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What will and won’t happen when abortion is banned 堕胎被禁止后会发生什么,不会发生什么
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2022-01-01 DOI: 10.1093/jlb/lsac011
M. Oberman
Abstract For the past 50 years, abortion opponents have fought for the power to ban abortion without little attention to how things might change when they won. The battle to make abortion illegal has been predicated on three nebulous assumptions about how abortion bans work. First, supporters believe banning abortion will deter it. Second, they hope bans will send a message about abortion—specifically, that abortion is immoral. And third, they expect bans to be competently implemented and enforced. Drawing on empirical work from within and outside of the U.S., this Article offers an evidence-based assessment of each of these assumptions. Part One examines the question of deterrence by exploring findings from countries with relatively high and relatively low abortion rates. After explaining why restrictive abortion laws alone do not reduce aggregate abortion rates, I consider the matter of individual deterrence. By identifying those most likely to be deterred by U.S. abortion bans, I illustrate how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children. Part Two tests the idea that abortion bans send a message. I consider the bans’ meaning in context with U.S. laws and policies affecting families, exposing the difference between laws discouraging abortion, and those encouraging childbirth. Then, drawing from literature on the expressive function of the law, I assess the limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitment to children living in poverty. Part Three turns to the expectation that abortion bans will be competently enforced, noting the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans. This article concludes by considering why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.
摘要在过去的50年里,堕胎反对者一直在为禁止堕胎的权力而斗争,而很少关注他们获胜后情况会发生什么变化。将堕胎定为非法的斗争是基于对堕胎禁令如何运作的三个模糊假设。首先,支持者认为禁止堕胎会阻止堕胎。其次,他们希望禁令能传递一个关于堕胎的信息——特别是堕胎是不道德的。第三,他们希望禁令能够得到适当的实施和执行。本文借鉴了美国国内外的实证研究,对这些假设中的每一个进行了循证评估。第一部分通过探索堕胎率相对较高和相对较低的国家的调查结果来研究威慑问题。在解释了为什么仅凭限制性堕胎法并不能降低总堕胎率之后,我考虑了个人威慑的问题。通过确定那些最有可能被美国堕胎禁令阻止的人,我说明了堕胎禁令如何与结构性不平等交叉,从而对有色人种贫困妇女及其子女产生不成比例的影响。第二部分检验了堕胎禁令传递信息的观点。我认为,这些禁令的含义与影响家庭的美国法律和政策相结合,暴露了劝阻堕胎和鼓励生育的法律之间的区别。然后,从有关法律表达功能的文献中,我评估了在一个因堕胎及其对贫困儿童的承诺而产生分歧的社会中,堕胎禁令的信息传递能力的局限性。第三部分转向对堕胎禁令将得到有效执行的期望,指出执法模式引发的合法性斗争,以及监督堕胎禁令的各种例外情况所固有的行政挑战。这篇文章最后考虑了为什么堕胎禁令的后果和限制对支持者和反对者都很重要。
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引用次数: 4
Prospect patents and CRISPR; rivalry and ethical licensing in a semi-commons environment. 前景专利与CRISPR;半公共环境中的竞争和道德许可。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-10-24 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab031
Andreas Panagopoulos, Katerina Sideri
Abstract The prospect theory of patents views patents as a tool for the development and commercialization of inventions. Prospect patents rely on broad control of technology so that rivalry between competing products is diminished thus avoiding waste of common-pool resources. The theory has been widely criticized but in this article we argue that it does not address the realities of an economy where many innovations are created by universities. Although university patents on inventions such as new gene-editing tools fit squarely in the definition of prospect patents, they may still allow rivalry to resurface at the commercialization stage. This rivalry is not between competing firms; it is between competing visions of the prospect: ‘the university’s vision versus the licensees.’ We use as a case study the CRISPR-Cas9 technology invented by universities and commercialized by licensees. We employ patent landscape analysis showing that CRISPR-Cas9’s prospects comply with the characteristics of prospect patents and, above all, diminish rivalry at the commercialization stage. As the lack of competition leads to excessive treatment prices, tensions arise because the licensee understands CRISPR-Cas9 as a revenue-generating prospect, whereas the university views it as a technology requiring broad distribution. Such discerning visions can breed rivalry between licensor and licensee despite broad patent rights. In addressing this we turn to the literature on semi-commons, which implies an environment where private rights of exclusion such as prospect patents work with ethical licenses and a domain of resources open for reuse to foster innovation. We argue that in this environment, universities can emerge as important actors in the regulatory enterprise through additional ex post licensing. To this end, we propose a market-based solution in the form of a license allowing for patent re-licensing if the licensee fails to address a predefined demand for the final product.
专利前景理论将专利视为发明开发和商业化的工具。前瞻性专利依赖于对技术的广泛控制,从而减少竞争产品之间的竞争,从而避免浪费公共资源。这一理论受到了广泛的批评,但在本文中,我们认为它没有解决许多创新都是由大学创造的经济现实。尽管大学对新基因编辑工具等发明的专利完全符合前景专利的定义,但它们仍可能使竞争在商业化阶段重新浮出水面。这种竞争不是在相互竞争的公司之间;这是对前景的相互竞争的愿景:“大学的愿景与被许可方的愿景”。我们使用由大学发明并被授权商商业化的CRISPR-Cas9技术作为案例研究。我们采用专利景观分析显示,CRISPR-Cas9的前景符合前景专利的特征,最重要的是,在商业化阶段减少竞争。由于缺乏竞争导致治疗价格过高,紧张局势出现了,因为被许可方认为CRISPR-Cas9是一种创收前景,而大学认为它是一种需要广泛推广的技术。尽管拥有广泛的专利权,但这种敏锐的眼光可能会在许可方和被许可方之间滋生竞争。在解决这个问题时,我们转向关于半公地的文献,这意味着一种环境,在这种环境中,私人的排他权(如前景专利)与道德许可一起工作,并且资源领域开放以供重用以促进创新。我们认为,在这种环境下,通过额外的事后许可,大学可以成为监管企业中的重要参与者。为此,我们提出了一种基于市场的解决方案,以许可的形式允许专利再许可,如果被许可方未能满足对最终产品的预定需求。
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引用次数: 3
Demystifying Schrems II for the cross-border transfer of clinical research data. 揭开临床研究数据跨境转移的Schrems II的神秘面纱。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-10-23 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab032
Joseph Liss, David Peloquin, Mark Barnes, Barbara E Bierer

The Courts of Justice of the European Union (CJEU) held in its July 2020 Schrems II decision that, in order for entities in other countries to import personal data from the European Economic Area (EEA), the importer must be able to provide data protections 'essentially equivalent' to those the EEA offers under its General Data Protection Regulation. The CJEU expressed particular concern that United States' national security intelligence gathering laws prevent U.S.-based entities from providing such protections. This decision has sharply limited the sharing of clinical research data from the EEA to the United States. After describing the pertinent aspects of the Schrems II decision, this article evaluates U.S. national security intelligence gathering frameworks, including Section 702 of the Foreign Intelligence Surveillance Act and Executive Order 12333. The article then leverages recent draft guidance from the European Data Protection Board to explain how entities may be able to adopt widely used contractual and technical measures, such as data pseudonymization, to provide 'essentially equivalent' protections in the clinical research context.

欧盟法院(CJEU)在其2020年7月的Schrems II决定中裁定,为了使其他国家的实体从欧洲经济区(EEA)进口个人数据,进口商必须能够提供与EEA根据其通用数据保护条例提供的数据“本质上等同”的数据保护。欧洲法院特别关切的是,美国的国家安全情报收集法阻止美国实体提供此类保护。这一决定严重限制了从欧洲经济区到美国的临床研究数据共享。在描述了Schrems II案判决的相关方面之后,本文评估了美国国家安全情报收集框架,包括《外国情报监视法》第702条和行政命令12333。然后,文章利用欧洲数据保护委员会最近的指导草案来解释实体如何能够采用广泛使用的合同和技术措施,例如数据假名,以在临床研究背景下提供“本质上等同”的保护。
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引用次数: 1
Patient data ownership: who owns your health? 患者数据所有权:谁拥有你的健康?
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-10-01 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab023
Kathleen Liddell, David A Simon, Anneke Lucassen

This article answers two questions from the perspective of United Kingdom law and policy: (i) is health information property? and (ii) should it be? We argue that special features of health information make it unsuitable for conferral of property rights without an extensive system of data-specific rules, like those that govern intellectual property. Additionally, we argue that even if an extensive set of rules were developed, the advantages of a property framework to govern health information would be slight: propertization is unlikely to enhance patient self-determination, increase market efficiency, provide patients a foothold in the data economy, clarify legal uses of information, or encourage data-driven innovation. The better approach is to rely less, not more, on property. We recommend a regulatory model with four signature features: (i) substantial protection for personal health data similar to the GDPR with transparent limits on how, when, and by whom patient data can be accessed, used, and transmitted; (ii) input from relevant stakeholders; (iii) interoperability; and (iv) greater research into a health-data service, rather than goods, model.

本文从英国法律和政策的角度回答了两个问题:(i)健康信息是财产吗?(ii)应该是这样吗?我们认为,健康信息的特殊特征使其不适合在没有广泛的数据特定规则体系(如管理知识产权的规则)的情况下授予产权。此外,我们认为,即使制定了一套广泛的规则,财产框架管理健康信息的优势也很小:财产化不太可能增强患者的自决,提高市场效率,为患者提供数据经济中的立足点,澄清信息的合法用途,或鼓励数据驱动的创新。更好的方法是减少而不是增加对房地产的依赖。我们建议采用一种具有四个标志性特征的监管模式:(i)对个人健康数据提供类似于GDPR的实质性保护,对如何、何时以及由谁访问、使用和传输患者数据进行透明限制;(ii)相关利益相关者的意见;(3)互操作性;(四)加大对健康数据服务模式的研究,而不是商品模式。
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引用次数: 20
Protecting research data of publicly revealing participants. 保护公开披露参与者的研究数据。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-09-06 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab028
Kyle J McKibbin, Bradley A Malin, Ellen Wright Clayton

Biomedical researchers collect large amounts of personal data about individuals, which are frequently shared with repositories and an array of users. Typically, research data holders implement measures to protect participants' identities and unique attributes from unauthorized disclosure. These measures, however, can be less effective if people disclose their participation in a research study, which they may do for many reasons. Even so, the people who provide these data for research often understandably expect that their privacy will be protected. We discuss the particular challenges posed by self-disclosure and identify various steps that researchers should take to protect data in these cases to protect both the individuals and the research enterprise.

生物医学研究人员收集了大量关于个人的个人数据,这些数据经常与存储库和一系列用户共享。通常,研究数据持有者会采取措施保护参与者的身份和独特属性免受未经授权的披露。然而,如果人们透露了他们参与研究的情况,这些措施就不那么有效了,他们这样做可能有很多原因。即便如此,为研究提供这些数据的人通常希望他们的隐私得到保护,这是可以理解的。我们讨论了自我披露带来的特殊挑战,并确定了研究人员在这些情况下应该采取的保护数据的各种步骤,以保护个人和研究企业。
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引用次数: 1
The invisible child of personalized medicine. 个性化医疗的隐形孩子。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-09-06 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab029
Katharina Ó Cathaoir

This article seeks to bring the invisible child of personalized medicine out from the shadows through legal analysis and empirical data. It uses Denmark as a case to argue that existing policies, laws and practices on personalized medicine neglect the legal and ethical issues specific to children. The article investigates Danish laws and practices in clinical genetics and describes how the law neglects children's right to self-determination in three ways. Firstly, while child participation is provided for by law, no guidelines have been created to operationalize this norm. Secondly, children's right not to know is inadequately reflected in current policies. Thirdly, the storage of information from prenatal genetic sequencing raises important issues that are in need of reflection. Several recommendations are made, including for strengthening children's participation and limiting parents' access to secondary findings where they relate to untreatable or unpreventable conditions. It furthermore recognizes, however, that children's self-determination in some circumstances should be viewed relationally due to the interconnected nature of genetics.

本文试图通过法律分析和实证数据,将个性化医疗这个看不见的孩子从阴影中带出来。它以丹麦为例,论证了关于个性化医疗的现行政策、法律和实践忽视了针对儿童的法律和伦理问题。这篇文章调查了丹麦的法律和临床遗传学实践,并描述了法律如何在三个方面忽视儿童的自决权。首先,虽然法律规定了儿童的参与,但没有制定任何准则来实施这一规范。第二,儿童的不知情权在现行政策中没有得到充分体现。第三,产前基因测序信息的存储提出了需要反思的重要问题。提出了几项建议,包括加强儿童的参与和限制父母获得与无法治疗或不可预防的疾病有关的次要调查结果。然而,它进一步认识到,由于遗传的相互联系性质,儿童在某些情况下的自决应被视为关系。
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引用次数: 1
Paying Americans to take the vaccine-would it help or backfire? 付钱让美国人接种疫苗——是有益还是适得其反?
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-09-06 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab027
Christopher Robertson, Daniel Scheitrum, Aleks Schaefer, Trey Malone, Brandon R McFadden, Kent D Messer, Paul J Ferraro

This research investigates the extent to which financial incentives (conditional cash transfers) would induce Americans to opt for vaccination against coronavirus disease of 2019. We performed a randomized survey experiment with a representative sample of 1000 American adults in December 2020. Respondents were asked whether they would opt for vaccination under one of three incentive conditions ($1000, $1500, or $2000 financial incentive) or a no-incentive condition. We find that-without coupled financial incentives-only 58 per cent of survey respondents would elect for vaccination. A coupled financial incentive yields an 8-percentage-point increase in vaccine uptake relative to this baseline. The size of the cash transfer does not dramatically affect uptake rates. However, incentive responses differ dramatically by demographic group. Republicans were less responsive to financial incentives than the general population. For Black and Latino Americans especially, very large financial incentives may be counter-productive.

这项研究调查了财政激励(有条件的现金转移支付)在多大程度上诱使美国人选择接种2019年冠状病毒疫苗。我们在2020年12月对1000名美国成年人的代表性样本进行了随机调查实验。受访者被问及他们是否会选择在三种激励条件(1000美元、1500美元或2000美元的财政激励)或无激励条件下接种疫苗。我们发现,在没有经济激励的情况下,只有58%的受访者会选择接种疫苗。与此基线相结合的财政激励可使疫苗接种率提高8个百分点。现金转移的规模不会显著影响吸收率。然而,不同人口群体的激励反应差异很大。共和党人对财政刺激的反应不如普通民众。特别是对黑人和拉丁裔美国人来说,非常大的财政激励可能会适得其反。
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引用次数: 0
Psychiatric genetic essentialism and stigma in child custody proceedings: public views. 精神病遗传本质主义和儿童监护程序中的耻辱:公众观点。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-08-26 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsab026
Maya Sabatello, Audrey Chao, Beverly J Insel, Thomas Corbeil, Bruce G Link, Paul S Appelbaum

The introduction of behavioral, including psychiatric, genetic information in American courts has gained traction but raises concerns of undue influence on judicial outcomes. We conducted a vignette-based survey of a nationally representative sample of US adults to assess how evidence about a parent's psychiatric genetic makeup and explicit and implicit stigmatizing beliefs about psychiatric conditions may affect key decisions in child custody proceedings. Psychiatric genetic evidence did not affect public perspectives on custody decisions, but it increased the genetic essentialist understanding of psychiatric conditions (regardless of a diagnosis). Explicit stigma was associated with a preference to deny parents with a (or with an alleged) psychiatric condition joint custody. Our newly created Implicit Association Test identified an association between psychiatric conditions and perceived bad parenting. Research to identify effective interventions and educational programs to address genetic essentialism and to reduce bias against people, including parents, with psychiatric conditions is urgently needed.

在美国法院引入行为学信息,包括精神病学信息和遗传信息,已经取得了进展,但也引发了对司法结果产生不当影响的担忧。我们对具有全国代表性的美国成年人样本进行了一项基于小插图的调查,以评估有关父母精神疾病基因构成的证据以及对精神疾病的显性和隐性污名化信念如何影响儿童监护程序中的关键决定。精神病学遗传证据并不影响公众对监护决定的看法,但它增加了对精神疾病的遗传本质主义者的理解(无论诊断如何)。明确的耻辱与倾向于拒绝有(或据称有)精神疾病的父母共同监护有关。我们新创建的内隐联想测试确定了精神状况和感知到的不良教养之间的联系。迫切需要研究确定有效的干预措施和教育计划,以解决遗传本质主义,并减少对患有精神疾病的人(包括父母)的偏见。
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引用次数: 1
Framing and legitimating EU legal regulation of human gene-editing technologies: key facets and functions of an imaginary. 构建和合法化欧盟人类基因编辑技术的法律法规:一个虚构的关键方面和功能。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-08-16 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsaa080
Aurélie Mahalatchimy, Pin Lean Lau, Phoebe Li, Mark L Flear

Gene-editing technologies, ie those able to make changes in the DNA of an organism, are the object of global competition and a regulatory race between countries and regions. There is an attempt to craft legal frameworks protective enough for users, but flexible enough for developers of gene-editing technologies. This article examines the imaginary built into the framing of EU-level legal regulation of human gene-editing technologies and identifies its three key related facets: the tension around naturalness; safeguarding morality and ethics; and the pursuit of medical objectives for the protection of human health. Concerns around the use of gene-editing technologies in relation to eugenics and human enhancement have produced a multifaceted imaginary. We argue that this imaginary not only places a limit on EU-level regulation, despite a strong EU competence in respect of the internal market, but also seeks to ensure its legitimation.

基因编辑技术,即那些能够改变生物体DNA的技术,是全球竞争的对象,也是国家和地区之间监管竞赛的对象。有一种尝试是制定对用户足够保护,但对基因编辑技术开发者足够灵活的法律框架。本文考察了欧盟层面人类基因编辑技术法律监管框架中的想象,并确定了其三个关键相关方面:围绕自然性的紧张关系;维护道德伦理;而医学追求的目标为保护人类健康。对基因编辑技术在优生学和人类增强方面的使用的担忧产生了多方面的想象。我们认为,这一设想不仅限制了欧盟层面的监管,尽管欧盟在内部市场方面具有强大的能力,而且还试图确保其合法性。
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引用次数: 5
Expectations as techniques of legitimation? Imagined futures through global bioethics standards for health research. 作为合法化技术的期望?通过全球健康研究生物伦理标准想象未来。
IF 3.4 2区 哲学 Q1 ETHICS Pub Date : 2021-08-16 eCollection Date: 2021-07-01 DOI: 10.1093/jlb/lsaa086
Mark L Flear

I argue that expectations or strong beliefs about what can occur, and the imaginaries they construct, can be shaped by organizations and used by them as techniques for public legitimation of their governance and regulatory activities. I advance this argument by reference to the International Council on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The expectations and imaginary flowing from the ICH's mission and framing, 'harmonisation for better health', support a focus on technological development for the production of safe, quality, and effective pharmaceuticals and individual ethical conduct to achieve it. The expectations also marginalize wider systemic issues relating to social justice, particularly those affecting the global South. The central role of scientific-technical knowledge and expertise to harmonization abets the latter by minimizing the value to governance of public knowledges on systemic issues. Instead of ensuring the contribution of these knowledges to governance through public participation, there is an attempt to bolster legitimation through communication of expectations and transparency to show practices are in accordance with them (ie expectations are met).

我认为,对可能发生的事情的期望或强烈信念,以及它们所构建的想象,可以由组织塑造,并被组织用作使其治理和监管活动公开合法化的技巧。我以《国际人用药品注册技术要求协调理事会》(ICH)为例推进这一论点。ICH 的使命和框架--"为更好的健康而协调"--所产生的期望和想象,支持将重点放在生产安全、优质、有效药品的技术发展上,以及实现这一目标的个人道德行为上。这种期望也使与社会公正有关的更广泛的系统性问题边缘化,特别是那些影响全球南部的问题。科技知识和专业知识在协调方面的核心作用,通过最大限度地降低系统性问题上的公共知识对治理的价值,助长了后者。人们不是通过公众参与来确保这些知识对治理的贡献,而是试图通过传达期望和透明度来表明做法符合这些期望(即期望得到满足),从而加强合法性。
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引用次数: 0
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