Bioethics最新文献

This paper explores the notion of loneliness as lack of solidarity in relations to Palestinians living in the Occupied Palestinian Territory, Israel, and the diaspora. Loneliness as lack of solidarity is defined as lacking someone to identify with and/or lacking someone who is willing to assist while carrying a burden. We describe the mechanism of lack of identification using the concept of epistemic injustice. The paper suggests that art may serve as a way to mitigate this kind of loneliness, and focus on the Freedom Theater, which was operating in Jenin Refugee Camp until recently.

The subject of this paper is a critique of the pronatalist metaphysics that underlies bioethics and shapes the thinking and discourse on reproductive rights. The point of reference is the philosophy of antinatalism presented by Marcus T. L. Teo. Seemingly arguing in favor of antinatalism, Teo mixes antinatalist concepts with pronatalist intuitions. The consequence of combining the impossible is the restoration of negative eugenics on the one hand, and a series of contradictions on the other. The article shows that philosophical antinatalism is a universal position that indicates that procreation always, everywhere and for everyone is wrong. The paper simultaneously exposes and criticizes the metaphysics of pronatalism underlying bioethical discourse. Weakening pronatalism in bioethics and turning more attention to antinatalism could bring good results for women, the environment, and bioethics itself in terms of its thematic preferences.

From an ethical point of view, there is an important distinction between two types of prenatal screening. The first of these targets maternal or foetal conditions (e.g., infectious diseases, blood group sensitization) where early detection allows for interventions that improve the chances of a healthy pregnancy outcome. The second screens for foetal conditions such as Down syndrome, where a timely diagnosis in most cases only allows for a choice between preparation for a child with special needs or termination of the pregnancy. Whereas the former makes an easy fit with the prevention aim of most other population screening programmes, the latter does not. In order to steer clear from a possible eugenic reading of its aim, a wide international consensus has emerged for the view that prenatal screening of this type should have the atypical aim of helping women (couples) to make autonomous reproductive choices, rather than reducing the birth prevalence of the relevant disorders. However, keeping these types of prenatal screening apart may become increasingly difficult given the development of tests, such as the Non-Invasive Prenatal Test, which cannot only be used for both types of screening but may also lead to interconnected findings on both sides of the divide. This makes it an urgent question: What the aim or aims of this new hybrid screening should be? As neither ‘prevention’ nor ‘autonomy’ will do, we argue for a normative framework that gives both aims their due, while recognizing the tensions between them.

Can it be ethical to conduct xenotransplant research on a human brain-dead decedent (HB-DD) whose organs could otherwise be given to persons in need? The ethical consensus is that it is better to save existing persons via organ donation than to devote a HB-DD to research that will not directly benefit anyone. I argue otherwise. Given how rapidly xenotransplant research is progressing, and its clinical promise in the next couple of years or decades, I argue that it can be ethical to conduct xenotransplant research on a HB-DD whose organs could otherwise be given to individuals in need.

This study examines the ethical permissibility of biomedical moral enhancement (BME) for psychopaths, considering both coercive and voluntary approaches. To do so, I will first briefly explain what psychopaths are and some normative implications of these facts. I will then ethically examine three scenarios of BME for psychopaths: (1) coercive BME for non-criminal psychopaths, (2) coercive BME for psychopathic offenders, and (3) voluntary BME for psychopathic offenders. I will argue that coercive BME for non-criminal psychopaths is ethically problematic due to issues of cost, invasion of privacy, and stigmatic effects of compulsory diagnosis. Similarly, I will argue that coercive BME for criminals is impermissible due to violations of the rights to bodily and mental integrity. However, I will show that voluntary BME for offenders may be ethically permissible under certain conditions, challenging the critique that the consent of vulnerable prisoners cannot be considered fully voluntary. I argue that when an offender is provided with sufficient medical and legal information, incentives such as the possibility of parole review based on BME results do not preclude the voluntariness of consent. Ultimately, I aim to advance the debate on BME for psychopaths by delineating and defending conditions for the ethical permissibility of voluntary BME.

It may only be a handful of years before fully autonomous neurosurgical robots (ANRs) are pushed into widespread clinical adoption. Nevertheless, whether it is ethical to greenlight the development and adoption of ANRs is still up for debate. On the one hand, the widespread adoption of ANRs may lead to unprecedented therapeutic effects, increase sterility, improve pain profiles, increase precision, and reduce complications over the long term. On the other hand, ANRs may lead to human neurosurgical skill atrophy, increased legal uncertainty, increased burnout rates, and may produce no significant effect on pain profiles or complication rates, all of which may put patients at novel levels of risk. At this watershed, it is critical for stakeholders to preemptively deliberate about whether they would ultimately agree to these ethical trade-offs and decide to consciously support, thus help usher in the advent of autonomous neurosurgical technology.

Since its launch in November 2022, ChatGPT has become a global phenomenon, sparking widespread public interest in chatbot artificial intelligences (AIs) generally. While not approved for medical use, it is capable of passing all three United States medical licensing exams and offers diagnostic accuracy comparable to a human doctor. It seems inevitable that it, and tools like it, are and will be used by the general public to provide medical diagnostic information or treatment plans. Before we are taken in by the promise of a golden age for chatbot medical AIs, it would be wise to consider the implications of using these tools as either supplements to, or substitutes for, human doctors. With the rise of publicly available chatbot AIs, there has been a keen focus on research into the diagnostic accuracy of these tools. This, however, has left a notable gap in our understanding of the implications for health outcomes of these tools. Diagnosis accuracy is only part of good health care. For example, crucial to positive health outcomes is the doctor–patient relationship. This paper challenges the recent focus on diagnostic accuracy by drawing attention to the causal relationship between doctor–patient relationships and health outcomes arguing that chatbot AIs may even hinder outcomes in numerous ways including subtracting the elements of perception and observation that are crucial to clinical consultations. The paper offers brief suggestions to improve chatbot medical AIs so as to positively impact health outcomes.

Despite its prevalence today, the practice of purely performative resuscitation (PPR)-paradigmatically, the "slow code"-has attracted more critics in bioethics than defenders. The most common criticism of the slow code is that it's fundamentally deceptive or harmful, while the most common justification offered is that it may benefit the patient's loved ones, by symbolically honoring the patient or the care team's relationship with the family. I argue that critics and defenders of the slow code each have a point. Advocates of the slow code are right that not all PPR is wrongly deceptive or harmful to the patient or his family and that the symbolic aspect of medicine is itself morally significant. But the critics are also correct: slow codes are prima facie wrong. I argue that pursuing a slow code amounts to treating the patient as a tool for others' benefit-hence, treating him as an object-and that this instrumentalizing quality constitutes one core prima facie wrong of the practice. I also build a case for the idea that the slow code may not always be all-things-considered wrong, specifying certain limited conditions under which acts of PPR might ultimately be permissible. Thus, the symbolic dimension of medical treatment is indeed morally important, both in morally favorable and in morally problematic respects-namely, in its symbolic denial of the patient's humanity.