BMC Medical Ethics最新文献

The relationship between cognitive enhancements (CE) and human autonomy or authenticity is generally positioned as how CE impact human autonomy or authenticity. But rarely, if ever, do we consider whether the value and pursuit of CE is an authentic one. In this paper, I will argue that the moral permissibility of cognitive gene enhancements is undone by the legitimate concern that the near universal value for such modifications is likely driven by oppressive norms for superintelligence and productivity. I argue that these norms derive from the capitalist meritocracy: an economic system that structures inclusion and success based on patriarchal and racist norms of intelligence and productivity. The claim that the use of such enhancements fits within the autonomous scope of individual power is thus far weaker than it claims to be, particularly within the context of genetic modification.

Background: The rapid digitalization of healthcare-from telemedicine and Artificial Intelligence (AI)-driven diagnostics to wearable biosensors-has profoundly disrupted traditional norms of patient confidentiality. Classical privacy theories, anchored in physical co-presence and individual control, struggle to address the ethical challenges posed by opaque, persistent, and infrastructural data exposures in digital clinical environments.

Methods: This study employs a theoretical-conceptual methodology to develop a multidimensional privacy framework responsive to the spatial and technological complexities of the digital clinic. Drawing from Edward T. Hall's proxemics theory and the concept of cyberspace, we reinterpret interpersonal spatial zones (intimate, personal, social, public) in cyberspace. We introduce "cyberspatial privacy" as a transversal dimension that modulates privacy expectations across physical and digital layers. A hypothetical case-"Patient X," a woman undergoing hybrid care-is used to demonstrate the framework's practical utility in ethical analysis.

Results: The proposed framework reconceptualizes privacy as a dynamic continuum structured by both spatial proximity and digital mediation. By mapping risks across four proxemic zones and overlaying a cyberspatial dimension, the model reveals how privacy breaches differ not only in kind but in normative weight. For instance, biometric data collected by wearables (intimate zone) carries higher ethical risk than metadata exposed via public interfaces. The case of Patient X illustrates how classical theories fail to capture this gradient, while the new model enables zone-sensitive assessments of vulnerability, exposure, and trust.

Conclusions: This framework advances the ethical understanding of privacy in digitally mediated healthcare by offering a granular, relational, and context-aware approach. It supports clinicians, designers, and policymakers in tailoring privacy safeguards to the spatial and digital contours of care. By reframing privacy as a condition of relational co-presence rather than isolated consent, this model promotes ethically robust design and governance in the era of cyber-augmented medicine.

Background: Social Egg Freezing (SEF), often promoted in Western contexts as a means to enhance reproductive autonomy, has seen varied uptake in countries with wider gender disparities. In such settings, where reproductive decisions are shaped by strong societal norms, SEF raises ethical concerns about whether it enables autonomy or reinforces prevailing expectations.

Objectives: This study examines how SEF is framed and regulated in countries ranking in the lowest quintile of the 2024 Gender Gap Index (GGI), where reproductive autonomy is emergent and SEF is increasingly promoted as a demographic intervention.

Methods: A scoping review was conducted on SEF literature published between 2013 and 2025 across 29 countries in the lowest GGI quintile. English-language sources were retrieved from PubMed, while Japanese (J-Stage, Ichushi-web) and Arabic (Arabase [al-manẓūma], E-Marefa) were searched. Supplementary materials-including government policies, religious texts, and professional guidelines-were identified through Google Advanced Search, manual screening, and documents from the International Islamic Fiqh Academy (IIFA). Eligible sources included empirical and normative publications addressing SEF in the countries under review. Three reviewers screened and extracted data. Themes were developed iteratively.

Results: Sixty-eight sources met inclusion criteria and were organized into five themes: (1) awareness and education; (2) sociocultural and religious values; (3) policy and legal frameworks; (4) clinical practices and outcomes; and (5) commercialization and autonomy. Most sources (73.9%) focused on themes (2)-(4), while awareness (12.2%) and commercialization (13.9%) received limited attention. In most Muslim-majority countries reviewed, religious frameworks restricted SEF to married women. Turkey is a notable exception, permitting SEF for single women though embryo transfer requires marriage. Only 23 of the 68 sources were empirical, and just four employed qualitative methods.

Conclusion: Although SEF is often framed as empowering, this promise is context-dependent and frequently illusory. Cultural and structural constraints shape women's choices, limiting the autonomy SEF claims to offer. Rather than imposing hegemonic neo-liberal assumptions, future policy and research should engage with local moral reasoning while examining how norms may reinforce inequality. Empirical studies are urgently needed to illuminate lived realities and improve policy development.

Aim: The study aims to explore (1) Chinese medical students' prioritization of various factors in decision-making about disclosing information to patients with life-threatening illness, (2) heterogeneous subgroups with respective prioritization of factors and, (3) between-subgroup differences in basic demographics and background information.

Methods: In a cross-sectional observational survey, 196 second-year master's medical students in mainland China reported preferences for disclosing diagnoses and prognoses to terminal cancer patients in 18 scenarios varying in patient preference, family preference, patient sex, age, education, and finance. Conjoint analysis was performed on the entire sample for diagnosis and prognosis disclosure preferences. Cluster analysis identified homogeneous subgroups, followed by conjoint analysis within each cluster. ANOVAs and chi-squared tests compared basic demographics and background information between clusters.

Results: Conjoint analysis found similar factor prioritization for both diagnosis and prognosis disclosure. The most important are patient preference (27.57%) and family preference (24.88%), followed by patient age (15.38%), finance (13.14%), education (11.10%), and sex (7.74%). With diagnosis and prognosis disclosure preference scores combined, cluster analysis identified three subgroups: A preference-driven group (n = 109) that mainly considers patient preference and family preference; a condition-driven group (n = 29) that prioritizes patient age and finance; and a balanced consideration group (n = 58) that takes relatively even consideration of all factors. Between-cluster comparisons unveiled significant differences in sex and major.

Conclusion: Incorporating both Western and Confucian values, as well as practical factors, these medical students act as active agents in the decision-making process, guided by their personal identities and professional beliefs.

Background: Nursing students frequently access patient information during clinical practice and face ethical challenges in protecting patient information. This study aimed to explore and describe nursing students' experiences of patient information protection during clinical practice.

Methods: A qualitative descriptive approach was employed to understand nursing students' experiences of patient information protection. Using convenience sampling, twenty-three nursing students were recruited from four nursing schools in South Korea. Data were collected using semi-structured interviews and field notes until data were saturated. A qualitative content-analysis was conducted for data analysis. Rigor was ensured achieving four criteria including credibility, dependability, confirmability, and transferability.

Results: Four themes emerged from the data analysis. Nursing students experienced awareness of the importance of patient confidentiality, challenges of protecting patient information, inappropriate use of patient information, and need for more education about patient confidentiality.

Conclusions: Nursing students recognized gaps between their awareness and practice in terms of patient confidentiality. They reported the need for repetitive and case-based education on patient information protection. This study provides valuable data for developing strategies for patient information protection. Future research need to develop better pedagogical strategies to improve students' protection of patient information during clinical practice.

Background: The conflict between legal requirements and the principles of care ethics is one of the fundamental challenges in healthcare settings. Such conflicts can lead to moral distress, emotional exhaustion, and a crisis of professional identity among healthcare staff. This study aimed to identify and explain the dimensions and consequences of these conflicts in a hospital nursing care.

Methods: This research employed thematic synthesis of qualitative studies. A systematic search was conducted in reputable national and international databases for studies published between 2010 and 2025. Of the retrieved literature, 15 qualitative studies were included that examined legal-ethical conflicts in hospital settings. Data were synthesized through open coding, axial categorization, and the development of analytical themes.

Results: Four overarching themes and twelve subthemes emerged: (1) Patient autonomy versus legal protection, (2) Organizational directives and resource allocation versus moral duty of care, (3) Defensive documentation versus ethical transparency, and (4) Hierarchy, inequality, and professional silence versus justice and integrity. These tensions frequently led to moral distress, erosion of professional identity, and emotional strain among healthcare professionals.

Conclusion: Legal-ethical conflicts deeply affect both caregivers and institutional cultures. Mitigating their impact requires coordinated reforms: integrating ethics education and decision-making training into nursing curricula, revising legal frameworks to allow greater contextual flexibility, and establishing psychosocial and ethical support systems for staff exposed to recurring moral tensions. Such multi-level strategies can bridge the gap between law and moral care, fostering ethical coherence, professional sustainability, and trust within healthcare systems.