Bioethics最新文献

Critics of clinical artificial intelligence (AI) suggest that the technology is ethically harmful because it may lead to the dehumanization of the doctor–patient relationship (DPR) by eliminating moral empathy, which is viewed as a distinctively human trait. The benefits of clinical empathy—that is, moral empathy applied in the clinical context—are widely praised, but this praise is often unquestioning and lacks context. In this article, I will argue that criticisms of clinical AI based on appeals to empathy are misplaced. As psychological and philosophical research has shown, empathy leads to certain types of biased reasoning and choices. These biases of empathy consistently impact the DPR. Empathy may lead to partial judgments and asymmetric DPRs, as well as disparities in the treatment of patients, undermining respect for patient autonomy and equality. Engineers should consider the flaws of empathy when designing affective artificial systems in the future. The nature of sympathy and compassion (i.e., displaying emotional concern while maintaining some balanced distance) has been defended by some ethicists as more beneficial than perspective-taking in the clinical context. However, these claims do not seem to have impacted the AI debate. Thus, this article will also argue that if machines are programmed for affective behavior, they should also be given some ethical scaffolding.

An increasing vaccine hesitancy among parents, which has resulted in insufficient rates of immunization, provides reason to reconsider childhood vaccination practices. Studies suggest that parents' decision-making process concerning whether to vaccinate their child is highly influenced by cognitive biases. These biases can be utilized to increase vaccination uptake via changes in the choice context. This article considers childhood vaccination programmes, which involve children being vaccinated in school or daycare unless their parents actively ‘opt out’. We suggest that such programmes reconcile parents' decisional authority and vaccination duties. First, opt-out childhood vaccination based in schools or daycare centres are not disrespectful of parental authority. Second, the programme aligns the default setting with a moral obligation to vaccinate one's child that most parents have.

Policy makers and health professionals are grappling with the high costs of and demand for health care, questions of sustainability and value, and changing population demographics—in particular, ageing populations. Digital solutions, including the adoption of patient-reported measures, are considered critical in achieving person-centred and value-based health care. However, the utility of patient-reported measures and the data they produce may be subject to ageist beliefs, prejudices and attitudes, rendering these data ineffective at promoting improved patient experiences and outcomes for older adults. This article explores the ethical considerations raised in relation to patient-reported measures and the digital agency of older patients.

Hendricks' pregnancy rescue case (PRC) tries to show that abortion is typically morally wrong. I argue here that there are at least two morally relevant differences between the abortion in PRC and the typical abortion so that the latter isn't morally wrong even if the former is morally wrong. I develop five modifications to PRC to show that these two differences are morally important. First, in PRC we don't know whether the person gives informed consent to the abortion, nor does the medical professional who will perform the abortion, and so the abortion can't be performed because the patient gives informed consent to it. Second, not preventing the death of the fetus in PRC brings about the death of an additional fetus gestating in a separate pregnant person, whereas most abortions don't entail the termination of another's pregnancy.

This article offers a narrative analysis of the contributing factors of moral distress (MD) and moral injury (MI) among mental health clinicians working amidst humanitarian crises. It discusses the impact of moral stress on therapeutic relationships in mental health trauma. The article originated from the author's experience developing a peer-to-peer support program at a nongovernmental organization (NGO) and conducting peer-to-peer support for mental health clinicians and healthcare providers in Ukraine and Turkey. A significant amount of literature has documented the detrimental effects of MD and MI on mental health, job sustainability, and resilience of healthcare providers and first responders. The negative effects of MD and MI are particularly relevant in trauma counseling, where clinicians must draw upon the use of self to develop therapeutic relationships with their clients. This process demands a high level of moral reasoning and self-awareness, which can be severely tested under the morally challenging conditions of a humanitarian crisis. There is an imperative need to deepen our understanding and to swiftly address the factors that precipitate MD and MI in mental health clinicians working in crisis zones. By doing so, we aim to bolster their resilience and the enduring nature of their commitment to help and save others. This, in turn, will not only contribute to saving more lives but also enable those who are affected by trauma to flourish in the aftermath of their experiences.

In this article, I propose an ethical analysis of assistive domestic robots for older users. In doing so, I illustrate my inquiry with the example of ROB-IN assistive robot. ROB-IN is a Spanish project which is devoted to developing a robot that will perform in the private home of nondependent, aged users. It is aimed to help people in their daily activities and contribute to appropriate health monitoring. One of their potentially most useful features is related to data gathering and sharing. For the inquiry on the ethical underpinnings of this case, I develop a framework for domestic assistive robots for competent older adults drawn on the ethics of care. I assess that this type of robots could be ethically appraised attending to their impact on the well-being and autonomy of users. I approach autonomy from a relational perspective, and I delve into the relationship between autonomy and well-being through the concept of paternalism. I argue that this type of assistive robots should never act paternalistically. Given ROB-IN great implications regarding privacy, I subsequently explore the ways in which the privacy of users should be respected in their interaction with assistive robots, focusing on the relation with autonomy and well-being. Lastly, I highlight the need for avoiding ageism. This investigation focuses on aged users, but it is suggested that the situation of caregivers should be also the object of further investigations.

According to the sufficiency theory of justice in health, justice requires that people have equal access to adequate health. In this article, I lay out the structure of this view and I assess its distributive implications for setting priority (i) between health needs across persons and (ii) between health care spending and other societal goods. I argue, first, that according to the sufficiency theory, deficiency in health cannot be completely offset by providing other societal goods. And, second, that it can prevent the medicalization of societies by stressing that improvements beyond the level of adequate health have relatively little weight, if any, from the standpoint of justice.

The progress the Internet has experienced in recent years has brought about huge changes and social transformation in all aspects of our lives. One such aspect greatly impacted has been our health, where we can talk about the existence of an 'Internet of Medical Things'. Amid this digital drift, we have seen the development of pharmaceutical drugs that provide information to patients and their attending healthcare teams concerning medication, doses ingested, and time of ingestion. These are digital pills or digital medication. In this context, the purpose of my paper is to analyze the ethical and legal impact of digital medication, further analyzing the implications concerning the right of service users to make decisions over their own health in Spain.