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  1. added 2018-12-13
    Prior Authorization as a Potential Support of Patient-Centered Care.Leah Rand & Zackary Berger - 2018 - Patient 4 (11):371-375.
    We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...)
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  2. added 2018-12-12
    The Conditions For Ethical Application of Restraints.Parker Crutchfield, Tyler Gibb, Michael Redinger, Dan Ferman & John Livingstone - forthcoming - Chest.
    Despite the lack of evidence for their effectiveness, the use of physical restraints for patients is widespread. The best ethical justification for restraining patients is that it prevents them from harming themselves. We argue that even if the empirical evidence supported their effectiveness in achieving this aim, their use would nevertheless be unethical, so long as well known exceptions to informed consent fail to apply. Specifically, we argue that ethically justifiable restraint use demands certain necessary and sufficient conditions. These conditions (...)
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  3. added 2018-10-26
    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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  4. added 2018-10-02
    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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  5. added 2018-09-24
    ONT Vol 6.Paul Bali - manuscript
    contents -/- i. short review: The Intern -/- ii. the confusion of Chinatown -/- iii. we'll remember water, in Theology -/- iv. Respironics versus ResMed -/- v. i'd bet my life, my home and happiness -/- vi. hypothetic as a deaththreat -/- vii. the Mad Max deity -/- viii. they'd kill my rat, not heal him .
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  6. added 2018-09-21
    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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  7. added 2018-09-17
    Deep Brain Stimulation, Authenticity and Value.Pugh Jonathan, Maslen Hannah & Savulescu Julian - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (4):640-657.
    Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and (...)
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  8. added 2018-09-17
    Ravines and Sugar Pills: Defending Deceptive Placebo Use.Jonathan Pugh - 2015 - Journal of Medicine and Philosophy 40 (1):83-101.
    In this paper, I argue that deceptive placebo use can be morally permissible, on the grounds that the deception involved in the prescription of deceptive placebos can differ in kind to the sorts of deception that undermine personal autonomy. In order to argue this, I shall first delineate two accounts of why deception is inimical to autonomy. On these accounts, deception is understood to be inimical to the deceived agent’s autonomy because it either involves subjugating the deceived agent’s will to (...)
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  9. added 2018-07-13
    The Need for Donor Consent in Mitochondrial Replacement.G. Owen Schaefer - 2018 - Journal of Medical Ethics 44 (12):825-829.
    Mitochondrial replacement therapy requires oocytes of women whose mitochondrial DNA will be transmitted to resultant children. These techniques are scientifically, ethically and socially controversial; it is likely that some women who donate their oocytes for general in vitro fertilisation usage would nevertheless oppose their genetic material being used in MRT. The possibility of oocytes being used in MRT is therefore relevant to oocyte donation and should be included in the consent process when applicable. In present circumstances, specific consent should be (...)
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  10. added 2018-04-16
    Do Machines Have Prima Facie Duties?Gary Comstock - 2015 - In Machine Medical Ethics. London: Springer. pp. 79-92.
    A properly programmed artificially intelligent agent may eventually have one duty, the duty to satisfice expected welfare. We explain this claim and defend it against objections.
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  11. added 2018-03-23
    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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  12. added 2017-10-30
    Adverse Consequences of Article 12 of the UN Convention on the Rights of Persons with Disabilities for Persons with Mental Disabilities and an Alternative Way Forward.Matthé Scholten & Jakov Gather - forthcoming - Journal of Medical Ethics.
    It is widely accepted among medical ethicists that competence is a necessary condition for informed consent. In this view, if a patient is incompetent to make a particular treatment decision, the decision must be based on an advance directive or made by a substitute decision-maker on behalf of the patient. We call this the competence model. According to a recent report of the United Nations (UN) High Commissioner for Human Rights, article 12 of the UN Convention on the Rights of (...)
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  13. added 2017-08-11
    The Need for Authenticity-Based Autonomy in Medical Ethics.Lucie White - 2018 - HEC Forum 30 (3):191-209.
    The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of “authenticity”, the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical (...)
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  14. added 2017-08-05
    The Political Morality of Nudges in Healthcare.Jonathan Gingerich - 2016 - In I. Glenn Cohen, Holly Fernandez Lynch & Christopher T. Robinson (eds.), Nudging Health: Health Law and Behavioral Economics. Baltimore: Johns Hopkins University Press. pp. 97-106.
    A common critique of nudges is that they reduce someone's of choices or elicit behavior through means other than rational persuasion. In this paper, I argue against this form of critique. I argue that, if there is anything distinctively worrisome about nudges from the standpoint of morality, it is is their tendency to hide the amount of social control that they embody, undermining democratic governance by making it more difficult for members of a political community to detect the social architect’s (...)
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  15. added 2017-07-25
    Autonomy and Consent in Biobanks.Peter H. Schwartz - 2010 - The Physiologist 53 (1):1, 3-7.
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  16. added 2017-07-23
    Patient Understanding of Benefits, Risks, and Alternatives to Screening Colonoscopy.Peter H. Schwartz, Elizabeth Edenberg, Patrick R. Barrett, Susan M. Perkins, Eric M. Meslin & Thomas F. Imperiale - 2013 - Family Medicine 45 (2):83-89.
    While several tests and strategies are recommended for colorectal cancer (CRC) screening, studies suggest that primary care providers often recommend colonoscopy without providing information about its risks or alternatives. These observations raise concerns about the quality of informed consent for screening colonoscopy.
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  17. added 2017-07-14
    Discounting a Surgical Risk: Data, Understanding, and Gist.Peter H. Schwartz - 2012 - American Medical Association Journal of Ethics 14 (7):532-538.
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  18. added 2017-07-14
    Questioning the Quantitative Imperative: Decision Aids, Prevention, and the Ethics of Disclosure.Peter H. Schwartz - 2011 - Hastings Center Report 41 (2):30-39.
    Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.
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  19. added 2017-07-14
    The Ethics of Information: Absolute Risk Reduction and Patient Understanding of Screening.Peter H. Schwartz & Eric M. Meslin - 2008 - Journal of General Internal Medicine 23 (6):867-870.
    Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem (...)
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  20. added 2017-07-07
    “I’D Rather Be Dead Than Disabled”—The Ableist Conflation and the Meanings of Disability.Joel Michael Reynolds - 2017 - Review of Communication 17 (3):149-63.
    Despite being assailed for decades by disability activists and disability studies scholars spanning the humanities and social sciences, the medical model of disability—which conceptualizes disability as an individual tragedy or misfortune due to genetic or environmental insult—still today structures many cases of patient–practitioner communication. Synthesizing and recasting work done across critical disability studies and philosophy of disability, I argue that the reason the medical model of disability remains so gallingly entrenched is due to what I call the “ableist conflation” of (...)
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  21. added 2017-03-30
    Communication Behaviors and Patient Autonomy in Hospital Care: A Qualitative Study.Zackary Berger - 2017 - Patient Education and Counseling 2017.
    BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...)
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  22. added 2017-03-27
    Animals, Advance Directives, and Prudence: Should We Let the Cheerfully Demented Die?D. G. Limbaugh - 2016 - Ethics, Medicine and Public Health 2 (4):481-489.
    A high level of confidence in the identity of individuals is required to let them die as ordered by an advance directive. Thus, if we are animalists, then we should lack the confidence required to apply lethal advance directives to the cheerfully demented, or so I argue. In short, there is consensus among animalists that the best way to avoid serious objections to their account is to adopt an ontology that denies the existence of brains, hands, tables, chairs, iced-tea, and (...)
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  23. added 2017-02-11
    Manipulation in the Enrollment of Research Participants.Amulya Mandava & Joseph Millum - 2013 - Hastings Center Report 43 (2):38-47.
    In this paper we analyze the non-coercive ways in which researchers can use knowledge about the decision-making tendencies of potential participants in order to motivate them to consent to research enrollment. We identify which modes of influence preserve respect for participants’ autonomy and which disrespect autonomy, and apply the umbrella term of manipulation to the latter. We then apply our analysis to a series of cases adapted from the experiences of clinical researchers in order to develop a framework for thinking (...)
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  24. added 2017-01-20
    Liberalism, Altruism and Group Consent.Kalle Grill - 2009 - Public Health Ethics 2 (2):146-157.
    This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people (...)
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  25. added 2016-12-15
    Review of Listening Into the Heart of Things-on MDMA and LSD by Samuel Widmer (1989).Michael Starks - 2016 - In Suicidal Utopian Delusions in the 21st Century: Philosophy, Human Nature and the Collapse of Civilization-- Articles and Reviews 2006-2017 2nd Edition Feb 2018. Henderson,NV, USA: Michael Starks. pp. 573-575.
    This is an early volume from a much respected psychedelic psychotherapist. He has written several other books since this one but until recently none of his books were on Amazon and still you can only find a German edition and a Spanish one (from 1993) but no English one (except a couple used copies). This is sad since these drugs have enormous therapeutic potential but afaik government suppression still prevents their use. The most interesting and readable parts are the case (...)
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  26. added 2016-10-05
    Neurosurgery for Psychopaths? An Ethical Analysis.Dietmar Hübner & Lucie White - 2016 - American Journal of Bioethics Neuroscience 7 (3):140-149.
    Recent developments in neuroscience have inspired proposals to perform deep brain stimulation on psychopathic detainees. We contend that these proposals cannot meet important ethical requirements that hold for both medical research and therapy. After providing a rough overview of key aspects of psychopathy and the prospects of tackling this condition via deep brain stimulation, we proceed to an ethical assessment of such measures, referring closely to the distinctive features of psychopathic personality, particularly the absence of subjective suffering and a lack (...)
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  27. added 2016-08-28
    Clinical Research: Should Patients Pay to Play?Ezekiel J. Emanuel, Steven Joffe, Christine Grady, David Wendler & Govind Persad - 2015 - Science Translational Medicine 7 (298):298ps16.
    We argue that charging people to participate in research is likely to undermine the fundamental ethical bases of clinical research, especially the principles of social value, scientific validity, and fair subject selection.
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  28. added 2016-07-05
    Why High-Risk, Non-Expected-Utility-Maximising Gambles Can Be Rational and Beneficial: The Case of HIV Cure Studies.Lara Buchak - 2016 - Journal of Medical Ethics (2):1-6.
    Some early phase clinical studies of candidate HIV cure and remission interventions appear to have adverse medical risk–benefit ratios for participants. Why, then, do people participate? And is it ethically permissible to allow them to participate? Recent work in decision theory sheds light on both of these questions, by casting doubt on the idea that rational individuals prefer choices that maximise expected utility, and therefore by casting doubt on the idea that researchers have an ethical obligation not to enrol participants (...)
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  29. added 2016-06-03
    Two Cautions for a Common Morality Debate: Investigating the Argument From Empirical Evidence Through the Comparative Cultural Study Between Western Liberal Individualist Culture and East Asian Neo-Confucian Culture.Marvin J. H. Lee - 2012 - In Peter A. Clark (ed.), Contemporary Issues in Bioethics. InTech Publisher. pp. 1-14.
    The paper attempts to set a guideline to contemporary common morality debate. The author points out what he sees as two common problems that occur in the field of comparative cultural studies related to a common morality debate. The first problem is that the advocates and opponents of common morality, consciously or unconsciously, define the moral terms in question in a way that their respective meanings would naturally lead to the outcomes that each party desires. The second problem is that (...)
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  30. added 2016-04-26
    The Ableism of Quality of Life Judgments in Disorders of Consciousness: Who Bears Epistemic Responsibility?Joel Michael Reynolds - 2016 - American Journal of Bioethics Neuroscience 7 (1):59-61.
    In this peer commentary on L. Syd M. Johnson’s “Inference and Inductive Risk in Disorders of Consciousness,” I argue for the necessity of disability education as an integral component of decision-making processes concerning patients with DOC and, mutatis mutandis, all patients with disabilities. The sole qualification Johnson places on such decision-making is that stakeholders are educated about and “understand the uncertainties of diagnosis and prognosis.” Drawing upon research in philosophy of disability, social epistemology, and health psychology, I argue that this (...)
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  31. added 2016-03-03
    Ancillary Care Obligations in Light of an African Bioethic: From Entrustment to Communion.Thaddeus Metz - 2017 - Theoretical Medicine and Bioethics 38 (2):111–126.
    Henry Richardson has recently published the first book ever devoted to ancillary care obligations, which roughly concern what medical researchers are morally required to provide to participants beyond what safety requires. In it Richardson notes that he has presented the ‘only fully elaborated view out there’ on this topic, which he calls the ‘partial-entrustment model’. In this article, I provide a new theory of ancillary care obligations, one that is grounded on ideals of communion salient in the African philosophical tradition (...)
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  32. added 2015-12-28
    Moral Conflict in the Minimally Conscious State.Joshua Shepherd - 2016 - In Walter Sinnott-Armstrong (ed.), Finding Consciousness: The Neuroscience, Ethics, and Law of Severe Brain Damage. Oxford University Press. pp. 160-179.
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  33. added 2015-10-05
    Offensive Defensive Medicine: The Ethics of Digoxin Injections in Response to the Partial Birth Abortion Ban.Colleen Denny, Govind Persad & Elena Gates - 2014 - Contraception 90 (3):304.
    Since the Supreme Court upheld the partial birth abortion ban in 2007, more U.S. abortion providers have begun performing intraamniotic digoxin injections prior to uterine dilation and evacuations. These injections can cause medical harm to abortion patients. Our objective is to perform an in-depth bioethical analysis of this procedure, which is performed mainly for the provider’s legal benefit despite potential medical consequences for the patient.
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  34. added 2014-09-24
    Can Informed Consent to Research Be Adapted to Risk?Danielle Bromwich & Annette Rid - 2015 - Journal of Medical Ethics 41 (7):521-528.
    The current ethical and regulatory framework for research is often charged with burdening investigators and impeding socially valuable research. To address these concerns, a growing number of research ethicists argue that informed consent should be adapted to the risks of research participation. This would require less rigorous consent standards in low-risk research than in high-risk research. However, the current discussion is restricted to cases of research in which the risks of research participation are outweighed by the potential clinical benefits for (...)
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  35. added 2014-08-19
    Euthanasia, Assisted Suicide and the Professional Obligations of Physicians.Lucie White - 2010 - Emergent Australasian Philosophers 3:1-15.
    Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two influential views (...)
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  36. added 2014-07-04
    The 21st Century Challenge to Autonomy and Informed Consent.Dena S. Davis - 2012 - Les ateliers de l'éthique/The Ethics Forum 7 (3):45-58.
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  37. added 2014-04-26
    Disclosure and Consent to Medical Research Participation.Danielle Bromwich & Joseph Millum - 2013 - Journal of Moral Philosophy 10 (4):195-219.
    Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. The standard view (...)
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  38. added 2014-04-10
    Minimizing Harm Via Psychological Intervention: Response to Glannon.Joshua Shepherd - 2014 - Journal of Medical Ethics 40 (10):662-663.
    In a recent discussion, Walter Glannon discusses a number of ways we might try to minimize harm to patients who experience intraoperative awareness. In this response I direct attention to a possibility that deserves further attention. It might be that a kind of psychological intervention – namely, informing patients of the possibility of intraoperative awareness and of what to expect in such a case – would constitute a unique way to respect patient autonomy, as well as minimize the harm that (...)
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  39. added 2014-03-04
    What You Don't Know Can Help You: The Ethics of Placebo Treatment.Daniel Groll - 2011 - Journal of Applied Philosophy 28 (2):188-202.
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  40. added 2014-01-18
    Criticising Religious Practices.Brian D. Earp - 2013 - The Philosophers' Magazine 63:15-17.
    In 2012, a German court ruled that religious circumcision of male minors constitutes criminal bodily assault. Muslim and Jewish groups responded with outrage, with some commentators pegging the ruling to Islamophobic and anti-Semitic motivations. In doing so, these commentators failed to engage with any of the legal and ethical arguments actually given by the court in its landmark decision. In this brief commentary, I argue that a firm distinction must be drawn between criticisms of religious practices that stem from irrational (...)
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  41. added 2013-11-17
    THE MAXIM OF SUICIDE: ONE ANGLE ON BIOMEDICAL ETHICS.Yusuke Kaneko - 2012 - ASIAN JOURNAL OF SOCIAL SCIENCES and HUMANITIES 1 (3).
    Addressing the question in the form of Kant’s maxim, this paper moves on to a more controversial topic in biomedical ethics, physician-assisted suicide. However, my conclusion is tentative, and what is worse, negative: I partially approve suicide. It does not imply a moral hazard. The situation is opposite: in the present times, terminal patients seriously wish it. I, as an author, put an emphasis on this very respect. Now suicide is, for certain circles, nothing but justice. The arguments of thinkers (...)
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  42. added 2013-09-24
    Plenty to Worry About: Consent, Control, and Anxiety.Danielle Bromwich - 2012 - American Journal of Bioethics 12 (3):35-36.
    The American Journal of Bioethics, Volume 12, Issue 3, Page 35-36, March 2012.
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  43. added 2013-07-07
    On Nudging and Informed Consent—Four Key Undefended Premises.J. S. Swindell Blumenthal-Barby - 2013 - American Journal of Bioethics 13 (6):31 - 33.
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  44. added 2013-02-27
    Habits, Nudges, and Consent.Ezio Di Nucci - 2013 - American Journal of Bioethics 13 (6):27 - 29.
    I distinguish between 'hard nudges' and 'soft nudges', arguing that it is possible to show that the latter can be compatible with informed consent - as Cohen has recently suggested; but that the real challenge is the compatibility of the former. Hard nudges are the more effective nudges because they work on less than conscious mechanisms such as those underlying our habits: whether those influences - which are often beyond the subject's awareness - can be reconciled with informed consent in (...)
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  45. added 2012-09-19
    The Consumer Protection Model of Decisional Capacity Evaluation.Daniel D. Moseley & Gary J. Gala - 2013 - Southwest Philosophy Review 29 (1):241-248.
    Decisional capacity evaluations (DCEs) occur in clinical settings where it is unclear whether a consumer of medical services has the capacity to make an informed decision about the relevant medical options. DCEs are localized interventions, not the global loss of competence, that assign a surrogate decision maker to make the decision on behalf of the medical consumer. We maintain that one important necessary condition for a DCE to be morally justified, in cases of medical necessity, is that the health care (...)
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  46. added 2012-07-12
    Autonomy, Value and the First Person.Hallvard Lillehammer - 2012 - In Lubomira Radoilska (ed.), Autonomy and Mental Disorder. Oxford University Press.
    This paper explores the claim that someone can reasonably consider themselves to be under a duty to respect the autonomy of a person who does not have the capacities normally associated with substantial self-governance.
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