Journal international de bioethique et d'ethique des sciences最新文献

As a part of personalized medicine, pharmacogenomics (PGx) allows practitioners to provide the right drug for a given patient, in accordance with the result of a genetic test. This practice raises many ethical issues that are discussed in the literature, sometimes within the larger context of personalized medicine. This article is based on a literature review that is original insofar as it is interdisciplinary and based on an approach that articulates individual and social rights. Here, we propose to reconsider some classic ethical issues, such as informed consent, incidental findings and data protection which are raised by genetic testing and also by PGx in the same or in a different way. We also analyse broader collective issues around racialization and health equality. Our purpose is to contribute in drawing links and parallels between individual rights and collective rights using a social approach. This analysis discusses these ethical issues in research and in clinical setting, understanding the treatment of the individual in his dual quality of patient and research participant.

Since the 60s, and particularly after various scandals in the 90s, national research ethics committees in Africa have established themselves as key players in the field of international clinical research. Notably based on the principle of double ethical review, their existence has historically been aimed at preventing a form of ethical dumping, a temptation that still exists today on the part of some research promoters. While the international framework of “soft” law has favored their emergence and legitimacy, a legal and regulatory framework of “hard” law is also necessary at local level for each national research ethics committee, to ensure its proper functioning and the optimal fulfillment of its missions. The aim of this article is to analyze the similarities and differences between three national ethics committees in Africa, specifically the CNERS of Guinea, the CNERS of Benin and the CNESVS of Côte d’Ivoire, in terms of status, missions, legal or regulatory ground and, more generally, autonomy. This analysis will enable us, on the one hand, to take account of common logistical difficulties and, on the other, to go beyond differences in legal status and missions to define what enables this type of committee to fully exercise its role(s). Finally, this article proposes to model the various elements that contribute to the autonomy and resilience of a national research ethics committee, around a notion proposed on this occasion: the “circles of autonomy”.

Introduction: A legal exception to the principle of equal health rights, discriminatory subsidies often pose an ethical dilemma in the field of application.

Aim: To analyze discriminatory subsidies for healthcare in the light of the ethical principle of justice and to propose alternatives to any inherent legal and ethical conflicts.

Method: This was a qualitative, descriptive and analytical study based on semi-structured interviews with caregivers.

Results: Participants felt that the application of discriminatory subsidies has a negative impact on substantial distributive justice. The infringements of the award conditions were exclusively for the benefit of the patients concerned. Their impact was considered positive on distributive justice and negative on formal justice.

Discussion: Discriminatory care subsidies generally stem from a legal requirement whose application should not be ambiguous. It is apparent that the infringements of the conditions for attribution were in favour of substantial distributive justice. This opposition is a potential source of decision-making difficulties for caregivers who often choose to violate conditions for the benefit of their indigent patients. There are therefore violations of ethically understandable standards, which must be admitted. This could be done through the provision of exceptions for the application of standards for ”noble causes” and conscientious objection clauses in health policy texts.

Conclusion: The legitimacy of health policy norms is essential for their effective application, hence the interest of taking distributive justice into account in the genesis of formal norms.

The present contribution aims to provide an overview of the role attributed to digitalization in relation to the EU Farm to Fork Strategy. The Strategy represents the set of instruments that the European Commission identified to achieve a European Union sustainable food system, and the role attributed to digitalization is pivotal, as the main overall instrument to boost sustainability. Based on the existing literature on the specific subject matter, the authors attempt to provide an analysis of the document looking for specific references to digitalization and highlighting possible emerging related ethical issues with the aim of initiating the discourse for further research on possible legal solutions.

With the emergence of innovations and technological advancements – exemplified by telemedicine and more recently by the extremely rapid development of Generative Artificial Intelligence systems (Gen AI) like Large Language Models (LLM) such as ChatGPT – we are witnessing a progressive transformation of ancient Hippocratic medicine and the physician-patient relationship. These healthcare Gen AI, which carry inherently stakes, risks, opportunities, hopes, and concerns, justify an increased and reinforced ethical vigilance. These digital applications, multiplying, diversifying, and improving their performance day by day, tend to reshape the role and practices of healthcare professionals in their analytical and decision-making medical process.The digitalization of medicine will inevitably encourage physicians to undergo specific training and acquire new competences in new technologies so that they can learn to navigate better in this new ecosystem of knowledge and practices while preserving their medical expertise, skills, and critical thinking. Therefore, faced with the inevitable arrival of Gen AI in medicine, this article aims to question how we can approach and use this technological tool within an evolving ethical framework to maintain a quality healthcare service for users.

The widespread use of teleworking during the health crisis reduced the flow of occupational accident claims by 20%. This applies to commuting accidents, as well as claims related to « immediate » or “deferred” risks (Rapp. annuel 2020 de l’Assurance maladie - Risques professionnels : Eléments statistiques et financiers, déc. 2021, p. 2 and 113). On the basis of these figures, working at home could be analyzed as a means of preventing occupational risks and improving workers’ health. In reality, however, these figures should not obscure the fact that telecommuting is a major occupational hazard. This is all the more the case given that, while telecommuting was not very widespread before the pandemic, it is now popular with employees and is being developed by many companies as a source of productivity (Rapp. CNP, May 16 2022). We therefore need to keep a close eye on the development of workplace accident legislation in this area, its adaptability to the specific claims experience of teleworkers and its perfectibility, not forgetting the thorny question of the possible recognition of the employer’s inexcusable fault in the event of the accident being covered by professional legislation.