在国家未能实现哈苏恩所捍卫的权利的情况下。哈苏恩认为,法律权利将促进解决药品获取问题所需的 "创造性决心",并以 "全球健康影响项目"(Global Health Impact Project)为例,提出了一个可能的创造性解决方案。该项目将允许制药公司在其所有产品上标注 "来自具有影响力的公司 "字样,这些公司开发的产品价格低廉,并能明显减轻全球疾病负担。哈苏恩认为,如果消费者认识到他们有责任进行道德消费,他们就会在不同的标签竞争中做出购买决定。这反过来又会激励开发价格合理、疗效显著的药品,帮助实现获得基本药物的权利,并解决相关的错误。根据这一观点,哈松的回答具有以下特点:(1) 无法获得基本药物是不法行为,因为它妨碍了人们过上最起码的美好生活的能力,而这种不法行为侵犯了权利;(2) 国际社会应承认获得这些物品的法律权利,各国应承认相应的国内法律权利,制药公司和消费者应填补各国在实现这些权利方面的空白,而全球健康影响项目则为实现这些权利提供了一个富有成效的潜在途径。
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引用次数: 0
Global Health Impact: Human rights, access to medicines, and measurement 全球健康影响:人权、药品获取和衡量。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-02-07 DOI: 10.1111/dewb.12441
Nicole Hassoun

Should people have a legal human right to health? And, if so, what exactly does protecting this right require? This essay defends some answers to these questions recently articulated in Global Health Impact. It explains how these answers depend on a particular way of thinking about health and the minimally good life, how quality of life matters at and over time, what various agents should do to help people who are unable to live well enough, and many other things. Moreover, it suggests some ways of improving common metrics for measuring and advancing our collective global health impact.

人们是否应该享有合法的健康人权?如果是,保护这一权利究竟需要什么?本文为最近在《全球健康影响》(Global Health Impact)上阐述的这些问题的一些答案进行辩护。文章解释了这些答案如何取决于对健康和最低限度的美好生活的特定思考方式,生活质量在任何时候以及随着时间的推移是如何重要的,各种机构应该做些什么来帮助那些无法过上足够美好生活的人,以及其他许多事情。此外,它还提出了一些改进通用指标的方法,以衡量和推进我们对全球健康的集体影响。
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引用次数: 0
The wisdom of claiming ownership of human genomic data: A cautionary tale for research institutions. 主张人类基因组数据所有权的智慧:研究机构的警示故事。
IF 0.9 3区 哲学 Q3 ETHICS Pub Date : 2024-01-31 DOI: 10.1111/dewb.12443
Donrich Thaldar

This article considers the practical question of how research institutions should best structure their legal relationship with the human genomic data that they generate. The analysis, based on South African law, is framed by the legal position that although a research institution that generates human genomic data is not automatically the owner thereof, it is well positioned to claim ownership of newly generated data instances. Given that the research institution exerts effort to generate the data, it can be argued that it has a moral right to claim ownership of such data. Combined with the fact that it has an interest in having comprehensive rights in such data, it appears that the prudent policy for research institutions is to claim ownership of the human genomic data instances that they generate. This policy is tested against two opposing policy positions. The first opposing policy position is that research participants should own the data that relate to them. However, in light of data protection legislation that already provides extensive protections to research participants, bestowing data ownership on research participants would offer little benefit to such individuals, while leading to significant practical problems for research institutions. The second opposing policy position is that the concept of ownership should be abandoned in favour of data custodianship. This opposing position is problematic, as avoiding reference to ownership is a denial of legal reality and hence not a useful policy. Also, avoiding reference to ownership will leave research institutions with limited legal remedies in the event of appropriation of data by third parties. Accordingly, it is concluded that the wisest policy for research institutions is indeed to explicitly claim ownership of the human genomic data instances that they generate.

本文探讨的实际问题是,研究机构应如何以最佳方式构建与其生成的人类基因组数据之间的法律关系。分析以南非法律为基础,其法律立场是,虽然产生人类基因组数据的研究机构并不自动拥有这些数据,但它完全有能力主张对新产生的数据实例的所有权。鉴于研究机构为生成数据付出了努力,可以说它在道义上有权主张对这些数据的所有权。再加上研究机构希望对这些数据拥有全面的权利,因此研究机构的审慎政策似乎是要求对其生成的人类基因组数据实例拥有所有权。这一政策要接受两种对立政策立场的检验。第一个对立的政策立场是,研究参与者应拥有与其相关的数据。然而,鉴于数据保护法已经为研究参与者提供了广泛的保护,赋予研究参与者数据所有权对这些人来说好处甚微,同时也会给研究机构带来严重的实际问题。第二种对立的政策立场是,应放弃所有权概念,转而采用数据监护权。这一反对立场是有问题的,因为避免提及所有权是对法律现实的否定,因此不是一项有用的政策。此外,避免提及所有权会使研究机构在数据被第三方盗用时只能获得有限的法律补救。因此,结论是研究机构最明智的政策确实是明确主张对其生成的人类基因组数据实例的所有权。
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引用次数: 0
Ethical and legal challenges of medical AI on informed consent: China as an example. 医疗人工智能对知情同意的伦理和法律挑战:以中国为例。
IF 2.2 3区 哲学 Q3 ETHICS Pub Date : 2024-01-19 DOI: 10.1111/dewb.12442
Yue Wang, Zhuo Ma

The escalating integration of Artificial Intelligence (AI) in clinical settings carries profound implications for the doctrine of informed consent, presenting challenges that necessitate immediate attention. China, in its advancement in the deployment of medical AI, is proactively engaging in the formulation of legal and ethical regulations. This paper takes China as an example to undertake a theoretical examination rooted in the principles of medical ethics and legal norms, analyzing informed consent and medical AI through relevant literature data. The study reveals that medical AI poses fundamental challenges to the accuracy, adequacy, and objectivity of information disclosed by doctors, alongside impacting patient competency and willingness to give consent. To enhance adherence to informed consent rules in the context of medical AI, this paper advocates for a shift towards a patient-centric information disclosure standard, the restructuring of medical liability rules, the augmentation of professional training, and the advancement of public understanding through educational initiatives.

人工智能(AI)在临床环境中的应用不断升级,对知情同意原则产生了深远的影响,提出了需要立即关注的挑战。中国在推进医疗人工智能应用的同时,也在积极制定法律和伦理法规。本文以中国为例,以医学伦理原则和法律规范为理论基础,通过相关文献资料对知情同意和医疗人工智能进行了分析。研究发现,医疗人工智能对医生披露信息的准确性、充分性和客观性提出了根本性挑战,同时也影响了患者的能力和同意意愿。为了在医疗人工智能的背景下加强对知情同意规则的遵守,本文提倡向以患者为中心的信息披露标准转变,调整医疗责任规则,加强专业培训,并通过教育活动增进公众理解。
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引用次数: 0
期刊
Developing World Bioethics
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