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Switch to: References
Citations of:
Principles of biomedical ethics
New York: Oxford University Press. Edited by James F. Childress (1994)
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In this article, we develop and defend an account of the normative significance of nonhuman animal agency. In particular, we examine how animals’ agency interests impact upon the moral permissibility of our interactions with them. First, we defend the claim that nonhuman animals sometimes have rights to self-determination. However, unlike typical adult humans, nonhuman animals cannot exercise this right through the giving or withholding of consent. This combination of claims generates a puzzle about the permissibility of our interactions with nonhuman (...) |
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This paper exhorts geographers to become more active in debate about ethical research practice. It also suggests that ethical theory, practical problems, and lessons learned from postmodern thought make the prospects of establishing prescriptive codes of ethics unlikely. Instead, flexible prompts for moral contemplation might be used to encourage careful thought on matters of ethics. Because the practical feasibility of moral prompts rests on the existence of moral imaginations, it is vital to consider ways in which those imaginations might be (...) |
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This paper exhorts geographers to become more active in debate about ethical research practice. It also suggests that ethical theory, practical problems, and lessons learned from postmodern thought make the prospects of establishing prescriptive codes of ethics unlikely. Instead, flexible prompts for moral contemplation might be used to encourage careful thought on matters of ethics. Because the practical feasibility of moral prompts rests on the existence of moral imaginations, it is vital to consider ways in which those imaginations might be (...) |
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In the 1970s “bioethics” emerged as a new interdisciplinary discourse on medicine, health care, and medical technologies, primarily in Western, developed countries. The main focus was on how individual patients could be empowered to cope with the challenges of science and technology. Since the 1990s, the main source of bioethical problems is the process of globalization, particularly neo-liberal market ideology. Faced with new challenges such as poverty, inequality, environmental degradation, hunger, pandemics, and organ trafficking the bioethical discourse of empowering individuals (...) |
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With the advent of the newest technologies, it is necessary for engineering to incorporate the integration of social responsibility and technical integrity. A possible approach to accomplishing this integration is by expanding the culture of the engineering profession so that it is more congruent with the complex nature of the technologies that are now being developed. Furthermore, in order to achieve this expansion, a shift in thinking is required from a linear or reductionist paradigm (atomistic, deterministic and dualistic) to a (...) |
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I Norge er ikke surrogati tillatt, og myndighetene fraråder norske statsborgere å benytte seg av surrogati i utlandet. I denne artikkelen fokuserer vi på kommersiell gestational surrogati og stiller spørsmålet: Bør man tillate at norske statsborgere benytter seg av surrogati i India? De etiske problemstillingene rundt surrogati er mange og sammensatte og blir spesielt utfordrende når tjenesten tilbys i et land med store kulturelle og økonomiske forskjeller både internt og i forhold til Norge. Vi baserer analysen og drøftingen av dette (...) |
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The Malaysian government recognises the potential contribution of biotechnology to the national economy. However, ongoing controversy persists regarding its ethical status and no specific ethical guidelines have been published relating to its use. In developing such guidelines, it is important to identify the underlying principles that are acceptable to Malaysian society. This paper discusses the process of determining relevant secular and Islamic ethical principles and establishing their similarities before harmonising them. To achieve this, a series of focus group discussions were (...) |
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Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) |
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Professional engineering societies which are based in the United States, such as the American Society of Mechanical Engineers (ASME, now ASME International) are recognizing that their codes of ethics must apply to engineers working throughout the world. An examination of the ethical code of the ASME International shows that its provisions pose many problems of application, especially in societies outside the United States. In applying the codes effectively in the international environment, two principal issues must be addressed. First, some Culture (...) |
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Although there is much discussion in scientific and law journals regarding direct-to-consumer genetic testing (DTCGT), there is a paucity of philosophical-ethical examination of how such services threaten to repeat the essentialist, racial-projects of the past. On the one hand, testing for ancestry can be cathartic: for those lacking familial history as to when and how they came to be where they are, DTCGT can offer powerful access to their lineage and identity-formation. On the other hand, DTCGT inevitably reinscribes problematic epistemologies (...) |
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This article addresses how health professionals should monitor and safeguard their patients’ ability to participate in making clinical decisions and making subsequent decisions regarding the implementation of their treatment plan. Patient participation in clinical decision-making is essential, e.g. in self-care, where patients are responsible for most ongoing care. We argue that one common, fact-oriented patient education strategy may in practice easily tend to take a destructive form that we call error trawling. Illustrating with empirical findings from a video study of (...) |
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Mother-to-child transmission of the Human Immunodeficiency –Virus is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees. It is through the process of Provider Initiated Counseling and Testing that counselling is offered participant confidentiality and voluntariness are upheld and valid consent obtained. The objective of the study was to (...) |
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In the traditions of narrative ethics and casuistry, stories have a well-established role. Specifically, illness narratives provide insight into patients’ perspectives and histories. However, because they tend to see fiction as an aesthetic endeavour, practitioners in these traditions often do not realize that fictional stories are valuable moral sources of their own. In this paper I employ two arguments to show the mutual relationship between bioethics and fiction, specifically, science fiction. First, both discourses use imagination to set a scene and (...) |
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We analyzed a sample of 356 forms containing information that Colorado law legally requires both licensed and unlicensed therapists to disclose to clients. The majority of forms contained the legally mandated information; fewer forms contained ethically desirable information. The average readability grade level was 15.74, corresponding to upper-level college, and 63.9% of the forms reached the highest (most difficult) readability grade of 17 +. Therapists are obeying the law, but do not appear to be taking advantage of the opportunity to (...) |
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The news reminds us almost daily that the truth is apparently not highly valued by many in business. This paper develops two prescriptive standards — the Expectation and Reputation guidelines — that may help businesspeople avoid violating clearly accepted truth standards. The guidelines also assist in determining whether truth is required in circumstances where honesty seems in conflict with the practical demands of business. A discussion of why, when and how these guidelines may be applied to facilitate truth-telling by business (...) |
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Recent advances in neuroscience have led to numerous ethical questions. Neuroethics is the study of ethical, legal and social advancements in neuroscience which, despite being a recently developed discipline, has a long historical tradition. The concern with ethical issues in neuroscience is extremely old and dates back to the philosophical and scientific traditions that originally sought to understand the relationship between the brain and behavior. More recently, the field of neuroethics has emerged in the context of public and academic debate (...) |
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In the current era patient autonomy is enormously important. However, recently there has also been some movement back to ensure that trust in the doctor's skill, knowledge and virtue is not excluded in the process. These new nuances of informed consent have been referred to by terms such as beneficent paternalism, experience-based paternalism and we would add virtuous paternalism. The purpose of this paper is to consider the history and current problematic nature of counselling and consent. Starting with the tradition (...) |
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Unrealistic therapeutic beliefs are very common—the majority of patient-subjects enrol in phase 1 trials seeking and expecting significant medical benefit, even though the likelihood of such benefit has historically proven very low. The high prevalence of therapeutic misestimation and unrealistic optimism in particular has stimulated debate about whether unrealistic therapeutic beliefs in early-phase clinical trials preclude adequate informed consent. We seek here to help resolve this controversy by showing that a crucial determination of when such therapeutic beliefs are ethically problematic (...) |
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BackgroundMany studies have been published about ethics committees and the clarifications requested about the submitted applications. In Finland, ethics committees require a separate statement on ethical aspects of the research in applications to the ethics committee. However, little is known about how researchers consider the ethical aspects of their own studies.MethodsThe data were collected from all the applications received by the official regional ethics committee in the Hospital District of Northern Savo during 2004–2009 (n = 688). These included a total (...) |
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The article raises the issue of ‘the right to be ill’, formulated by Tadeusz Kielanowski, a Polish physician and humanist. According to him, the right to health should be supplemented by the principle which would serve the protection of people with diseases or disabilities. One-sided interpretation of ‘the right to health’ may result in various forms of intolerance and discrimination. This paper presents what dangers Kielanowski recognized and explains why his approach was considered to be a novelty; what the idea (...) |
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Australia does not allow adult smokers to buy or use electronic nicotine delivery systems that contain nicotine without a prescription. This paper critically evaluates the empirical and ethical justifications provided for the policy by Federal and State governments, public health advocates and health organisations. These are: that ENDS should only be approved as products for smoking cessation when there is evidence from randomised controlled trials that they are effective; that as a matter of precaution we should not allow the sale (...) |
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Bisher ist die Rolle von Ethikkomitees und Ethikberatenden als Ressource im Umgang mit der Covid-19-Pandemie ungeklärt. Im vorliegenden Beitrag wird diskutiert, worin spezifische Herausforderungen bei der ethischen Bewertung von Fragen an Ethikkomitees im Pandemiekontext bestehen und welche möglichen Aufgaben für Ethikberatende identifiziert werden könnten. Dabei wird die Ansicht vertreten, dass es für die kompetente, professionelle Bearbeitung dieser Fragen hilfreich wäre, das theoretische Grundverständnis der Ethikberatung für den Pandemiekontext zu reflektieren, die begründungstheoretischen, normativen Argumente aktueller Publikationen und Stellungnahmen der Fachgesellschaften zu (...) |
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This article reviews key philosophical and legal underpinnings of mental health professionals' obligation to obtain informed consent from consumers of their services. The basic components of informed consent are described, and strategies for clinically and ethically appropriate methods of obtaining informed consent are discussed. Emerging issues in informed consent involving duty to assess and protect against client dangerousness, obligations to third parties, and issues of deception are considered as well. The article proposes that part of the process of obtaining informed (...) |
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Psychiatric patients may try (or express a desire) to injure themselves in hospital in order to cope with overwhelming emotional pain. Some health care practitioners and patients propose allowing a controlled amount of self-injury to occur in inpatient facilities, so as to prevent escalation of distress. Is this approach an example of professional assistance with harm? Or, is the approach more likely to minimise harm, by ensuring safer self-injury? In this article, I argue that health care practitioners who use harm-minimisation (...) |
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Die Posttraumatische Belastungsstörung (PTBS) ist ein schwerwiegendes psychisches Krankheitsbild, das Betroffene nach dem Erleben traumatisierender Situationen entwickeln. Im Zusammenhang mit den Auslandseinsätzen der Bundeswehr ist die PTBS bei Soldaten in den letzten Jahren verstärkt in den Fokus der deutschen Öffentlichkeit gerückt. Auch zivile Traumata bergen ein großes PTBS-Risiko. Seit einigen Jahren werden Methoden zur medikamentösen Prävention der PTBS erforscht. Die beiden wichtigsten Ansätze, die Prävention mit zentralnervös wirkenden Betablockern und Glukokortikoiden, basieren auf der Idee, durch den Eingriff in neuroendokrine Stressachsen (...) |
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Background Genetic testing is moving from targeted investigations of monogenetic diseases to broader testing that may provide more information. For example, recent health economic studies of genetic testing for an increased risk of breast cancer suggest that it is associated with higher cost-effectiveness to screen for pathogenic variants in a seven gene panel rather than the usual two gene test for variants in BRCA1 and BRCA2. However, irrespective of the extent to which the screening of the panel is cost-effective, there (...) |
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Machine learning and other forms of artificial intelligence can improve parts of clinical decision making regarding the gathering and analysis of data, the detection of disease, and the provis... |
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Moral theories, such as the variations on virtue ethics, deontological ethics, contractualism, and consequentialism, are expected – inter alia – to explain the basic orientation of morality, give us principles and directives, justify those, and thereby guide our actions. I examine some functions and characteristics of the extant moral theories from a moral metatheoretical point of view, in order to clarify the generally assumed rivalry between them. By thinking of moral theories in analogy to languages it is argued that different (...) |
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Work on analogy has been done from a number of disciplinary perspectives throughout the history of Western thought. This work is a multidisciplinary guide to theorizing about analogy. It contains 1,406 references, primarily to journal articles and monographs, and primarily to English language material. classical through to contemporary sources are included. The work is classified into eight different sections (with a number of subsections). A brief introduction to each section is provided. Keywords and key expressions of importance to research on (...) |
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ZusammenfassungJeder extrahierte Zahn ist primär Eigentum des betreffenden Patienten und unterliegt dessen autonomiebasiertem Selbstbestimmungsrecht. Diesem weitgehend unstrittigen Sachverhalt steht die praktische Notwendigkeit gegenüber, extrahierte Zähne für Forschung und Lehre bereitzustellen. So ist z. B. die Erprobung neuer Wurzelfüllmaterialien und -techniken ohne den Einsatz extrahierter Zähne ebenso wenig denkbar wie eine zahnbezogene praktische Ausbildung angehender Zahnärzte im Rahmen des universitären Studiums. In jüngster Zeit wurde vermehrt Kritik an der konventionellen Praxis der Rekrutierung und Nutzung extrahierter Zähne geübt. Vor diesem Hintergrund widmet (...) |
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Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? -/- This paper deals with the first question, with a special focus on paternalism (...) |
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Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? In Medical Paternalism Part 1, I answered the first question. This paper answers the (...) |
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Medical ethics prohibits caregivers from discriminating and providing preferential care to their compatriots and comrades. In military medicine, particularly during war and when resources may be scarce, ethical principles may dictate priority care for compatriot soldiers. The principle of nondiscrimination is central to utilitarian and deontological theories of justice, but communitarianism and the ethics of care and friendship stipulate a different set of duties for community members, friends, and family. Similar duties exist among the small cohesive groups that typify many (...) |
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Professional ethics has currently raised its public profile in the UK as part of social anxiety around governance of health and social care, fuelled by catastrophically bad practice identified in particular healthcare facilities. Professional ethics is regulated by compliance with abstracted, normative codes but experienced as contextualised exercise of personal qualities, understanding and engagement. This study examined how practitioners from one speciality of occupational therapy, an Allied Health Profession, develop ethical practice through dialogical engagement in local OT communities of practice, (...) |
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In this paper we describe the objectives of teaching medical ethics to undergraduates and the teaching methods used. We describe a workshop used in the University of Liverpool Department of Psychiatry, designed to enhance ethical sensitivity in psychiatry. The workshop reviews significant historical and current errors in the ethical practice of psychiatry and doctors' defence mechanisms against accepting responsibility for deficiencies in ethical practice. The workshop explores the student doctors' own group ethos in response to ethical dilemmas, and demonstrates how (...) |
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This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) |
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There are studies on the normative ethical frameworks used by long-term care staff and studies proposing how staff should reason, but few studies explore how staff actually reason. This study reports on the ethical reasoning process and experiences of moral distress of long-term care staff in the provision of social care. Seven interdisciplinary focus groups were conducted with twenty front-line staff. Staff typically did not have difficulty determining the ethical decision and/or action; however, they frequently experience moral distress. To manage (...) |
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In 2035 global egg demand will have risen 50% from 1985. Because we are not able to tell in the egg whether it will become a male or female chick, billons of one day-old male chicks will be killed. International research initiatives are underway in this area, and governments encourage the development of an alternative with the goal of eliminating the culling of day-old male chicks. The Netherlands holds an exceptional position in the European egg trade, but is also the (...) |
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While copious quantities of ink have been spilled on the topic of autonomy in the context of health care, little has been written about autonomy in relation to intellectual disability. After presenting the received account of capacity, we argue that it cannot account for the moral permissibility of limiting an individual with intellectual disability’s access to diet soda. In cases of preventative medicine and intellectual disability, the philosophical motivation for the received account of capacity is incompatible with the actions it (...) |
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It is almost universally accepted that traditional provider-patient relationships should be governed, at least in part, by the ethical principles set forth by Beauchamp and Childress. These principles include autonomy, beneficence, non-maleficence and justice. Recently, however, the nature of medial practice has changed. The pervasive presence of computer technology in medicine raises interesting ethical questions. In this paper we argue that some software designers should be considered health care providers and thus be subject the ethical principles incumbent upon “traditional” providers. (...) |
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In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their (...) |
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Accountable Care Organizations are a key mechanism of the Patient Protection and Affordable Care Act. ACOs will influence incentives for providers, who must understand these changes to make well-considered treatment decisions. Our paper defines an ethical framework for physician decisions and action within ACOs. Emerging ethical pressures providers will face as members of an ACO were classified under major headings representing three of the four principles of bioethics: autonomy, beneficence, and justice. Conflicts include a bias against transient populations, a motive (...) |
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This paper discusses the Saudi Arabian case by Abdallah Adlan and Henk ten Have, published in a 2012 issue of the Journal of Bioethical Inquiry, regarding a congenitally disabled child enrolled in a research project examining the genetics of her condition. During the course of the study, her father was found not to be genetically related, and the case discussed the dilemma between disclosing to the family all findings as promised in consent documents or withholding paternity information because of the (...) |
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