Hastings Center Report最新文献

Scientists have begun using AI agents in tasks such as reviewing the published literature, formulating hypotheses and subjecting them to virtual tests, modeling complex phenomena, and conducting experiments. Although AI agents are likely to enhance the productivity and efficiency of scientific inquiry, their deployment also creates risks for the research enterprise and society, including poor policy decisions based on erroneous, inaccurate, or biased AI works or products; responsibility gaps in scientific research; loss of research jobs, especially entry-level ones; the deskilling of researchers; AI agents’ engagement in unethical research; AI-generated knowledge that is unverifiable by or incomprehensible to humans; and the loss of the insights and courage needed to challenge or critique AI and to engage in whistleblowing. Here, we discuss these risks and argue that, for responsible management of them, reflection on which research tasks should and should not be automated is urgently needed. To ensure responsible use of AI agents in research, institutions should train researchers in AI and algorithmic literacy, bias identification, and output verification, and should encourage understanding of the risks and limitations of AI agents. Research teams may benefit from designating an AI-specific role, such as an AI validator expert or AI guarantor, to oversee and take responsibility for the integrity of AI-assisted contributions.

Cicero's treatise On Old Age offers an optimistic account of aging and responds to the prejudiced arguments of those who might otherwise ridicule older members of Roman society. While Cicero's rhetoric is, at times, scientifically naive and moralistic, this article argues that there are important insights that can be gained from carefully theorizing later life as a distinct and valuable stage of human existence—a stage of life that ought not be reduced to a mere proxy for health risk. A careful analysis provides insight into the conditions for flourishing in later life notwithstanding a more pronounced expression of the aging process. Some scholars downplay possibilities for agency and meaning in later life and foreground dignity as an overarching value for old age. We argue, however, that agency and meaning are not only possible but also central in later life but must be supported by social relationships that enhance well-being and the pursuit and realization of life goals.

In another essay in this issue of the Hasting Center Report, an argument is made in favor of offering a “faux code” in the setting of a patient who cannot say no to her family who insists her code status remain “full.” Under the proposal, an unwritten agreement is made between the patient and the clinical team to withhold cardiopulmonary resuscitation while maintaining a “full code” status in the medical record. The ethical question in this case involves how best to support and uphold the patient's autonomy while minimizing the distress of the patient's family, and the “faux code” is proposed as an ethically supportable intervention. However, pressing ethical concerns remain. In this essay, we offer three main objections to the provision of a “faux code”: the role of deceit and its consequences for public trust, the impact on nurses and trainees, and the framing of autonomy under the faux code proposal.

Cancer mortality has experienced a sharp decline over the past three decades. This transformation, due mostly to biomedical breakthroughs and novel therapies, raises the key question of Gluck's An Exercise in Uncertainty: A Memoir of Illness and Hope: what is it like to live in a state of chronic, existential uncertainty? In answering this question, the book subverts traditional prototypes of contemporary cancer memoirs and offers instructive insights for bioethics researchers and practitioners on treating cancer as chronic illness.

On the cover: Pile of Care, by Tizta Berhanu, 2024, oil on canvas, 66 9/10 × 59 1/10 in.

Image courtesy the artist and Addis Fine Art, Photo: Eyerusalem Jiregna, © Tizta Berhanu

Some patients do not want medically appropriate cardiopulmonary resuscitation (CPR) at the end of life but cannot withstand family pressures to request a “full code” status. This essay defends offering these patients a “faux code,” which would involve keeping the patient's status “full code” in the chart, with an unwritten agreement between the patient and the medical team that an effort will be made to withhold CPR at the time of arrest. Objections to faux codes are addressed, and it is concluded that faux codes are an ethically permissible option for some patients at the end of life.

Time for planning is hard to come by but essential to invest in when much is on the line for people with disabilities facing public health crises. This point is underscored in the book Disability Justice in Public Health Emergencies, edited by Joel Michael Reynolds and Mercer E. Gary. This collection of essays provides a disability justice lens to philosophical and pragmatic critiques of pandemic responses during Covid-19. The book unpacks the composition and effects of misguided policies and programs on people with disabilities during the pandemic and outlines helpful recommendations. Readers will come away with a greater sense of what it takes to achieve pandemic preparedness that is focused on proactive, intersectional, and equitable solutions for people living with one or multiple disabilities. The reader will also gain an appreciation for the varied opportunities to seize before the next pandemic.

This is a commentary on an historical analysis by Anne E. Clinton in the Hastings Center Report's November-December 2025 issue on the creation of the Uniform Determination of Death Act in 1980, focusing on the attempt by the Uniform Law Commission to revise the act in 2020. The original UDDA was based on scientific evidence that the brain is responsible for maintaining the integrated functioning of the body, such that brain death quickly leads to the biological death of the person. During the deliberations, however, it became clear that this was not scientifically correct and that biological life can continue for years after the diagnosis of brain death. This commentary argues that this new understanding of brain death generated intractable disagreement among the commissioners, leading the committee to abandon its efforts in 2023. The commentary closes with how the impact of this failure to revise the act will affect clinical practice and organ transplantation in the years to come.

Health care faces a rising population of patients with reliance on advanced technologies to sustain life, such as ventricular assist devices. Caregivers are so essential to the success of the technology and patient well-being that the establishment of a reliable caregiver outside of the hospital is standardly required before these technologies are offered. Making the choice to engage in the relationships of care required by the use of advanced life-sustaining technologies (ALSTs) is a significant decision, one that is often taken up out of necessity but also in the context of a loving and caring relationship. However, the value of caregivers, as well as the benefits and burdens of their care labor, can easily be neglected in a decision-making process that focuses on patients alone. Research has repeatedly recommended a more just recognition of the care work in the context of ALST, but few models for involving caregivers alongside patients in shared decision-making exist. We offer a taxonomy of possible models for recognizing the impact and value of care labor in medical decision-making about ALSTs. Ultimately, we recommend a model grounded in care ethics—the care-centered model—because it recognizes and values both the caregiving relationship and the individuals involved.