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  1. Is Transhumanism a Health Problem?Michael Kowalik -
    In medical sciences, health is measured by reference to our species-typical anatomy and functional integrity – the objective standard of human health. Proponents of transhumanism are committed to biomedical enhancement of human beings by augmenting our species-typical anatomy and functional integrity. I argue that this normative impasse is not only a problem for the transhumanist movement, but also undermines the rationale for some common medical interventions.
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  2. Experimental Philosophy of Emotion.Rodrigo Díaz - forthcoming - In M. Bauer & S. Kornmesser (eds.), Compact Compendium of Experimental Philosophy. Berlin and Boston: De Gruyter.
    Are emotions bodily feelings or evaluative cognitions? What is happiness, pain, or “being moved”? Are there basic emotions? In this chapter, I review extant empirical work concerning these and related questions in the philosophy of emotion. This will include both (1) studies investigating people’s emotional experiences and (2) studies investigating people’s use of emotion concepts in hypothetical cases. Overall, this review will show the potential of using empirical research methods to inform philosophical questions regarding emotion.
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  3. Of Blood Transfusions and Feeding Tubes: Anorexia-Nervosa and Consent.Samuel Director - forthcoming - Public Affairs Quarterly:1-26.
    Individuals suffering from anorexia-nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. In this paper, I answer this question: if an anorexic, A, wants to refuse food when the food would either be life-saving or prevent serious bodily harm, can A’s refusal be valid? I argue that there is compelling reason to think that anorexics can validly refuse food, even (...)
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  4. Unauthorized Pelvic Exams Are Sexual Assault.Perry Hendricks & Samantha Seybold - forthcoming - The New Bioethics:1-9.
    Pelvic exams are used to assess the health of female reproductive organs. As such, they involve digital penetration by a medical professional. However, in the service of medical student education, many pelvic exams are performed on unconscious patients without authorization. In this article, we argue that unauthorized pelvic exams (UPEs) are sexual assault. Our argument is simple: in any other circumstance, unauthorized digital penetration amounts to sexual assault. So, unless there’s a morally significant difference between UPEs and other instances of (...)
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  5. Coercion and the Neurocorrective Offer.Jonathan Pugh - forthcoming - In David Rhys Birks & Thomas Douglas (eds.), reatment for Crime: Philosophical Essays on Neurointerventions in Criminal Justice. Oxford, UK:
    According to what Douglas calls ‘the consent requirement’, neuro-correctives can only permissibly be provided with the valid consent of the offender who will undergo the intervention. Some of those who endorse the consent requirement have claimed that even though the requirement prohibits the imposition of mandatory neurocorrectives on criminal offenders, it may yet be permissible to offer offenders the opportunity to consent to undergoing such an intervention, in return for a reduction to their penal sentence. I call this the neurocorrective (...)
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  6. Deep Brain Stimulation and Revising the Mental Health Act: The Case for Intervention-Specific Safeguards.Jonathan Pugh, Tipu Aziz, Jonathan Herring & Julian Savulescu - forthcoming - British Journal of Psychiatry.
    Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.
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  7. The Moral Obligation to Prioritize Research Into Deep Brain Stimulation Over Brain Lesioning Procedures for Severe Enduring Anorexia Nervosa.Jonathan Pugh, Jacinta Tan, Tipu Aziz & Rebecca J. Park - forthcoming - Frontiers in Psychiatry 9:523.
    Deep Brain Stimulation is currently being investigated as an experimental treatment for patients suffering from treatment-refractory AN, with an increasing number of case reports and small-scale trials published. Although still at an exploratory and experimental stage, initial results have been promising. Despite the risks associated with an invasive neurosurgical procedure and the long-term implantation of a foreign body, DBS has a number of advantageous features for patients with SE-AN. Stimulation can be fine-tuned to the specific needs of the particular patient, (...)
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  8. Why We Should Stop Using Animal-Derived Products on Patients Without Their Consent.Daniel Rodger - forthcoming - Journal of Medical Ethics.
    Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. Firstly, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Secondly, it risks causing non-trivial psychological harm. Thirdly, it is morally inconsistent to respect (...)
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  9. Why Decision-Making Capacity Matters.Ben Schwan - forthcoming - Journal of Moral Philosophy.
    Decision-making Capacity (DMC) matters to whether a patient’s decision should determine her treatment. But why it matters in this way isn’t clear. The standard story is that DMC matters because autonomy matters. And this is thought to justify DMC as a gatekeeper for autonomy—whereby autonomy concerns arise if but only if a patient has DMC. But appeals to autonomy invoke two distinct concerns: concern for authenticity—concern that a choice is consistent with an individual’s commitments; and concern for sovereignty—concern that an (...)
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  10. A Mixed Judgment Standard of Surrogate Decision Making.Nathan Stout - forthcoming - Journal of Medicine and Philosophy.
    The Substituted Judgment Standard (SJS) for surrogate decision-making dictates that a surrogate, when making medical decisions on behalf of an incapacitated patient, ought to make the decision that the patient would have made if the patient had decisional capacity. Despite its intuitive appeal, however, SJS has been the target of a variety of criticisms. Most objections to SJS appeal to epistemic difficulties involved in determining what a patient would have decided in a given case. In this paper, I offer an (...)
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  11. Reforming Informed Consent: On Disability and Genetic Counseling.Elizabeth Dietz & Joel Michael Reynolds - 2023 - In Michael J. Deem, Emily Farrow & Robin Grubs (eds.), The Oxford Handbook of Genetic Counseling. Oxford: Oxford University Press.
    [Forthcoming Fall 2022] Informed consent is a central concept for empirical and theoretical research concerning pregnancy management decisions and is often taken to be one of the more fundamental goals of the profession of genetic counseling. Tellingly, this concept has been seen by disability communities as salutary, despite longstanding critiques made by disability activists, advocates, and scholars concerning practices involved in genetic counseling more generally. In this chapter, we show that the widespread faith in informed consent is misleading and can (...)
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  12. Equipoise, Standard of Care, and Consent: Responding to the Authorisation of New COVID-19 Treatments in Randomised Controlled Trials.Soren Holm, Jonathan Lewis & Rafael Dal-Ré - 2022 - Journal of Medical Ethics:1-6.
    In response to the COVID-19 pandemic, large-scale research and pharmaceutical regulatory processes have proceeded at a dramatically increased pace with new and effective, evidence-based COVID-19 interventions rapidly making their way into the clinic. However, the swift generation of high-quality evidence and the efficient processing of regulatory authorisation have given rise to more specific and complex versions of well-known research ethics issues. In this paper, we identify three such issues by focusing on the authorisation of Molnupiravir, a novel antiviral medicine aimed (...)
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  13. Ethics of Vaccine Refusal.Michael Kowalik - 2022 - Journal of Medical Ethics (48):240-243.
    Proponents of vaccine mandates typically claim that everyone who can be vaccinated has a moral or ethical obligation to do so for the sake of those who cannot be vaccinated, or in the interest of public health. I evaluate several previously undertheorised premises implicit to the ‘obligation to vaccinate’ type of arguments and show that the general conclusion is false: there is neither a moral obligation to vaccinate nor a sound ethical basis to mandate vaccination under any circumstances, even for (...)
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  14. Patient Autonomy, Clinical Decision Making, and the Phenomenological Reduction.Jonathan Lewis & Søren Holm - 2022 - Medicine, Health Care and Philosophy:1-13.
    Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...)
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  15. Organoid Biobanking, Autonomy and the Limits of Consent.Jonathan Lewis & Søren Holm - 2022 - Bioethics:1-15.
    In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognise or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which (...)
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  16. Algorithms for Ethical Decision-Making in the Clinic: A Proof of Concept.Lukas J. Meier, Alice Hein, Klaus Diepold & Alena Buyx - 2022 - American Journal of Bioethics 22 (7):4-20.
    Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report on the (...)
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  17. Should the Family Have a Role in Deceased Organ Donation Decision-Making? A Systematic Review of Public Knowledge and Attitudes Towards Organ Procurement Policies in Europe.Alberto Molina-Pérez, Janet Delgado, Mihaela Frunza, Myfanwy Morgan, Gurch Randhawa, Jeantine Reiger-Van de Wijdeven, Silke Schicktanz, Eline Schiks, Sabine Wöhlke & David Rodríguez-Arias - 2022 - Transplantation Reviews 36 (1).
    Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...)
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  18. An Ethical Framework for Presenting Scientific Results to Policy-Makers.S. Andrew Schroeder - 2022 - Kennedy Institute of Ethics Journal 32 (1):33-67.
    Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists’ presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like (...)
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  19. Informed Consent in Clinical Studies Involving Human Participants: Ethical Insights of Medical Researchers in Germany and Poland.Cristian Timmermann, Marcin Orzechowski, Oxana Kosenko, Katarzyna Woniak & Florian Steger - 2022 - Frontiers in Medicine 9:901059.
    Background: The internationalization of clinical studies requires a shared understanding of the fundamental ethical values guiding clinical studies. It is important that these values are not only embraced at the legal level but also adopted by clinicians themselves during clinical studies. Objective: Our goal is to provide an insight on how clinicians in Germany and Poland perceive and identify the different ethical issues regarding informed consent in clinical studies. Methods: To gain an understanding of how clinicians view clinical studies in (...)
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  20. Shared Decision‐Making and Maternity Care in the Deep Learning Age: Acknowledging and Overcoming Inherited Defeaters.Keith Begley, Cecily Begley & Valerie Smith - 2021 - Journal of Evaluation in Clinical Practice 27 (3):497–503.
    In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...)
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  21. El derecho al consentimiento informado del paciente. Una perspectiva iusfundamental.Noelia Martínez Doallo - 2021 - Granada, España: Comares.
    El consentimiento informado del paciente se inserta en el ámbito de su autonomía decisoria. Aunque presenta un sustrato corporal, este aparece combinado con elementos de índole moral que presuponen una noción concreta de persona como libre y autónoma. Tanto de las definiciones doctrinales como del material normativo se desprende que se trata de una posición jurídica subjetiva del paciente, alternativamente calificada como una “pretensión” o “derecho subjetivo en sentido estricto”, en términos hohfeldianos; un “derecho negativo de defensa”, o una “inmunidad”. (...)
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  22. Psychotherapy, Placebos, and Informed Consent.Garson Leder - 2021 - Journal of Medical Ethics 47 (7):444-447.
    Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of psychotherapy have (...)
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  23. How to Obtain Informed Consent for Psychotherapy: A Reply to Criticism.Garson Leder - 2021 - Journal of Medical Ethics 47 (7):450-451.
    In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy [CBT]). I also argued that the minimal requirements for informed consent do not include (...)
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  24. Capturing and Promoting the Autonomy of Capacitous Vulnerable Adults.Jonathan Lewis - 2021 - Journal of Medical Ethics 47 (12):e21.
    According to the High Court in England and Wales, the primary purpose of legal interventions into the lives of vulnerable adults with mental capacity should be to allow the individuals concerned to regain their autonomy of decision making. However, recent cases of clinical decision making involving capacitous vulnerable adults have shown that, when it comes to medical law, medical ethics and clinical practice, vulnerability is typically conceived as opposed to autonomy. The first aim of this paper is to detail the (...)
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  25. European and Comparative Law Study Regarding Family’s Legal Role in Deceased Organ Procurement.Marina Morla-González, Clara Moya-Guillem, Janet Delgado & Alberto Molina-Pérez - 2021 - Revista General de Derecho Público Comparado 29.
    Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family's decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives' decisional capacity over individual's preferences (expressed or not while alive) regarding (...)
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  26. La confiscación de órganos a la luz del derecho constitucional a la protección de la salud.Clara Moya-Guillem, David Rodríguez-Arias, Marina Morla, Íñigo de Miguel, Alberto Molina-Pérez & Iván Ortega-Deballon - 2021 - Revista Española de Derecho Constitucional 122:183-213.
    This paper analyses the arguments for and against what we have called automatic organ procurement model in relation to the organs of the deceased. For this purpose, this work provides empirical evidence to assess the potential impact of this model on donation rates and on public opinion. Specifically, we examine first the reasons supporting this model, with special reference to utilitarian and justice arguments. On the other hand, we analyse both the approaches based on the violation of pre mortem and (...)
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  27. Normative Framework of Informed Consent in Clinical Research in Germany, Poland, and Russia.Marcin Orzechowski, Katarzyna Woniak, Cristian Timmermann & Florian Steger - 2021 - BMC Medical Ethics 22 (1):1-10.
    Background: Biomedical research nowadays is increasingly carried out in multinational and multicenter settings. Due to disparate national regulations on various ethical aspects, such as informed consent, there is the risk of ethical compromises when involving human subjects in research. Although the Declaration of Helsinki is the point of reference for ethical conduct of research on humans, national normative requirements may diverge from its provisions. The aim of this research is to examine requirements on informed consent in biomedical research in Germany, (...)
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  28. Improving the Ethical Review of Health Policy and Systems Research: Some Suggestions.Govind Persad - 2021 - Journal of Law, Medicine and Ethics 49 (1):123-125.
    Consistent and well-designed frameworks for ethical oversight enable socially valuable research while forestalling harmful or poorly designed studies. I suggest some alterations that might strengthen the valuable checklist Rattani & Hyder propose for the ethical review of health policy and systems research (HPSR), or prompt future work in the area.
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  29. Ethical Considerations of Offering Benefits to COVID-19 Vaccine Recipients.Govind Persad & Ezekiel J. Emanuel - 2021 - JAMA 326 (3):221-222.
    We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.
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  30. Governance Quality Indicators for Organ Procurement Policies.David Rodríguez-Arias, Alberto Molina-Pérez, Ivar R. Hannikainen, Janet Delgado, Benjamin Söchtig, Sabine Wöhlke & Silke Schicktanz - 2021 - PLoS ONE 16 (6):e0252686.
    Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...)
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  31. Aligning Patient’s Ideas of a Good Life with Medically Indicated Therapies in Geriatric Rehabilitation Using Smart Sensors.Cristian Timmermann, Frank Ursin, Christopher Predel & Florian Steger - 2021 - Sensors 21 (24):8479.
    New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a (...)
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  32. Ethical Implications of Alzheimer’s Disease Prediction in Asymptomatic Individuals Through Artificial Intelligence.Frank Ursin, Cristian Timmermann & Florian Steger - 2021 - Diagnostics 11 (3):440.
    Biomarker-based predictive tests for subjectively asymptomatic Alzheimer’s disease (AD) are utilized in research today. Novel applications of artificial intelligence (AI) promise to predict the onset of AD several years in advance without determining biomarker thresholds. Until now, little attention has been paid to the new ethical challenges that AI brings to the early diagnosis in asymptomatic individuals, beyond contributing to research purposes, when we still lack adequate treatment. The aim of this paper is to explore the ethical arguments put forward (...)
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  33. Public Interest in Health Data Research: Laying Out the Conceptual Groundwork.Angela Ballantyne & G. Owen Schaefer - 2020 - Journal of Medical Ethics 46 (9):610-616.
    The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of (...)
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  34. Epistemic Burdens, Moral Intimacy, and Surrogate Decision Making.Parker Crutchfield & Scott Scheall - 2020 - American Journal of Bioethics 20 (2):59-61.
    Berger (forthcoming) states that moral intimacy is important in applying the best interests standard. But what he calls moral intimacy requires that someone has overcome epistemic burdens needed to represent the patient. We argue elsewhere that good surrogate decision-making is first and foremost a matter of overcoming epistemic burdens, or those obstacles that stand in the way of a surrogate decision-maker knowing what a patient wants and how to satisfy those preferences. Berger’s notion of moral intimacy depends on epistemic intimacy: (...)
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  35. ‘The Right Not to Know and the Obligation to Know’, Response to Commentaries.Ben Davies - 2020 - Journal of Medical Ethics 46 (5):309-310.
    Response to commentaries on 'The right not to know and the obligation to know'.
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  36. The Right Not to Know and the Obligation to Know.Ben Davies - 2020 - Journal of Medical Ethics 46 (5):300-303.
    There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...)
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  37. The Narrative Coherence Standard and Child Patients' Capacity to Consent.Gah-Kai Leung - 2020 - American Journal of Bioethics Neuroscience 11 (1):40-42.
    Aryeh Goldberg compellingly argues for a Narrative Coherence Standard (NCS) to bolster existing methods of assessing patients' mental capacity. But his account fails to distinguish between the cognitive abilities of children and adults; consequently, worries may be raised about the scope of the NCS, in particular when we consider child patients. In this article, I argue the NCS cannot plausibly apply to children. Since children's self-conception does not arrive fully formed — but rather is a product of both incomplete cognitive (...)
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  38. Responsible Research for the Construction of Maximally Humanlike Automata: The Paradox of Unattainable Informed Consent.Lantz Fleming Miller - 2020 - Ethics and Information Technology 22 (4):297-305.
    Since the Nuremberg Code and the first Declaration of Helsinki, globally there has been increasing adoption and adherence to procedures for ensuring that human subjects in research are as well informed as possible of the study’s reasons and risks and voluntarily consent to serving as subject. To do otherwise is essentially viewed as violation of the human research subject’s legal and moral rights. However, with the recent philosophical concerns about responsible robotics, the limits and ambiguities of research-subjects ethical codes become (...)
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  39. Advance Directives and Transformative Experience: Resilience in the Face of Change.Govind C. Persad - 2020 - American Journal of Bioethics 20 (8):69-71.
    In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...)
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  40. Clarifying How to Deploy the Public Interest Criterion in Consent Waivers for Health Data and Tissue Research.G. Owen Schaefer, Graeme Laurie, Sumytra Menon, Alastair V. Campbell & Teck Chuan Voo - 2020 - BMC Medical Ethics 21 (1):1-10.
    Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards and regulators trying to implement the criterion. Main text This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the (...)
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  41. Traumatic Brain Injury with Personality Change: A Challenge to Mental Capacity Law in England and Wales.Demian Whiting - 2020 - Psychological Injury and Law 13 (1):11-18.
    It is well documented that people with moderate-to-severe traumatic brain injury (TBI) can undergo personality changes, including becoming more impulsive in terms of how they behave. Legal guidance and academic commentary support the view that impulsiveness can render someone decisionally incompetent as defined by English and Welsh law. However, impulsiveness is a trait found within the healthy population. Arguably, impulsiveness is also a trait that gives rise to behaviours that should normally be tolerated even when they cause harm to the (...)
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  42. The Role of the Family in Deceased Organ Procurement: A Guide for Clinitians and Policymakers.Janet Delgado, Alberto Molina-Pérez, David M. Shaw & David Rodríguez-Arias - 2019 - Transplantation 103 (5):e112-e118.
    Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...)
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  43. Consent’s Dominion: Dementia and Prior Consent to Sexual Relations.Samuel Director - 2019 - Bioethics 33 (9):1065-1071.
    In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse (...)
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  44. Nonconsensual Neurocorrectives and Bodily Integrity: A Reply to Shaw and Barn.Thomas Douglas - 2019 - Neuroethics 12 (1):107-118.
    In this issue, Elizabeth Shaw and Gulzaar Barn offer a number of replies to my arguments in ‘Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity’, Journal of Ethics. In this article I respond to some of their criticisms.
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  45. Does Shared Decision Making Respect a Patient's Relational Autonomy?Jonathan Lewis - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1063-1069.
    According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that (...)
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  46. Public Knowledge and Attitudes Towards Consent Policies for Organ Donation in Europe. A Systematic Review.Alberto Molina-Pérez, David Rodríguez-Arias, Janet Delgado-Rodríguez, Myfanwy Morgan, Mihaela Frunza, Gurch Randhawa, Jeantine Reiger-Van de Wijdeven, Eline Schiks, Sabine Wöhlke & Silke Schicktanz - 2019 - Transplantation Reviews 33 (1):1-8.
    Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...)
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  47. Using Animal-Derived Constituents in Anaesthesia and Surgery: The Case for Disclosing to Patients.Daniel Rodger & Bruce P. Blackshaw - 2019 - BMC Medical Ethics 20 (1):1-9.
    Animal-derived constituents are frequently used in anaesthesia and surgery, and patients are seldom informed of this. This is problematic for a growing minority of patients who may have religious or secular concerns about their use in their care. It is not currently common practice to inform patients about the use of animal-derived constituents, yet what little empirical data does exist indicates that many patients want the opportunity to give their informed consent. First, we review the nature and scale of the (...)
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  48. Hormone Replacement Therapy: Informed Consent Without Assessment?Toni C. Saad, Bruce Philip Blackshaw & Daniel Rodger - 2019 - Journal of Medical Ethics 45 (12):1-2.
    Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...)
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  49. Should Aggregate Patient Preference Data Be Used to Make Decisions on Behalf of Unrepresented Patients?Nathaniel Sharadin - 2019 - AMA Journal of Ethics 21 (7):566-574.
    Patient preference predictors aim to solve the moral problem of making treatment decisions on behalf of incapacitated patients. This commentary on a case of an unrepresented patient at the end of life considers 3 related problems of such predictors: the problem of restricting the scope of inputs to the models (the “scope” problem), the problem of weighing inputs against one another (the “weight” problem), and the problem of multiple reasonable solutions to the scope and weight problems (the “multiple reasonable models” (...)
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  50. Medical Privacy and Big Data: A Further Reason in Favour of Public Universal Healthcare Coverage.Carissa Véliz - 2019 - In T. C. de Campos, J. Herring & A. M. Phillips (eds.), Philosophical Foundations of Medical Law. Oxford, U.K.: Oxford University Press. pp. 306-318.
    Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about your health might (...)
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