Developing World Bioethics最新文献

A complex network of ethico-legal rules makes it difficult for health researchers in South Africa to lawfully recruit adolescents to the kinds of sensitive studies where it may be ethically appropriate to proceed without notifying parents or obtaining parental consent. This article responds to a recent proposal to amend the blanket requirement for mandatory parental consent presently contained in section 71 the South African National Health Act 61 of 2003 [NHA]. The proposed amendment is intended to bring the NHA into alignment with South Africa's 2015 Department of Health Guidelines on Ethics in Health Research by permitting greater flexibility for a health research ethics committee to waive parental consent, and permit adolescents to consent independently. A lacuna in this proposal is highlighted with reference to the requirements of South Africa's Protection of Personal Information Act 4 of 2013 [POPIA]: Even if the NHA is amended as proposed, the goal of aligning South African law with prevailing ethics norms in South Africa would not necessarily be attained, as parental consent may still be required by POPIA. This article investigates whether this goal (of aligning the law with ethics) can be attained in a way that is compliant with POPIA. It is concluded that this is indeed possible in a number of ways, and that the best way to attain this goal is by requesting the South African Information Regulator to issue a guidance note to the effect that all health research projects that are approved by institutional health research ethics committees are to be regarded as being in the public interest, which would qualify such health research projects to be exempted from POPIA's consent requirements.

This article provides a donor-focused analysis of how transnational reproductive donation intersects with issues central to bodily autonomy of surrogates and egg donors from the global South. Little is known about the autonomy of surrogates and egg donors, especially among those from the global South. This article addresses this gap by examining two key issues on surrogacy and egg donation—conflict of interest and recruitment market. With these issues, this paper presents contexts of the reproductive body as a space of contestation for autonomy. Analysis reveals that bodily autonomy is not an absolute entitlement available for surrogates and egg donors from the global South. Having bodily autonomy is a privileged disposition rather than a universal liberty for reproductive donors. The discussions in this work encourage further examination to understand the multi-layered experiences of reproductive donors from the global South, towards deeper interrogation of the processes of reproductive industry.

Among measures tackling the impacts of the COVID-19 pandemic, the selling of private insurance policies covering individual infection is overlooked by the ethics literature. To record the “COVID Claimania” in Taiwan and to assess its ethical implications, we collected 38 policies from 10 insurers sold between January 2020 and May 2022 and found that their risk calculation of the COVID-19 prevalence ranged from 0.5% to 11.08%. In reality, the prevalence by the end of 2022 was 37% in Taiwan. Selling private insurance policies is ethically problematic in three ways. First, it represents the insurance industry's irresponsible risk-taking profit-seeking behaviors. Second, it would jeopardize the effectiveness of the disease-prevention measures by inducing uncontrollable moral hazards. Third, it would expose the insurance companies to unbearable financial risks and cause substantial negative external impacts. The government should intervene in the private insurance market in preparation for future public health emergencies.

The need to understand the systems that support ethical health research has long been recognized, but there are limited descriptions of actual health research ethics (HRE) systems. Using participatory network mapping methods, we empirically defined Malaysia's HRE system. 13 Malaysian stakeholders identified 4 overarching and 25 specific HRE system functions and 35 actors internal and 3 external to the Malaysian HRE system responsible for those functions. Functions requiring the most attention were: advising on legislation related to HRE; optimizing research value to society; and defining standards for HRE oversight. Internal actors with the greatest potential for more influence were: the national network of research ethics committees; non-institution-based research ethics committees; and research participants. The World Health Organization, an external actor, had the largest untapped potential for influence overall. In summary, this stakeholder-driven process identified HRE system functions and actors that could be targeted to increase HRE system capacity.

La humanidad ya dispone de vacunas eficaces contra el COVID-19. En Perú se administraron 86 millones de dosis para cubrir la demanda de 33 millones de peruanos. Para ello, se ha priorizado la vacunación en grupos clave: personal de salud, sujetos con condiciones de salud preexistentes y mayores de 65 años. Sin embargo, dada la problemática social y la situación de la salud pública en Perú, este trabajo defiende que la prioridad de la vacunación debe centrarse en la población que vive en extrema pobreza. El método utilizado fue una argumentación ética sobre la distribución de la vacuna contra el COVID-19 en Perú. Esta argumentación se basa en el análisis de la población peruana que vive en extrema pobreza, la cual presenta diferentes estratos de vulnerabilidad, y que, ante una eventual infección por SARS-CoV-2, se irían agravando uno tras otro, a través de un efecto en cascada. Este escenario daría lugar a nuevas vulnerabilidades de las ya existentes, causando mayores daños. Los esfuerzos de vacunación en esta población clave les brindaría oportunidad de seguir encontrando formas de llevar alimentos a sus hogares, reduciendo significativamente el riesgo de contagio en su entorno y mitigando el efecto devastador de las enfermedades locales a las que ya está expuesta. Se plantean cuatro objeciones relacionadas con este argumento, con sus correspondientes respuestas. El acceso prioritario a la vacuna reduciría significativamente el daño a las personas que viven en la extrema pobreza, haciendo prevalecer los principios de justicia y equidad.

Nanotechnology (NT)-enabled disease-free life is a form of reconstruction of the human body that promises a paradigm shift toward a new form of human existence in an imaginable life. However, as human reconstruction may be within the limits of the concept of “human enhancement,” it is not clear to what extent “enhanced humans” will be ethically acceptable or desired. This study discusses the ethical implications of NT-embedded enhanced humans and this new imaginable life. First, ethical concerns arising from the existence of a grey zone of certain dilemmas regarding benefits and possible/unpredicted risks are addressed in terms of the four main principles of bioethics. Then, we focus on the ethical problems in human nano-enhancement. Finally, we study the methods of analyzing these ethical problems within the framework of principlism to conceive a comprehensive and coherent bioethical understanding.