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The various faces of vulnerability: offering neurointerventions to criminal offenders. 脆弱性的不同面貌:为罪犯提供神经干预。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad009
Sjors Ligthart, Emma Dore-Horgan, Gerben Meynen

In recent years, we have witnessed considerable progress in neurotechnologies that visualize or alter a person's brain and mental features. In the near future, some of these technologies could possibly be used to change neural parameters of high-risk behavior in criminal offenders, often referred to as neurointerventions. The idea of delivering neurointerventions to criminal justice populations has raised fundamental normative concerns, but some authors have argued that offering neurointerventions to convicted offenders could be permissible. However, such offers raise normative concerns too. One prominent worry that is often emphasized in the literature, relates to the vulnerability of convicted offenders in prison and forensic patients in mental health facilities. In this paper, we aim to show that as far as vulnerability is considered relevant within the context of offering medical interventions to offenders, it could contribute to arguments against as well as in favor of these offers.

近年来,我们目睹了神经技术的巨大进步,这些技术可以可视化或改变一个人的大脑和精神特征。在不久的将来,其中一些技术可能会被用来改变罪犯高危行为的神经参数,通常被称为神经干预。向刑事司法人群提供神经干预的想法引发了根本性的规范问题,但一些作者认为,向已定罪的罪犯提供神经干预是可以允许的。然而,这样的提议也引发了规范方面的担忧。文献中经常强调的一个突出的担忧涉及监狱中被定罪的罪犯和精神卫生设施中的法医病人的脆弱性。在本文中,我们的目的是表明,只要脆弱性被认为与向罪犯提供医疗干预的背景有关,它可能有助于反对和支持这些提议的论点。
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引用次数: 0
Ectogestation and the Good Samaritan Argument. 与好撒玛利亚人的争论。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad012
Christopher Stratman

Philosophical discussions concerning ectogestation are trending. And given that the Supreme Court of the United States overturned Roe v. Wade (1973) and Casey v. Planned Parenthood (1992), questions regarding the moral and legal status of abortion in light of the advent of ectogestation will likely continue to be of central importance in the coming years. If ectogestation can intersect with or even determine abortion policy in the future, then a new philosophical analysis of the legal status of abortion is both warranted and urgently needed. I argue that, even if there is no 'moral' right to fetal destruction once ectogestation becomes a reality, societies ought not to implement legal prohibitions on a pregnant person's ability to safely obtain an abortion that results in fetal death because such laws are systemically misogynistic.

关于共生的哲学讨论是一种趋势。鉴于美国最高法院推翻了1973年的罗伊诉韦德案(Roe v. Wade)和1992年的凯西诉计划生育案(Casey v. Planned Parenthood),鉴于人工流产的出现,有关堕胎的道德和法律地位的问题在未来几年可能会继续成为至关重要的问题。如果堕胎可以与未来的堕胎政策相互影响,甚至决定堕胎政策,那么对堕胎的法律地位进行新的哲学分析既是必要的,也是迫切需要的。我认为,即使一旦怀孕成为现实,就不存在破坏胎儿的“道德”权利,社会也不应该实施法律禁止孕妇安全进行导致胎儿死亡的堕胎,因为这些法律是系统性的厌女主义。
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引用次数: 0
Confidentiality, public interest, and the human right to science: when can confidential information be used for the benefit of the wider community? 保密、公共利益和科学的人权:什么时候可以将机密信息用于更广泛的社会利益?
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad013
Edward S Dove

This article explores whether the human right to science can support the public interest as a legal basis to use and disclose confidential information. The contextual focus is scientific research; the jurisdictional focus is England. The human right to science, as reflected in the Universal Declaration of Human Rights (Article 27) and the International Covenant on Economic, Social and Cultural Rights (Article 15), hitherto has not been invoked in support of a public interest basis for lawful disclosure, but the argument is made herein that there may be scope to develop this jurisprudentially. On grounds of both law and policy, and in line with the underlying rationale of recent UK Government deployment of 'COPI Notices' for lawful use of confidential patient information in the course of the COVID-19 pandemic, I contend that the human right to science may well serve as a valuable juridical buttress to an overriding public interest justification to lawfully share confidential information. However, this could occur only in restricted circumstances where the public interest is clearly manifest, namely studies researching serious, imminent health threats to the general population that rely on confidential information accessed outside of existing statutory gateways, and not more routine scientific endeavors.

本文探讨了科学人权是否可以作为公共利益的法律依据来支持机密信息的使用和披露。语境焦点是科学研究;管辖权的焦点是英格兰。《世界人权宣言》(第27条)和《经济、社会及文化权利国际公约》(第15条)所反映的科学人权迄今尚未被援引来支持合法披露的公共利益基础,但本文提出的论点是,在法理上可能有发展这一权利的余地。基于法律和政策的理由,并与最近英国政府在COVID-19大流行期间合法使用机密患者信息的“COPI通知”的基本理由相一致,我认为,科学的人权很可能成为合法共享机密信息的压倒一切的公共利益理由的宝贵司法支持。然而,这只能发生在公共利益明显的有限情况下,即研究对一般人群的严重、迫在眉睫的健康威胁,这些研究依赖于在现有法定门户之外获取的机密信息,而不是更常规的科学努力。
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引用次数: 0
Should Canada adopt managed access agreements in Canada for expensive drugs? 加拿大是否应该在加拿大对昂贵药物采用管理准入协议?
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad014
Melanie McPhail, Tania Bubela

Drugs are increasingly authorized based on less mature evidence, leaving payors faced with significant clinical and cost-effectiveness uncertainties. As a result, payors must often choose between reimbursing a drug that may not turn out to be cost-effective (or may even be unsafe) or delaying the reimbursement of a drug that is cost-effective and offers clinical benefit to patients. Novel reimbursement decision models and frameworks, such as managed access agreements (MAAs), may address this decision challenge. Here, we provide a comprehensive overview of the legal limitations, considerations, and implications for adopting MAAs in Canadian jurisdictions. We begin with an overview of current drug reimbursement processes in Canada, terminology and definitions of the different types of MAAs, and select international experiences with MAAs. We discuss the legal barriers to MAA governance frameworks, design and implementation considerations, and legal and policy implications of MAAs. Finally, we provide recommendations to guide policy development for implementing MAAs in Canada, based on existing literature, international experience, and our legal analysis. We conclude that legal and policy barriers likely prevent the adoption of a pan-Canadian MAA governance framework. More feasible is a quasi-federal or provincial approach, building on existing infrastructure.

越来越多的药物是基于不太成熟的证据获得批准的,这使得付款人面临着重大的临床和成本效益不确定性。因此,付款人经常必须在报销可能不具有成本效益(甚至可能不安全)的药物或延迟报销具有成本效益并为患者提供临床益处的药物之间做出选择。新的报销决策模型和框架,如管理访问协议(MAAs),可以解决这一决策挑战。在这里,我们全面概述了在加拿大司法管辖区采用maa的法律限制、考虑因素和影响。我们首先概述了加拿大当前的药品报销流程,不同类型MAAs的术语和定义,并选择了MAAs的国际经验。我们将讨论MAA治理框架的法律障碍、设计和实现方面的考虑,以及MAA的法律和政策含义。最后,基于现有文献、国际经验和我们的法律分析,我们提出了指导加拿大实施MAAs的政策制定的建议。我们的结论是,法律和政策障碍可能会阻碍采用泛加拿大MAA治理框架。更可行的办法是在现有基础设施的基础上,采取准联邦或省级的方式。
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引用次数: 0
Rules for robots, and why medical AI breaks them. 机器人的规则,以及为什么医疗人工智能打破了这些规则。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad001
Barbara J Evans

This article critiques the quest to state general rules to protect human rights against AI/ML computational tools. The White House Blueprint for an AI Bill of Rights was a recent attempt that fails in ways this article explores. There are limits to how far ethicolegal analysis can go in abstracting AI/ML tools, as a category, from the specific contexts where AI tools are deployed. Health technology offers a good example of this principle. The salient dilemma with AI/ML medical software is that privacy policy has the potential to undermine distributional justice, forcing a choice between two competing visions of privacy protection. The first, stressing individual consent, won favor among bioethicists, information privacy theorists, and policymakers after 1970 but displays an ominous potential to bias AI training data in ways that promote health care inequities. The alternative, an older duty-based approach from medical privacy law aligns with a broader critique of how late-20th-century American law and ethics endorsed atomistic autonomy as the highest moral good, neglecting principles of caring, social interdependency, justice, and equity. Disregarding the context of such choices can produce suboptimal policies when - as in medicine and many other contexts - the use of personal data has high social value.

本文批评了对AI/ML计算工具保护人权的一般规则的追求。《白宫人工智能权利法案蓝图》(White House Blueprint for AI Bill of Rights)是最近的一次尝试,但在本文探讨的方面失败了。伦理法律分析在将AI/ML工具作为一个类别,从部署AI工具的特定环境中抽象出来的程度是有限的。卫生技术为这一原则提供了一个很好的例子。人工智能/机器学习医疗软件的突出困境是,隐私政策有可能破坏分配正义,迫使人们在两种相互竞争的隐私保护愿景之间做出选择。第一种观点强调个人同意,在1970年后赢得了生物伦理学家、信息隐私理论家和政策制定者的青睐,但它显示出一种不祥的可能性,即人工智能训练数据可能会导致医疗保健不公平。另一种选择是,来自医疗隐私法的旧的基于责任的方法,与对20世纪后期美国法律和伦理如何将原子自治作为最高道德善的广泛批评相一致,忽视了关怀、社会相互依存、正义和公平的原则。当个人数据的使用具有很高的社会价值时,忽视这些选择的背景可能会产生次优政策——比如在医学和许多其他领域。
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引用次数: 1
Legal personhood and frozen embryos: implications for fertility patients and providers in post-Roe America. 法律人格和冷冻胚胎:对美国roe案件后生育患者和提供者的影响。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad006
Gerard Letterie, Dov Fox

The demise of Roe v. Wade has prompted some state lawmakers to try to redefine legal personhood to begin before birth and even before pregnancy. The sweeping abortion bans passed and pending in the wake of Dobbs pose a threat to reproductive rights that extends beyond abortion. That threat spills over into in vitro fertilization (IVF) and other assisted reproductive technologies (ART). If legislatures designate embryos as legal persons, fertility clinics will be forced to change how they manage embryos, including current standard practices such as pre-implantation genetic testing, storage of unused embryos, and the disposal of those unlikely to have reproductive potential. This essay examines the many ways in which conferring the status of persons under private and public law is likely to impact patients pursuing IVF and clinics practicing ART.

罗伊诉韦德案的终结促使一些州议员试图将法律人格重新定义为出生前甚至怀孕前就开始了。在多布斯案之后通过和未决的全面堕胎禁令对堕胎以外的生殖权利构成了威胁。这种威胁蔓延到体外受精(IVF)和其他辅助生殖技术(ART)。如果立法机关将胚胎指定为法人,生育诊所将被迫改变管理胚胎的方式,包括植入前基因检测、储存未使用的胚胎、处理不太可能具有生殖潜力的胚胎等现行标准做法。本文考察了在私法和公法下授予个人地位的许多方式,这些方式可能会影响追求试管婴儿的患者和实施ART的诊所。
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引用次数: 0
Pathogen dematerialization and the ABS loophole. 病原体非物质化和ABS漏洞。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad002
Abbie-Rose Hampton
Law School, Oxford University Press, and Stanford Law School. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Journal of Law and the Biosciences, 1–20 https://doi.org/10.1093/jlb/lsad002 Essay
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引用次数: 0
Why reason-based abortion bans are not a remedy against eugenics: an empirical study. 为什么基于理性的堕胎禁令不是对优生学的补救措施:一项实证研究。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsac033
Sonia M Suter

In Box v Planned Parenthood, Justice Thomas wrote an impassioned concurrence describing abortions based on sex, disability or race as a form of 'modern-day eugenics'. He defended the challenged Indiana reason-based abortion (RBA) ban as a necessary antidote to these practices. Inspired by this concurrence, legislatures have increasingly enacted similar bills and statutes allegedly as a prophylactic to 'eugenics', its underlying discrimination, and the racial disparities eugenics caused. This article tests my hypothesis that this legislative focus on eugenics is largely performative, rather than evidence of true concern about the discrimination and disparities underlying eugenics. My research examined state laws in several areas that fall within narrow and broad understandings of eugenics to determine whether states with RBA bans have implemented policies to counteract eugenics more broadly. My analysis shows that they generally have not. Instead, the apparent motivation is to commandeer concerns about eugenics to restrict reproductive rights. This legislative mission is hypocritical, and it harms the very groups impacted by the eugenics movements-minorities, women, people with disabilities, the LGBTQ+ community, and immigrants. Ultimately, it has led us to Dobbs, which makes everyone vulnerable to the eugenics policies Thomas condemns by undercutting previous constitutional protections against eugenics.

在方框诉计划生育一案中,托马斯大法官写了一篇慷慨激昂的意见书,将基于性别、残疾或种族的堕胎描述为“现代优生学”的一种形式。他为印第安纳州受到质疑的理性堕胎禁令(RBA)辩护,称这是应对这些做法的必要手段。在这种共识的启发下,立法机构越来越多地颁布了类似的法案和法规,据称是为了预防“优生学”,其潜在的歧视,以及优生学造成的种族差异。本文验证了我的假设,即立法对优生学的关注主要是表现性的,而不是对优生学背后的歧视和差异的真正关注的证据。我的研究检查了几个领域的州法律,这些领域属于对优生学的狭义和广义理解,以确定有RBA禁令的州是否实施了更广泛的政策来抵制优生学。我的分析表明,他们通常没有。相反,明显的动机是利用对优生学的担忧来限制生育权利。这项立法任务是虚伪的,它伤害了受优生学运动影响的群体——少数民族、妇女、残疾人、LGBTQ+社区和移民。最终,它把我们引向了多布斯,它削弱了以前反对优生学的宪法保护,使每个人都容易受到托马斯谴责的优生学政策的影响。
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引用次数: 0
Chinese legal response to the shared motherhood model in lesbians' family-making. 中国法律对女同性恋共同母性模式的回应。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad015
Chunyan Ding

Despite the non-recognition of same-sex relationships or marriage by the law, lesbian motherhood has become an emerging socio-legal issue in China. To fulfil their desires to reproduce and make a family, some Chinese lesbian couples adopt a `shared motherhood model' where one lesbian contributes an egg while her partner becomes pregnant through embryo transfer following artificial insemination with a donor's sperm. Because the shared motherhood model intentionally divides the roles of biological mother and gestational mother between lesbian couples, this has allowed legal controversies to emerge associated with the parenthood of the conceived child as well as custody, support of, and visitation of the child. There are two pending judicial cases involving a shared motherhood arrangement reported in the country. The courts have appeared reluctant to rule on them because Chinese law has not provided clear legal solutions to these controversial issues. They are highly cautious about delivering a decision not in line with the current legal position of non-recognition of same-sex marriage. Given little literature discussing Chinese legal responses to the shared motherhood model, this article aims to fill the gap by investigating the basis of parenthood under Chinese law and analysing the parentage issue concerning the different types of relationships between lesbians and children born of a shared motherhood arrangement.

尽管法律不承认同性关系或婚姻,但女同性恋母亲已经成为中国一个新兴的社会法律问题。为了满足生育和组建家庭的愿望,一些中国女同性恋夫妇采取了“共享母性模式”,即女同性恋一方提供卵子,而她的伴侣则通过人工授精后的胚胎移植怀孕。由于共同母性模式有意地将女同性恋伴侣之间的生母和孕母的角色分开,这就导致了与怀孕孩子的父母身份以及孩子的监护权、抚养权和探视权相关的法律争议。据报告,该国有两起涉及共同母亲安排的未决司法案件。法院似乎不愿就这些问题作出裁决,因为中国法律没有为这些有争议的问题提供明确的法律解决方案。他们对做出不符合目前不承认同性婚姻的法律立场的决定非常谨慎。鉴于很少有文献讨论中国法律对共同母性模式的回应,本文旨在通过调查中国法律下的亲子关系基础,并分析涉及女同性恋者与共同母性安排下出生的孩子之间不同类型关系的亲子关系问题,来填补这一空白。
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引用次数: 0
Who would own the HeLa cell line if the Henrietta Lacks case happened in present-day South Africa? 如果亨丽埃塔·拉克斯的案子发生在今天的南非,谁会拥有海拉细胞系?
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2023-01-01 DOI: 10.1093/jlb/lsad011
Donrich W Thaldar

The HeLa cell line was created in 1951 without consent from Henrietta Lacks, the person whose tissue sample was used. In 2021, the descendants of Henrietta Lacks sued a well-known biotechnology company for the profits it made from the HeLa cell line. In this article, ownership of the cell lines is investigated from a South African legal perspective by considering three possible contemporary scenarios bearing points of similarity to the Henrietta Lacks case. In the first scenario, informed consent is obtained to use a tissue sample for research and to commercialize the products of such research; in the second scenario, informed consent is materially deficient because of an honest mistake on the part of the research institution; and in the third scenario, informed consent is materially deficient due to willful disregard of the law on the part of the research institution. In the first two scenarios, ownership of the cell line created from the tissue sample would vest in the research institution, and the research participant would not have any legal action for financial compensation. However, in the third scenario, ownership of the cell line would vest in the research participant, who would be able to claim all profits made from trading the cell line. Whether the research institution acted in good faith is therefore a crucial determinant of the legal outcome.

海拉细胞系是在1951年未经亨丽埃塔·拉克斯(Henrietta Lacks)同意的情况下创建的,她的组织样本被使用了。2021年,亨丽埃塔·拉克斯的后代起诉了一家知名生物技术公司,要求该公司从海拉细胞系中获利。在本文中,通过考虑与Henrietta Lacks案件相似的三种可能的当代情景,从南非法律角度调查了细胞系的所有权。在第一种情况下,获得知情同意,使用组织样本进行研究并将此类研究的产品商业化;在第二种情况下,由于研究机构的无心之失,知情同意存在重大缺陷;在第三种情况下,由于研究机构故意无视法律,知情同意在实质上是有缺陷的。在前两种情况下,从组织样本中产生的细胞系的所有权将归属于研究机构,研究参与者无需采取任何法律行动以获得经济赔偿。然而,在第三种情况下,细胞系的所有权将归属于研究参与者,他们将能够要求从交易细胞系中获得的所有利润。因此,研究机构的行为是否诚信是决定法律结果的关键因素。
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引用次数: 0
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