Compared with traditional medical technologies, medical new-quality technologies demonstrate stronger autonomy, such as self-generation, replication, amplification, variation and reproduction, and can interact deeply with the intrinsic mechanisms of life systems, adapt to environmental changes dynamically, and intervene in life processes autonomously at different scales. Its intervention in natural life has led to the blurring of life boundaries and have brought more profound and ethical challenges to biosecurity, life dignity, and personal identity. Interpreting and responding to these challenges through the lens of body theory not only helps to clarify the definition of life and return to the embodied life of human beings, but also facilitates upstream governance. This approach advances ethics as a guiding principle, strengthens ethical awareness, reinforces ethical boundaries, enforces rigorous review mechanisms, and promotes global ethical co-governance.
Abstract Modern medical technology is advancing at an unstoppable pace. The scope of medical research has expanded from organs and tissues to the cellular and genetic levels, touching the essence of human life. The modern medical ethics review systems and theories, predominantly rooted in Western frameworks, have not been fully integrated with Chinese cultural contexts, leading to challenges in resolving increasingly complex ethical disputes. By reflecting on the limitations of modern medical ethics review systems and exploring the potential of integrating traditional Chinese philosophy with Western theories, this article aims to develop a framework tailored to Chinese cultural and academic contexts. This approach includes integrating conventional Chinese philosophy into the academic foundation of medical ethics, recruiting ethics committee members with expertise in Chinese culture and philosophy.
Melissa Mccradden, Oluwadara Odusi, Shalmali Joshi
et al.
The problem of algorithmic bias represents an ethical threat to the fair treatment of patients when their care involves machine learning (ML) models informing clinical decision-making. The design, development, testing, and integration of ML models therefore require a lifecycle approach to bias identification and mitigation efforts. Presently, most work focuses on the ML tool alone, neglecting the larger sociotechnical context in which these models operate. Moreover, the narrow focus on technical definitions of fairness must be integrated within the larger context of medical ethics in order to facilitate equitable care with ML. Drawing from principles of medical ethics, research ethics, feminist philosophy of science, and justice-based theories, we describe the Justice, Equity, Fairness, and Anti-Bias (JustEFAB) guideline intended to support the design, testing, validation, and clinical evaluation of ML models with respect to algorithmic fairness. This paper describes JustEFAB's development and vetting through multiple advisory groups and the lifecycle approach to addressing fairness in clinical ML tools. We present an ethical decision-making framework to support design and development, adjudication between ethical values as design choices, silent trial evaluation, and prospective clinical evaluation guided by medical ethics and social justice principles. We provide some preliminary considerations for oversight and safety to support ongoing attention to fairness issues. We envision this guideline as useful to many stakeholders, including ML developers, healthcare decision-makers, research ethics committees, regulators, and other parties who have interest in the fair and judicious use of clinical ML tools.
Introduction. The health of centenarians is a major focus in global studies. Dyslipidemia is directly linked to the risk of cardiovascular diseases, which pose a growing burden on healthcare due to the increasing elderly population. Studying the lipid profiles of centenarians is important for preventing circulatory system diseases and promoting healthy aging. This research aims to compare the prevalence of dyslipidemia in centenarians (median age 96 [95-97]) with elderly individuals (median age was 69 [64 – 74]) in the Republic of Kazakhstan and examine potential predictors of dyslipidemia in the centenarian group.
Methods. The study involved 46 centenarians (study group) and 82 elderly individuals (control group). Statistical analysis was used to process the data, including blood markers and demographic variables, to identify factors contributing to dyslipidemia.
Results and conclusion. The prevalence of hypercholesterolemia in centenarians was 32.6% (15 people - 3 men; 12 women), with elevated LDL levels in 4.3% (2 women). In the control group, hypercholesterolemia prevalence was 29.3% (24 people - 6 men; 18 women) and elevated triglycerides in 6.1% (3 women; 2 men). The study and control groups were compared based on their lipid profile characteristics, which showed similarities as indicated by all p-values being above 0.05: Cholesterol (p=0.348), HDL (p=0.975), LDL (p=0.161), and Triglycerides (p=0.159). Decreased physical activity was a predictor of dyslipidemia in centenarians. Excessive cholesterol levels were significantly higher among women than men in both groups. The primary factor for dyslipidemia was low physical activity, with other predictors having no significant impact on the lipid profiles of centenarians. This factor should be considered when assessing cardiovascular disease risks and all-cause mortality.
R. Jean Cadigan, Margaret Waltz, John M. Conley
et al.
Heritable human genome editing has garnered significant attention in scholarly and lay media, yet questions remain about whether, when, and how heritable genome editing ought to proceed. Drawing on interviews with scientists who use genome editing in their research and professionals engaged in human genome editing governance efforts, we examine their views on the permissibility of heritable genome editing and the governance strategies they see as necessary and realistic. For both issues, we found divergent views from respondents. We place the views of these scientists and governance professionals within the context of the larger bioethical discussion of heritable genome editing governance, along a continuum of hard to soft approaches. These respondents’ views highlight the challenges of various hard forms of governance and the potential virtues of soft governance approaches.
Massimiliano Esposito, Konrad Szocik, Emanuele Capasso
et al.
Abstract Background Respect for human rights and bioethical principles in prisons is a crucial aspect of society and is proportional to the well-being of the general population. To date, these ethical principles have been lacking in prisons and prisoners are victims of abuse with strong repercussions on their physical and mental health. Methods A systematic review was performed, through a MESH of the following words (bioethics) AND (prison), (ethics) AND (prison), (bioethics) AND (jail), (ethics) AND (jail), (bioethics) AND (penitentiary), (ethics) AND (penitentiary), (prison) AND (human rights). Inclusion and exclusion criteria were defined and after PRISMA, 17 articles were included in the systematic review. Results Of the 17 articles, most were prevalence studies (n.5) or surveys (n.4), followed by cross-sectional studies (n.3), qualitative studies (n.1), retrospective (n.1) and an explanatory sequential mixed-methods study design (n.1). In most cases, the studies associated bioethics with prisoners’ access to treatment for various pathologies such as vaccinations, tuberculosis, hepatitis, HIV, it was also found that bioethics in prisons was related to the mental health of prisoners, disability, ageing, the condition of women, the risk of suicide or with the request for end-of-life by prisoners. The results showed shortcomings in the system of maintaining bioethical principles and respect for human rights. Conclusions Prisoners, in fact, find it difficult to access care, and have an increased risk of suicide and disability. Furthermore, they are often used as improper organ donors and have constrained autonomy that also compromises their willingness to have end-of-life treatments. In conclusion, prison staff (doctors, nurses, warders, managers) must undergo continuous refresher courses to ensure compliance with ethical principles and human rights in prisons.
Abstract Context The toolbox of instructional methods available to medical ethics educators is richly stocked and well-catalogued. However, the history of ideas relating to its contents is relatively under-researched in the medical education literature. History This paper proposes an approach to professional medical ethics education that adapts the ancient maieutic, question-asking method associated with Socratic dialogue, and particularly its uptake in educational theory developed by nineteenth and twentieth century American pragmatic philosophers, who in turn were profoundly influenced by the eighteenth century Common Sense school of philosophy from the Scottish Enlightenment. Theory The ‘ethical sense’ postulated in this article is a distant echo of moral sense in Scottish Enlightenment thought. However, ethical sense as posited here is not the natural faculty variously theorised by Scottish Enlightenment philosophers such as Francis Hutcheson and Thomas Reid, but derives from the pre-understandings of students with respect to professional medical ethics. Conclusions The ethics educator can engage the ethical sense of students through maieutic ‘teaching and learning by asking’ in relation to actual clinical narratives, beginning not with the teacher’s questions but importantly with those of the learners based on what they would need to know in order to determine the professional ethical obligations entailed.
Medical ethics is increasingly culturally subjective. A clear understanding of medical ethics must be grounded in a clear philosophy of medicine and philosophical anthropology. Philosophically, medicine is a profession dedicated to the patient’s health. A better understanding of health or wholeness will lead to better healing. Health or wholeness is best understood as well-functioning. The philosophical and anthropological biopsychosocial-spiritual model informs the roots of well-functioning. These four interrelated dimensions must be balanced and work in harmony, ultimately aimed at the basic goods (e.g., health, life, and personal integrity among others) and should be strived for but never harmed. This holistic approach helps determine the primary cause of unwellness while also explaining that biologic healing frequently relies as much on the other dimensions as the biologic treatment. Historically, physicians refined their skills ensuring that the best biologic means addressed the most well-defined biological diseases. This dimension-specific philosophical framework formed the basis of a physician’s diagnostic investigation. If the source of unwellness was primarily in another dimension, then appropriate therapeutic referrals to dimension-specific experts were offered. This framework prevented or corrected egregious excesses due to medicalization of social issues. Traditional boundaries of medicine are now challenged by contraceptives, elective abortion, cosmetic procedures, and euthanasia/physician-assisted suicide, steering medicine away from treating biologic problems with biologic solutions towards treating psychologic and/or social problems with biologic solutions. Countries now inconsistently require their physicians to provide biologic means aimed at specific psychologic and/or social goals to advance sexual and/or economic goals, the country’s laws, or patient autonomy. This is conceptually flawed requiring special exemptions from the profession of medicine while also resulting in biologic harm, damage to the basic goods, and negative psychologic and/or social effects, while transforming medicine into a commodity. Physicians have an ethical obligation to provide effective biologic means to treat biologic diseases while promoting healing and wholeness among all four dimensions. On the other hand, physicians have no obligation to use biologic means for non-biologic problems. This multi-dimensional model with dimension-specific therapies is conceptually consistent, socially agnostic, empirically sound, and provides a clearer understanding of medical ethical obligations.
İnsan, yaratıcının özel bir statü verdiği varlıklar arasında mükemmel bir donanıma sahip olmasının yanı sıra, doğuştan veya sonradan gelişen engellilik durumu da insanlık tarihinde yaygın ve yadsınamaz bir gerçekliktir. İnsan, sadece mükemmel ve sağlıklı bir şekilde var olmanın ötesinde, yaşamın karmaşıklığını ve çeşitliliğini engellilikle mücadele eden bireylerin varlığıyla birlikte deneyimlemektedir. Bu durum, insan varlığının zenginlik ve çeşitliliği içinde, her bireyin benzersiz bir hikâyeye sahip olduğu evrensel bir gerçekliği yansıtmaktadır. Aslında dezavantajlı bireylere olan bakış, o toplumdaki insanların ahlaki seviyelerini ve insana verdikleri değeri de göstermektedir. Seri editörlüğünü Adem APAK’ın yaptığı “Tüm İnsanların Peygamberi” konulu bir projede, on başlık altında Hz. Peygamber’in çocuklar, gençler, yaşlılar, kadınlar, devlet görevlileri, varlıklılar, yoksullar, yakınlar, gayri müslimler ve engellilerle ilişkileri serisinin 10’uncu kitabı olarak “Hz. Peygamber (sav) ve Engelliler” adıyla alanın uzmanlarından Cuma KARAN tarafından telif edilen bu eser, toplumumuzun neredeyse yüzde onunu aşan “engelliler” ile ilgili farkındalık oluşturması açısından önemlidir. Eserin değerlendirilmesine yönelik olmak üzere; Engelli insanların horlandığı bir dönemde gerek bu durumu düzeltmeye yönelik inen âyetler ve gerekse Hz. Peygamber’in engelli sahâbîlere gösterdiği ilgi, empati ve anlayışla dolu iletişimi, engelli bireylerin toplum içinde etkin bir şekilde yer almalarını teşvik etmesinin önemi ve bu değerleri güncel yaşantımıza entegre etmek gibi konular üzerinde durulmuştur.
Pedro Dias Ramos, Maria Strecht Almeida, I. Anna S. Olsson
CRISPR-Cas9 revolutionized the precise editing of mammalian cells genome. The present study explores genome editing (GE) in the context of the Responsible Research and Innovation framework for emerging technologies, through semi-structured interviews with life sciences researchers worldwide. Our study demonstrates that for researchers in the field, GE technology is viewed as promising but also harboring unsolved challenges. These experts call for complementary research to improve the technology and increase knowledge of the genome function. They clearly do not support what they perceive as unsafe, unpredictable and irrelevant applications, and they view the lack of international harmonization of regulation in combination with cultural differences in public attitude as difficult challenges. Interviewees see public misconceptions as a problem while recognizing the need to foster a clear science-society dialogue with informed citizens. This study with scientists provides insight into the science-based priorities for GE to be a technology that can be responsibly applied.
Ahmed Ragib Chowdhury, Sal Sabil Chowdhury, Arif Jamil
Pragmatism is a school of moral philosophy, and of contemporary in origin, comparing to the other schools of moral philosophy. It evaluates the action based on the practical applicability and relevance. Pragmatism can, therefore, be useful to make a law that govern the society contemporary and relevant for the constantly changing world. Biomedical laws in particular are needed to correspond to the changing standards and good practices in tandem with their advancements. This paper will assess from a pragmatic point of view, the efficacy of the biomedical laws of Bangladesh.
Public and academic medical ethics debates surrounding justice and age discrimination often proceed from a problematic understanding of old age that ignores the diversity of older people. This article introduces the feminist perspective of intersectionality to medical ethical debates on aging and old age in order to analyze the structural discrimination of older people in medicine and health care. While current intersectional approaches in this field focus on race, gender, and sexuality, we thus set out to introduce aging and old age as an additional category that is becoming more relevant in the context of longer life expectancies and increasing population aging. We analyze three exemplary cases on the individual, institutional, and public health level, and argue that considering the intersections of old age with other social categories helps to accommodate the diverse identities of older people and detect inequality and structural discrimination.
Abstract This paper considers the relation between medical ethics (ME) and common morality (CM), professional norms, and moral philosophy. It proceeds by analyzing two recent book-length critical analyses of this relationship by Bob Baker in “The Structure of Moral Revolutions—Studies of Changes in the Morality of Abortion, Death, and the Bioethics Revolution” and Rosamond Rhodes in “The Trusted Doctor—Medical Ethics and Professionalism.” It argues that despite the strengths of these critical arguments, there is nevertheless a relationship between ME, understood as the professional ethics of the healthcare professions, and both CM and moral philosophy. It also argues that ME cannot and should not be understood purely as the internally developed professional norms of the medical or healthcare professions.
Abstract Background Nowadays, social media have become central in the daily lives of people, including healthcare professionals. Fears arise that the accelerated growth of these social platforms was not accompanied by the appropriate training of the healthcare students and workers on the professional use of social media. This study primarily aimed to assess the awareness of the healthcare students at Beirut Arab University, Lebanon on the professional standards of social media. It also aimed to assess the presence of differences in the practices and attitudes of healthcare students according to gender and major. Methods A cross-sectional study was designed, and a paper-based questionnaire was distributed to healthcare students. Chi-Square test was used to analyse certain findings. Results Out of 1800 students approached, 496 participated in the questionnaire. All participants used social media. Only 19.5% (96/496) of them had received a structured education on the professional use of social media during their university study. The majority of students (349/488, 71.5%) thought that the professional standards on social media are distinct from those established in face-to-face interactions. Female students were more likely to get adequate answers in accordance with international guidelines. There were statistically significant differences in the practices and attitudes of students belonging to different majors (p value < 0.05). Conclusion The line between what is professional on social media, and what is not, remains blurred for healthcare students. This study uncovered the need for clear and updated evidence-based guidelines assisting students in making the most appropriate decisions in the various online scenarios faced in healthcare practice.
Abstract Background The South African legal framework requires mandatory parental/legal guardian consent for all research with children. Ethics guidelines provide some reprieve by allowing RECs to grant waivers of parental or guardianship consent in certain defined circumstances. In the first instance, consent may be provided by a proxy when parents or guardians are unavailable, for example with orphaned children. In the second instance, guidelines permit adolescent self-consent when the nature of the study justifies this approach, for example, research on sensitive issues like sexual behaviour or substance use. Discussion South African guidelines set several conditions that must be met for waivers to be granted. These norms overlap with those in international guidelines. However, the ethical norms, especially related to self-consent are sometimes vague. This article critically evaluates the consent norms in the national ethics guidelines and makes recommendations for reform to ethics guidelines in a way that recognises the value of child participation in research, their evolving decision-making capacity and their best interests. Conclusion Recommendations are made to harmonise ethics guidelines and law in a way that promotes child participation in research, to ensure additional protections for adolescents when self-consent is allowed, and to withdraw procedural requirements for the community endorsement of self-consent strategies.
The traditional structure of medical school curriculum in the United States consists of 2 years of pre-clinical study followed by 2 years of clinical rotations. In this essay, I propose that this curricular approach stems from the understanding that medicine is both a science, or a body of knowledge, as well as an art, or a craft that is practiced. I then argue that this distinction between science and art is also relevant to the field of medical ethics, and that this should be reflected in ethics curriculum in medical education. I introduce and argue for virtue ethics as the best opportunity for introducing practical ethical knowledge to medical trainees.
from its content. It is not an easy read. The writing is highly technical and will be difficult to follow for those previously unacquainted with this particular branch of philosophy. This is particularly true of the sections explaining the phenomenological work of Levinas and Kierkegaard, which make up the majority of the book. Technical terms are introduced and used without proper definition. Moreover, it is not clear that the length and complexity of these passages are justified by the conclusions drawn from them in later sections when they are applied to addiction. Such difficulties might in part be accounted for by the complexities in the writings of Levinas and Kierkegaard themselves, but one would have hoped that these concepts could have been simplified and made more accessible. Finally, Westin could surely have been served better by her editor in this book’s production. The text is marred by an unusual number of grammatical errors. On one occasion, almost an entire paragraph is duplicated at two different points in a section (pp. 102–103). It would be remiss to overlook such shortcomings, which make this book on such an important topic into a somewhat onerous read. Nevertheless, Westin has embarked on an ambitious project, engaging with the large corpus of work of two eminent thinkers. By bringing their thought into contemporary discourse she shows us how a new perspective can give us a broader and deeper understanding of the experience of addiction. In this respect at least, it is a valuable contribution to the literature.