Bioethics最新文献

The question whether or not patients ought to be involved in clinical ethics interventions (CEI) remains unresolved. While generally it has been recognized that patients’ active participation in health care decisions and processes is important, this is not unequivocally accepted for CEIs. Patient participation in CEI (PP) is common in the United States, but PP seems far from the prevailing practice in Europe. In Europe, CEIs often involve discussions of the ethics issue by the healthcare team only; the patient or proxy is not included, consulted or even informed about such an intervention. In this paper, we submit that policies or standards which resist PP and disable it as an option conflict with procedural and epistemic justice requirements in CEIs. We conceptually develop how the two concepts of procedural justice (PJ) and epistemic justice (EJ) relate to CEIs and to PP. We also engage with four cases to illustrate the risks of injustices and how PP facilitates CEIs to meet justice requirements. We conclude that in settings where CEIs systematically do not involve PP, and where patients are neither asked about the ethics issue nor informed about the intervention, policy and practice presumptions should be adjusted.

Drawing upon a deprivationist account of the badness of death, Ingemar Patrick Linden advocates for a hypothetical state called "contingent immortality." The future Linden champions is one in which every person would be able to live for as long as they would like, save for events like accidents or murder. We recognize Linden's foundational claims in defense of contingent immortality as weighty and reasonable, but consider whether there are defensible reasons to forgo the inhibition of aging and living well past a natural human lifespan. Drawing partly upon the work of Carter Snead and Alasdair MacIntyre, we outline the nature of self-giving love, how love provides for many persons a measure of meaning and purpose in life, and the ways in which given and self-imposed limitations can help imbue our actions as embodied beings with a particular and richer sense of that meaning and purpose. We conclude that love provides defensible grounds as to why one might reasonably choose to accept our shared human identity as creatures with naturally bounded lifespans. This conclusion takes into account both the benefits and costs of love, especially in light of our existence as embodied beings.

In this paper, we examine the potential effects of relationships with Large Language Model (LLM)-based digital doppelgängers (DDs) on users' values, concerns, and interests, that is, on their practical identity. DDs are artificially intelligent conversational agents trained on individuals' data to replicate their speech patterns, mannerisms, and personality traits. We start by showing that practical identity is largely defined by the relationships we find ourselves in or cultivate. Next, we discuss how DDs work and distinguish between task-specific and relational DDs, arguing that the latter are specifically created to take on the role of relational partners by imitating other people we care about. We then consider how relationships with DDs might shape individuals' practical identities, before concluding with some general thoughts regarding what we should be paying attention to before developing and deploying DDs.

Growing recognition of intersections between our health and the environment, healthcare systems and the environment, and health research and the environment has led bioethics scholars to advocate that the field readopt a broader perspective that considers nature. As part of doing so, we urgently need to reimagine research ethics concepts and frameworks so that they account for the environment. This paper focuses on how we should reinterpret the ethical concept of social value in health research. The concept is understood in absolute and relative terms, and both must be revised. The absolute social value of health research is determined by judging its magnitude of benefits and likelihood of benefits. This paper aims to generate considerations for judging health research's magnitude of benefits that capture its environmental benefits. We start from the most comprehensive definition of absolute social value to-date and show how it falls short of adequately capturing the magnitude of potential benefits generated by health research that yields knowledge related to nature. Based on that analysis, we propose how to revise the definition of absolute social value to better account for the environment. To conclude, we highlight questions that our suggested revisions raise for making relative social value assessments that consider the environment.

Philosophers have debated on the “mere-difference” view of disability, according to which disability as such is neutral in terms of well-being, just like race and gender. It is contrasted with the “bad-difference” view, which holds that disability is bad for its possessor even in a non-ableist situation. We first illustrate how neither view can be sensitive to the diversity of disabled people and their disabilities. Subsequently, we propose an alternative outlook—the conditional bad-difference view of disability: a disability is bad for its possessor if and only if it hampers her aspired way of life, even without ableism. In addition to being theoretically moderate and thus more plausible than the existing outlooks, this view also offers a robust ethical case for policies and practices catering to the varying needs and values of disabled people, such as personalized healthcare and the user-led research of assistive technologies.

This paper develops a vision for The Ecological Genome Project: an aspirational, global endeavour to connect human genomic sciences with the ethos of ecological sciences. The Project's goal is to strengthen interdisciplinary networks that relate to diverse initiatives using genomic technologies, with respect to shared ethical frameworks and governance structures. To this end, this paper proposes a practical definition of ecogenomics to align various methodologies and values in a single environmental field using principles used to safeguard all forms of life in their habitats. We achieve this by using a One Health approach as a pretext for disparate disciplines to collaborate and also a lens to view the Ethical, Legal and Social Implications (ELSI) inherent in ecological systems.